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18 May 1999 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine.

Patients Prefer Making Advance Care Decisions with Family, Not Physicians

A study of 400 dialysis patients found that patients had discussed end-of-life decisions more frequently with family members than physicians, would prefer to discuss them with family members in the future and favored legislation granting the family -- rather than physicians -- decision-making authority over end-of-life care. (Brief Communication, p. 825.)

Comparisons of Two Anticoagulants to Treat Deep Vein Blood Clots

Two studies and an editorial examine trials using unfractionated heparin or the newer, easier to use and more expensive low-molecular-weight heparin to treat deep vein thrombosis. (Articles, p. 789, 800; Editorial, p. 857.)

Two Articles Guide Physicians When Patients' Wishes May Be Unclear

Special Curriculum Helps Doctors Communicate with Patients of Other Cultures

Physicians cannot know all aspects of the cultures or socioeconomic backgrounds of each patient. However, an innovative, new curriculum involving sensitivity to core cultural issues, interviewing techniques and negotiation, recently introduced in one medical teaching program, may help to bridge cultures. (Academia and Clinic, p. 829.)

New Paper Guides Physicians Treating Patients Without Decision-Making Capacity

Dialogue, listening and building consensus at each step in end-of-life decision making can help physicians and family make treatment decisions that respect the patient's dignity and quality of life, even when the patient cannot make a decision for himself. (Academia and Clinic, p. 835.) This is the second paper in the series by the ACP-ASIM End-of-Life Consensus Panel, helping physicians and others caring for dying patients improve care at the end of life.

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