Newsbites

Australia

Health equality for Aborigines

Australia’s government has pledged to tackle health inequalities that affect Aborigines, who die an average 17 years younger than other Australians.

Twice as many aboriginal infants die in their first year as do non-indigenous children

The prime minister, Kevin Rudd, said that this statistic, and another that shows that twice as many aboriginal infants died in their first year as did non-indigenous children, was unacceptable. He signed a pledge to improve health services for remote indigenous communities and close the gap in life expectancy within 30 years.

“We want to get to this end point which is to close the obscene gap of life expectancy between indigenous and non-indigenous Australians, to close the obscenity of the gap between indigenous children under the age of 5 and non-indigenous children,” he said.

Australia has about 460,000 indigenous Aborigines and Torres Strait Islanders, who make up about 2% of the 21 million population and are the country’s most disadvantaged group (http://ca.reuters.com/article/topNews/idCASYD29920020080320, 20 Mar 2008, “Australian government pushes to stop early Aboriginal deaths”).

South Korea

Doctors oppose prescribing oversight

South Korea wants to introduce a centralised system to monitor prescriptions that will generate alerts for potentially inappropriate drugs, but doctors are threatening to boycott the plan, saying it interferes with their professional rights.

The Drug Utilisation Review system will send prescriptions in real time to the Health Insurance Review and Assessment Service, where they will be stored on a central computer. Proponents say that, as well as reducing drug errors, this will make medical practice more transparent.

“In 2004, 277 medicines were listed as risky or banned, but more than 30 000 patients have been reported to have had them prescribed since then,” said Hyun Su-yeop, an official at the Ministry of Health, Welfare, and Family Affairs.

But the Korean Medical Association is arguing that the system violates doctors’ rights to practice without interference. “The government will have easier access to information and tell us what to do and what not to,” said the association’s chairman, Ju Su-ho (www.koreatimes.co.kr/www/news/nation/2008/03/117_21615.html, 20 Mar 2008, “Doctors challenge new prescription plan”).

United Kingdom

Junior doctor shortage

The National Health Service will have a chronic shortage of junior doctors because of a new centralised recruitment system that only fills jobs once a year, leaving gaps whenever a doctor is promoted or leaves a post, the BMA has warned.

The association says that because recruitment is no longer staggered throughout the year but managed all at once in August, registrars and house officers are being pressured to work excessive hours to fill gaps in ward rotas.

A BMA poll of junior doctors found that 29% were working on a rota with at least one vacancy. Ram Moorthy, chairman of the BMA’s Junior Doctors Committee, said, “If the problem continues it can only damage the quality of patient care.”

The Department of Health said that it took the problem seriously and asked regional health chiefs to investigate last month. A spokesman said, “We are talking to the NHS, to the medical profession and others about potential solutions” (www.guardian.co.uk/society/2008/mar/31/nhs.health, 31 Mar 2008, “Doctor shortage is threat to care, warns BMA”).

United States

Patients rate their hospitals

A project by the federal government has given patients in the United States a chance to rate the hospitals that treat them and to air any grievances. Most of the patients surveyed were happy with their experiences. Two thirds of patients were keen to recommend the institution treating them to friends and relatives, and almost the same proportion rated their hospital nine or 10 out of 10.

But many patients also reported that they had not been treated courteously and respectfully by medical and nursing staff; had not received adequate drugs for pain after surgery; and did not understand the instructions they received when discharged.

At the average hospital more than 25% of patients said that nurses had not always communicated well with them, for example (www.nytimes.com/2008/03/29/washington/29hospital.html, 29 Mar 2008, “Study finds many patients dissatisfied with hospitals”).

Netherlands

An alternative to euthanasia?

Doctors in the Netherlands are using continuous deep sedation more commonly when treating terminally ill patients who are nearing death. It may be considered as an alternative to euthanasia, Dutch researchers have said.

The researchers found that the use of continuous deep sedation rose from 5.6% of all deaths in 2001 to 7.1% of deaths in 2005.

“The increased use of continuous deep sedation for patients nearing death in the Netherlands suggests that this practice is increasingly considered as part of regular medical practice,” said lead researcher Judith Rietjens, of the Department of Public Health at Erasmus University Medical Center in Rotterdam.

She said that wider knowledge of the technique could explain why it is being used more. “Also, the use of continuous deep sedation may in some situations be a relevant alternative to the use of euthanasia for patients,” she added. Euthanasia is legal in the Netherlands (www.washingtonpost.com/wp-dyn/content/article/2008/03/21/AR2008032101363.html, 21 Mar 2008, “Deep sedation becoming more common for dying patients in Holland” and BMJ 2008;336:810-3).

France

Suicide prompts euthanasia debate

A French cancer patient died from an overdose of barbiturates days after her request for euthanasia was refused by officials, the state prosecutor said.

Chantal Sebire, a 52 year old former teacher, had had an esthesioneuroblastoma that had disfigured her face. Her request for doctor assisted suicide had raised calls to re-evaluate French laws that currently prohibit euthanasia for patients with terminal diseases.

Legislation written in 2005 allows doctors and families to stop administering life sustaining treatment to terminally ill patients. Some 300 000 people have signed a petition urging the government to go a step further and allow active euthanasia.

The housing minister, Christine Boutin, declared that she was “scandalised that people can envision granting this woman death because she’s suffering and deformed,” adding that if France legalises “the right to kill, we’re heading towards a barbarian society” (http://edition.cnn.com/2008/WORLD/europe/03/27/euthanasia.debate.ap, 20 Mar 2008, “Report: overdose killed face tumor woman” and www.time.com/time/world/article/0,8599,1724062,00.html).

   

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