Sunday, September 4, 2005
The current J of Clinical Oncology has a couple of articles on prognosis. One is a review of the evidence about prediciting prognosis in advanced cancer . The other presents a model for predicting survival in patients presenting with pathologic fractures with the goal of helping to delineate better who will actually benefit from going to the OR. There are no real surprises in either of these; performance status & clinicians' estimates of survival remain key. There's really not much in the orthopedic article to change the current practice of us physicians weighing things out and deciding who we'd think would benefit from surgical repair. There's also brief case-based review of artificial nutrition & hydration at the end of life; it would make a nice teaching supplement for those interested.
The current Lancet continues their viewpoints series on the end of life from different religious perspectives with the Jewish view. The first in this series, which I originally missed, was a Hindu perspective. After reading 3 of these now I'm realizing they are too short, perhaps necessarily so, and I am left with more questions than answers. Anyway, it's notable that the author--who appears to be a member of the Conservative Movement--notes that in his opinion artificial nutrition and hydration are medicine & not food.