The rose of Sharon: what is the ideal timing for palliative care consultation versus ethics consultation?

Ethics committees and palliative care consultants can function in a complementary fashion, seamlessly and effectively. Ethics committees can "air" and help resolves issues, and palliative care consultants can use a low-key, longitudinal approach.

Credentialing and certification in ethics consultation: lessons from palliative care.

In response to an article by Acres and colleagues, "Credentialing the Clinical Ethics Consultant: An Academic Medical Center Affirms Professionalism and Practice:" the authors urge continued action for the credentialing and certification of clinical ethics consultants. They also promote a vigorous and engaged model for ethics consultation.

The Art of Medicine through the Humanities: an overview of a one-month humanities elective for fourth year students.

BACKGROUND: The purpose of incorporating humanities teaching into medical education is to encourage students to develop into more sensitive and caring doctors who communicate well with their patients and colleagues. CONTENT: A unique 4th year student elective at the Medical College of Wisconsin incorporates reflective and writing activities. Small group sessions are facilitated by faculty with specific interest and expertise in the humanities. EVALUATION: Students keep a journal in which they record their reflections on personal issues, career planning and reactions to classroom discussions. Each student writes a poem and an essay or short story. The course is well received and oversubscribed. CONCLUSIONS: Students increase their understanding of the humanities through readings, small group discussions, journal keeping and formal writing. By incorporating humanism into their professional lives, medical students can learn to care for their patients in a more humane and thoughtful manner.

Meals at medical specialty society annual meetings: a preliminary assessment.

Little isd known about how meals are chosen for medical meetings. We surveyed the annual meeting planners for 20 major specialty societies. Thirteen (65%) responded; all were currently planning their next meeting. Attendance in 2000 was reported at 113,477 physicians, with 2 million planned meals and snacks. No physician was named as responsible for food choices; the meeting planner and staff were primarily responsible for deciding what food to serve, excluding exhibit halls. Twelve (92%) respondents rated "available budget" as the most important factor. "Nutritional guidelines" were rated "very important" by eight of 13 (63%). However, no specific nutritional guidelines could be identified by any planner. All respondents indicated that members would attend a meeting if "healthy" food were the only option. For 2000, 100% of respondents indicated that for each lunch and for each dinner, a dessert had been included. No annual meeting and no planned 2001 meeting excluded potato chips, snack mixes, or candies at breaks; soda pop was offered at each break. Most respondents (89%) relied on a concluding questionnaire about the meeting facilities to evaluate the food. Respondents reported no difference in charges for "special meals," including vegetarian and kosher meals. Physicians may be unaware that some food served at medical meetings may impair learning, with excessive calorie, fat, and carbohydrate consumption. Small changes can improve the quality of food and beverages selected, without increased cost, and provide choices that conform to national nutritional guidelines. Medical meetings should serve flavorful, healthful food.

Bioethics and the breakdown of the bicameral mind: Sacks and Luria revisited.

Since antiquity, individuals have attempted to relate mental processes to circumscribed areas of the brain. In 1935 the neurologist Wilder Penfield purported to know, "the humming of the mind's machinery, and where words come from," after he electrically stimulated areas of the exposed human cortex. Recent theories have suggested a functional separation of the dominant and the nondominant hemispheres, the right brain/left brain concept of thought and personality. One author has even proposed that human consciousness and modern civilization developed when the bicameral mind broke down, and the left brain achieved mastery over the right nondominant temporal lobe. Compared to these mechanistic approaches to brain function and human personality, the Russian neurologist, A.R. Luria and his American follower, Oliver Sacks, have developed a more intellectually satisfying and clinically useful approach which relies on a fuller understanding of the doctor-patient....