Viewpoints: The Opioid Epidemic Through The Lens Of Neuroscience; Prognostic Uncertainty, Outcomes And Medical Decisions.

Bloomberg: Neuroscience Offers Insights Into The Opioid Epidemic
Most Americans say they’re interested in scientific discoveries, but they may be thinking of the kinds of findings that lead to new gadgets and wonder drugs. When it comes to discoveries about hazards and risks -- especially the risks of those wonder drugs -- Americans seem more likely to tune out. (Faye Flam, 7/21)

The New England Journal Of Medicine: Managing Uncertainty — Harnessing The Power Of Scenario Planning
Although prognostic certainty remains elusive, many clinicians use statistics to quantify outcomes. We strive to achieve increasing precision with risk calculators and use the best available evidence to report probabilities of discrete complications. Decision aids allow us to share these predictions with patients and facilitate comparison between treatments. Although numbers quantify uncertainty, they offer little guidance to patients for managing this uncertainty. Moreover, these strategies fail to illuminate logical connections between the patient’s current condition, downstream outcomes, and events experienced along the way. (Margaret L. Schwarze and Lauren J. Taylor, 7/20)

The New England Journal Of Medicine: Certain About Dying With Uncertainty
Mrs. C., a woman with whom we’d had a long-standing patient–physician relationship, one of us for over 25 years, died recently in the 87th year of her life. A woman who had always maintained her cheerful spirit even in the midst of quite trying medical setbacks, she was one of our favorite patients. But what made her most special was her perspective on life and death: we learned a lot from her. ... when her husband died of a brain tumor about 5 years ago, she witnessed the good and the not-so-good that medicine had to offer. She saw interventions that improved things slightly for a short while but did not provide meaningful and sustained benefit. After he died, we had “the conversation”; we had broached the subject before but had never discussed it in great depth. She knew what she wanted. ... We vowed to keep our part of the bargain. If we had only known how hard that would be. (Jeffrey M. Drazen and Maria A. Yialamas, 7/20)

Los Angeles Times: Dear Media: When You Cover Death By Suicide, Do It Thoughtfully
When a family member died by suicide, my parents chose not to tell me his method. They wanted me to remember him as he lived, for both of our sakes. While I didn’t understand their decision at the time, I now see it as one borne out of deep care. I was especially thankful for my parents’ thoughtfulness after reading the media coverage of Linkin Park singer Chester Bennington’s death by suicide this week. (Melissa Batchelor Warnke, 7/21)

The Wall Street Journal: In The Netherlands, The Doctor Will Kill You Now
In 2002 the Netherlands became the first country to legalize euthanasia and physician-assisted suicide for those suffering deadly diseases or in the last stages of life. Not long after the legislation was enacted, eligibility was expanded to include those experiencing psychological suffering or dementia. Today pressure is mounting for the Dutch government to legalize a “euthanasia pill” for those who are not ill, but simply consider their lives to be “full.” (Kees van der Staaij, 7/20)

RealClear Health: Digital Health Hope: Personalized Care Is The Final Frontier
For many health care providers, personalized or precision medicine is the holy grail of their practice. While we have made great gains as new technologies develop, progress in medicine in the past decade has been lacking despite all-time spending highs in research. In order to improve outcomes and make significant progress, physicians must accept change and move toward the more precise approach that personalized medicine affords. Today, medicine revolves around standards of care: the best courses of prevention or treatment for the general population, or the average person on the street—not necessarily what is best for the individual. In personalized medicine, physicians cater medical treatment to a patient based on their particular genetic, environmental and clinical information. This personalized approach results in a more precise treatments that are much more likely to be effective. (Kevin Campbell, 7/21)

St. Louis Post-Dispatch: The U.S. Attorney General Is Stuck In A 'Reefer Madness' Time Warp
For reasons that defy understanding, science, public opinion and most state governments, Attorney General Jeff Sessions has decided that cracking down on the use of medical marijuana is a priority. Assuming he survives President Donald Trump’s pique, he wants Congress to roll back rules that prohibit the Justice Department from going around state laws to enforce a federal ban against medical cannabis. As recently as May, Congress reaffirmed that the Justice Department can’t spend money to prevent states from “implementing their own laws that authorize the use, distribution, possession, or cultivation of medical marijuana.” (7/20)

Los Angeles Times: USC Bosses Flunk The Leadership Test Amid Shocking Allegations About Former Medical School Dean
By now you probably know the details. Dr. Carmen Puliafito, a $1.1-million-a-year professor, doctor, dean and big-bucks rainmaker for the University of Southern California, left plenty of time in his busy schedule for extracurricular activities. They included drug-fueled parties with a prostitute, convicted criminals and drug addicts. Los Angeles Times sleuths dug up photos of Puliafito’s exploits in hotel rooms, apartments and even the dean’s office at USC, including a shot of him using a butane torch to light a glass pipe while a female companion smoked heroin. (Steve Lopez, 7/20)