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Sound Medicine -- December 6, 2003

Hosts Barbara Lewis and Dr. Eric Meslin talk to physicians and researchers about:

End of Life Issues

Growth Hormone in Children

Real Media | Windows Media

End of Life Issues

Recently in Florida, a woman's husband and family battled for control of her life. The woman was brain-damaged, and her high-profile case has once again shined a light on one of the most difficult things to deal with in the medical profession: end of life issues. From living wills, to organ donations, to removing someone from life support, these are never easy decisions for loved ones -- even with clear directions from the patient. Even for the medical professional, who is trained to save lives, letting go has its own ethical dilemmas.

Dr. Gregory Gramelspacher is director of the Palliative Care Program for Wishard Health Services in Indianapolis. He is also associate professor of medicine at the Indiana University School of Medicine. Palliative care, already common in Europe and Canada, is an emerging physician specialty in the U.S. Necessary skills include managing chronic symptoms and working with a team of medical and community professionals.

Resources:

Hospital-based palliative care helps patients understand the nature of their illness, and assists them and their families in making informed decisions about their care.

Search for a local hospice, palliative care program, or grief counselor in the database for the National Hospice and Palliative Care Organization.

Last Acts is a campaign to improve end-of-life care. The organization's website provides resources for professionals and volunteers working to improve care for the dying.

Growth Hormone in Children

Bioethicists have been debating the ethics of using human growth hormones for children who are short. The children do not have any life threatening or life alternating medical condition behind their short stature. Is exposing these children to human growth hormone, for the purpose of growing a few inches, worth the risk? And is it right to "cure" physical conditions whose biggest disadvantage is a social one? And who has the right to decide these issues for the child?

Dr. Ora Pescovitz conducted trials on children using Humatrope, a human growth hormone produced by Eli Lilly and Company. Dr. Pescovitz is also president of the Academy of Pediatrics, an influential group that helps shaped the practice of Pediatrics.

Resources:

Read a press release from the US Food and Drug Administration about its approval of Humatrope for short stature.

There are many risks involved with human growth hormones, both direct effects and indirect.

These websites all debate the ethics surrounding the use of growth hormone in children: MotherJones.com, the Physicians Committee for Responsible Medicine, and analyst Howard J. DeMonaco of Massachusetts General Hospital.