Longer looks: Disparities in nursing home penalties; Understanding dying with dignity

Dec 21 2012

Every week Shefali S. Kulkarni selects interesting reading from around the Web.

Los Angeles Times: Chorus Of Voices Grows Stronger For 'Death With Dignity'
My mortality wake-up call came in a hospital after knee surgery, when I flat-lined because of a heart arrhythmia and was resuscitated by a nurse. In response to columns about those events, stories have streamed in from people who are running out of time themselves, or enduring the pain of watching loved ones fade. The deaths they face are as different as the lives they've lived, but a steady refrain runs through their emails and letters. People want more control in the end. They want to be in charge of one last thing. These people speak a common language, linked by a desire to have lethal, doctor-prescribed medication as a legal option, as do residents of Oregon and Washington (Steve Lopez, 12/18).

ProPublica: Two Deaths, Wildly Different Penalties: The Big Disparities In Nursing Home Oversight
At a nursing home in the East Texas town of Hughes Springs earlier this year, a resident approached the nurses' station gagging on a cookie. ... he died. Government inspectors determined that staff at the home were not trained for emergencies ... Months earlier, in North Augusta, S.C., a resident pulled out her breathing tube and died. Inspectors faulted the home for failing to take appropriate steps to keep the resident from harming herself ... Both homes posed an "immediate jeopardy" to residents' health and safety, inspectors [working on behalf of the U.S. Centers for Medicare and Medicaid Services] determined. But the consequences were starkly different. ... The average fine paid by a South Carolina nursing home in the past three years was $40,507. The average fine in Texas: $6,933 (Charles Ornstein and Lena Groeger, 12/17).

The New York Times: In Gun Debate, A Misguided Focus On Mental Illness
[T]here is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness. ... Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. ... It's possible that preventing people with schizophrenia, bipolar disorder and other serious mental illnesses from getting guns might decrease the risk of mass killings. ... But mass killings are very rare events, and because people with mental illness contribute so little to overall violence, these measures would have little impact on everyday firearm-related killings. ... Perhaps more significant, we are not very good at predicting who is likely to be dangerous in the future (Dr. Richard A. Friedman, 12/17).

The Economist: Obesity: Fat Chance
In 2008 obesity rates were nearly double those of 1980. One in three adults was overweight, with a body-mass index (BMI) of 25 or more (at least 77kg for a man 175cm tall); 12% were obese, with a BMI of at least 30. ... in most countries the state covers some or most of the costs of health care, so fat people raise costs for everyone. ... Obesity is, at its heart, the result of many personal decisions. But the rise of obesity-;across many countries and disproportionately among the poor-;suggests that becoming fat cannot just be blamed on individual frailty. ... In the absence of a single big solution to obesity, the state must try many small measures (12/15).