Category: NEJM

Informed Consent and the Role of the Treating Physician

In the century since Justice Benjamin N. Cardozo famously declared that “[e]very human being of adult years and sound mind has a right to determine what shall be done with his own body,” informed consent has become a central feature of American medical…

Sociogenetic Risks — Ancestry DNA Testing, Third-Party Identity, and Protection of Privacy

The recent capture of the suspected Golden State Killer on “National DNA Day” was a startling public illustration of the reality that DNA information may be pertinent to people far removed from the one who was tested — and the fact that information may…

The 2017 Nobel Peace Prize and the Doomsday Clock — The End of Nuclear Weapons or the End of Us?

The awarding of the 2017 Nobel Peace Prize to the International Campaign to Abolish Nuclear Weapons (ICAN) may mark a turning point in efforts to ensure that humanity survives the nuclear-weapons era. The urgency of ICAN’s work was recently highlighted…

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation

Most large U.S. companies offer smoking-cessation programs for their employees, and nearly half of those companies offer financial incentives for employees who successfully stop smoking. These benefit designs are motivated by evidence that smoking rema…

Assessing Drug Safety in Children — The Role of Real-World Data

Over the past 20 years, several legislative initiatives in the United States have resulted in hundreds of clinical trials assessing the treatment effects of various drugs in children. Since 1998, a total of 712 drug labels have been updated with inform…

Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing

We are rapidly moving toward a world in which broad sharing of participant-level clinical trial data is the norm. The European Medicines Agency has implemented a policy to expand public access to data concerning products it approves, the Food and Drug …

Integrating Medical and Nonmedical Services — The Promise and Pitfalls of the CHRONIC Care Act

Efforts to provide more integrated care for Medicare beneficiaries to better address health and well-being needs that are not strictly medical have received a major boost with the enactment of the Creating High-Quality Results and Outcomes Necessary to…

Turning the Tables — The New European General Data Protection Regulation

“Action required: Make sure you receive important information!” was the alarming message my Internet service provider recently sent me. It turned out they wanted me to review my privacy settings — or, really, to agree that they could continue using dat…

Innovation for Pandemics

Over recent decades, the world has seen incredible progress in reducing child mortality and tackling infectious diseases. Thanks to better vaccines and other interventions, child mortality has decreased by more than 50% since 1990. We are on the verge …

Excluding Observation Stays from Readmission Rates — What Quality Measures Are Missing

For the past several years, health care reform efforts have focused on reducing preventable hospital readmissions. Most notably, in 2012, the Centers for Medicare and Medicaid Services introduced the Hospital Readmissions Reduction Program (HRRP), whic…