KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Longer Looks: Understanding the Mind; Facebook Depression; Planning For A Successful End Of Life

Every week reporter Ankita Rao selects interesting reading from around the Web.

The New York Times: The New Science Of Mind
These days it is easy to get irritated with the exaggerated interpretations of brain imaging — for example, that a single fMRI scan can reveal our innermost feelings — and with inflated claims about our understanding of the biological basis of our higher mental processes. Such irritation has led a number of thoughtful people to declare that we can never achieve a truly sophisticated understanding of the biological foundation of complex mental activity. In fact, recent newspaper articles have argued that psychiatry is a "semi-science" whose practitioners cannot base their treatment of mental disorders on the same empirical evidence as physicians who treat disorders of the body can. The problem for many people is that we cannot point to the underlying biological bases of most psychiatric disorders. In fact, we are nowhere near understanding them as well as we understand disorders of the liver or the heart. But this is starting to change (Eric R. Kandel, 9/6).

The Wall Street Journal: The Ultimate End-Of-Life Plan
My mother died shortly before her 85th birthday, in a quiet hospital room in Connecticut. One of my brothers was down the hall, calling me in California to say, too late, that it was time to jump on a plane. We were not a perfect family. She did not die a perfect death. But she died a "good-enough" death, thanks to choices she made earlier that seemed brutal at the time. … In California, my home state, a 2012 survey by Lake Research Partners and the Coalition for Compassionate Care of California found that 70% of state residents want to die at home, and national polls have registered even higher proportions. But in fact, nationally, less than a quarter of us do. Two-fifths die in hospitals, and a tragic one-fifth in intensive care, where deaths are often harrowing. This is an amazing disconnect in a society that prides itself on freedom of choice. This disconnect has ruinous economic costs. About a quarter of Medicare's $550 billion annual budget pays for medical treatment in the last year of life (Katy Butler, 9/6).

NBC News: Shakedown: How Doctors Sought Gifts From Little Old Lady Living In The Hospital -- 'Empty Mansions' Excerpt
How tantalizing this eccentric patient was for the leaders of a nonprofit hospital dependent on fundraising. Here was a woman, well into her 90s, with something more than $300 million, and she was living in their hospital. Huguette Clark was the girl who could spin straw into gold. From age 85 to well past 100, when most people need elaborate pillboxes marked with the days of the week, Huguette was remarkably healthy, requiring no daily medications other than vitamins. Yet she stayed in the hospital for a bit more than 20 years, for 7,364 nights, though she said she couldn't stand the hospital food. Why? She said she felt safe there. When one of her round-the-clock private nurses kept urging her to move back home, Huguette fired her. On New York's Upper East Side at Doctors Hospital, which became part of Beth Israel Medical Center, the hospital's doctors and managers could have discharged her after her skin cancer was cured. But repeatedly they came back to her for larger and larger donations (Bill Dedman and Paul Clark Newell Jr., 9/11).

Slate: The Disturbing, Shameful History Of Childbirth Deaths
Bearing a child is still one of the most dangerous things a woman can do. It's the sixth most common cause of death among women age 20 to 34 in the United States. If you look at the black-box warning on a packet of birth control pills, you'll notice that at most ages the risk of death from taking the pills is less than if you don't take them—that's because they're so good at preventing pregnancy, and pregnancy kills. ... In the United States today, about 15 women die in pregnancy or childbirth per 100,000 live births. ... Evolutionarily, childbirth seems like an exceptionally bad time to die. If by definition the ultimate measure of evolutionary success is reproducing successfully, the fact that women and newborns frequently died in childbirth suggests that powerful selective forces must be at work. Why is childbirth such an ordeal? (Laura Helmuth, 9/10).

The New Yorker: How Facebook Makes Us Unhappy
No one joins Facebook to be sad and lonely. But a new study from the University of Michigan psychologist Ethan Kross argues that that's exactly how it makes us feel. Over two weeks, Kross and his colleagues sent text messages to eighty-two Ann Arbor residents five times per day. The researchers wanted to know a few things: how their subjects felt overall, how worried and lonely they were, how much they had used Facebook, and how often they had had direct interaction with others since the previous text message. Kross found that the more people used Facebook in the time between the two texts, the less happy they felt—and the more their overall satisfaction declined from the beginning of the study until its end. The data, he argues, shows that Facebook was making them unhappy (Maria Konnikova, 9/10).

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