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British Medical Bulletin Advance Access

Published: Mon, 12 Feb 2018 00:00:00 GMT

Last Build Date: Mon, 12 Feb 2018 03:43:50 GMT


Death on demand? An analysis of physician-administered euthanasia in The Netherlands

Mon, 12 Feb 2018 00:00:00 GMT

Physician-administered euthanasia (PAE) was legalized, along with physician-assisted suicide (PAS), in The Netherlands in 2001.
Sources of data
Annual reports of the Dutch Regional Euthanasia Review Committees, the committees’ 2015 published Code of Practice and research studies
Areas of agreement
There is a general openness about the practice of PAE/PAS in The Netherlands and an avoidance of misleading euphemisms. The 2001 law also includes arrangements for post-event review of PAE/PAS decisions.
Areas of controversy
Rising numbers of annually reported deaths from PAE and uncertainty over actual numbers. Movement away from the principle that euthanasia must take place within an established doctor–patient relationship. Increasing extension of the 2001 law to people with mental health conditions, dementia and multiple co-morbidities. Nature of the post-event scrutiny applied to reported cases.
Growing points
The predominance of PAE over PAS where both are legalized raises questions over how these two acts are perceived and whether there are implications for such laws.
Areas for timely research
Are the criteria for PAE/PAS in the 2001 law appropriate for a law of this nature? What should be the respective roles of the second-opinion doctors and the review committees?

The role of the food industry in health: lessons from tobacco?

Fri, 09 Feb 2018 00:00:00 GMT

In this review, we highlight poor diet as the biggest risk factor for non-communicable diseases. We examine the denial tactics used by the food industry, how they reflect the tactics previously used by the tobacco industry, and how campaigners can use this knowledge to achieve future public health successes.
Sources of data
Data sources are wide ranging, notably publications relating to public health, obesity and processed food, the effectiveness hierarchy and food industry denialism tactics.
Areas of agreement
Global burden of disease analyses consistently demonstrate that poor diet produces a bigger burden of non-communicable disease than tobacco, alcohol and inactivity put together. The lessons learnt from the tobacco control experience of successfully fighting the tobacco industry can be applied to other industries including processed food and sugary drinks.
Areas of controversy
Tackling obesity and poor diet is a more complex issue than tobacco. Food industries continue to promote weak or ineffective policies such as voluntary reformulation, and resist regulation and taxation. However, the UK food industry now faces increasing pressure from professionals, public and politicians to accept reformulation and taxes, or face more stringent measures.
Growing points and areas timely for developing research
The rise in childhood and adult obesity needs to be arrested and then reversed. Unhealthy processed food and sugary drinks are a major contributing factor. There is increasing interest in the tactics being used by the food industry to resist change. Advocacy and activism will be essential to counter these denialism tactics and ensure that scientific evidence is translated into effective regulation and taxation.