Editor's pick.

In 1994, the US Congress passed a law severely curtailing the powers of the Food and Drug Administration to regulate herbs and other alternative health products or dietary supplements. The law was in part a response to manufacturers, who urged deregulation to foster growth of their industry. (The manufacturers were no fools: the industry has tripled in economic terms since the law was passed.) But Congress was also responding to the passions of consumers who use alternative products on a regular basis. Many of these consumers have doctors.

Legal issues surrounding privately funded research cause furore in Toronto.

Toronto physician Miriam Shuchman has spent the last 4 months tracking the research issues surrounding a controversial clinical trial conducted in Toronto. Much of the information appearing in this article was gathered while she was preparing a segment for the CBC Radio program Quirks and Quarks. Earlier, she had reported on similar issues in the US for the Annals of Internal Medicine.

Medical scientists and health news reporting: a case of miscommunication.

The public is poorly served by the coverage of medical science in the general press. Scientists and physicians blame the press, claiming that journalists are careless in their reporting, subject to competitive pressures, and ignorant of the scientific process. Journalists accuse the medical community of limiting access to information and erecting barriers to the public dissemination of medical research. In many areas of health news reporting, the underlying problem is an interactive dynamic that involves scientists and journalists. Both parties share the responsibility for accurate communication to the public. This report suggests ways to improve health news reporting, focusing on four problem areas: sensationalism, biases and conflicts of interest, lack of follow-up, and stories that are not covered.

Accuracy of clinical impressions and Mini-Mental State Exam scores for assessing capacity to consent to major medical treatment. Comparison with criterion-standard psychiatric assessments.

The authors evaluated the accuracy of clinical impressions and Mini-Mental State Exam scores for assessing patient capacity to consent to major medical treatment, relative to expert psychiatric assessment. Consecutive medical inpatients (N = 63) facing a decision about major medical treatment received a clinical impression of capacity from their treating physician and the Standardized Mini-Mental State Exam (SMMSE); 48 received independent psychiatric assessment of capacity. Analyses revealed that both clinical impressions and SMMSE scores were generally inaccurate in determining capacity, although all 23 participants with a clinical impression of "definitely capable" were found capable by the psychiatrist. Given the importance of assessing capacity to consent to major medical treatment, better approaches to the clinical assessment of capacity are required. Several strategies are discussed.

Interventions among adolescents who were violently injured and those who attempted suicide.

To examine responses to the psychological needs of adolescent injury victims, the records of all adolescents hospitalized at an urban trauma center during a one-year period for injury by gunshots, stabbings, and physical assaults (N = 59) were compared with the records of adolescents admitted that year for attempting suicide (N = 28). Victims of intentional injuries received significantly lower levels of psychosocial interventions than suicide attempters, and access to such interventions appeared to be influenced by gender and race. Intentionally injured adolescents may not receive available interventions for the psychosocial consequences of their injuries.