Medical Journal News

A ward round in the intensive care unit ended with more questions than answers for the team. Only after seeing 10 critically ill patients did the hard work start: it was clear what was needed to help patients survive, but working out the “why” was more difficult. We knew that we needed to start steroids in a patient with septic shock—but why? We quickly decided that a patient recovering from a brain injury, who was weak, needed a tracheotomy—but why? And we’d already booked a brain scan for a patient after a cardiac arrest—but why? These were the questions I set the team to work on, to find the reasons behind our decisions.Ultimately, these decisions didn’t need me to make them: they were based on established international guidelines. Anyone who can follow a flowchart or use Google would have come to the same conclusions. But what mattered was that the...

I agree with Moreno that society needs a new perspective on time.1 A 24 h workforce is “productivity driven,” a functional necessity embedded in NHS practice. It follows that irregular sleep schedules and sleep deficiency are controlled by commercial actors.2 Seeking to affect policies at all levels of governance, through systems, practices, and pathways,3 commercial determinants influence non-communicable disease,4 with which shift work and long working hours are associated.5 Pressure to squeeze as many hours as possible from workers is a latent timebomb of ill health, which the exchequer will be obliged to fund.One in nine NHS employees works a night shift,6 and the associated circadian disruption and sleep loss puts both patient and employee health at risk.7 Such work should come with a health warning. More data on sleep duration would be helpful to inform risk management, because sleep health (socially and commercially determined) influences every facet of human...

New England Journal of Medicine, Volume 391, Issue 20, Page 1890-1900, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1913-1923, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1877-1889, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1901-1912, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1949-1958, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1924-1935, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1966-1968, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1963-1966, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1959-1960, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1961-1963, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1947-1948, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1937-1945, November 21, 2024.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

Doctors and other health practitioners around the world are not worried about the impact of artificial intelligence on their profession provided they are involved in the development of tools for using it, a working paper of the Paris based Organisation for Economic Cooperation and Development (OECD) has found.1A survey of 18 medical associations around the world was conducted last year on behalf of the OECD to inform discussion on AI from healthcare providers’ perspective. It found that 72.2% of medical leaders believed the benefits of AI in healthcare outweighed the risks. But respondents were fearful about poor understanding, communication, and risk management, and called for governments to take action on regulation, safeguards, and other matters.The result of their hesitation is that only a third said they were “likely or very likely to use AI as a tool.” The contradiction between belief in the benefits of AI and reluctance to use...

New England Journal of Medicine, Ahead of Print.