Making Medical Decisions for Incapacitated Patients Without Proxies: Part I.

To date no one has identified or described the population of incapacitated patients being treated in an inpatient setting who lack proxy decision-makers. Nor, despite repeated calls for protocols to be developed for decision-making, has any institution reported on the utilization of such a protocol. In 2005, our urban tertiary care hospital instituted a protocol utilizing community members of the ethics committee to meet with the medical providers and engage in shared decision-making for patients without proxies (PWPs).

Carotenemia in Normal-weight Bulimia: A Finding Unrelated to Other Physical Manifestations of the Syndrome.

Carotenemia, well described in eating disorders, is considered a marker for one or another pathophysiologic process occurring during the disease. We studied 17 adolescent, normal-weight women with bulimia, 11 of whom were determined clinically to be candidates for outpatient treatment, and 6 of whom were recommended for hospitalization. The outpatient group had an elevated serum carotene level (mean = 309.