CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Editorial Comment
The PMAC code of marketing practices: time for improvement? Pharmaceutical Manufacturers Association of Canada.
In this issue (see pages 351 to 356) Dr. Joel Lexchin proposes reforms that could help the Pharmaceutical Manufacturers Association of Canada (PMAC) adapt its Code of Marketing Practices to changing times. ⋯ The PMAC should take this opportunity to address the concerns raised by Lexchin. For example, proactive assessment of advertising would improve the current system.
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Physician leaders will meet in Ottawa Feb. 28 and Mar. 1 for the CMA's 9th Annual Leadership Conference to examine how evidence, research and data influence health policy. For information or to register contact CMA Meetings and Travel Department, 800 663-7336, ext. 2274; fax 613 731-8047.
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To determine when respirologists approach patients with end-stage chronic obstructive pulmonary disease (COPD) to decide about the use of mechanical ventilation, what information they provide to patients and how they provide it. ⋯ Discussions with COPD patients concerning end-of-life decisions about mechanical ventilation are reported to occur in advanced stages of the disease or not at all, with patients' input where possible. Information presented to patients is often modified in order to influence the decision. Future studies should explore ways to involve patients further in the decision-making process and to improve the process for both patients and physicians.
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The standard of professional candour with patients has undergone a significant change over the past 30 years. Independent of their obligation to disclose information necessary for informed consent, physicians are increasingly expected to communicate important information to patients that is not immediately related to treatment decisions. ⋯ Truth telling fosters trust in the medical profession and rests on the respect owed to patients as persons. It also prevents harm, as patients who are uninformed about their situation may fail to get medical help when they should.
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To assess the effect of the tobacco tax cuts made in 1994 on the smoking habits of Canadians. ⋯ Although smoking rates are declining in Canada, tobacco tax cuts appear to have slowed the rate of decline by inducing more nonsmokers to take up smoking and leading fewer smokers to quit.