Using Tools for Providing Information

In helping patients make good decisions, clinicians should give patients written information to help them comprehend their clinical alternatives, when possible, or refer them to appropriate Websites. Providing audiotapes of visits where important decisions are discussed may increase patient satisfaction and retention of information and is nearly universally preferred by patients.60-62 Clinicians should encourage patients to review all materials with loved ones, and arrange for an opportunity to answer any questions that arise. Use of these tools may provide additional benefits by facilitating caregiver support during the decision process.63

Risk communication is an important component of providing information to patients about their medical decisions. Thus, the use of specific strategies for improving risk communication may have substantial benefits for involving patients in their decisions. Presentation of frequencies with specific reference groups (25 of 1,000 people who undergo chemotherapy will die of the treatment) instead of percentages (0.25%) may reduce confusion and facilitate understanding of small risks.64 Furthermore, the use of the same denominator (i.e., 1,000 people) for different risks (e.g., risk of dying of chemotherapy and risk of cancer recurrence) simplifies the comparison of these risks.64 Presentation of both negative (25 of 1,000 people who undergo chemotherapy will die of the treatment) and positive framing (975 of 1,000 people who undergo chemotherapy will not die of the treatment) can reduce biases in decision making.65,66 Furthermore, when possible, the use of visual aids, such as bar graphs or pie charts, can increase the comprehension and saliency of risk infor-mation28 and can even reduce the influence of anecdotal information.67

A Disquistion On The Evils Of Using Tobacco

A Disquistion On The Evils Of Using Tobacco

Among the evils which a vitiated appetite has fastened upon mankind, those that arise from the use of Tobacco hold a prominent place, and call loudly for reform. We pity the poor Chinese, who stupifies body and mind with opium, and the wretched Hindoo, who is under a similar slavery to his favorite plant, the Betel but we present the humiliating spectacle of an enlightened and christian nation, wasting annually more than twenty-five millions of dollars, and destroying the health and the lives of thousands, by a practice not at all less degrading than that of the Chinese or Hindoo.

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