Latest news with #Belgium
Medscape
14 hours ago
- Health
- Medscape
Doctors' End-of-Life Choices Break the Norm
A new survey revealed that most doctors would decline aggressive treatments, such as cardiopulmonary resuscitation (CPR), ventilation, or tube feeding for themselves if faced with advanced cancer or Alzheimer's disease, choosing instead symptom relief and, in many cases, assisted dying. 'Globally, people are living longer than they were 50 years ago. However, higher rates of chronic disease and extended illness trajectories have made end-of-life care the need for improved end-of-life care an issue of growing clinical and societal importance,' the authors, led by Sarah Mroz, PhD, a doctoral researcher with the End‑of‑Life Care Research Group at Vrije Universiteit Brussel and Ghent University, based in Brussels and Ghent, Belgium, wrote. Physicians play a critical role in initiating and conducting conversations about end-of-life care with patients, whose deaths are often preceded by decisions regarding end-of-life practices. These decisions may include choosing to forgo life-prolonging therapies or opting for treatments that could hasten death. Such choices have a significant impact on individuals, families, and the healthcare system. 'Since physicians have a significant influence on patients' end-of-life care, it is important to better understand their personal perspectives on such care and its associated ethical implications. However, existing studies on physicians' preferences for end-of-life practices are outdated and/or focus on a narrow range of end-of-life practices. Additionally, knowledge on whether physicians would consider assisted dying for themselves is limited, and no international comparative studies have been conducted,' the authors wrote. To address this gap, the researchers conducted a cross-sectional survey of 1157 physicians, including general practitioners, palliative care specialists, and other clinicians from Belgium, Italy, Canada, the US, and Australia. Physician Choices Physicians were surveyed regarding their end-of-life care preferences in cases of advanced cancer and end-stage Alzheimer's disease. Over 90% preferred symptom-relief medication, and more than 95% declined CPR, mechanical ventilation, or tube feeding. Only 0.5% would choose CPR for cancer and 0.2% for Alzheimer's disease. Around 50%-54% supported euthanasia in both cases. Support for euthanasia varied by country, from 80.8% in Belgium to 37.9% in Italy for cancer and from 67.4% in Belgium to 37.4% in Georgia, US, for Alzheimer's disease. 'Physicians practicing in jurisdictions where both euthanasia and physician-assisted suicide are legal were more likely to consider euthanasia a (very) good option for both cancer (OR [odds ratio], 3.1) and Alzheimer's disease (OR, 1.9),' the researchers noted. The results show how laws and culture shape end-of-life choices. Practice Gap The article highlights a striking disconnect: While most doctors would refuse aggressive interventions for themselves at the end of life, such treatments are still commonly administered to patients. What explains this gap? 'The gap between doctors' preference for comfort-focused care for themselves and the aggressive treatments they often provide to patients highlights a deeper conflict between personal understanding and professional obligation,' said Andrea Bovero, psychologist at the University Hospital Città della Salute e della Scienza and faculty member in the Department of Neurosciences at the University of Turin, both in Turin, Italy, in an interview with Univadis Italy , a Medscape Network platform. Physicians, he explained, understand the limits of medical interventions and their real impact on quality of life due to their training and experience. 'When they become patients themselves or must make decisions for loved ones, they tend to choose less invasive options — prioritizing quality of life over simply extending it,' he added. However, the situation changes when treating patients. Doctors operate within a system that rewards intervention, action, and a 'fight the disease' mindset — often under pressure from families who want every possible option pursued and from the fear of appearing negligent to the patient. 'There's also the fear of legal consequences,' Bovero said. 'This drives a defensive approach to medicine, where taking action feels safer than choosing not to intervene.' According to Bovero, who was not involved in the study, bridging the gap between what doctors would choose for themselves and what they offer their patients requires a broader rethinking of the healthcare system. 'We need new cultural models, medical education that centers on the individual and the ethics of boundaries, and a healthcare system that prioritizes listening and support,' he said. Rethinking the Role of Death Deeper cultural factors influence the choice of end-of-life care. 'In many Western societies, death is still seen as a failure — even in medicine,' Bovero said. This mindset, he explained, contributes to the avoidance of honest conversations about dying and a preference for treatments that delay or deny death. As a result, physicians are often caught between what they know is clinically appropriate and what social or institutional norms they are expected to follow. 'Regulatory frameworks play a major role in defining what is considered possible or acceptable in end-of-life care,' Bovero said. He emphasized that clear, shared laws on practices, such as deep palliative sedation or euthanasia, could give physicians greater freedom to express and follow care decisions focused on patient comfort and relief. 'In countries where the law explicitly supports patients' rights to palliative care, informed consent, and advance directives, physicians are better positioned to align care with patient values,' Bovero noted. For example, Italy's legislation ensures access to palliative care and upholds the right to refuse treatment or plan future care, which promotes dignity and autonomy at the end of life. Individualized Care Good care doesn't always mean curative treatment; it often means focusing on quality of life,' Bovero said. He noted that this mindset becomes evident when healthcare professionals, as patients, opt for palliative care. However, he cautioned that physicians' personal preferences shouldn't be applied as a universal standard, because 'every patient has unique values, priorities, experiences, and goals that must be acknowledged and respected.' Placing the individual at the center of care is fundamental. Bovero emphasized that good clinical practice involves tailoring medical knowledge, evidence, and even a clinician's personal insights into the specific needs of each patient. Good communication between doctors and patients is key to providing thoughtful care to patients. From the beginning, there should be open, honest discussions between healthcare providers, patients, and families. It is not enough to list treatment options; doctors need to understand what truly matters to the patient, including their fears, desires, and values. This kind of communication requires time, empathy, and real listening qualities that are often overlooked in health systems prioritizing efficiency and technical fixes. 'When doctors and patients connect not only on a medical level but also around personal meaning and existential priorities, care becomes truly personalized,' Bovero said. His research, published in the Journal of Health Psychology , highlights the importance of addressing patients' spiritual needs and encouraging providers to reflect on their own spirituality to improve support for people at the end of life.
The Independent
14 hours ago
- Automotive
- The Independent
Kimi Antonelli reveals ‘really nice' words of wisdom from Lewis Hamilton
Kimi Antonelli has revealed the advice Lewis Hamilton gave him amid an emotional weekend at the Belgian Grand Prix. Antonelli, the 18-year-old Italian who replaced Hamilton at Mercedes this season, has endured a difficult run of F1 races since finishing on the podium in Canada last month, retiring from two grands prix and finishing 16th at Spa on Sunday. Prior to Sunday's race, Hamilton was spotted leaving the Mercedes motorhome as he paid Antonelli, 22 years his junior, a supportive visit. Antonelli was emotional in the media pen after being knocked out in Q1 of qualifying on Saturday and, a day later, the Italian revealed what Hamilton said to him amid a tricky period. 'He came to say hi to the team and definitely we had a couple of words,' Antonelli said. 'He was telling me to keep my head up and that it's normal to have bad weekends. 'And to just keep believing. It was really nice.' Hamilton, who was arguably the last driver to make his F1 debut with a top team with McLaren in 2007, threw his support behind the teenager. 'I can't imagine what it's like at 18, or try to imagine what it's like at 18, to do what he's doing,' Ferrari driver Hamilton told Sky Sports F1. 'He's been doing fantastic. But to be thrown in at the deep end at 18… he hadn't even had his driving licence when he first started racing. 'I think it's a lot on someone's shoulders. He's doing a great job and he's got a great group of people around him. So, I think you've just got to take it in your stride, which I think he is. 'And he's got Bono [Peter Bonnington, who used to work with Hamilton] by his side. He doesn't have anyone better.' Hamilton joked in Thursday's press conference that he could help Antonelli 'work' Mercedes boss Toto Wolff, as the Italian eyes a new contract with the Silver Arrows. Wolff, with Max Verstappen set to stay at Red Bull for 2026, admitted it is now his 'priority' to keep his current driver line-up of Antonelli and George Russell for next year. Antonelli is seventh in the world championship after 13 races, 94 points behind teammate Russell.
New York Times
14 hours ago
- Sport
- New York Times
Newcastle's Antonio Cordero set to join Belgian club Westerlo on loan deal
Newcastle United winger Antonio Cordero is set to join Belgian club Westerlo on a season-long loan deal. The 19-year-old joined Newcastle in a permanent move earlier this summer when his contract at Spanish second tier side Malaga expired. The club had always planned to loan out the Spain under-19 international for 2025-26 to gain first-team experience. Advertisement Westerlo recorded a ninth-place finish in the Belgian top flight last season. Cordero regularly appeared for Malaga in 2024-25, starting 23 of his 40 games; providing six goals and seven assists. Anthony Elanga is the only senior addition to Eddie Howe's squad so far this summer, with Sean Longstaff, Callum Wilson and Lloyd Kelly among those leaving the club on a permanent basis. Speaking on Sunday, head coach Howe said Newcastle are 'not deluded' and recognise the urgent need for transfer reinforcements ahead of the new season. Hugo Ekitike (Liverpool), Bryan Mbeumo (Manchester United), Liam Delap, Joao Pedro (both Chelsea), Dean Huijsen (Real Madrid) and James Trafford (Manchester City) have moved elsewhere, rather than Tyneside, during the current window. Howe desires a centre-half, a goalkeeper and a striker — or two, should Alexander Isak depart — and possibly a midfielder, following Longstaff's exit to Leeds United. (Serena Taylor/Newcastle United via Getty Images)
News.com.au
15 hours ago
- Automotive
- News.com.au
F1 great Martin Brundle's belated praise for Oscar Piastri GP win
F1 commentator Martin Brundle has belatedly praised Oscar Piastri for his latest Grand Prix victory and made a call on the 2025 world title battle. Starting from second on the grid, Piastri won the Belgian Grand Prix ahead of McLaren teammate and title rival Lando Norris, with the Aussie extending his championship lead to 16 points. Fox Sports, available on Kayo Sports, is the only place to watch every practice, qualifying session and race in the 2025 FIA Formula One World Championship™ LIVE in 4K. New to Kayo? Join now and get your first month for just $1. Many fans were left fuming, however, as the Sky Sports broadcast once again focused predominantly on Englishman Norris, rather than his race-winning stable mate. With Norris making a series of crucial errors in the closing stages as he attempted to catch Piastri, Brundle instead highlighted his compatriot's 'brilliant charge' on the broadcast. Perhaps the criticism that rained down upon him was fresh on 66-year-old Brundle's mind when he penned a post-Spa opinion piece for the Sky Sports website. Brundle, who picked up nine podiums in his 12-year career in the premier category, ultimately had some lofty comparisons when assessing Piastri's drive in Belgium. 'It was a champion's drive from Oscar Piastri in the main race on Sunday at Spa,' he wrote. 'The kind of performance reminiscent of the likes of Michael Schumacher, Lewis Hamilton, and Max Verstappen in this modern era. 'A small error at Stavelot cost him pole position to teammate Lando Norris, who had impressively homed in on peak performance overnight. 'But then Piastri read and stalked his championship rival from the eventual rolling start, exited turn one La Source more cleanly, followed closely through Eau Rouge and Radillion, and kept momentum to sweep past into a lead he would not relinquish. 'This also gave him the all-important pit stop priority between the two.' Horrendous conditions delayed the start of the race on Sunday, with it finally getting underway behind a safety car. While Piastri jumped his teammate and grabbed the lead in the early stages, Norris was on the better compound tyre for a one-stop strategy. It left the Aussie with a huge fight on his hands to retain the lead, particularly in the closing stages. Brundle had high praise for the Victorian's effort, stating he 'made it look easy'. 'Because we waited so unnecessarily long to get underway, the race was much drier than expected, and this meant managing intermediate tyres through their compound destruction phase into a tread-less bald contact patch,' Brundle continued. 'The other McLaren side of the garage cleverly agreed with Norris to opt for the hard dry compound tyre, after Piastri's medium compounds were already fitted the previous lap, which meant Lando wouldn't have to pit again. 'Piastri then had to completely reset and coax his tyres for the remaining 70 per cent of the race, which he did with utter calmness and without error despite Norris coming back at him with increasing chunks each lap. 'Basically, he needed to deploy all the driving tools in the toolbox on the day and made it look easy. 'Lando was unlucky with having to go an extra lap on the intermediates because they were too close to do a double stack pit stop and then to compound that his stop was slow. 'As he said in the cooldown room post-race, 'I just thought bye-bye Oscar'.' Norris threw away any chance at victory due to those three costly mistakes as Piastri oozed class and kept his cool. As Norris began to close the gap to Piastri, he ran wide at turn 10 and lost more than a second before losing another half a second thanks to a big lockup. With only three laps to go and the margin down to three seconds, Norris once again locked up at turn one and saw the margin blow back out to 4.7 seconds. Those miscalculations ultimately allowed the Aussie to hold off his teammate and secure his sixth win of the season. But fans were left furious at the commentary, which seemed to downplay the Aussie's masterclass and instead hinted Norris was somewhat unlucky not to win. Piastri's win was put down to 'superior race management', while Norris' fate was sealed by 'unfortunate miscalculations'. Fans vented their feelings towards the commentary online. 'Insufferable dribble coming from Crofty. Piastri, no mistakes on higher degrading tyres with something left in the tank at the end not mentioned at all. Let's talk about his race management skills, which are superior to Lando's. The bias of Crofty is oozing out of him,' one fan wrote. 'As an Aussie, the absolutely anti-Piastri commentary from Sky Sports has been disgraceful. Brundle and Crofty normally love listening to both of you every race, but today's obsession with Lando was incredibly biased, English or not,' another said. 'Tell Crofty his sh** British Lando bias is getting out of hand! Lando is making mistakes left, right and centre and Croft still has him winning! Even after Oscar crossed the line and won, Croft was STILL crapping on about Norris. It's time for him to go,' a third added. Brundle noted those errors again when stating his belief – and hopes – for the remainder of the season. 'Once again in certain phases we saw the McLarens a second or two clear of the field every lap,' he wrote. 'Lando threw caution to the wind, he had nothing to lose, and he had to somehow disturb Oscar's tyre economy run, but three errors we saw on TV meant he came up short and had to settle for second and a further loss of eight points. 'I've felt the same way all year, when all the stars align I believe Lando is marginally the faster, but Oscar is more consistent, makes fewer errors, and is more clinical in combat. 'And his head is always rock solid. He'll take some beating in the closing stages now. 'Lando will need absolutely all he's got, all the time, to win this. 'We've very often seen two championship combatants find an overdrive and move to a scarcely believable level of delivery, it will be interesting to see if that happens over the next three Sprints and 10 GPs.' The Formula 1 season moves to the Hungaroring circuit this weekend for the Hungarian Grand Prix and the only place to see every F1 race live is on Kayo Sports and Foxtel.
The Independent
15 hours ago
- Health
- The Independent
The Trump administration has just sent $10m worth of birth control to be burnt – rather than donate it as aid
A stock of $9.7m (£7.2m) worth of contraceptives, purchased by the US for use in low-income countries is now in transit to France to be burnt rather than distributed as aid. Governments and family planning providers in France and Belgium – where the items were held in a warehouse – have been scrambling to block the US from destroying the supplies. The products, which include contraceptive pills, implants and IUDs (intrauterine devices or coils) and have already been paid for by US taxpayers, are being sent to a specialist facility to be incinerated, at an additional cost of $167,000 (£124,000). That's despite offers from charities including MSI Reproductive Choices and the International Planned Parenthood Federation (IPPF) to take on the costs of donating the contraception. The Belgian Ministry of Foreign Affairs had also said it was, 'exploring all possible avenues to prevent the destruction of these stocks, including their temporary relocation.' A ministry spokesperson said the department had acted as soon as the plans to destroy stocks of contraception, held in Geel in the north of the country, came to its attention - including sending formal diplomatic representations to the US embassy. French member of parliament Soumya Bourouaha asked in an official question on Monday for the prime minister to, 'do everything possible to save these contraceptive stocks and deliver them to the populations who need them'. However, the negotiations faltered, The Independent understands. The supplies are understood to now be in the process of being transferred between the two countries. Access to contraception can be life-saving: unintended pregnancies in countries with high maternal mortality and no access to safe abortion can be a death sentence. Research by the Guttmacher Institute, a reproductive rights research group, has found roughly the $600m spent on family planning overseas by the US government in 2024 prevented 34,000 maternal deaths and over five million unsafe abortions. The contraception was purchased under a contract managed by development firm Chemonics, which has been partly cancelled as part of the Donald Trump 's deep cuts to foreign aid. Chemonics said it was unable to comment on the programme. Two family planning charities said they had been told by representatives of the project that the destruction of contraceptives was part of an effort to save money, despite the fact the supplies have already been paid for. Marcel Van Valen, IPPF's head of supply chain said the argument that the destruction of these products would come in at a lower cost was, 'utter nonsense' adding that the charity had offered to ' go and collect the products, to repack them [at] our cost and to do the distribution throughout the globe with our partners and even competitors in this space'. MSI's associate advocacy director Sarah Shaw said, 'This isn't about government efficiencies. This is about exporting an ideology that's harmful to women.' To give one example, she said, 'the annual contraceptive bill for Senegal for the entire country is $3 million dollars a year. So the contents of that warehouse could have met all of Senegal's contraceptive needs for three years. And instead we're going to see massive shortages. 'We're going to see Senegalese women dying of unsafe abortion, girls having to drop out of school'. A bill has been introduced by Democratic senators Jeanne Shaheen and Brian Schatz to prevent the destruction of the $9.7 of contraceptives specifically, as well as other medicines and food. It's not expected to pass however, as it would need Republican support. IPPF had previously raised concerns that an additional $2 million worth of condoms housed in a warehouse in Dubai were also in line to be destroyed. These were purchased under the HIV programme the President's Emergency Plan for Aids Relief (Pepfar). A State Department spokesperson described the birth control currently earmarked for destruction as 'abortifacient', and said it did not include condoms. They added that the Mexico City Policy, also known as the Global Gag Rule - first introduced in 1984 and brought back in by every Republican president since - prohibits providing assistance to foreign nongovernmental organizations that perform or promote abortion. It's not clear what the administration means by birth control that is abortifacient (an agent that causes abortions). A Democratic congressional aide whose team has visited the warehouse told The Independent their team who had visited the Belgian warehouse had seen only contraceptives, not abortion pills. The stocks they had seen were not approaching their expiry date. 'Contraceptives are saving tons of women from things like pregnancy after sexual assault or rape and saving abortions too,' the aide said. 'It's just not true that mifepristone or any of these abortion pills are in these warehouses. That's completely false.' In the past, conservative and religious groups in the US have falsely claimed contraceptives count as abortion agents. Dr Janet Barter, president of UK clinical membership body the Faculty of Sexual and Reproductive Healthcare, explained an abortion was defined by when, 'there is a pregnancy and the abortion tablets or medications cause that pregnancy to be lost.' On the other hand, 'when contraception is used properly, there is no pregnancy. 'It's very straightforward with pills, implants, injections. They all work by stopping you from producing an egg. If there is no egg, there is no pregnancy,' she said, while in the case of the copper coil, it largely works by killing sperm before an egg could be fertilised. While family planning has come into the firing line, Médecins Sans Frontières (MSF) pointed out this was the latest in a series of destructions including 500 tons of emergency food aid and almost 800,000 mpox vaccines which had been allowed to expire while active outbreaks rage. 'The US government manufactured this problem,' said Avril Benoît, CEO of MSF USA. 'Destroying valuable medical items that were already paid for by US taxpayers does nothing to combat waste or improve efficiency. This administration is willing to burn birth control and let food supplies rot, risking people's health and lives to push a political agenda.'
