instruction:
Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
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Paragraph: In almost all the 12 countries polled, three-quarters or more of those responding to questions posed by the Swiss Medical Lawyers Association (SMLA) said people should be able to decide when and how they die. Two-thirds to three-quarters of them said they could imagine opting for assisted suicide themselves if they suffered from an incurable illness, serious disability or uncontrollable pain. “In practically all European countries, many signs indicate that the prevailing legal system no longer reflects the will of large parts of the population on this issue,” the SMLA said. The results of its poll “should allow politicians to take democratic principles into account when considering legislation on these issues,” it added in its introduction to the study. Assisted suicide is now allowed only in Belgium, Luxembourg, Netherlands and Switzerland. The German government has proposed legalizing it as long as no profit is involved while France is debating whether to allow it. In both Germany and France, the Roman Catholic and Protestant churches oppose legalizing euthanasia and argue for better palliative care to ease pain for dying patients. The study was conducted by the Swiss pollster Isopublic in Austria, Britain, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Portugal, Spain and Sweden. It did not survey the four European countries that allow assisted suicide, or countries in eastern Europe. Germans were most open to letting people decide when and how they die, with 87 percent supporting the idea, and results slowly descended to Denmark’s 71 percent in 11th place. Greece was the only exception to this strong support, with only 52 percent backing the idea of allowing assisted suicide. Spaniards were the most willing to consider asking for help to die, with 78 percent support, followed closely by Germans (77 percent) and the French (75 percent). In Britain, 71 percent said they might seek assisted suicide while Greece was again the most reluctant with 56 percent saying they might do so. More than three-quarters of those polled in all countries said only doctors or trained practitioners should perform assisted suicides. A majority of all respondents said doctors should not lose their licenses if they help a patient die. Results ranged from 84 percent in Britain to 58 percent in Greece. About 30 percent of those polled thought dying patients might occasionally be pressured by relatives or doctors into accepting assisted suicide if it is legalized. Roughly another 30 percent thought this would almost never happen. In Germany, where the government’s bill is now being debated in parliament, 76 percent said the proposed law was wrong to ban assisted suicide if the doctor is paid for the service. The bill would not punish those helping patients commit suicide, for example by accompanying them to Switzerland where assisted suicide has been legal since 1942. A rise in dying foreigners - particularly from Germany, France and Britain - ending their lives there has prompted calls for tighter laws, but Zurich voters rejected in 2010 a proposed ban on what opponents called “suicide tourism”. In the United States, assisted suicide is allowed in Oregon, Washington and Montana. Massachusetts voters narrowly defeated a proposal to legalize it there this month. Claim: Large Europe majorities for assisted suicide: survey.
answer:
Large majorities of west Europeans favor the legalization of assisted suicide, now allowed only in four countries on the continent, according to a new survey.


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Paragraph: Mentions cost for one year of Herceptin as $40,000-$50,000. Mentions quantitative benefit of 9 weeks of Herceptin vs. no Herceptin with certain chemotherapy. Also, while no women in the Herceptin group had cardiac failure at 3 years, the follow-up period may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Mentions potential harms of Herceptin on the heart, especially when given after certain chemotherapy. The story does not mention that there were side effects with certain chemotherapy drugs and doses needed to be decreased during the course of the trial. One aspect of this trial focused on randomization of women with Her2/neu overexpression to 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery. The drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy”, which is not completely accurate. There is an adequate mention of the study design and discussion of disease-free survival at 3 years follow-up. Good job putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup – 116 in each arm. Appropriately discusses the percentage of women who are eligible for Herceptin due to overexpression of HER2/neu. The story would have been helped by some context for the risk these women face. As Herceptin is used earlier and earlier these women have less to gain because they have less risk to begin with. Relative risk reductions may be very high but the absolute is not as big. Sources in addition to study authors are cited. No mention that this trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding drug companies. Other doctors cited express caution about the early results of Herceptin studies, so there is some balance to the piece. The women in this trial had undergone breast cancer surgery and those with ER+ tumors were taking Tamoxifen. This is not explicitly mentioned, only that treatment took place following surgery. Still OK. Herceptin is only FDA approved to treat advanced breast cancer, but is used in clinical trials in early-stage breast cancer. This is not mentioned in the story. Novel use of Herceptin for short-term treatment prior to anthracycline chemotherapy. No evidence that this story relies on a press release. Claim: Short stint of Herceptin holds promise for breast cancer
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This story discusses the results of a recent study involving women with high-risk early breast cancer (node positive or >2cm, age younger than 66 – there were 25 year olds on the trial). One aspect of this trial focused on the short-term use of Herceptin with chemotherapy. Women with overexpression of the HER2/neu gene, as measured by the CISH immunohistochemistry, were randomly assigned 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery and in conjunction with certain types of chemotherapy. This regimen of treatment differed from other trials in which Herceptin was given for 12 months following chemotherapy. In this study, the drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy,” which is not completely accurate. Herceptin is only FDA approved to treat advanced breast cancer, but it is used in clinical trials in early-stage breast cancer. However, this is not mentioned in the story. There is adequate discussion of the study design and reporting of disease-free survival at 3 years follow-up. There was little discussion in the piece of the side effects of chemotherapy as reported in the trial, but the addition of Herceptin was the main focus of the story. While the journalist provides quantitative benefit of 9 weeks of Herceptin vs. no Herceptin, and notes no cardiac failure in the Herceptin group, the follow-up period of 3 years may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Overall, the journalist did a good job describing the randomization, as well as putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup (116 in each arm). The small sample randomized to Herceptin certainly warrants more study, and although the relative benefits were large, these women still had fairly good recurrence free survival — 80% w/o and 90% with — so although it looks like that will translate to overall survival. The question for women with overexpression of the HER/neu gene is: How much do you want to do to avoid recurrence? Sources in addition to the study investigators are cited, which provides some balance to the piece, however, there is no mention that the trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding from drug companies.


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Paragraph: "While it could have been more detailed about the actual numbers involved, this story explained that the cost of palliative care is currently comprised primarily of fees for doctor visits. It could have noted that this is the only component of palliative care that is billable currently, and that other members of the interdisciplinary care team usually cannot bill, so the cost of their salaries/time is usually borne by the institution. This story is also the only one of the four we reviewed to directly explain that palliative care might reduce overall health care costs by reducing hospital stays, emergency treatments, and futile end-of-life care. Far from ideal, but a borderline satisfactory in our view. None of the other stories we reviewed even came close to matching this. Although the description of the survival benefit was accurate and other important outcomes were at least mentioned, the story provides relative — not absolute — differences in its reporting on depression scores. It notes that depression ""was less than half as common in the palliative care group"" compared with the standard care group. So to readers this could mean that depression was found in 2% vs. less than 1% of patients in the standard and palliative care groups — a trivial difference. As it turns out, depression was found in 38% of standard care patients vs. 16% of palliative care patients, which is a very robust finding. Providing the absolute numbers to readers would have allowed them to judge the importance of this finding for themselves. As with the competing coverage, we’ll rule this one not applicable since the harms of palliative care are thought to be minimal. On the positive side, this story did a good job of describing the experiment and its outcomes and explained that the study is ""one of the best tests yet of palliative care"" — which it is. However, this story, like much of the competing coverage, failed to make note of any limitations in the research. We especially think it should have challenged the assertion, made by an editorialist, that ""palliative care should be a routine part of managing any serious illness."" We think it’s a stretch to draw that conclusion considering the limited evidence we have to support it so far. Soliciting a comment from someone outside the field of palliative medicine (a point addressed below under ""Sources"") may have yielded a counterpoint to this argument. No disease-mongering here. The story included multiple interviews with investigators and other experts and satisfies the criterion. However, we should point out that all of these sources could be loosely described as boosters for this particular study or palliative medicine in general. Two of the experts are the current and former presidents of the American Academy of Hospice and Palliative Medicine–a professional group that obviously supports increased awareness and use of palliative care. The editorialists quoted are affiliated with the department of palliative medicine at a major medical center. This reporter clearly was not afraid to pick up the phone and talk to people–an instinct which we applaud. But we wish she had spoken to someone — an oncologist, surgeon or geriatrician outside of the palliative care field–more likely to provide a different, perhaps more cautious, perspective on the results. As noted in the competing reviews, the point of the study was to compare early palliative care with existing standard cancer treatment. However, the story could have provided more detail on the existing alternative – ""standard of care"" oncology care – which many have thought to be ""state of the art"". This story didn’t mention any of the barriers patients may face in obtaining access to palliative treatments–especially the specific type of care offered in this study. While there is a significant number of larger hospitals that offer inpatient palliative care consultation or services, many fewer offer outpatient palliative care services, which was the intervention in this study. Such an article may encourage cancer centers to initiate such services, but they do not often currently exist. This story did a good job of describing the palliative care offered in this study and how it differed from ""comfort care"" offered in the last few months of life. It accurately portrayed the novelty of the research. It is clear that this story didn’t rely on a press release." Claim: Study shows value of quality-of-life cancer care
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The story was marred, however, by a failure to discuss any limitations of the research or to properly quantify the benefits. In addition, its sourcing included only experts likely to hold a favorable view of palliative medicine. We cannot tackle the health care crisis without looking at the costs of care at the end of life. Medicare spends about $50 billion dollars per year on care during the last two months of life. Decreasing the suffering and improving the quality of life of people with advanced illness (lung cancer in this case) is an important goal in and of itself – and argues for the need to improve the quality of cancer care to address these issues.