We appreciate the excellent study by Heffner et al1 of end-of-life ethics publications in journals representing 5 internal medicine subspecialties: cardiology, critical care medicine, nephrology, oncology, and pulmonary medicine. In support of its hypothesis of differences among subspecialties, the article convincingly documented significant diversity among 19 journals reviewed, ranging from a low average of 0.25 items (representing nephrology) to a high average of approximately 4 items (representing critical care medicine) per subspecialty journal per year, during a 20-year period: 1975-1995.
In addition to documenting significant differences among the 5 internal medicine subspecialties studied, as represented by the journals, these findings also document that end-of-life ethics items are scarce in the 19 journals studied.
End-of-life ethics readers seeking substantially greater concentration on this subject will find the Journal of the American Geriatrics Society to be a valuable resource. During the past several years, almost every issue had 1 or more