Hasil untuk "Public aspects of medicine"

Yanqing Xie, Wenjing Zhang

IntroductionThe Consistency Evaluation Policy of Generic Drugs is a major quality-oriented regulatory reform in China’s pharmaceutical manufacturing industry. Whether and how this policy facilitates the integration of the innovation chain and the industrial chain at the enterprise level remains insufficiently examined. This study evaluates the policy effect and investigates potential mechanisms.MethodsThis study used panel data on A-share listed pharmaceutical enterprises from 2013 to 2023. Enterprises were treated as the micro-level carriers of both the innovation chain and the industrial chain, and a enterprise-level index was constructed to measure their integration. A difference-in-differences (DID) design was employed to estimate the impact of the Consistency Evaluation Policy of Generic Drugs. Mechanism analyses focused on government subsidies and market concentration, and heterogeneity was assessed by market demand and total factor productivity (TFP).ResultsThe Consistency Evaluation Policy of Generic Drugs significantly promoted the integration of the innovation chain and the industrial chain. Mechanism tests suggested that the effect operated through two channels: increased government subsidies and higher market concentration. The positive effect was stronger among enterprises facing larger market demand. Moreover, the effect was significant for enterprises with higher TFP, while it was not statistically significant for enterprises with lower TFP.DiscussionThese findings suggest that policy implementation can be strengthened by (1) improving the depth and precision of the Consistency Evaluation Policy of Generic Drugs, (2) enhancing the targeting of government subsidies and supporting an appropriate degree of industry concentration where warranted, and (3) adopting differentiated guidance to stimulate enterprise vitality through multiple measures.

Mary Anne Nascimento-Souza, Luiz Sérgio Silva

Resumo Introdução O trabalho em turnos e o trabalho noturno (TN) podem resultar em consequências adversas para os trabalhadores. Objetivo Avaliar a prevalência do TN e do trabalho em turnos ininterruptos (TTI) e sua associação com acidentes de trabalho e de trajeto. Métodos Estudo transversal com dados de trabalhadores adultos participantes da Pesquisa Nacional de Saúde, realizada em 2019, no Brasil. Foram construídos modelos de regressão logística, ajustados por sexo, faixa etária e escolaridade. Resultados Foram incluídos 51.186 trabalhadores, dos quais 55,0% eram do sexo masculino. A prevalência do TN foi de 13,4% (IC95% 12,9;14,0) e do TTI foi de 1,8% (IC95% 1,6;2,0). O TN esteve associado a maior chance de acidentes de trabalho (OR ajustado: 1,4; IC95%: 1,1;1,8) e de trajeto (OR ajustado: 1,4; IC95%: 1,1;1,8), enquanto o TTI associou-se apenas a acidentes de trabalho (OR ajustado: 2,5; IC95%: 1,5;4,2). Conclusão A maior chance de acidentes de trabalho e de trajeto entre trabalhadores em turnos noturnos, assim como de acidentes de trabalho entre aqueles que trabalhavam em turnos ininterruptos, revela a necessidade de políticas adicionais de saúde e segurança voltadas para a redução do risco de acidentes entre tais trabalhadores.

Adrian Singer, Katharina Tropschuh, Marc von Gernler et al.

Abstract Background Progestogens, synthetic analogues of progesterone, are widely used in clinical practice for contraception, hormone replacement therapy, and the management of gynecological disorders. Understanding the specific impacts of different progestogens on the renin-angiotensin-aldosterone system (RAAS) is crucial due to their potential effects on cardiovascular and renal outcomes. Objective This systematic review aims to synthesize existing research on the effects of various progestogens on the RAAS and associated clinical outcomes. Methods We conducted a comprehensive search of databases up to the search date, including randomized controlled trials (RCTs), cohort studies, case-control studies, cross-sectional studies, and qualitative studies. The NIH Study Quality Assessment Tool for Controlled Intervention Studies was used to evaluate the quality of the included studies. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved through discussion. Results Forty-two studies on drospirenone (DRSP) were the most extensively investigated, showing either decreased or unchanged blood pressure (BP), mostly unchanged serum sodium, and an increased risk of hyperkalemia only in patients with mild renal impairment. Sixteen studies on norethindrone (NET/NETA) presented conflicting results on BP and a higher risk of hyperkalemia. Other progestogens, such as levonorgestrel (LNG) and medroxyprogesterone acetate (MPA), showed varied effects on RAAS parameters. Notably, changes in plasma renin activity (PRA), serum aldosterone, and angiotensin II levels were inconsistent across different progestogens and study designs. Conclusion The effects of progestogens on the RAAS are complex and varied, influenced by the type of progestogen, dosage, and combination with estrogen. While some progestogens like DRSP may offer benefits in BP management with minimal electrolyte disturbances, others like NET/NETA might require more careful monitoring due to their associated risks. These findings highlight the importance of personalized medicine approaches in the use of progestogens, tailored to individual patient characteristics and specific hormonal profiles. Further research with standardized methodologies is needed to clarify these effects and guide clinical practice. Trial registration This review was prospectively registered with PROSPERO.

Ramona Schweitzer, Stephan Schlögl, Marco Schweitzer

Non-communicable diseases are the leading cause of global deaths. The risk of their development and progression is increased by modifiable behavioral risk factors. Yet, despite the known benefits of primary and secondary prevention, people often do not follow recommendations for a healthier lifestyle. To this end, mobile health (mHealth) applications offer features for behavioral interventions. Yet, reported user engagement is often low. The objective of the work presented in this article is thus to evaluate the suitability of Design Thinking (DT) as a means to inform the development of an mHealth application that helps increase long-term engagement, and consequently supports individuals in sustainably changing their lifestyle. Applying the DT approach, key user needs and challenges were investigated and used to design a first low-fidelity mHealth application prototype. Think-Aloud analysis, task completion, and post-test interviews were then used to evaluate the prototype and generate early-stage insights. Subsequently, a structured, retrospective analysis of this process, evaluating the insight-generation potential of each step in the DT process cycle, was used to reflect on its suitability to inform mHealth application development. The respective results highlight (1) the distinct value of the DT method, particularly in the early stages of a development project; (2) the strong need for interdisciplinary collaboration in such projects, so as to capture realistic end-user requirements and improve the overall effectiveness of the application design; and (3) the significance of integrating behavioral change theories into the design of mHealth applications, in order to promote long-term engagement.

Kayoko Ishii, Hiroko Sumita, Hitomi Nagamine et al.

Abstract Background In occupational health, the maintenance and promotion of workers’ health, especially lifestyle motivation-based interventions, have gained considerable attention and are actively implemented. Motivational theories include self-determination theory, and some studies focus on healthy lifestyles. However, the effectiveness of health promotion interventions varies depending on the health awareness and motivation of the participants. Therefore, this study aimed to clarify the processes by which workers are motivated to improve their health and to identify the need for and type of support according to their motivation. Methods Using a mixed-research design, an initial questionnaire survey of 94 employees (mean age = 40.97 ± 9.65) at a multicenter company in Japan, followed by semi-structured interviews with 16 employees (mean age = 40.13 ± 9.45) from the high- and low-motivation groups, were conducted. Multiple regression analysis followed by modified grounded theory-based analysis of the results of the first stage was used and the quantitative and qualitative results were integrated. Results In the first stage, autonomous motivation scores were predicted by the behavioral change stage and relatedness satisfaction/frustration. The second stage revealed that “the process of reflecting and managing one’s own health while receiving support and feedback for maintaining and improving health” was the motivational process of workers. Result integration revealed that motivation increased through repeatedly escaping and adjusting to real problems and situational coping until the behavioral change. Despite interruptions during behavioral change, receiving feedback from others could increase motivation and continued behavioral change. Conclusion Regardless of their level of motivation for health behaviors, workers indicated that support from others was essential. The nature of this support was found to range from providing information to offering feedback. Interventions individualized by the identified process could enable customized motivation-driven health guidance.

J. Santaló, M. Berdasco

Given the increasing research activity on epigenetics to monitor human diseases and its connection with lifestyle and environmental expositions, the field of epigenetics has attracted a great deal of interest also at the ethical and societal level. In this review, we will identify and discuss current ethical, legal and social issues of epigenetics research in the context of personalized medicine. The review covers ethical aspects such as how epigenetic information should impact patient autonomy and the ability to generate an intentional and voluntary decision, the measures of data protection related to privacy and confidentiality derived from epigenome studies (e.g., risk of discrimination, patient re-identification and unexpected findings) or the debate in the distribution of responsibilities for health (i.e., personal versus public responsibilities). We pay special attention to the risk of social discrimination and stigmatization as a consequence of inferring information related to lifestyle and environmental exposures potentially contained in epigenetic data. Furthermore, as exposures to the environment and individual habits do not affect all populations equally, the violation of the principle of distributive justice in the access to the benefits of clinical epigenetics is discussed. In this regard, epigenetics represents a great opportunity for the integration of public policy measures aimed to create healthier living environments. Whether these public policies will coexist or, in contrast, compete with strategies reinforcing the personalized medicine interventions needs to be considered. The review ends with a reflection on the main challenges in epigenetic research, some of them in a technical dimension (e.g., assessing causality or establishing reference epigenomes) but also in the ethical and social sphere (e.g., risk to add an epigenetic determinism on top of the current genetic one). In sum, integration into life science investigation of social experiences such as exposure to risk, nutritional habits, prejudice and stigma, is imperative to understand epigenetic variation in disease. This pragmatic approach is required to locate clinical epigenetics out of the experimental laboratories and facilitate its implementation into society.

A. Lonardo, A. Suzuki

Nonalcoholic fatty liver disease (NAFLD) embraces the clinico-pathological consequences of hepatic lipotoxicity and is a major public health problem globally. Sexual dimorphism is a definite feature of most human diseases but, under this aspect, NAFLD lags behind other medical fields. Here, we aim at summarizing and critically discussing the most prominent sex differences and gaps in NAFLD in humans, with emphasis on those aspects which are relevant for clinical practice and translational research. Sexual dimorphism of NAFLD is covered with references to the following areas: disease prevalence and risk factors, pathophysiology, comorbidities, natural course and complications. Finally, we also discuss selected gender differences and whether sex-specific lifestyle changes should be adopted to contrast NAFLD in men and women.

Alicia Gonzalez-Flores, W. Clay, Juliana Madzia et al.

Addressing the unequal impact of health disparities on historically marginalized communities is a top public health priority. Diversifying the work force has been lauded as key to addressing this challenge. Contributing to diversity in the workforce is the recruitment and retention of health professionals previously excluded and underrepresented in medicine. A major obstacle to retention, however, is the unequal way in which health professionals experience the learning environment. Through this perspective of 4 generations of physicians and medical students, the authors seek to highlight the similarities that have persisted over 40 years in the experiences of being underrepresented in medicine. Through a series of conversations and reflective writing, the authors reveal themes that spanned generations. Two common themes among the authors are the feeling of not belonging and feeling invisible. This is experienced in various aspects of medical education and academic careers. The lack of representation, unequal expectations, and over taxation contributes to the feeling of not belonging, leading to emotional, physical, and academic fatigue. Feeling invisible, yet paradoxically being hyper-visible, is also common. Despite the challenges, the authors conclude with a sense of hope for the future, if not for them, for the generations to come.

Y. Picón-Jaimes, I. Lozada‐Martínez, J. E. Orozco-Chinome et al.

End-of-life care is an increasingly relevant topic due to advances in biomedical research and the establishment of new disciplines in evidence-based medicine and bioethics. Euthanasia and assisted suicide are two terms widely discussed in medicine, which cause displeasure on many occasions and cause relief on others. The evolution of these terms and the events associated with their study have allowed the evaluation of cases that have established useful definitions for the legal regulation of palliative care and public policies in the different health systems. However, there are still many aspects to be elucidated and defined. Based on the above, this review aimed to compile relevant historical aspects on the evolution of euthanasia and assisted suicide, which will allow understanding the use and research of these terms.

S. Park, K. Do, Sung-Woo Kim et al.

Artificial intelligence (AI) is expected to affect various fields of medicine substantially and has the potential to improve many aspects of healthcare. However, AI has been creating much hype, too. In applying AI technology to patients, medical professionals should be able to resolve any anxiety, confusion, and questions that patients and the public may have. Also, they are responsible for ensuring that AI becomes a technology beneficial for patient care. These make the acquisition of sound knowledge and experience about AI a task of high importance for medical students. Preparing for AI does not merely mean learning information technology such as computer programming. One should acquire sufficient knowledge of basic and clinical medicines, data science, biostatistics, and evidence-based medicine. As a medical student, one should not passively accept stories related to AI in medicine in the media and on the Internet. Medical students should try to develop abilities to distinguish correct information from hype and spin and even capabilities to create thoroughly validated, trustworthy information for patients and the public.

Aino Vesikansa, Juha Mehtälä, Katja Mutanen et al.

ABSTRACTBackground: The increasing prevalence of obesity imposes a significant cost burden on individuals and societies worldwide.Objective: In this nationally representative study, the association between body mass index (BMI) groups and the number of metabolic comorbidities (MetC) with total direct costs was investigated in the Finnish population.Study design, setting, and participants: The study cohort included 5,587 adults with BMI ≥18.5 kg/m2 who participated in the cross-sectional FinHealth 2017 health examination survey conducted by the Finnish Institute for Health and Welfare. Data on healthcare resource utilization (HCRU) and drug purchases were collected from national healthcare and drug registers.Main outcome measure: The primary outcome was total direct costs (costs of primary and secondary HCRU and prescription medications).Results: Class I (BMI 30.0–34.9 kg/m2) and class II – III (BMI ≥35.0 kg/m2) obesity were associated with 43% and 40% higher age- and sex-adjusted direct costs, respectively, compared with normal weight, mainly driven by a steeply increased comorbidity in the higher BMI groups. In all BMI groups combined, individuals with ≥2 MetCs comprised 39% of the total study population and 60% of the total costs.Conclusion: To manage the cost burden of obesity, treatment should be given equal consideration as other chronic diseases, and BMIs ≥30.0 kg/m2 should be considered in treatment decisions.

E. Cercenado, J. Rodríguez-Baño, J. Alfonso et al.

In 2012, The Spanish Societies of Infectious Diseases and Clinical Microbiology (SEIMC), Hospital Pharmacy (SEFH), and Preventive Medicine, Public Health and Healthcare Management (SEMPSGS) lead a consensus document including recommendations for the implementation of antimicrobial stewardship (AMS) programs (AMSP; PROA in Spanish) in acute care hospitals in Spain. While these recommendations were critical for the development of these programs in many centres, there is a need for guidance in the development of AMS activities for specific patient populations, syndromes or other specific aspects which were not included in the previous document or have developed significantly since then. The objective of this expert recommendation guidance document is to review the available information about these activities in these patient populations or circumstances, and to provide guidance recommendations about them. With this objective the SEIMC, SEFH, SEMPSPGS, the Spanish Society of Intensive Care Medicine (SEMICYUC) and the Spanish Pediatric Infectious Disease Society (SEIP) selected a panel of experts who chose the different aspects to include in the document. Because of the lack of high-level evidence in the implementation of the activities, the panel opted to perform a narrative review of the literature for the different topics for which recommendations were agreed by consensus. The document was open to public consultation for the members of these societies for their comments and suggestions, which were reviewed and considered by the panel.

H. Sorg, J. Ehlers, C. G. Sorg

The German healthcare system is facing a major transformation towards digitalized medicine. The aim was to find out the attitude and the degree of preparation of upcoming medical professionals for digital medicine. By means of an online survey, medical students from 38 German faculties were asked about different topics concerning digitalization. Most students (70.0%) indicated that they had not had any university courses on digital topics. Thus, only 22.2% feel prepared for the technical reality of digitalized medicine. Most fear losing patient contact because of digitalized medicine and assume that the medical profession will not be endangered by digitalization. Security systems, data protection, infrastructure and inadequate training are cited as the top problems of digitalization in medicine. Medical students have major concerns about incorrect decisions and the consecutive medicolegal aspects of using digital support as part their treatment plans. Digitalization in medicine is progressing faster than it can currently be implemented in the practical work. The generations involved have different understandings of technology, and there is a lack of curricular training in medical schools. There must be a significant improvement in training in digital medical skills so that the current and future healthcare professionals are better prepared for digitalized medicine.

M. Yakhchali, Z. Taghipour, Mehran Mirabzadeh Ardakani et al.

The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases.

Le-le Ma, Hui-min Liu, Chuan-hong Luo et al.

The coronavirus disease, 2019 (COVID-19), has spread rapidly around the world and become a major public health problem facing the world. Traditional Chinese medicine (TCM) has been fully committed to treat COVID-19 in China. It improved the clinical symptoms of patients and reduced the mortality rate. In light of the fever was identified as one of leading clinical features of COVID-19, this paper will first analyze the material basis of fever, including pyrogenic cytokines and a variety of the mediators of fever. Then the humoral and neural pathways of fever signal transmission will be described. The scattered evidences about fever recorded in recent years are connected in series. On this basis, the understanding of fever is further deepened from the aspects of pathology and physiology. Finally, combining with the chemical composition and pharmacological action of available TCM, we analyzed the mechanisms of TCMs to play the antipyretic effect through multiple ways. So as to further provide the basis for the research of antipyretic compound preparations of TCMs and explore the potential medicines for the prevention and treatment of COVID-19.

Benjamin A. Howell, Lisa B. Puglisi, Jenerius Aminawung et al.

Abstract Background People who have been incarcerated have high rates of cardiovascular risk factors, such as hypertension and smoking, and cardiovascular disease (CVD) is a leading cause of hospitalizations and mortality in this population. Despite this, little is known regarding what pathways mediate the association between incarceration exposure and increased rates of CVD morbidity and especially what incarceration specific factors are associated with this risk. The objective of this study is to better understand CVD risk in people exposed to incarceration and the pathways by which accumulate cardiovascular risk over time. Methods and Analysis The Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study is a prospective cohort study of individuals released from incarceration with known cardiovascular risk factors. We are recruiting 500 individuals within three months after release from jail/prison. At baseline we are assessing traditional risk factors for CVD, including diet, exercise, and smoking, and exposure to incarceration-related policies, psychosocial stress, and self-efficacy. Cardiovascular risk factors are measured at baseline through point of care testing. We are following these individuals for the 12 months following the index release from incarceration with re-evaluation of psychosocial factors and clinical risk factors every 6 months. Using these data, we will estimate the direct and indirect latent effects of incarceration on cardiovascular risk factors and the paths via which these effects are mediated. We will also model the anticipated 10-year burden of CVD incidence, health care use, and mortality associated with incarceration. Discussion Our study will identify factors associated with CVD risk factor control among people released from incarceration. Our measurement of incarceration-related exposures, psychosocial factors, and clinical measures of cardiovascular risk will allow for identification of unique targets for intervention to modify CVD risk in this vulnerable population.

Isabel Foster, Michelle Galloway, Wieda Human et al.

Stigma is a critical barrier for TB care delivery; yet data on stigma reduction interventions is limited. This review maps the available literature on TB stigma reduction interventions, using the Health Stigma and Discrimination framework and an implementation analysis to identify research gaps and inform intervention design. Using search terms for TB and stigma, we systematically searched PubMed, EMBASE and Web of Science. Two independent reviewers screened all abstracts, full-texts, extracted data, conducted a quality assessment, and assessed implementation. Results were categorized by socio-ecological level, then sub-categorized by the stigma driver or manifestation targeted. After screening 1865 articles, we extracted data from nine. Three studies were implemented at the individual and interpersonal level using a combination of TB clubs and interpersonal support to target internal and anticipated stigma among persons with TB. Two studies were implemented at the interpersonal level using counselling or a video based informational tool delivered to households to reduce stigma drivers and manifestations. Three studies were implemented at the organizational level, targeting drivers of stigma among healthcare workers (HW) and enacted stigma among HWs. One study was implemented at the community level using an educational campaign for community members. Stakeholder consultation emphasized the importance of policy level interventions and education on the universality of risk to destigmatize TB. Review findings suggest that internal and anticipated TB stigma may be addressed effectively with interventions targeted towards individuals using counselling or support groups. In contrast, enacted TB stigma may be better addressed with information-based interventions implemented at the organizational or community level. Policy level interventions were absent but identified as critical by stakeholders. Implementation barriers included the lack of high-quality training and integration with mental health services. Three key gaps must be addressed in future research: consistent stigma definitions, standardized stigma measurement, and measurement of implementation outcomes.

Ummay Nayeema Islam, Kanchan Kumar Sen, Wasimul Bari

Abstract Background Although Bangladesh has an impressive track record in the reduction of maternal and child mortality, tetanus, a dreadful disease, impedes the way to achieve Sustainable Development Goal (SDG) in this respect. Sufficient doses of tetanus toxoid containing vaccine during pregnancy ensure immunity against tetanus to mothers as well as newborns. Since inequalities persist across vaccination programs globally, in this paper, an attempt has been made to examine whether tetanus toxoid immunization (TTI) status among the women of reproductive age in Bangladesh for their most recent live birth born preceding 2 years of the survey changes with their living standard index (LSI). Methods Five domains of deprivation such as energy use, improved sanitation, drinking water, housing and assets ownership were used to compute the LSI using a approach proposed by Alkire and Foster. The adjusted association between LSI and TTI was established by using logistic regression model. For the purpose of statistical analysis, a nationally representative cross-sectional data extracted from Bangladesh Multiple Indicator Cluster Survey (BMICS), 2019 have been used. Result The bivariate analysis revealed that 79.5% (95% CI 78.0–81.0) of women with low and 83.1% (95% CI 81.3–84.9) with moderate living standards had sufficient vaccination coverage for their most recent pregnancies while this percentage was higher for the women who belonged to high living standard (85.2, 95% CI = 84.2–86.2). A strong evidence for greater odds of sufficient immunization with TT among the women maintaining a high standard of living (AOR = 1.24, 95% CI = 1.08–1.42, p < 0.01) was found from regression analysis. Conclusion The results depict existing living standard disparity with respect to TT vaccination coverage among women in Bangladesh. Present research suggests that immunization campaigns need to be conducted especially for the disadvantaged people to improve their health care and immunization service utilization among women within the age bracket of 15 to 49. This study proposed a scientific way to enhance TT vaccination among Bangladeshi women, which could help Bangladesh attain a widespread tetanus protection and thus, meet the SDGs for maternal and child mortality reduction.

Girum Tareke Zewude, Sisay Demissew Beyene, Belayneh Taye et al.

The outbreak of the COVID-19 pandemic has impacted many professions with short-, medium-, and long-term consequences. Hence, this study examined the mediating role of sense of coherence (SOC) and resilience in the relation to COVID-19 stress and teachers’ well-being (TWB). It recruited 836 teachers from Ethiopia’s higher-education institutions, of which 630 (75.4%) were men and 206 (24.6%) were women, with a mean age of 32.81 years and a standard deviation of 6.42. Findings showed that COVID-19 stress negatively predicted SOC, resilience, and TWB and that SOC and resilience positively predicted TWB. It was concluded that SOC and resilience, both together and separately, mediated the relation between COVID-19 stress and TWB. These results were discussed alongside relevant literature, and the study is found to be valuable for practitioners and researchers who seek to improve well-being using SOC and resilience as resources across teaching professions.

F. Selter, Kirsten Persson, Johanna Risse et al.

Standard views of good death in human and veterinary medicine considerably differ from one another. Whereas the good death ideal in palliative medicine emphasizes the positive aspects of non-induced dying, veterinarians typically promote a quick and painless killing with the aim to end suffering. Recent developments suggest a convergence of both professions and professional attitudes, however. Palliative physicians are confronted with patients wishing to be ‘put to sleep’, while veterinarians have begun to integrate principles and practices from hospice care. We will argue that the discourses on good human and animal deaths are not distinct, but that they interact and influence each other. On the one hand, veterinary medicine adapts techniques like chemotherapy or sedation from palliative end-of-life care. On the other hand, philosophers, veterinarians, pet owners, patients and the general public alike make certain assumptions about the (dis)analogy of human and animal dying or killing. Unfortunately, these interactions have only scarcely been reflected normatively, especially on the part of human medicine. Conflicts and misattributions with potential serious negative consequences for the (animal and human) patients’ wellbeing are provoked. For these reasons, palliative physicians and veterinarians are invited to engage in the debate around human and animal end-of-life care.