Clin Med
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Non-alcoholic fatty liver disease (NAFLD), the liver manifestation of the metabolic syndrome, is now considered to be the commonest liver problem in the western world. This apparent 'epidemic', coupled with an accumulating body of evidence that a significant proportion of patients with NAFLD can progress to cirrhosis, liver failure and hepatocellular carcinoma (HCC), has--perhaps not surprisingly--led to an exponential growth in clinical and basic studies investigating all aspects of this hitherto largely ignored disease. The result is a vast increase in understanding of the natural history, clinical features and pathophysiology of NAFLD over the last five years which has now begun to inform the development of rational management strategies.
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The Royal College of Physicians took a neutral position on the House of Lords Assisted Dying for the Terminally Ill Bill. While modern palliative care and the hospice approach have greatly reduced terminal suffering, they do not always achieve total relief of distressing symptoms--he majority of dying patients and their families probably do not receive optimal terminal care. In this article I try to rebut the common arguments against assisted dying and add some arguments in favour. I suggest that on this issue the medical professions are out of tune with majority public opinion.