Pittsburgh Post-Gazette from Pittsburgh, Pennsylvania • Page 3

A-3 Health Science PITTSBURGH POST-GAZETTE THURSDAY, JUNE 5, 1997 Body beyond Neptune Mini-planet is linked to creation rubble at edge of solar system 'Great gap' found in care of dying I Mr -a Fr'imn V--' -A Dr. John Hoyt "Try to go in and change the behavior of working doctors for something they never saw in their culture is tough. The discoverers, based at Harvard, the University of Hawaii and the University of Arizona, as well as an amateur astronomer based in Cloudcroft, N.M., estimate that 6,400 similar objects might be orbiting the dim expanse between the Kuiper belt and the Oort cloud, two regions on the solar system's edges that are thought to be reservoirs of cometary material left over from the creation of the solar system. The Kuiper belt lies beyond Neptune and is believed to be the source of most of the comets that cross the Earth's path. The hypothesized Oort cloud lies much farther out, at the dimmest fringes of the solar system.

Astronomers have proposed the existence of the Oort cloud to account for a class of comets whose orbits are so large that they rarely reappear in the inner solar system. Dr. Martin J. Duncan of Queen's University in Kingston, Ontario, and Dr. Harold F.

Levison of the Southwest Research Institute in Boulder, writing in the upcoming issue of the journal Science, dated June 13, say that 1996 TL66 is in fact part of a never-before-seen cosmic structure near the Kuiper belt. This new structure, they say, can be distinguished from the Kuiper belt by the unusual paths of its icy bodies, which are moving in eccentric and highly inclined orbits relative to the solar plane. According to computer simulations, the structure was formed in the early days of the solar system when cosmic rubble encountered Neptune. The planet's powerful gravitational force then threw the rubble into chaotic paths, the simulations indicate. Today, the Science authors say, the new structure might contain millions of objects and produce the comets that pass near Jupiter and occasionally bombard the giant planet.

By William J. Broad The New York Times An icy, 300-mile-wide mini-planet has been found beyond Neptune on the dark fringes of the solar system, and scientists believe it may be part of a hidden belt of millions of bits of speeding rubble left over from the creation of the solar system, pieces of which occasionally crash into Jupiter. In 1994, a celestial enigma known as comet Shoemaker-Levy 9, which might be from the hidden belt, plunged into Jupiter in a fiery death marked by bright flashes and fireballs the size of the Earth. The new mini-planet, known as 1996 TL66, is the brightest object that has been found beyond Neptune since the discovery in 1978 of Pluto's moon, Charon, which is 750 miles wide. It joins some three dozen known small objects orbiting the sun at the distant edges of the planetary domain.

The object was discovered by a team of seven American astronomers led by Dr. Jane Luu at the Harvard-Smithsonian Center for Astrophysics, in Cambridge, Mass. The find is reported in today's issue of Nature, the British scientific weekly. At the most distant point of its orbit, the object travels three times farther from the sun than Pluto, arcing through a region of great interest and mystery to astronomers. At its closest point, it travels within the orbit of Pluto.

The find was made after a systematic but limited search with a powerful telescope at the University of Hawaii. "The discovery of this object in such a small fraction of the sky suggests that, unless we are improbably lucky, it is merely the first detected of a larger population of similar bodies," the Nature paper says. By Sharon Voas Post-Gazette Staff Writer Profound changes are needed to: stop people from dying in needless misery, an Institute of Medicine committee said in a report issued! yesterday. "What the committee has identi-' fied is a great gap in the quality of care provided to people who are dying," said Dr. Christine Cassel, who chairs the committee and heads the geriatrics department at Mount Sinai Medical Center in New York City.

"We have the knowledge to relieve most of the pain and other symptoms that people suffer from when they die, but that knowledge is not widely used." The Institute of Medicine advises the federal government on public health policy. The committee that studied care of the dying included doctors, lawyers, nurses and economists. The committee said palliative care, which eases pain and suffering as much as possible, should be 1 available to every dying patient. "We hope that medical schools, research institutions, health-care financing agencies and state regulatory agencies will all begin to pay more attention to this important need as a result of the report," Cassel said. "We also hope and expect the public will begin to learn more about this area and begin to learn that they should be demanding more from their health-care providers." Among the committee's recommendations: Health-care providers, news media and others need to give the public a better understanding about dying in the age of high-tech medicine and the options available to patients and their families.

People should learn about hospice care palliative care provided in the home and how to plan ahead to have their wishes about life support treatment carried out. That is best done by designating people to make the decisions as the patient would if he should become -incompetent, rather than relying solely on living wills that can't respond to unpredictable situations. Health-care professionals must commit themselves to improving their care of dying patients. Major changes are needed in the health-care system. Methods must be developed for measuring the quality of care of the dying and for holding health-care organizations accountable for that care.

Health-care financing must be revised so it encourages rather than impedes good end-of-life care. For instance, doctors are paid now for performing procedures, but not for talking with dying patients and their families or for evaluating ways to ease suffering. Outdated laws that inhibit doctors from prescribing adequate pain medication by requiring hard-to-obtain forms and limiting the dosages must be reformed. Medical research, which now focuses almost exclusively on preventing, detecting and curing disease, should look more closely at how to relieve symptoms that are common at the end of life. Medical students and practicing physicians need to be taught how to relieve the suffering of dying patients and how to talk to patients and their families about death.

Dr. John Hoyt, past president of the Society of Critical Care Medicine, said he didn't expect to see many doctors practicing palliative care until a new generation of medical students graduated. "When it becomes a part of their culture in graduate education, they will treat it as normal and carry it into their practices," said Hoyt, who heads St. Francis Hospital's critical-care department. "But to try to go in and change the behavior of working doctors for something they never saw in their culture is tough." Dr.

Scott Miller, chairman of the Allegheny County Medical Society's bioethics committee, nevertheless believes doctors will provide better care to the dying. "One of he reasons I think it's achievable is because the public is demanding it," said Miller, an internist at Allegheny General Hospital. "A physician who doesn't know about pain management and palliative care and hospice is going to find patients go elsewhere for that treatment. Thurmond disputes book on alien spaceship Caring for the dying Here is a look at the Institute of Medicine's recommendations on improving care of the dying: Educate people about the type and quality of care they should expect at life's end, and teach them how to prepare living wills and make other preparations for end-of-life decisions. Eliminate obstacles to humane care, including regulations that might keep doctors from giving effective pain treatment and "health insurance criteria that discourage high-quality end-of-life care.

Teach medical students and practicing doctors how to alleviate pain and how to talk, to dying patients and their families about death. Make palliative care relief of symptoms of the dying a medical specialty or at least a defined area of expertise. Increase research to understand and treat symptoms of dying people. Foster a continuing public discussion to developing a better understanding of dying in an age of high-tech medicine and the care and treatment options available to patients and their families. In the foreword, Thurmond says Corso worked for him as an aide after leaving the Army and praises him as a person of integrity who served his country well.

"He has many interesting stories to share with individuals interested in military history, espionage and the workings of our government," Thurmond wrote. But he made no mention of the book's central thesis of inadvertent aid to the United States by space aliens. In a statement, Thurmond said that he agreed to provide the foreword on the understanding that the book was autobiographical and that he regretted that it appeared to bolster claims of a government conspiracy and cover-up. "I know of no such the senator said, "and do not believe one existed." By William J. Broad The New York Times A new book contending that the nation's military and industrial power largely derive from a crashed alien spaceship is being disparaged by Sen.

Strom Thurmond, chairman of the Senate Armed Ser-. vices Committee, who wrote the book's foreword. The book, "The Day After Ros-well," published by Pocket Books, says the government found an alien craft that had crashed in the desert near Roswell, N.M., in July 1947 and set up a program to glean its secrets, including things like lasers, computer chips and fiber optics. The government clandestinely fed the alien technology to the military and industry, the book says, while engaging in a wide conspiracy to keep the existence of the aliens from the American public. The book might be dismissed as part of a genre making similar wild claims except for the author's military background, his claimed role in the endeavor and Thurmond's praise of the author in the foreword.

The author, Philip J. Corso, who wrote the book with William J. Bimes, retired from the Army in 1963. The book says he retired as a colonel. The Army said its best records showed that he retired as a lieutenant colonel.

In that rank, he served on the National Security Council under President Dwight D. Eisenhower. Corso contends that, while at the Pentagon, he personally spearheaded an Army project that secretly planted the alien technologies throughout the economy and military, mainly to build up U.S. strength to fight an inevitable war against alien invaders. Post-Gazette HE 1W as em mum mm fi nwfci" fix AY ft SA1URDAY SHOP FRID GREAT GIFT SAVINGS JUST IN TIME FOR FATHER'S DAY, SUNDAY, JUNE 15 0 FINANCE CHARGE.

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