Today I read a story about a woman at the center of a controversial legal battle in Italy.

Eluana Englaro had been in a vegetative state since she was in a car accident 17 years ago. The media was calling Englaro “the Terri Schiavo of Italy,” because her case was similar to woman here in the United States. (Schiavo’s husband as legal guardian, wanted his wife’s feeding tube removed, but Schiavo’s parents fought their son-in-law for years to keep the tube in place).

Englaro’s father fought the Italian courts to remove his daughter’s feeding tube, which kept his daughter alive, saying it was not his daughter’s wish to be kept alive “artificially.”

This case sparked heated debate between parts of the Italian government and the Catholic Church, who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

This case sparked heated debate between parts of the Italian government and the Catholic Church who likened the removal of the feeding tube to euthanasia, which is illegal in Italy. And the legal battle that ensued brought to light the ethical issues surrounding euthanasia and the right-to-die, as well as the legality of living wills.

Unfortunately, the woman died before any of these legal issues were resolved, and I’m sure this is a controversial debate that will rage on among contending parties for years to come.

But one of the most interesting aspects of this story has nothing to do with lawmakers and government officials at the center of the debate. Rather, it’s the way the people in the region have taken matters into their own hands, and the ever-expanding role technology is beginning to play in the public’s interpretation of the law.

Over the weekend, some Italian citizens began creating living wills on YouTube, documenting their personal wishes with regard to “do not resuscitate” (DNR) orders, designation of health care proxies and any other modifications they feel are important, in the event they are rendered incapacitated. But the irony lies in the fact that in Italy, there is no legislation on end-of-life issues and no recognition of living wills as legal documentation of a person’s wishes.

Here in the U.S., it’s quite the opposite. As physicians, a standard question that we must ask all patients upon admission to the hospital is whether or not they have a living will. If they do, we request to see a copy of it so that it can described in detail in the patient’s chart.

But I have to tell you, in the last few years since this law was mandated, I can literally count on one hand, the number of patients that have answered yes to that question. For many of us, it’s human nature to try not to think about what could go wrong, so we often don’t take the time to plan for it.

So when I look at these people taking matters into their own hands, making a short video clip detailing what they would want done in a worst-case scenario, I’m curious about how these videos will be interpreted by the law in future ethical debates, and at the end of the day, if their wishes will be honored.

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Congratulations mom, on the birth of your eight beautiful children! Being the resident obstetrician here at FOX News, my staff has been asking me all day today “Oh, Dr. Manny did you hear about the lady who had octuplets in California? Isn’t that amazing?”

And yet, despite the fact that I’m very happy for these parents, and I’m very proud of the physicians and nurses that took care of this patient, I also realize that this was a very high-risk pregnancy that could have easily ended up with significant problems. That’s the topic I want to talk about.

Many times we tend to focus on these medical miracles, and we often do not realize all the potential complications that could arise when facing challenging clinical scenarios.

Take, for instance, the story that we did a couple of years ago about the woman who had twins at the age of 60 — after that story ran, I started getting phone calls from women all over the world, asking how they too could have children after the age of 55.

I assisted in that delivery, and what many people don’t know is that that there were many issues we had to deal with having a patient over the age of 60 delivering twins. The same thing is true for anybody that has a multiple pregnancy because a woman’s womb was generally made to birth only one child at a time. When we artificially enhance that number by 3, 4, 5 or 6, we are playing Russian roulette.

The most common complication for multiple pregnancies is prematurity. A premature infant has a significant risk of developmental delays, visual problems and hearing problems.

There are also a number of maternal complications that can arise from multiple pregnancies like high blood pressure, diabetes and significant post-partum bleeding.

So the take-away is this: Medicine has a beginning and an end. But somehow, many people tend to forget the middle part – and that is the part that must be clearly understood by the patient and physician for the miracle to take place.

A recent survey of 12,000 general practice physicians found that 60 percent of them feel they’re overworked, are planning on quitting or cutting back their hours, and that they would not recommend medicine as a career.

I get it — I too feel tired and overworked — but I would not go as far as to say that I don’t recommend medicine as a career. Medicine, to me, is an art. I just wish I could practice it with less bureaucracy. One of the most common complaints I get from physicians, nurses and general medical personnel, is the tremendous amount of paperwork that is required in today’s heavily regulated industry. Many people would argue that physicians brought this upon themselves, that all this regulation was necessary to make sure safety standards grew and that patients’ bill of rights were protected.

So I asked some of my friends in the healthcare field: “Would President-elect Obama bring good news for our healthcare system?” And the most frequent answer I got was, “We don’t know.”

I believe some of my peers feel that there are so many priorities for our new government, healthcare may take a backseat.

So then I asked them, “How would you advise our new president-elect with regard to some of the doctor dissatisfaction survey results?”

Here’s a compilation of their wish list:

1. Malpractice reform

2. Significantly reduce the cost of medical education

3. Educate the consumer to create realistic expectations on what the healthcare system can provide

4. Decrease bureaucracy

Let’s face it, there are many choices President-elect Obama can make. But unfortunately, with the state of the economy being a top priority, his resources are limited and his agenda is yet to be seen. So I guess as physicians, we just have to continue to create innovative ways to save the American healthcare system. But one thing is for sure — I still dream of my little girl being a doctor one day.

The National Institutes of Health recently published an interesting study in the “BMJ,” where they approached 1,200 internists and rheumatologists about what they called “placebo treatments,” where patient expectations rather than an expected physiological response was the rationale for the treatment. Only 679 physicians responded, which limited the conclusions, along with the design of the study itself, as this type of survey is a weak form of science. Nevertheless, the results were disturbing – about half of the responding doctors indicated they prescribed these kind of treatments on a regular basis, and more than 60 perecent believed there was no ethical problem in doing so. It has long been known that cures and responses to treatment can be affected by a patient’s mental attitude and expectation, and that healing itself involves suggestion as well as chemical intervention.

But I find these results deeply disturbing for the following reasons:

1) Most of those surveyed were not using sugar pills or harmless salt water, they were using medicines with potential side effects. These included over-the-counter analgesics (41percent), vitamins (38 percent), sedatives (13 percent), and antibiotics (13 percent).

2) More than 90 percent of upper respiratory infections are viral, yet physicians are knowingly prescribing antibiotics to meet patient expectation.

3) Patients are fueled to ask for pills because of advertising, the Internet and a culture of instant gratification.

4) Physicians are motivated to provide a quick fix rather than a more elaborate explanation which could eliminate the need or urge for the treatment. A study published in the “Annals of Family Medicine” published in 2005 concluded that physicians only spend 55 percent of their time in face-to-face patient care. In this environment of 5 to 10 minute office visits, it is often easier for doctors to provide a quick placebo treatment rather than a more elaborate diagnosis and explanation.

5) This is a survey of doctors, but it is highly doubtful to me that patients would be satisfied with this approach. I suspect that a similar survey of patients would reveal that less than 10 percent of patients believe that it is okay for placebo treatments to be given for deceptive reasons, with false expectations. I suspect that most patients would like an interaction with their doctor to be completely honest and based on full disclosure.

Do my readers agree?

VIDEO: Watch Dr. Siegel Talk About The Placebo Problem

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

Police have arrested 13 doctors from a clinic in Milan who investigators suspect performed needless and sometimes fatal operations to make more money.

Police said Tuesday the charges resulting from the investigation of Santa Rita Clinic ranged from fraud to homicide.

Three of the doctors were arrested on suspicion of murder for allegedly having performed on several patients “abnormal or invasive surgeries, without taking into consideration the fragility of the patients because of age or their medical condition,” the police statement said.

Police officials said five patients at the clinic are believed to have died after suspected needless surgeries. A hospital official was also arrested, police said.

If your heart stops for an hour-and-a half, are you dead? There’s a walking, talking French man who might disagree with you.

The 45-year-old man suffered a massive heart attack and rescuers used cardiac massage to try and revive him without success before transferring him to a nearby hospital.

He was revived just as doctors were preparing to remove his organs for transplants, now fueling ethical debates in France about when a person is dead.

Suzanne Kreuziger is a registered nurse who uses e-mail almost exclusively to communicate with friends. But when it comes to reaching her doctor, there’s a frustrating firewall.

The barrier is her doctor’s own reluctance to talk to patients through e-mail.  Most doctors won’t respond through email.

Leave your comments below. 

Australian singer Kylie Minogue told talk show host Ellen DeGeneres this week that doctors initially misdiagnosed her breast cancer.

Minogue is in America promoting her new album “X.”