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When legislators in Sacramento passed a reasonable and conservative assisted-suicide law in 2015, California was only the fifth U.S state to allow terminally ill people to obtain a lethal prescription. Giving dying people who have six months or less to live an alternative to terrible pain and suffering was the compassionate and correct thing to do, so it's no surprise that Colorado and Washington, D.C., have passed similar right-to-die laws since then, and that more than two dozen states — from Hawaii to Maine — are now considering doing the same. California can't take credit for this trend. Oregon passed the first such law more than 20 years ago, establishing a successful model that California and other states have followed, setting strict rules to safeguard against abuse. (4/5)

By now, Donald Trump’s process of filling key jobs in his administration should be mind-blowingly familiar. First, fire the incumbent by tweet — in this case, Veterans Affairs Secretary David Shulkin, a respected physician appointed by President Obama with overwhelming bipartisan support. Next, apply beauty-pageant standards to the global search for a replacement. Affable and telegenic? Check. Has lavished praise for Trump’s intelligence, stamina, and robust health? Check. Military record with nary a bone spur deferment in sight? Check again. But Ronny Jackson, the newest winner in Trump’s round-robin reality show, should face heightened scrutiny from Congress, which must approve his nomination as head of the second-largest federal department — one that oversees the benefits, health care, and well-being of more than 9 million veterans. (4/4)

President Donald Trump’s March 28 dismissal of Veterans Affairs Secretary David Shulkin has focused attention on a major battle shaping up over the Veterans Health Administration. At issue is how much further should the nation go in allowing veterans to get taxpayer-funded health care from private doctors and hospitals. Access to private providers, particularly in rural areas, is a useful idea. But draining money from the current system to pay for it is like draining money from public schools to pay for private school vouchers: It helps the few at the expense of the many. (4/4)

Why do so many soldiers continue to take their own lives at a higher rate than their civilian counterparts, whether young or old? I’ve spent a lot of time stewing about this over the past few days. It began Monday morning, when I got a note from a vet in a very dark place and contemplating the act. He’d served in Vietnam. His risk of suicide is about 22 percent higher than that of his non veteran peers, according to a report last year from the Department of Veterans Affairs. (Thomas E. Ricks, 4/4)

Medicare officials have announced plans to crack down on prescriptions for opioids in an attempt to limit their use and thus their damage. But making it harder for people to get pain medication legally will most likely drive many to seek relief from far more dangerous and superpotent synthetic opioids. And they are surprisingly easy to obtain. (Richard A. Friedman, 4/4)

Amid a presidential call for ominous commercials and increased use of the death penalty to curb the U.S. opioid crisis, areas around the country are toying with a different idea to stop the deadly scourge: letting people use drugs freely, but under supervision. (Katelyn Newman, 4/3)

The Labor Department is set to issue a new rule that will lower health care costs and increase choices for millions of American small businesses, which have been among the hardest hit by rising health care costs including those caused by Obamacare. Following an executive order last fall from President Trump, the department will expand what are known as association health plans (AHPs) in the coming weeks. These plans allow small businesses to band together to purchase health insurance in bulk, lowering prices and mitigating risk. (Alfredo Ortiz and Thomas Price, 4/4)

Recently, there has been a shift away from calling e-cigarettes “e-cigs.” In public health circles, people now tend to call them by what they do: deliver nicotine to the inhaler. Thus, the term Electronic Nicotine Delivery Systems, ENDS for short, has come into vogue. But I have a problem with that name. Nicotine isn’t the only thing e-cigs deliver; they also deliver formaldehyde, a carcinogen. It seems equally fair to call them Electronic Formaldehyde Delivery Systems. (Joseph G Allen, 4/4)

The Iowa Legislature is regularly a dysfunctional, polarized disappointment. But every once in a while lawmakers listen to experts, pay attention to public opinion and do something right. This legislative session that something is House File 2456, signed last week by Gov. Kim Reynolds. The new law is intended to fill gaps in Iowa’s mental health system. Among its most significant provisions is directing the development of six access centers in the state. A December report from a work group of mental health stakeholders provides an example of how such centers can help make a difference for Iowans. (4/4)

The NIH is accepting public comment until June 12, and it will issue its recommendations this December. The time is right for thoughtful reform. We urge federal decision-makers and the research community not to let legitimate and important concerns about administrative burdens obscure the crucial role that regulations can play in promoting the ethical and humane use of lab research animals. (Elisa A. Hurley, 4/4)

Surveys of graduating medical students in the United States annually document intimidation and harassment of student learners, often on the basis of sex, ethnicity, race, or gender identity, reflecting US culture as a whole but also the historical hierarchical, competitive culture of US medical schools. Of 14,405 US medical school doctor of medicine graduates in 2017 who answered the specific questions on the Association of American Medical Colleges 2017 graduate questionnaire, 33% reported personally experiencing sexist, racist, or other offensive comments; lower grades; or denial of training or awards based on sex, gender identity, sexual orientation, race, or ethnicity. (Karen Antman, 4/2)

It is telling that TIME Magazine’s Person of the Year honor was shared by “the silence breakers,” 61 women and men, from familiar actors to ordinary people, who came forward to report sexual assault and harassment, mostly in the workplace. Their stories are powerful and, sadly, not at all unfamiliar. From the perspective of a female surgeon, one of the first female chairs of surgery, and now as one of a handful of female medical center chief executive officers and medical school deans, it appears that US society is on the cusp of a change in addressing sexual harassment and abuse. (Julie A. Freischlag, 4/2)