Tag: medicine

Contributor Post Created with Sketch. Where Affordable, Altruistic Healthcare Goes to Die

 

As conservatives, we’re never surprised by news that Obamacare hasn’t fixed the nightmares facing the typical American confronted with medical bills. Nor are we surprised when Obamacare only makes them worse. A few years ago, Jim Epstein at Reason predicted the demise of health-sharing ministries at the hands of Obamacare’s subsidized exchanges. The good news is that Epstein was wrong: Membership in health-sharing ministries has only grown as frustration with commercial prepaid plans under the Affordable Care Act continues to mount. According to the New York Times,

[M]embership in sharing ministries has more than doubled over the last six years, to 535,000 from about 200,000, according to the Alliance of Health Care Sharing Ministries.

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Contributor Post Created with Sketch. Recommended by Ricochet Members Created with Sketch. Thoughts on Tiamat this Electoral Eve

 

The maples, wicks of autumn, go to cinder from the top down, the blaze on most trees past its prime, now mostly scattered at our feet. The plant kingdom burns brightly as it plunges into wintry darkness. A plunge into some outcome or another awaits us tomorrow, too. We can estimate what it might be – and we should. But as Ricochet Member @rodin reminds us, “none of us will ever know (or at least [not] for a long long time) whether the way we cast our ballot was better than the alternative.”

All this fall, I’ve had an unknown greater than the outcome of this election hanging over my head – or at least greater to me. One reason it’s greater is that I’m more responsible for it. However I vote, whatever I say, the outcome of this election is largely out of my hands. This other thing, though, is very much in my hands, or it’s supposed to be, and so the moral weight I bear for its unknown nature is far greater than the weight I bear for my vote.

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As a chronic melancholic I measure my age by the rate of my physical decline. It’s not because I’m completely falling apart, although that’s the case for all of us. I recognize, however, that man is dust and to dust he shall return. We melacholics are realists. Over the last nine months I’ve spent most […]

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It was big national news when federal regulators working for Obama went beyond the written law passed by Congress to insist on having Catholic universities and charities provide birth control coverage. Ditto for the requirement that Protestants who’d happened to incorporate cover abortifacient birth control drugs. Ditto for the requirement that public schools join the […]

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Contributor Post Created with Sketch. The Doctors, and Other Great Journalism

 

Screen Shot 2016-08-12 at 14.58.49Looking for summer reading? Conor Friedersdorf has published links to 100 great pieces of long-form journalism at The Atlantic. I haven’t read them all, but every one I’ve read so far has been terrific. (Don’t click on that link if you thought you’d get something useful done today. You’re welcome.)

I found two pieces especially riveting. The first, by Henry Marsh, a British neurosurgeon, is called The Aneurysm:

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Promoted from the Ricochet Member Feed by Editors Created with Sketch. Nicotine as Miracle Drug

 

leovapeDr. Anna Fels recently saw a patient who had an interesting method of self-medication. The psychiatrist wrote up the experience in the New York Times:

We talked for a long time about why she had come to see me. Then, as is my practice with a new patient, I asked what, if any, psychiatric medications and nonprescription, psychoactive substances — legal or illegal — she had used. Her answer was a new one for me. She stated that she chewed approximately 40 pieces of nicotine gum per day and had done so for well over a decade.

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Contributor Post Created with Sketch. The Other Drug War

 

Earlier this month, the Food and Drug Administration rejected the application of Biomarin Pharmaceutical to market its drug Kyndrisa™ (drisapersen) for use in the treatment of Duchenne muscular dystrophy. The FDA, as is often the case when it rejects a drug application, listed all sorts of technical reasons why the data presented was not sufficient to establish by respectable scientific means that the drug in question was safe and effective in its intended use. Without question, much evidence from the clinical trials revealed serious complications from the drug’s use, including blood-platelet shortages that were potentially fatal, kidney damage, and severe injection-site reactions. But the no-treatment alternative could prove far worse.

Duchenne is a rare but fatal genetic disorder that attacks only young boys, roughly 1 in 3,500 to 5,000. Typically, it first manifests itself between two and five years of age. With time, it relentlessly weakens the skeletal muscles that control movement in the arms, legs, and trunk. Most of its victims are wheelchair-bound between the ages of seven and 13. By 20, many have died.

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Contributor Post Created with Sketch. Unintended Consequences: Docs & Glocks Edition

 

shutterstock_151057025Several years ago, the American Medical Association instituted a new policy of recommending that doctors enquire about their patients’ firearms. This was pitched as a matter of household and child safety and — while the policy stressed “education” — its language makes it pretty clear that this is not something Eddie Eagle would endorse. Despite not having kids, I’ve been asked about my guns at least twice at the doctor’s. The first time, I wasn’t expecting it and simply answered the nice nurse’s question. The second time, I said something to the effect of, “Thank you, but I don’t think that’s a medical question.” The nurse shrugged and the appointment proceeded as before.

Unsurprisingly, stories soon emerged about doctors dropping patients who refused to answer the question, as well as others who (chillingly) tried to talk to children about it behind their parents’ backs. In response, several states, including Florida, passed legislation that forbade doctors and other medical professionals to bring up the subject of guns under most circumstances.

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Contributor Post Created with Sketch. The Uneasy Legacy of Henrietta Lacks

 

henrietta-lacksRecently, Rebecca Skloot, author of the major best-seller The Immortal Life of Henrietta Lacks, wrote an impassioned plea in the New York Times, urging people to support sweeping revisions to the Federal Policy for the Protection of Human Subjects, which is now under active review in the Department of Health and Human Services. These revisions are directed to the rules that now govern the collection and use of “clinical biospecimens,” which include all the organic substances that are routinely removed from the human body as a consequence of surgery, childbirth, or even normal testing. At first appearance, these materials look like waste products best disposed of in a safe and sanitary manner. But, in fact, they are invaluable in medical research to treat cancer and a host of other genetic and life-threatening diseases.

Without question, the most dramatic illustration of this process involves the so-called HeLa cell line derived from the cancer cells of Henrietta Lacks, an African American tobacco farmer who died of cancer in 1951 at the age of 31. When she was treated at Johns Hopkins Medical Center, her cancer cells were given to the pathologist Dr. George Gey. Gey found to his amazement that, unlike other cancer cells, Lack’s cells were immortal in that they could be cultured and reproduced indefinitely. Within three years of her death, her cell line helped develop the Salk polio vaccine. In the 65 years since Lacks died, about 20 tons of her cell line have been reproduced and distributed worldwide for medical research.

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Promoted from the Ricochet Member Feed by Editors Created with Sketch. Make the Argument

 

shutterstock_210347026Most people in the country are at their limit, emotionally. It can be seen in the comments section here at Ricochet, on TV news, on campuses, and even among friends and family. The emotions include anger, fear, disgust, distrust, and doubt. These aren’t exactly the best emotions for this time of year. The Christmas season is supposed to be a time of hope and expectation, so I’d like to share a recent experience that buoys my spirit.

I’m in graduate school in DC receiving a Masters Degree in Physiology before beginning medical school next year. Occasionally, we will have speakers who discuss relevant issues in medicine, followed by small group discussions. During a discussion of end-of-life care, one student in my group of 20 made an argument in favor of physician-assisted suicide. He said that he would happily assist a patient end his own life, if he wanted to end it. The room fell silent and awkward silences make me uncomfortable, so I decided to offer a retort.

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Contributor Post Created with Sketch. Pain Demands An Explanation

 

shutterstock_314240933There are two truths about pain that every good conservative believes. First, pain is the most straightforward incentive; people need pain to correct their behavior. Second, we believe in “no pain, no gain;” i.e., that pain is a necessary sacrifice in the pursuit of accomplishment. In either case, pain is useful. At least, that is our moral ideal of pain and how it ought to act to fulfill its purpose.

That pain, whether of the body or the psyche, serves a useful purpose is easy enough to see. We need only consider what happens when it’s absent. Lepers and CIPA patients become horribly disfigured because they can’t feel pain. Lepers lose sensation in their extremities. CIPA patients cannot feel pain at all. They only avoid injury and disfigurement through a tedious process of consciously checking themselves, which is much less effective than simply feeling pain. Similarly, mania and psychopathy both reduce a person’s capacity to feel the psychic pains — shame, remorse, etc. — that keep us on the straight and narrow, and both mental states are quite sensibly regarded as dangerous.

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Contributor Post Created with Sketch. Nearing a Sunset on Monsters

 

shutterstock_200494427Some months back, I wrote about how the Guinea worm — a vile and disgusting parasite that used to infect millions in Sub-Saharan Africa — is now on the brink of extinction. There is more good news on the war against two similar parasites. First, and amazingly when you consider just how recently we were powerless against it, polio appears to also be on the verge of eradication. Second, and though we’ve a very long way to go yet, we’re making significant headway against malaria. It’s entirely possible that both of these scourges could follow smallpox into the history books within our lifetimes; with polio, perhaps within the next decade or so.

It’s difficult to overstate how significant the progress has been, especially in Africa, or how heavy the human cost these diseases have wrought. As recently as the year 2000, malaria killed about 850,000 annually; it’s about half that number now. Polio infected about 350,000 in 1988; it was down to a few hundred cases earlier this decade and it’s in the low dozens now, restricted to three countries (Nigeria, Pakistan, and Afghanistan). When you consider the human costs endured by so many people for so long, it’s little wonder why some places have struggled to develop.

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Contributor Post Created with Sketch. Denying The Last Gamble

 

IMG_0660Public policy, like life, is always a matter of trade-offs. The difficulty often arises not so much in determining what is good and what is bad, but in comparing goods’ value to each other, especially when they come into conflict. Further complicating matters, this weighing of risk varies for any given individual depending on his situation: under some circumstances, risks that would be otherwise unthinkable may well be prudent and wise. And the only thing more difficult than anticipating changed circumstances is accurately forecasting people’s reaction to them.

This complexity — or, more specifically, the inherent difficulties in understanding this complexity — is one of the best arguments against Progressivism: no one is smart enough to be a philosopher king and attempts to approximate one through law and regulation are doubly doomed to failure. Leaving people to make their own choices and evaluate their own risks not only wins on its philosophical appeal to liberty (no small thing that), but also on terms of pure pragmatism.

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Promoted from the Ricochet Member Feed by Editors Created with Sketch. Why Suicide Shouldn’t Be a Choice

 
Brittany
Brittany Maynard — the face of the assisted suicide campaign

Here in California, SB128 has made it out of the Senate and is heading to the Assembly for debate and a vote. SB128 is a bill to make doctor-assisted suicide legal in California.

When people think about this issue, the scenario that comes up always is that of terminally ill patients who want to end their pain and suffering. You can find support for this position even among Republicans who are older and/or libertarian. The coalition opposed to the measure is constantly struggling to point out that assisted suicide on the basis of personal choice is an argument for suicide-on-demand. You can look at this piece to see the abuse taking place in Belgium, but it also happens here, where miscommunication between doctors leads to one endorsing suicide and another suggesting further treatment.

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Member Post

 

Question for the migraine sufferers: For those who get histamine / allergen migraines (be they from cheese, red wine, etc.) do any antihistamines work to stave off or mitigate the effects? Was at my in laws this evening, was given a slice of gluten free cheesecake, only upon leaving an hour later did I enquire […]

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Promoted from the Ricochet Member Feed by Editors Created with Sketch. How Can You Not Know This?

 

shutterstock_172810082I have a peculiar area of expertise: I know a lot about death. Well, more precisely, I know more than the average person about bereavement, especially sudden, violent bereavement. I have come by this through my own losses, dedicated study, and, especially, through nearly 15 years of experience as a law enforcement chaplain. Law enforcement officers often have the sad duty of performing what is known as “death notification,” and it is one they gladly hand off to the chaplain whenever possible. It is one of the subjects I teach at our academy.

A few years ago, I began to receive invitations from members of the medical profession who wished to learn more about death notification. The first time the state’s chapter of the American Academy of Surgeons asked me to address their meeting, I was puzzled. After all, these were doctors: highly educated professionals that must regularly (if reluctantly) come face-to-face with death. “Don’t you know more about this than I do?” I asked.

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Member Post

 

I visited my doctor a couple of weeks ago. I’m one of those lucky persons who has weight issues because I’m pre-diabetic, not the usual issue of weight gain leading to diabetes (heredity can be a curse). Anyway I mostly control it through keeping carbs low (most of the time), and trying to get exercise […]

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Member Post

 

I don’t want to distract from Tom Meyers’ contraception thread by asking this question there, as it’s only peripherally related. It’s a simple question, but I suspect that the answer is not so simple. Even now, decades after “the pill” became a normal regimen for young women whether they are sexually active or not, do […]

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Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital malformation that occurs in about one in every 4,500 girls. The Müllerian duct fails to develop and they are born without a vagina or uterus (warning: graphic medical image). They are, however, born with functioning ovaries and therefore develop typical secondary sex characteristics and can have children, although through surrogates. […]

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