Gene Editing Is Revolutionizing Medicine but Causing a Government Ethics Nightmare

Reports emerging in late July indicate that a team of researchers, led by Shoukhrat Mitalipov, at Oregon Health and Science University successfully altered the genetic makeup of a human embryo, marking the first known occurrence of intentional human embryo gene editing in U.S history. The team employed a technology called CRISPR, an experimental technique that allows practitioners to alter DNA by transfecting an embryo with cells containing cut and repair enzymes. Though CRISPR technology has a long and complex history, its use in altering human embryos only began in 2015, with research primarily taking place in China, where scientists have been experimenting with curative interventions for rare blood disorders and cancer.

A variety of factors account for the slow development of CRISPR studies in the US. Both Congress and the NIH have expressed unwillingness to support human-gene editing research. Additionally, the scientific community is not well poised to resolve the ethical dilemmas inherent in this endeavor, evidenced by the dearth of clearly articulated guidelines circumscribing the parameters of human embryonic research. Find out more in the full article here!

We Are What We Eat: The Importance of Nutrition in Medical Education

As busy medical students, there is never enough time to accomplish everything we set out to do in a day. We look for ways squeeze every possible minute out of our daily routine. Usually, one of the first things to go is home cooked meals. Raise your hand if you like Chipotle? I know I do. Our patients are not so different from us. Many people have full time jobs and families that can be all consuming, leaving little time to cook healthy meals. In an article published by NPR, and as discussed in All Things Considered, the lack of dietary education in the medical school curriculum is examined. According to the article, only a quarter of medical schools offer the recommended 25 hours of nutrition training to students. Students at the University of Chicago Medical School have taken it upon themselves to enroll in a culinary nutrition class, where they learn to cook healthy yet simple and gustatorily pleasing meals. By learning how to prepare healthy meals, students can better advise patients on how to prepare meals conducive to their health. At Tulane, medical students are even required to take these classes! A 2013 article published in JAMA ranks eating habits as the single most important factor contributing to premature death and disease. If eating habits are so important to health, it seems that medical schools should be spending more time teaching medical students about nutrition. What better way to do it than learning how to cook healthy meals for ourselves!

The Role of Social Media in Medicine

Tweets, posts, blogs, snaps. Social media is pervasive in today’s culture, and medicine is no exception. Common uses of social media by physicians include connecting with patients, growing a professional network, and disseminating information. What do you think the role of social media in healthcare is?

There are a multitude of beneficial applications for social media in healthcare, however there are also some significant concerns including issues of privacy, professionalism, and maintaining the integrity of the doctor-patient relationship.

One such issue is documented in a recent study that looked at social media use among physicians from a different perspective: Are physicians who use social media skewed by payments from pharmaceutical companies? The study team found that 72% of hematologist-oncologists who were active on Twitter also received payments from drug companies. Despite the limitations this study, it questions whether physicians should be required to report conflicts of interest when using social media. 

Do you think physicians using social media should be required to disclose conflicts of interest? How do you think physician use of social media should be regulated? How do you use social media and what are the impacts (both good and bad)?

Uniquely Devastating Genital Injuries Among Troops

When we think of the lasting effects war has on our troops, psychological sequelae such as PTSD and major trauma like the loss of limbs frequently come to mind. A recent study has shed light on how war can impact fertility and sexual health in our service members. 1,367 troops had injuries to their genitals during the Iraq and Afghanistan war from 2001 to 2013, with 94% of the victims being 35 or younger. As a result, many have lost the ability to parent and raise a child of their own. Programs and novel forms of treatment are underway to help those affected. To date, only one penis transplant has been successfully performed, but there are currently a few troops on a transplant waiting list. For those who are no longer able to produce sperm, options are limited. Sperm donor programs are currently not a covered benefit for service members. However, the Pentagon recently started a pilot program for sperm and egg freezing to give young service members peace of mind, an increasingly popular practice among career driven women. Another solution is to collect sperm from soldiers immediately after being injured in the field, as is protocol for British military surgeons.

Article: Study Maps ‘Uniquely Devastating’ Genital Injuries Among Troops

Carrie Fisher, Advocate for ‘Bipolar Pride’

After the death of Carrie Fisher in December, many mourned the loss of the woman famed for bringing the character of Princess Leia to life in the “Star Wars” franchise. Beyond her acting career, however, Fisher also spent her life speaking openly about her own mental health issues, working to remove the stigma both from drug addiction (see her semi-autobiographical 1987 novel Postcards from the Edge, later adapted into a movie) and bipolar disorder. Fisher, who was diagnosed with the disorder at age 24, spoke often and openly about her struggles and inspired others to do the same, praising those who coped with such an illness and encouraging them to do so without shame.

Article: Carrie Fisher Put Pen and Voice in Service of Bipolar Pride

Ebola Vaccine Developed

Last week, a study published in the Lancet demonstrated that a new vaccine against the Ebola virus is incredibly effective (100% in study participants, in fact). Ebola virus, although frequently fatal, caused outbreaks only rarely until 2014, when multiple countries in West Africa experienced an epidemic of the disease, setting off international panic. These recent outbreaks fueled accelerated research to create an effective vaccine, which was tested in Guinea starting in 2015 (with initially promising results). The vaccine, now confirmed to be effective, was developed in Canada and is being fast-tracked to market in the U.S.

Article: Ebola Vaccine Gives 100% Protection, Study Finds

How Doctors Could Thwart Health-Care Reform

As physicians in training, we conceive of ourselves in many ways - as future healthcare professionals, community members, and agents of social change.  When you think about your future as a doctor, do you think of your role as a political entity as well?

This article from the New Yorker examines the political influence of physicians and the American Medical Association on healthcare reform.  Following the appointment of Dr. Tom Price as the incoming Secretary of Health and Human Services, James Surowlecki argues that doctors have resisted healthcare reforms whenever their autonomy or financial interests are at stake.  Before the election, many news outlets reported patients' frustrations with doctors who would not accept their ACA-affiliated plans.  Many are wondering what changes will come to our country's healthcare programs, although some in the healthcare industry are optimistic that a complete overhaul is not in order.  

What role do you think that physicians should play in healthcare reform?  Ultimately, what impact will it have on our patients?

Read more about the details of the new act to form your own opinion!

21st Century Cures Act Signed into Law

On Tuesday, President Barack Obama signed the $6.3 billion 21st Century Cures Act into law. This bipartisan effort is designed to accelerate approval of new drugs, invest in medical research, support the fight against the opioid abuse epidemic, and expand mental healthcare. Ultimately, supporters of this act state its purpose is to address significant health challenges facing us today. Meanwhile, critics of the bill argue that it does not increase funding enough to legitimately tackle these difficult health challenges and provides pharmaceutical companies a way to fast-track more marginally effective, overpriced drugs and devices to market. 

 Read more about the details of the new act to form your own opinion!