(Los Angeles Times) – In an opioid epidemic that currently claims an average of 91 lives per day, there have been many paths to addiction. For some, it started with a fall or a sports injury, a trip to a nearby emergency room and a prescription for a narcotic pain reliever that seemed to work well in the ER. New research underscores how tragically risky — and unnecessary — such prescribing choices have been. In a new study of patients who showed up to an emergency department with acute pain in their shoulders, arms, hips or legs, researchers found that a cocktail of two non-addictive, over-the-counter drugs relieved pain just as well as — and maybe just a little better than — a trio of opioid pain medications widely prescribed under such circumstances.
(New York Times) – Yet there are no widely accepted guidelines for dealing with these patients as they near death. Cancer specialists regularly move their patients to hospice at the end of life, for instance, but few cardiologists even think of it. Heart patients account for just 15 percent of hospice deaths, while cancer patients make up half, according to a recent study. That paper, published in the Journal of the American College of Cardiology, reviewed a number of ways in which heart patients are let down at the end of life. Implanted defibrillators often remain activated until the very end, for example, even for those in hospice.
Tokyo: Artificial Intelligence ‘Boy’ Shibuya Mirai Becomes World’s First AI Bot To Be Granted Residency
(Newsweek) – A chatbot programmed to be a seven-year-old boy has become the first AI bot to be granted official residence in Tokyo, Japan. Shibuya Mirai is the latest resident of Shibuya, a Tokyo ward with a population of around 224,000 people, despite only existing as a chatbot on the Line messaging app. The ward’s decision to make Mirai—meaning ‘future’ in Japanese—an official resident is part of a project aimed at making the local government more familiar and accessible to locals. The chatty seven-year-old is designed to listen to the opinions of Shibuya residents.
(Politico) – Patrick Soon-Shiong, the medical entrepreneur who has expanded his influence in Washington by cultivating close ties to both parties, has struggled to meet analysts’ expectations for sales of his GPS genetic test, the key to his plan to transform cancer treatment by matching patients with tailored drug treatments. At the same time, sales of the GPS test are being boosted by purchases from hospitals and clinics associated with doctors who have financial ties to his network of for-profit and non-profit companies.
(BMJ) – Of 33 DCNM, [due care not met], cases identified (occurring 2012–2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS [euthanasia and physician-assisted suicide]) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or ‘tired of life’, in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE’s focus was procedural.
(Sacramento Bee) – Medical treatments for transgender people have gone “mainstream,” according to Richard Paulson, an obstetrician-gynecologist in Los Angeles and the president of the American Society for Reproductive Medicine. With that comes the prospect for a medical development that could shatter some of the most strongly-held beliefs for centuries about biological sex and the ability to conceive a child. In short, some scientists believe that transgender women — those who were assigned male at birth — could soon give birth.
(The Scientist) – The Expert Group on Scientific Misconduct at Sweden’s Central Ethics Review Board (CEPN) has found evidence of scientific misconduct in all six of Paolo Macchiarini’s synthetic trachea transplantation publications it reviewed. The papers reported on the implantations of three patients with artificial tracheae—all of whom died.
(Medscape) – History tells us that fears about designer babies are exaggerated when it comes to the alteration, deletion, or swapping of genes in human embryos, renowned bioethicist Alta Charo, PhD, said during a TEDMED 2017 talk in Palm Springs, California. “In fact, we’ve now had 50 years of responsible and useful advances in genetic screening, genetic testing and, most recently, genetic treatment,” said Dr Charo, who is professor of law and bioethics at the University of Wisconsin in Madison and a member of the National Academies’ Human Gene Editing Initiative.
(Undark) – Harvard medical geneticist Robert C. Green, reflective, cautious, and as decent as a scientist can sound, took to television last month to make people aware of an open trial at the Brigham and Women’s Hospital, which uses genomic sequencing to screen for variants that can predict 1,800 genetic conditions in newborns. The cutting-edge study foreshadows what genetic science might bestow to human health, but the more interesting takeaway is that the failure of the study to connect with the public — very few are enrolling — may signify a deepening distrust of biotech.
(NPR) – People who abhor the thought of being kept alive with feeding tubes or other types of artificial nutrition and hydration have, for years, had a way out: They could officially document their wishes to halt such interventions using advance directives. Even patients diagnosed with progressive dementia who are able to record crucial end-of-life decisions before the disease robs them of their mental capacity could write advance directives. But caregivers and courts have rarely honored patients’ wishes to refuse food and fluids offered by hand.
(U.S. News & World Report) – More than half of U.S. physicians have at least one symptom of professional burnout, Shanafelt said, and the problem is getting worse. “We are seeing increasing rates of distress,” he said, and that equates to decreased quality of care for the patient – burnout correlates with mortality rates. There are implications for the health care professional, too, such as increased odds of substance abuse, suicide and leaving the profession.