"Consequently, it is very possible that millions of people in California will be left without insurance after just recently becoming covered."
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"The direct physiological effects of obesity are well documented, but what often gets swept under the rug is the indirect sociological effects that obese patients face in a clinical setting."
"However, a recent study suggests that drinking beer and exercising are positively correlated."
Millions of Americans suffer from life-threatening allergies, whether the antigen are peanuts, shellfish, or latex. The one line of defense these people possess in the instance that they suffer from an anaphylactic attack is the epinephrine auto-injector. Epinephrine, also known as adrenaline, acts as a bronchodilator and vasoconstrictor, effectively opening a patient’s airway and allowing adequate blood flow to the heart and lungs by diverting it from the extremities. There is no other medicine that has these same effects. It is becoming more and more difficult for Americans to procure this pharmaceutical because of its ever-increasing price. This has become such a concern that one individual opted not to use her EpiPen during an allergic reaction because of the cost to replace it.
Mylan, the company that produces the ubiquitous EpiPen, owns about 90% of the $1.3 billion U.S. auto-injector market and has increased its price of an EpiPen by 450% since 2004 (Iozzo). In 2004, the price of an EpiPen was $150, but has since skyrocketed to over $600. That cost reflects one dosage, but Mylan only sells EpiPens in packages of two. The pharmaceutical giant argues that a backup auto-injector is necessary in case the first one malfunctions. Therefore, buying this life-saving medicine costs consumers about $1,200. The actual epinephrine only costs Mylan one dollar to produce; the astronomical price of the product is mainly due to the company’s proprietary pen injector. Only recently, after much public pressure, has Mylan offered a discounted price on their EpiPen. However, even with this discount the product still costs well over $1,000. As a result, many consumers have attempted other ways to treat their allergies. An alternative company named Adrenaclick has emerged in the auto-injector market with a much cheaper product, selling for $142. While this product is much more affordable, doctors are hesitant to recommend it because the steps to use this new product are drastically different from those of the EpiPen (Cha). Since the EpiPen has monopolized the market, using a different product with different injection procedures will take time and practice. Doctors do not want individuals taking time during an emergency to stop and read the directions on how to use this relatively new product. Additionally, individuals have begun to create their own concoctions of epinephrine and use that in place of an EpiPen. This latter trend greatly worries legislators, particularly Iowa Senator Charles E. Grassley: “I am concerned that the substantial price increase could limit access to a much-needed medication. It could also create an unsafe situation as people untrained in medical procedures are incentivized to make their own kits”. The alternatives to using EpiPens are not very well established, so many consumers are forced to pay the exorbitant amount to use Mylan’s product. Those who cannot afford an EpiPen are turning to very drastic and radical measures to protect themselves in case they suffer an allergic reaction.
Alyssa Rosenberg has suffered from a severe tree-nut allergy since she was a toddler. Because of this diagnosis, she has needed an EpiPen for practically her entire life. Alyssa has lived a very functional and fulfilling life, as many allergy-sufferers do. However, last spring she had to make a decision after unknowingly eating kale chips that were seasoned with cashew dust. She reasoned that she would not have to go to the hospital, so rather than using her EpiPen she made herself vomit. Rosenberg went on to say that her health insurance plan is very expansive and that she rarely has allergic attacks. The attack she had last spring was the first one she had had in about ten years. Even though all of this is true, she still believed that not using her EpiPen was the best thing to do when she had an allergic reaction. There are many individuals in the United States who have very poor health insurance programs and use their EpiPens several times a year. The cost of replacing EpiPens to them is most daunting, and must be mitigated so that people do not have to think twice about using their EpiPen in the appropriate situation.
Epinephrine injection is the only way to treat anaphylactic shock in a patient, and the EpiPen is the only credible product available to people suffering from anaphylaxis. Mylan has consistently raised the price of their EpiPen over the past twelve years, which has greatly reduced individuals’ ability to purchase the device. This inability to access an EpiPen has lead people to make radical and potentially-dangerous decisions about treating their allergic reactions.
References:
Cha, A. E. (2016). U.S. lawmakers demand investigation of $100 price hike of lifesaving EpiPens. The Washington Post. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2016/08/23/u-s-lawmakers-demand-investigation-of-100-price-hike-of-life-saving-epipens/?tid=a_inl.
Iozzio, C. (2015). How one startup plans to end the EpiPen monopoly. Fortune. Retrieved from http://fortune.com/2015/07/21/epipen-alternative-medicine/.
Rosenberg, A. (2016). EpiPens are my armor against disaster. They shouldn’t be priced like a luxury. The Washington Post. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2016/08/25/epipens-are-my-armor-against-disaster-they-shouldnt-be-priced-like-a-luxur
Olympians amaze and astound people across the globe with their unmatched athleticism, agility, and stamina. Olympians perform such jaw-dropping feats that oftentimes people question whether they are human. However, they are every bit as human as you and me. Olympian Marieke Vervoot exemplifies this idea, for she currently faces the same challenge that thousands of individuals across the world face: ending one’s own life via euthanasia. Vervoot won gold in the 100-meter wheelchair sprint in 2012 and has recently competed in her final Paralympic Games in Rio de Janeiro. Citing that competing is her main passion in life, she has now requested to be euthanized. Many view her desire as inhumane and barbaric. While those people certainly have a valid argument, one must consider many different aspects of the individual’s life and evaluate the patient’s claim before dismissing it as unethical.
Belgium has the most liberal euthanasia laws in the world. The practice was legalized for adults in 2003, a year in which 235 people were euthanized. In 2013, there were 1,816 cases of euthanasia and currently about 1 in 20 Belgian deaths are assisted suicides (Carle). In 2014, Belgium became the first country in the world to legalize euthanasia of children (with parents’ consent). In order to be eligible for euthanasia, a patient must exhibit chronic, debilitating, and incurable physical or mental pain. Most patients seeking euthanasia are diagnosed with terminal cancer, but people with psychological disorders and autism have also been euthanized. Belgium’s cultural acceptance of euthanasia and the policies created as a result of this mindset have allowed people like Vervoot to pursue a more dignified and peaceful way to end their lives.
Marieke suffers from a degenerative disease that has impaired her vision and causes her great pain everyday. Her lone salvation is competing, saying, “sport is my only reason for living” (Cook). That is one thing her condition has not taken away from her: the ability to compete at a very high level. After these Olympics, Vervoot says that she will have nothing to live for, which is the primary reason she seeks to end her life. Dr. Wim Distelmans, a Belgian doctor on the vanguard of euthanasia, argues that the Vervoot’s prospect of being euthanized has actually extended her life. He explains, “The certainty that there is an emergency brake to stop the intolerable pain gives one peace. This mindset can extend one’s life”. Distelmans argues that euthanasia can bring clarity to someone whose life has been characterized by uncertainty and fear. By knowing that she is able to die on her own terms, Vervoot will be able to focus on all the positive aspects of her life rather than obsess over all of her interminable pain. As a result, she might find something so worthwhile, like competing, that will give her the motivation to live even longer.
Dr. Ezekiel Emanuel led a study about patients’ feelings towards euthanasia and whether they would seriously consider it for themselves. His study found that those seriously considering euthanasia had the following common characteristics: depressive symptoms, substantial caregiving needs, and pain. Why is it ethical for a judge to force these people to feel such anguish every day for the rest of their lives? This question becomes especially pertinent when the patient has a neurodegenerative disorder, such as amyotrophic lateral sclerosis (ALS). Is it not better for people to die on their own terms, rather than dependent on a machine to keep them living for an extra year or two? For some patients, euthanasia provides a more dignified and humane way to die.
There are millions of smart and talented individuals across the globe whose end-of-life experiences are plagued with machines breathing, eating, and speaking for them. After evaluating the costs of dying and the benefits of living, doctors, judges, and legislators must realize that sometimes it is ethical to die as a functioning human being rather than live with perpetual pain.
References:
Carle, Robert. “Give me Liberty and Give me Death: Belgium’s Brave new Euthanasia Regime”. The
Witherspoon Institute: Public Discourse. Accessed 22 August 2016.
<http://www.thepublicdiscourse.com/2015/09/15355/>.
Cook, Michael. “Gold medalist paralympian from Belgium seeks
euthanasia”. Bioedge: bioethics news from around the world.
Accessed 19 August 2016. <http://www.bioedge.org/bioethics/gold-medallist-
paralympian-from-belgian-seeks-euthanasia/11956>.
“Current Law Regarding Euthanasia in Belgium”. Patients Rights Council. Accessed 22 August 2016.
<http://www.patientsrightscouncil.org/site/belgium/>.
Emanuel, EJ, et. al. “Attitudes and Desires Related to Euthanasia and Physician-Assisted
Suicide among Terminally Ill patients and their Caregivers”. JAMA. Accessed 19
August 2016.
The zika virus is currently of paramount concern to many health care officials in the United States, as there have been 29 cases of zika originating in the U.S. in the past several months (CDC). One area that has been particularly afflicted with the virus is southern Florida. As new cases emerge in Miami Beach, biotechnology companies have begun to propose that surrounding areas adopt a novel, yet preventative approach to fighting the zika virus. These companies argue that current methods to tackle zika are ineffective, but there are uncertainties regarding this new proposed method.
Zika can be transmitted multiple ways, but the most common is by mosquito bites. Other ways the virus can infect people are through intercourse, blood transfusions, and from a mother to fetus. The primary demographic that should be concerned about zika is pregnant women. Many adults rarely get sick enough from zika to go to the hospital and almost never die from the disease. However, the pathogen does pose a real threat to pregnant women because of the birth defects that it can cause. The main birth defect associated with zika is microcephaly, a condition in which a newborn’s head is smaller than normal. This abnormal shape is due to the brain’s insufficient growth either during pregnancy or after birth (CDC). The severity of microcephaly varies case by case, where the more severe instances of the condition can lead to many different learning disabilities and health conditions. Some of these include propensity to have seizures, intellectual disability, hearing loss, and vision loss. These negative effects of the virus are so pressing that public service workers in the Miami area are working overtime to ensure that all mosquitoes have been eradicated from the city streets.
Last Thursday there were reports that two new cases of zika had been diagnosed in Miami Beach. Public works crews are working around the clock to ensure that the tourism capital of southern Florida is completely without zika-carrying mosquitoes. They are using two different strategies to eradicate the disease, and are encouraging all residents of the Miami Beach area to do the same: drain and cover. Sanitation workers are working with pressure washers at temperatures of 250 degrees Fahrenheit to force all stagnant water into the sewer system while simultaneously killing any bacteria living in the water. Additionally, public health officials are urging residents drain any standing irrigation or rain water that can collect in trash cans, pool covers, gutters, etc. (Flechas). Mosquitoes need standing water to lay their eggs, but not a lot of it; mosquito larvae can hatch in as little as a teaspoon of water. This fact is the reason that eliminating all standing water in the area is of the utmost importance. The other approach that Miami workers are using to combat Zika is to cover any isolated areas where the virus may be. Workers are vacuuming up debris where mosquitoes may lay their eggs are throwing larvicide pellets into storm-water drains. They also are requiring homeowners to cover up their doors, windows, porches, and patios with screens. People are also encouraged to wear clothing that does not expose their skin to potential mosquito bites. These are the current measures the Florida Department of Health is taking to protect its people from zika. There are certain biotechnology companies that are proposing more innovative measures to prevent this virus from spreading to other adjacent areas of the state.
Oxitec is a company that has genetically engineered mosquitoes designed to kill other ones carrying the zika virus. These synthetic mosquitos would mate with wild female ones and their offspring would die before adulthood. On August 5th, the Federal Drug Administration approved test trials of this new technology in the Florida Keys as a preventative measure. No cases of the zika virus have been reported in the Florida Keys at this time. Hadyn Perry, the CEO of Oxitec, advocates for the use of this technology to combat zika and cites its previous success. This same technology was employed in 2010 when there was a dengue outbreak in the Florida Keys, and it killed about 40% more mosquitos than the methods previously described. However, there had been opposition from local residents to use this technology, primarily because there is no current problem with zika in the Florida Keys and that there may be unpredictable side effects of this new technology (Allen). As such, this technology has not been used to date in the fight against zika, but its potential life-saving effects are very promising.
The zika virus is garnering all the attention among major healthcare officials in the United States, and for good reason. Its harmful effects on infant babies are very concerning, and must be dealt with. As such, Miami health officials have adopted a multi-faceted approach to battle the virus. However, more radical measures to fight this pathogen are on the horizon.
References:
Allen, Greg. “Florida Keys Opposition Stalls Tests of Genetically Altered Mosquitos”.
NPR Shots: Health News from NPR. August 17, 2016. Accessed August 26, 2016.
< http://www.npr.org/sections/health-shots/2016/08/17/490313999/opposition-in-
florida-puts-tests-of-genetically-altered-mosquitoes-on-hold>.
CDC. “Overview: How Zika Spreads”. Center for Disease Control and Prevention.
Accessed August 26, 2016. < http://www.cdc.gov/zika/about/overview.html>.
Flechas, Joey. “Miami Beach workers Sweep City for Zika Breeding Grounds”.
Miami Herald: Healthcare. August 19, 2016. Accessed August 26, 2016.
< http://www.miamiherald.com/news/health-care/article96637632.html>.