Long-Term Birth Control Becoming Popular Among North Carolina, Colorado Teens

An article dated October 6th, 2016 discusses the use of long-term, reversible contraception among young women in North Carolina and Colorado. Long-term contraception is endorsed by multiple medical organizations, and experts say that it is 99% effective. Despite this, young women in the United States are more reluctant to use this form of birth control than are their peers in other developed nations. In North Carolina and Colorado, however, long-term contraception is gaining traction among young women and teens. Healthcare providers in North Carolina clinics underwent training to learn about long-term contraceptives, and Colorado has been subsidizing the cost of them. Due to their success in lowering teen pregnancy and abortion, the Department of Health and Human Services suggests that this form of contraception should become more accessible to potential users.

From npr.org, “Long-Term, Reversible Contraception Gains Traction with Young Women”

Excerpt from article:

By using effective contraception to space out their children, teens and other young women can help reduce the risk of delivering a premature or low-birth-weight baby, research shows. And preventing unplanned pregnancies can be ‘essential to a woman’s long-term physical and emotional well-being,’ according to HHS.”

Read Full Article



First 3-Parent Baby Born in Mexico, Setting Off Regulatory and Ethical Concerns

According to an article published by CNN, dated September 28, 2016, on April 6, a baby was born with DNA from three people by using a new technique called “spindle nuclear transfer.” A team of doctors from New York went to Mexico to conduct the procedure since the Food and Drug Administration has not approved spindle nuclear transfer in the United States. Some are saying that this baby is the first to be born through this procedure, but critics state that the procedure produced children in the “1990s/early 2000s before the FDA” began to regulate it.

From Cnn.com, “Controversial 3-parent baby technique produces a boy”

Excerpt from article:

While in the past, the procedure was used to help women conceive and give birth to healthy babies in cases of infertility, the new version was created to tackle a specific problem: mitochondrial mutations.

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Editing Embryos: Scientist Begins Research Involving Modifying Genes of Human Embryos

In an article dated September 22, 2016, it was revealed that a Swedish scientist has become the first known researcher to begin attempts to modify genes in healthy human embryos—a practice which has been, and for many still is, considered “taboo.” Critics are concerned that people will begin to use such technology to create “designer” babies, or that such research could unintentionally create a new genetic disease; however, the scientist involved says he plans to use the embryos for no more than 14 days, in which time he may be able to discover new ways to treat infertility, prevent miscarriages, and use stem cells to treat various diseases.

From NPR.org, “Breaking Taboo, Swedish Scientist Seeks to Edit DNA of Healthy Human Embryos”

Excerpt from article:

“Lanner is planning to methodically knock out a series of genes that he has identified through previous work as being crucial to normal embryonic development. He hopes that will help him learn more about what the genes do and which ones cause infertility.”

Read Full Article.


To Treat or Not to Treat? The Debate on Incidental Medical Findings

In an article dated August 29, 2016, doctors and researchers debate whether they should disclose to patients minor abnormalities that are incidentally found during an imaging procedure (such as an MRI or CT scan). On the one hand, researchers say that doctors are going “overboard” on disclosing low-risk findings that lead to overtreatment and unnecessary worry by the patient.   However, on the other hand, a decision not to follow up on an incidental finding can have serious consequences. For one patient, kidney cancer was incidentally found and led to early treatment that arguably saved his life. Although the professionals disagree on whether to treat or not to treat, most agree that guidelines are needed to help doctors make the difficult decision.

Excerpt from article:

Often there is “little benefit” to patients knowing about minor, low-risk findings, and it can have significant financial, psychological and clinical consequences, they say.  Failure to follow up incidental findings can come back to haunt some patients, other experts say. . .

To read full article: When a Medical Test Leads to Another, and Another

FDA Takes the Advocates’ Advice: Approves Drug from Muscular Dystrophy

In an article dated September 19, 2016, Muscular Dystrophy patients and advocates, with the help of select members of Congress, celebrated the FDA’s approval of Eteplirsen, a drug manufactured by Sarepta Therapeutics for treatment of a type of muscular dystrophy that predominantly affects boys in their childhood. Advocates fought heavily for the approval even though there are limited clinical trials to confirm the drug’s effectiveness. While the drug may help up to 12,000 Americans affected by the disease, critics worry that the FDA has set a “dangerous precedent” by its decision.

From NYTimes.com, “F.D.A. Approves Muscular Dystrophy Drug That Patients Lobbied For”

Excerpt from article:

[I]t was taken as a deeply troubling sign among drug policy experts who believe the F.D.A. has been far too influenced by patient advocates and drug companies, and has allowed the delicate balance in drug approvals to tilt toward speedy decisions based on preliminary data and away from more conclusive evidence of effectiveness and safety. . .

To read full article:   F.D.A. Approves Muscular Dystrophy Drug That Patients Lobbied For



The Link Between C-Sections and Obesity

This article reports on a study showing that the method of childbirth might affect that child’s weight well into adulthood. Babies who were delivered by caesarean have a 15% higher risk of being obese than babies who were delivered vaginally. The article suggests causative links, but the study did not prove that a caesarean section is a cause of obesity.

From TheGuardian.com, “Babies born by caesarean more likely to be obese as adults, study suggests”

Excerpt from article:

“Birth by caesarean was linked to a 15% higher risk of obesity in children compared with vaginal birth.”

 To read full article: Babies born by caesarean more likely to be obese as adults, study suggests

Grim Numbers: Two Studies Show Link between Being Uninsured or on Medicaid and Lower Chances of Survival

Two studies show that the numbers comparing health outcomes show significant disparities between those who are privately insured and those who are either uninsured or on Medicaid.

One study of patients with testicular cancer, found that of the 10,200 surveyed, “those who were uninsured were 88 percent more likely to die from cancer, and Medicaid patients were 51 percent more likely to die of the disease.”

Excerpt from the article:

“There were some treatment differences, as well, between the patients with private insurance, and those who either had Medicaid or were uninsured. And those treatment differences could affect survival.”

To Read Full Article: Studies Link Cancer Patients’ Survival Time To Insurance Status


Americans are Increasingly Turning to Medicaid for Long Term Care Coverage

Currently, about 62% of nursing home beds in the U.S. are paid for by Medicaid. Many elderly individuals cannot afford to pay for such long term care—the average total cost of long term care received from age 65 to death is $91,100 for men and up to double that amount for women, based on the presumption that women live longer. Low income individuals rely on Medicaid to pay for these expenses and other middle-class individuals are forced to spend down their assets to qualify for Medicaid coverage for their long-term care.

Medicaid was created to provide health insurance to low-income individuals, and not to cover long term care for the majority of the elderly population. Yet, it has evolved into a “safety net” for millions of Americans who cannot afford to pay for their long-term care.  As the baby boomer generation continues to age, Medicaid spending on long term care is expected to rise by almost 50% by 2026, putting pressure on a system that was not designed to carry such a burden.

State and federal officials are working to control Medicaid costs. Some states, for example, are contracting with managed care companies to provide long term care services to Medicaid beneficiaries. However, many health advocates are concerned that these managed care companies, which traditionally provided only medical care, will restrict the coordination of care for the elderly.  California most recently announced that it will hold informational hearings to discuss possible resolutions to the increasing cost of long term care.

 Sources: http://www.npr.org/sections/health-shots/2016/08/03/488385286/medicaid-safety-net-stretched-to-pay-for-seniors-long-term-care

Tags: Long Term Care Coverage, Burdened Medicaid System, Lower and Middle Class Americans



Will Transgender Identity Be Declassified as a Mental Illness?

According to the current Internal Classification of Diseases (ICD) set forth by the World Health Organization, being transgender is considered a mental illness.  There have been proposals, however, to declassify transgender identity as a mental illness in the new ICD-11, which is expected to be approved in 2018.

Instead of removing the diagnosis altogether, Geoffrey Reed, a Professor of Psychology and consultant on the ICD-11, proposes a new diagnosis called “gender incongruence” that would be found in a new medically and biologically oriented chapter called “Conditions Related to Sexual Health.” It is important that the transgender classification is not removed from the ICD entirely to ensure that transgender individuals have continued, and hopefully improved, access to health care.

Yet, many transgender activists see this change as only “a small battle won” in the “war being waged for trans rights”. One activist, Alok Vaid-Menon, explains that stressors related to being transgender come from the outside world and there are bigger issues than the ICD classification that must be addressed, including violence, poverty, homelessness, and housing discrimination. “The true victory,” according to Vaid-Menon, “would be to de-stigmatize diversity and difference itself.”

Sources: http://www.chicagotribune.com/news/nationworld/ct-transgender-mental-illness-classification-20160729-story.html

Tags: Transgender Rights, ICD-11, Declassify Mental Illness, De-stigmatize diversity, Transgender Health Care Access, Gender Identity

Field Trial Supports Removal of “Transgender” from Mental Health Classification

The first field study was recently conducted in Mexico City to assess the transgender diagnosis listed in the mental disorders chapter of the World Health Organization’s (“WHO”) International Classification of Diseases. Senior author of the study, Professor Geoffrey Reed from the National Autonomous University of Mexico, explained that such diagnosis stigmatizes transgender individuals which, in turn, impacts legalization, human rights, and appropriate access to healthcare. These misconceptions have negatively impacted transgender rights across the globe, with many countries denying transgender individuals autonomy, such as in their legal documents and child custody rights.

The study consisted of interviewing 250 transgender individuals, ranging from 18 to 65 years old. The participants answered a series of questions, such as, when they first became aware that they were transgender, their experiences of gender, social rejection, violence, etc. Participants disclosed that they were often victims of violence and family rejection. Majority of participants cited their adolescent years as the highest period of distress.

The researchers believe that eliminating the transgender diagnosis from the WHO classification would be the first step in diminishing the stigma and abuse of transgender individuals. Dr. De Cuypere, from University Hospital in Belgium, and Dr. Winter, from Curtin University in Australia, stated: “‘Transphobia is a health issue’. This study prompts primary caregivers and psychiatrists to be aware of a ‘slope leading from stigma to sickness’ for transgender individuals, and to contribute to their mental health by a gender-affirmative approach.”

The study was published in The Lancet Psychiatry on July 26, 2016 and is now being replicated in Brazil, France, India, Lebanon and South Africa. These subsequent studies are being performed as an effort to build enough clinical evidence to remove transgender from the list of mental health disorders.

Source: http://www.eurekalert.org/pub_releases/2016-07/tl-tlp072516.php, http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30165-1/abstract


Tags: Clinical Ethics, Mental Health, Bioethics, Access, News, Gender Orientation