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Bioethics Blog Indiana University

The Moral Necessity of a Well Physician: Obligations to Providers and Patients

Posted on by Clayton Hicks

Clayton Hicks

Amanda Oster, Program Director of Healthy Work Environment at IU Health, and Eric Williams, Staff Chaplain at IU Health, presented a Fairbanks Ethics Grand Rounds on Healthcare Provider Wellbeing. The talk highlighted the importance of provider well-being and discussed evidence-based interventions to promote wellness among healthcare providers who are often taxed by an environment that can be unfriendly to personal wellness.

The unwell physician is unfortunately commonplace due to a variety of factors: burnout, time constraints on patient care, moral distress that arises in caring for patients, and the emotional stress of caring for ill and dying patients. While decreased from previous years, in 2023 48.2% of physicians reported symptoms of burnout. Medical residents are 4 times more likely to experience a major depressive episode during training than their age-matched counterparts. Additionally, physicians are at an increased risk to commit suicide, 1.41 times higher in male physicians and 2.27 times higher for female physicians, than their non-provider counterparts.

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Improving Social Media-Based Support Groups for the Rare Disease Community: Insights from an Interview Study

Posted on by Sam Vershaw

*For open access link to the full article click here.

Roughly one in 10 Americans are affected by a rare disease. That number further compounds when accounting for the individual rare features that can present in a single disease, thus making an even more sizable impact on the overall population in the US. Living with a rare disease or caring for a loved one with one can often feel isolating. With limited access to medical professionals who are well-versed in the specifics of rare conditions, many individuals turn to disease-related support groups (DRSGs), especially those on social media, to gather information, share experiences, exchange advice, and seek emotional support. These groups, often centered around specific conditions, provide invaluable spaces where participants can connect with others who understand their unique struggles.

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Developing AI and Limiting Risk:  An Impossible Balancing Act?

Posted on by Nicolas Oliver

Nicolas Oliver

How should we operationalize AI risk? It depends on who you ask. Dario Amodei and the team at Anthropic propose AI safety level standards in an effort to standardize the risks of various LLM models.[1] He is among the most concerned about the risks of AI, or as much as the CEO of an AI company can be, but I think his proposed system is helpful for understanding the potential dangers of AI. That said, it also has some glaring weaknesses.

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Insulin Price Controls, Who Falls Through the Gaps?

Posted on by Clayton Hicks

Clayton Hicks, Graduate Assistant IUCB

In the United States, 6 million people take insulin to control their type 2 diabetes. In recent years, the high price of insulin has been widely covered in the media. Disturbing stories of insulin rationing and patient deaths have been widely reported. A Yale study from 2018 found that 1 in 4 patients with diabetes were cutting back on insulin due to cost. More recently, price-capping measures have been implemented to lower insulin prices and increase access. With these price-settings measures, from federal and state regulations to company-sponsored programs, it might seem that the problem of insulin affordability has been solved. But the full story is complex, suggesting that at least some patients may still face significant charges for insulin. Patients on Medicare who do not have the Prescription Drug Benefit (Part D) are not protected by federal regulation and cannot benefit from the manufactured sponsored programs. The chance that a patient must pay a lot for insulin appears to vary, at least in part, by their insurance status. Current legislation and company-sponsored programs leave gaps in price protection and work must be done to provide more secure safety nets for insulin users. (more…)

Evaluating Patient Decisions: Dr. Schwartz’s View

Posted on by Clayton Hicks

Clayton Hicks

Peter Schwartz, MD PhD, director of the IU Center for Bioethics and Professor of Medicine and Bioethics at IU School of Medicine, presented at Bioethics Grand Rounds last week. He focused on how to evaluate patient decision-making and the somewhat elusive measurement of decision quality. Find the recording of the talk here. Schwartz’s talk not only informed but also gave some philosophical questions about the epistemological nature of decision-making. The following is my summary of his talk and some of my reflections.

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AI and Bioethics: Professor Hartsock’s View

Posted on by Peter Schwartz, MD, PhD

Jane Hartsock, JD, MA, faculty investigator at the IU Center for Bioethics and System Director of Clinical and Organizational Ethics at IU Health, presented the first IU Bioethics Grand Rounds of the year last week on AI, a topic that has become an obsession for many of us in bioethics.  Check out the recording here.  It was a terrific talk, and it inspired me to write this blog post to summarize what she said and add some thoughts of my own.

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Who Deserves Ozempic? The Ethical Challenges of Weight-Loss Use.

Posted on by Morgan Rich

Morgan Rich, Graduate Assistant IUCB

There isn’t enough Ozempic for everyone who wants it. People with health conditions like type 2 diabetes and severe obesity should get it before people who hope to lose a few pounds. As the new ‘miracle drug’ for weight loss, Ozempic is one of the most popular new drugs in America. This has come mostly from the media, celebrities, and TikTok influencers praising it for its short-term effects, but not from experts.

The FDA approved the top-selling GLP-1 agonist in 2017 to treat diabetes. One in eight American adults has taken a GLP-1 drug like Ozempic, and more than 15 million are currently taking one. Due to increased demand, Ozempic shortages are expected through 2024. With a large portion of Ozempic’s market consumed by people without diabetes, those seeking the drug for diabetes treatment face a new array of ethical challenges. This rise in Ozempic for weight loss highlights ongoing concerns, such as known adverse effects like low blood sugar and malnutrition, the unknown long-term health consequences, and newly developed problems, such as accessibility and economic challenges. Until the supply/demand discrepancy is solved, those with chronic diseases such as type 2 diabetes, hyperglycemia, and moderate to severe obesity, should be prioritized in receiving Ozempic.

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Social media use by patients with hypermobile EDS

Posted on by Sam Vershaw

*For open access link to the full article click here

Every 6.4 seconds a new social media account is created.

Since the rise of social media in the early 2000s, access to connection online has multiplied tenfold. On the average day, we spend about 2 and a half hours scrolling through social media. And this number will likely increase as the accessibility to modern electronics expands. In many ways social media has changed the way we communicate with the world around us. A multitude of platforms allows us to research dinner recipes, connect with people across the country, sell household items, and share life updates with just the tap of a few buttons.

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On the Increase in Use of GLP-1s

Posted on by Pierce Logan

Ozempic is suddenly a household brand name, akin to Aleve, Advil, or Nyquil. Many people are calling Ozempic, and other drugs like it, “miracle drugs.” Ozempic and Mounjaro are part of a class of drugs called GLP-1 receptor agonists (GLP-1s for short). Ozempic was approved by the F.D.A. in 2017, while Mounjaro, Ozempic’s primary competitor, was approved in 2022. Both were approved in the U.S. by the F.D.A. to help lower blood sugar. Soon after the drugs came onto the market, they were found to be quite useful to lose weight, which led the companies to develop analogous forms of the diabetes drugs that were designed and approved for weight loss. 

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