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  • Your destination feed for medical, health care and clinical science podcasts courtesy of HCPLive—featuring our shows DocTalk, Rare Disease Report, Heart Team, Overdrive, and Derm Discussions. Music Courtesy of BenSound
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Your destination feed for medical, health care and clinical science podcasts courtesy of HCPLive—featuring our shows DocTalk, Rare Disease Report, Heart Team, Overdrive, and Derm Discussions. Music Courtesy of BenSound
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  • Medical Ethics Unpacked: Euthanasia and Medical Assistance in Dying

    Medical Ethics Unpacked: Euthanasia and Medical Assistance in Dying
    2024/11/25
    In the first episode of Medical Ethics Unpacked, hosts Steve Levine, MD, and Dominic Sisti, PhD, examine the profound ethical and clinical challenges surrounding medically assisted suicide, or medical assistance in dying (MAID), for individuals with severe psychiatric conditions. Dr. Sisti, an associate professor at the University of Pennsylvania, interrogates pivotal questions central to this debate, including whether psychiatric disorders can be deemed terminal and whether individuals with such conditions possess the requisite capacity to make autonomous decisions regarding MAID. Drawing on data from jurisdictions such as Belgium and the Netherlands, he highlights critical concerns, including gender disparities, inconsistent capacity evaluations, and the societal risks of expanding access to psychiatric euthanasia without addressing structural deficiencies, such as inadequate mental health care systems or pervasive social inequities.

    Dr. Levine, a psychiatrist, explores the complex and dynamic nature of capacity assessments, emphasizing the episodic and often treatable trajectory of psychiatric conditions such as major depressive disorder and anorexia nervosa. He reflects on the potential for recovery facilitated by novel treatments, such as ketamine or psychedelics, juxtaposed with the limitations and gaps in current psychiatric care. Together, the hosts deliberate on the ethical implications of mandating exhaustive treatment attempts, including experimental options, before permitting MAID, balanced against the imperative to respect patient autonomy.

    Through a rigorous and nuanced discussion, Drs. Levine and Sisti advocate for the establishment of robust ethical frameworks, equitable practices, and comprehensive capacity evaluations. Their discourse challenges societal and professional norms, encouraging reflection on autonomy, human suffering, and the intrinsic value of life in the context of this ethically fraught issue.

    Relevant studies and documentation mentioned in this episode:

    • Doernberg, Samuel N., John R. Peteet, and Scott YH Kim. "Capacity evaluations of psychiatric patients requesting assisted death in the Netherlands." Psychosomatics 57, no. 6 (2016): 556-565.
    • Kim, Scott YH, Raymond G. De Vries, and John R. Peteet. "Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands 2011 to 2014." JAMA psychiatry73, no. 4 (2016): 362-368.
    • Kious, Brent M., and Margaret Battin. "Physician aid-in-dying and suicide prevention in psychiatry: A moral crisis?." The American Journal of Bioethics 19, no. 10 (2019): 29-39.
    • Nicolini, Marie E., Scott YH Kim, Madison E. Churchill, and Chris Gastmans. "Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons." Psychological medicine 50, no. 8 (2020): 1241-1256.
    • Nicolini, Marie E., Chris Gastmans, and Scott YH Kim. "Psychiatric euthanasia, suicide and the role of gender." The British Journal of Psychiatry 220, no. 1 (2022): 10-13.
    • Sisti, Dominic, J. John Mann, and Maria A. Oquendo. "Suicidal behaviour is pathological: implications for psychiatric euthanasia." Journal of Medical Ethics (2024).
    Relevant disclosures for Sisti include Lykos Therapeutics and Tactogen. Relevant disclosures for include Levine include Compass Pathways.

    Chapters
    00:00 - Introduction
    00:45 - Key Issues in the Debate on Euthanasia and Mental Illness
    07:25 - Clinical Perspective on Capacity and Competence
    12:45 - Challenges in Evaluating Capacity in Mental Illness
    19:32 - Treatment Options and the Role of Social Structures
    26:35 - The Parity Between Mental and Physical Illness
    31:41 - Requiring Treatment Before Considering Euthanasia
    34:44 - The Complexity of Egosyntonic Psychiatric Conditions
    37:52 - The Potential for "Terminal Addiction"
    43:05 - The Societal Impact and Implications of Psychiatric Euthanasia
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    47 分
  • Exploring Oral Systemic Therapies for Plaque Psoriasis: Efficacy, Safety, and Clinical Considerations

    Exploring Oral Systemic Therapies for Plaque Psoriasis: Efficacy, Safety, and Clinical Considerations
    2024/09/23
    Lauren Miller, MPAS, PA-C; Jayme M. Heim, MSN FNP-BC, and Lakshi Aldredge, MSN, ANP-BC, discuss recent advancements in plaque psoriasis treatment, focusing on novel oral systemic therapies like the TYK-2 inhibitor deucravacitinib and its clinical trial data, to inform therapeutic decisions for this systemic disease.
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    41 分
  • New Insight: A Look at Corneal Transplant Alternatives w/ John Sheets, PhD

    New Insight: A Look at Corneal Transplant Alternatives w/ John Sheets, PhD
    2024/09/05
    Corneal blindness has a significant public health impact, particularly in low- and middle-income countries where access to eye care is limited. It can contribute to a high burden of disability, affecting individuals' quality of life and economic productivity, while straining healthcare systems with the need for preventive measures, surgical treatments, and rehabilitation services.

    In the latest episode of New Insight, host Veeral Sheth, MD is joined by John Sheets, PhD, the president, chief executive officer, and co-founder of Pantheon Vision, a pioneering early research-stage organization working to develop bioengineered solutions to eliminate corneal blindness and restore sight to millions.

    As part of its mission, Pantheon is dedicated to reducing reliance on donated corneal tissues to address corneal blindness. Although corneal transplant surgery has long been the gold standard, there remains significant room for improvement in graft acceptance, vision restoration, and long-term outcomes to better combat corneal blindness.

    Highlights
    0:06 Introduction
    2:20 Sheet's Background
    6:30 Experience with FDA
    10:58 Mission of Pantheon Vision
    17:10 Corneal Transplant Alternatives
    22:54 Overcoming Challenges
    28:49 Conclusion

    #ophthalmology #cornea #podcast
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    31 分

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