エピソード

  • 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
    続きを読む 一部表示
    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.
    続きを読む 一部表示
    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
    続きを読む 一部表示
    31 分
  • Innovations in GERD: What Vonoprazan (Voquezna) May Offer Over PPIs, with Adelina Hung, MD

    Innovations in GERD: What Vonoprazan (Voquezna) May Offer Over PPIs, with Adelina Hung, MD
    2024/07/18
    Proton pump inhibitors have long been the mainstay of treatment for gastroesophageal reflux disease (GERD), dating back to omeprazole (Prilosec)’s initial approval in 1989. However, the treatment landscape has undergone its first major changes in the past 30 years with the emergence of vonoprazan (Voquezna).

    A novel, first-in-class small molecule potassium-competitive acid blocker (PCAB), vonoprazan now boasts 3 US Food and Drug Administration (FDA) approvals across both erosive and non-erosive GERD. Less than a year after earning approval for the healing and maintenance of healing of all grades of erosive GERD as well as the relief of heartburn associated with erosive GERD, vonoprazan has also been approved for the treatment of heartburn in non-erosive GERD.
    続きを読む 一部表示
    7 分
  • FDA First Half Recap: Dermatology in 2024

    FDA First Half Recap: Dermatology in 2024
    2024/07/03
    Led by a flood of biologic therapies becoming available and progressing within the therapeutic pipeline, the field of dermatology finds itself in the midst of a watershed moment for many dermatologic conditions. To celebrate and recap the advancements occurring in the first half of 2024, the editorial team of HCPLive Dermatology sat down with James Del Rosso, DO, research director of JDR Dermatology Research and president of the American Acne and Rosacea Society, for more perspective on pipeline movement.

    Del Rosso, who also serves as an adjunct clinical professor of Dermatology at Touro University, takes a deep dive into several different disease states in dermatology and highlights how the news to emerge in the last 6 months, as well as prior to the close of 2023, has influenced real-world management.
    続きを読む 一部表示
    40 分
  • New Insight: A Look at Gildeuretinol (ALK-001) for Stargardt Disease w/ Seemi Khan, MD

    New Insight: A Look at Gildeuretinol (ALK-001) for Stargardt Disease w/ Seemi Khan, MD
    2024/07/02
    In the latest episode of New Insight with Veeral Sheth, MD, host Veeral Sheth, MD, director of clinical research at University Retina, speaks with Seemi Khan, chief medical officer at Alkeus Pharmaceuticals, on the company’s lead candidate being evaluated in clinical trials for the treatment of Stargardt disease and geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

    Gildeuretinol is a novel molecule designed as a specialized form of deuterated vitamin A to reduce the dimerization of vitamin A without disrupting vision. The therapy has received Breakthrough and Orphan Drug designations from the US Food and Drug Administration (FDA).

    Listen to the conversation between experts on Khan’s background in the pharmaceutical industry, including time spent at Abbott, Abbvie, and Quark Pharmaceuticals, her experience bringing treatments to patients with rare diseases, and the impressive data from gildeuretinol in the TEASE clinical trial program for a currently unmet need.

    Episode Highlights
    0:07     Episode Intro
    0:57 Seemi Khan's background
    4:38 Mechanism of action of gildeuretinol
    7:22 Patient populations
    9:00 TEASE clinical trial program
    14:37 Gildeuretinol in GA
    16:32 Safety data
    18:47 Next steps for Alkeus
    22:28 Conclusion

    Check out more ophthalmology coverage at HCPLive.com!
    続きを読む 一部表示
    21 分
  • New Insight: A Look at the OcuLenz with Michael Freeman, CEO of Ocutrx

    New Insight: A Look at the OcuLenz with Michael Freeman, CEO of Ocutrx
    2024/06/11
    Since the mid-20th century ushered in the ‘Information Age’, a desire for innovation has driven the pursuit of technological advancements. Many may immediately consider the transformations personal computers and smartphones have had on modern society, but these advancements have transformed the fields of medicine time and time again.

    In the latest episode of New Insight with Veeral Sheth, MD, Michael Freeman, the chief executive officer of Ocutrx, joins Dr. Sheth to discuss the history of Ocutrx, its OcuLez and OR-Bot products, and what he envisions in the next decade at the company.

    Episode Highlights
    0:06 Introduction
    1:22 History of Ocutrx
    9:05 A look at the Oculenz
    18:27 Introduction of a caretaker app
    19:26 A look at the OR-Bot
    25:55 Envisioning the next decade at Ocutrx
    29:02 Conclusion

    Every episode of New Insight is available on HCPLive.com and be sure to subscribe to our channel on Spotify and Apple Podcasts. Please direct any podcast-related inquiries to show producer Connor Iapoce at ciapoce@mjhlifesciences.com.
    続きを読む 一部表示
    29 分
  • Andrew F. Alexis, MD, MPH: Discussing Controversies in Acne, Rosacea

    Andrew F. Alexis, MD, MPH: Discussing Controversies in Acne, Rosacea
    2024/03/14
    Episode Highlights:

    0:16 Intro

    0:28 Overview of presentation

    0:38 Acne and post-inflammatory hyperpigmentation

    01:35 Approaches to take

    03:21 Rosacea, use of dermoscopy and symptomatology assessment

    04:59 Necessity of inclusivity in clinical trials, other knowledge gaps

    06:05 Images used in education


    The American Academy of Dermatology (AAD) Annual Meeting in 2024 featured Dr. Andrew Alexis, a prominent figure in dermatology. Dr. Alexis, currently serving as the vice-chair for diversity in the department of dermatology and a professor of clinical dermatology at Weill Cornell Medical College in New York, presented a talk titled "Controversies in Acne and Rosacea."


    In the interview, he shed light on critical aspects of managing acne and rosacea, particularly focusing on patients with skin of color.


    Dr. Alexis advocated for inclusivity in clinical trials to improve understanding across diverse patient populations. He stressed the importance of expanding public awareness of rosacea in communities with skin of color and suggested incorporating diverse images into educational materials to better represent the spectrum of affected individuals.


    Dr. Alexis's insights underscore the necessity of tailored approaches and increased inclusivity in dermatological research and education to better serve patients with diverse skin tones and backgrounds.


    For additional information covered at the 2024 AAD conference, visit us at: https://www.hcplive.com/conference/aad.
    続きを読む 一部表示
    9 分