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Curious Bioethics: June 5-June 11, 2023
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Dr. Burgart pulls the curtain aside on the House of Medicine, revealing how injustice and politics impact patients—equipping you to discuss complex issues with wit, confidence, and clarity.
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Curious Bioethics

Curious Bioethics: June 5-June 11, 2023

East coast fires, long-covid, trans history, physician advocacy

Alyssa Burgart, MD, MA's avatar
Alyssa Burgart, MD, MA
Jun 11, 2023
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Curious Bioethics: June 5-June 11, 2023
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Hey there, Curious Human!

Today, I’m writing to you from a log cabin in the Eastern Sierra mountains, thankfully breathing fresh, woodsy, non-smoky air. I’ve done my best to edit this newsletter on my phone screen, so please excuse any funny formatting (especially with a few of new links). 🌲🙏

In today’s curated collection, you’ll find:

  • Bioethics in the News: East Coast fires 🔥 , a cheap drug to prevent long-covid

  • What I’m Reading: Susan Stryker’s Transgender History; physician advocacy as an ethical obligation

  • Educational Opportunities: Why Dobbs Matters as an Equity Issue

Thank you for reading Curious Bioethics: Curated Bioethics for Curious Humans! This post is public so feel free to share it.

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Bioethics in the News

Fires in Canada blowing smoke down the east coast of the US

Fires are still burning in eastern Canada. Last week’s sepia toned, apocalyptic NYC skyline is finally clearing up. Having lived through the 2020 Northern California fires, I wish I could loan folks across the country and in Canada our numerous air filters.

Massive fires - impacting far away places - appear to be a new normal. These dramatic events demonstrate the important connections among human induced climate change, the environmental impact, and health.

I noticed right away in the news cycle was that N95 masks were immediately abundant. Unfortunately, there was hardly a chance for folks to get a smoke induced headache before the mask misinformation and disinformation machines ramped up.

Politicizing masks makes about as much sense as politicizing gravity.

Katelyn Jetlina at

Your Local Epidemiologist
writes a wonderful overview of why more people wear masks for smoke than Covid-19.

Your Local Epidemiologist
Wildfire smoke, COVID-19, and striking comparisons
Watching wildfire smoke blanket the Northeast U.S. and parts of Canada over the past few days has been surreal. Air quality is impacted for tens of millions of people, with off the charts pollutant levels in some areas. I can’t help but notice striking comparisons with this publi…
Read more
2 years ago · 15 likes · Katelyn Jetelina

Cheap Long-Covid Prevention and Disease Validation

A very interesting study came out on preventing Long-Covid with metformin, an inexpensive anti-diabetes drug. Just as important as the potential to use a very inexpensive, familiar drug to reduce long-covid, the study also basically proved long-covid is real. You can’t effectively treat a disease if it doesn’t exist. Previously, we have relied on surveys of patients, and this study validates patient’s reports. There have been many folks who deny long-covid is real, attempting to invalidate patients’ lives experiences.

You can read the study here: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00299-2/fulltext

Outpatient treatment with metformin reduced long COVID incidence by about 41%, with an absolute reduction of 4·1%, compared with placebo. Metformin has clinical benefits when used as outpatient treatment for COVID-19 and is globally available, low-cost, and safe.

Jeremy Faust, MD
has an accessible explanation of not only this study, but also how to read Kaplan-Meier curves in his essay below. You’ll see what curves look happy (😁drug works) vs sad (😢drug doesn’t do squat-diddly).

Inside Medicine
Did a clinical trial just "prove" that Long Covid really exists?
On one hand, there are some who believe Long Covid afflicts 43% of Covid patients. On the other, some commentators say Long Covid is basically psychosomatic. Neither extreme is correct. And yet more than 3 years into the pandemic, the search for an objective medical finding that clinches a Long Covid diagnosis—be it blood markers, lung tests, specific co…
Read more
2 years ago · 21 likes · 2 comments · Jeremy Faust, MD

What I’m Reading This Week

Transgender History

The Roots of Today’s Revolution

If you care about the struggles faced by trans people, Susan Stryker’s 2008 book (updated in 2017) is unmissable. It’s full of amazing historical stories and photographs.

Available wherever books are sold, but also publicly via TransReads.org.

Cover of Transgender History: The Roots of Today's Revolution (revised edition)
I appreciate Professor Stryker’s visuals - used throughout the text - that help contextualize the work. This chart: Outlawing Cross-Dressing

Doctors think “advocate” is a dirty word. But it’s our ethical responsibility

Statehouses across the country have increasingly demonstrated a willingness to pass lawsthat obstruct physicians’ ability to practice comprehensive, evidence-based medicine. From pandemic public health measures to reproductive rights to gender-affirming care, many states are putting politicians between patients and their physicians.

This enthusiasm for legislating medical care has laid bare the fact that physicians have a role and responsibility to be public advocates when evidence-based care comes under attack.

Good Trouble Indiana founders Katie McHugh, Gabriel Bosslet, Caroline Rouse, and Tracey Wilkinson published a great piece on STAT Plus in response to the inappropriate sanctioning of physician Caitlin Bernard. It is our ethical obligation to ensure patients have access to care and that unjust laws are dismantled.

This National Doctor's Day, I Want Doctors to Be Allowed to Treat Patients

This National Doctor's Day, I Want Doctors to Be Allowed to Treat Patients

Alyssa Burgart
·
March 30, 2023
Read full story

Educational Opportunities

Why Dobbs Matters as an Equity Issue – Our Clarion Call for Reproductive Health

The webinar provides an overview of the national legal landscape in 2023, nearly a year after the Dobbs decision and new state-level restrictions. The session lays the foundation for upcoming webinars to delve into the specific impact of the Dobbs decision, ranging from implications for patient care to medical education to mental health. Invited speakers approach the issue of reproductive rights through an equity lens and elucidate the far-reaching consequences of reproductive health restrictions.

  • When: on demand

  • Where: this link ⤵️

  • https://www.aamc.org/career-development/affinity-groups/gwims/reproductive-health-post-dobbs-world-matters-all-us


That’s it!

As always, thanks for being curious!

Hit reply and let me know what ethics issues you are most curious about this week—I’d love to hear from you!

See you next week!

Be Well & Be Curious,

Alyssa


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By Alyssa Burgart · Launched 4 years ago
Dr. Burgart pulls the curtain aside on the House of Medicine, revealing how injustice and politics impact patients—equipping you to discuss complex issues with wit, confidence, and clarity.
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Curious Bioethics: June 5-June 11, 2023
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Be a Strong Link for Immigrant Patients 🔗
Enhance the ethical care of all patients when immigration agents enter hospitals
Jan 25 • 
Alyssa Burgart, MD, MA
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Pregnant Georgia woman declared dead, kept in ICU over family's objection
Misogyny know a no bounds in the anti-patient autonomy movement
May 17 • 
Alyssa Burgart, MD, MA
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Pregnant Georgia woman declared dead, kept in ICU over family's objection
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West Texas Measles Outbreak
One in five kindergarteners in Gaines County schools has a non-medical vaccine exemption. Low vaccination rates prime the area for the easy, natural…
Feb 9 • 
Alyssa Burgart, MD, MA
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