policy

This week, Idaho’s Republican Governor Brad Little signed HB 617 into law. The bill repeals Idaho’s five‐​year‐​old law that permits harm reduction organizations to operate syringe services programs (SSPs), also called “needle exchange” programs. Idaho becomes the first state to retrogress from the growing trend among US jurisdictions to embrace harm reduction. Lawmakers cited concerns that SSPs enable people to use illicit drugs and grumbled that there is not enough evidence SSPs entice people with substance use disorder to enter rehab...

The process of IVF necessarily entails creating "excess" embryos – the just “in case” ones used if the first round doesn’t implant or the parents later seek additional children. Necessary hormonal adjuvants to boost ovulation and surgical oocyte removal can be hazardous. To minimize or prevent these problems, “extra” embryos are created. Destruction of these excess...

“When AI contributes to patient injury, who will be held responsible?”

Great question. In the headlong rush by developers and health systems to embrace software systems using AI, little is known about how product liability and medical malpractice case law will be interpreted. A review in the New England Journal of Medicine (NEJM) lays out some legal issues and the “somewhat faint” signals emerging from case law.

A Legal Primer

There are three possible defendants in these cases: the product developer, the physician users, and, with increasing frequency, the physician’s employer or health system providing the AI healthware. [1] While each of these actors have different “standards of care” before the law, in...

With few exceptions, the New York Times's coverage of the real story of the opioid crisis – too few pills, not too many – has been atrocious. The paper, for the most part, has been blathering the party line – that prescription opioids are driving the soaring overdose death toll. Even as late as 2017, when illicit fentanyl killed roughly twice as many people as prescription opioids we still saw inaccurate nonsense like this:

 

 

Overdoses, fueled by opioids, are the leading cause of death for Americans under 50 years old — killing...

“Chicago is estimated to have nearly 400,000 lead service lines (where one line serves approximately one household), the most of any US city. Despite efforts to identify and replace lead service lines, progress has been slow, with only 280 (0.007%) lead pipes replaced by the city government from 2020 to 2022.”

These are concerning numbers from the point of view of the lead service lines in Chicago, as well as the evident inability of local officials to effectuate any meaningful change in a significant health risk. In a study relying significantly on Mathmagic and estimates, the authors estimate that “two-thirds of children are exposed to lead-contaminated drinking water. Could that be true?

To...

What is Ethylene Oxide?

As I discussed, ethylene oxide is a chemical found everywhere in the environment and produced naturally in our bodies. It is used in many industries and is particularly useful for sterilizing medical devices. It is found in urban air at levels ranging from 0.1 to 0.2 parts per billion (ppb) and is naturally found in the human body at levels equivalent to continuous exposure to 0.56 to 4.5 ppb in air.

The Ethylene Oxide Rule

In 2023, the EPA proposed new...

In 910, the Persian physician Al-Razi wrote that measles should be more dreaded than smallpox, an edict echoed in an old proverb:

“Count your children after the measles has passed.”

More than a thousand years later, measles remains the most contagious of modern diseases. In the first 75 days of this year, the number of US measles cases surpassed the entire tally for 2023. During the week from March 8 to 14 alone, fifteen new ones were reported, and as of the Ides of March 2024, 60 cases of measles had been reported in the US. Fortunately, it is also highly...

There comes a point in the care of an acutely critically ill patient when you can do no more for them; you’ve maxed out your options, and the outcome is out of your hands. At that moment, your attention must turn and prioritize their family, who will be left with a full blown disaster at the end of the day. The NY Times wrote about how society might make that turn, towards the survivors of the tragedy of unintentional deaths from drugs, more specifically opioids. They discussed a debate over categorizing those deaths as overdoses or poisonings.

“If I tell you my child was poisoned by fentanyl, you’re like, ‘What happened?’ It keeps the door open...

Join Cameron English and Dr. Chuck Dinerstein on Episode 66 of the Science Dispatch podcast as they examine the growing problem of scientific fraud:

Far too many scientific papers are being retracted from prestigious scientific journals because scientists fabricated or falsified data. Although no one defends scientific fraud, few recognize its long-lasting impacts on governmental policy and society.

Listen to the Science Dispatch on iTunes...

Two cases stand out as a beacon of sound jurisprudence, requiring governmental restraint, even in the face of pandemics. In Jew Ho v. Williamson, the court annulled a quarantine against the Chinese community when the Bubonic Plague struck San Francisco in the Spring of 1900. The legal community touts the decision as a testament to the 14th Amendment and the doctrine of Equal Protection. But in retrospect, this reading overlooks the adverse public health consequences generated by partisan doctors and the impact of economic drivers of policy. It also demonstrates unfamiliarity of the law with public health responses.

The Year of the Rat

On March 7, 1900, paradoxically...