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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, May 6 2019

Full Issue

Viewpoints: Lessons From A Pediatrician On The Unnecessary Dangers Of Measles; Worrisome Trends Soar After Marijuana Legalization

Opinion writers weigh in on these health topics and others.

As a hospital pediatrician, I was heartbroken to care for my first patient with measles. Despite knowing intellectually that, due to poor vaccine uptake, this completely preventable disease would make a resurgence in my career, the severity of the illness still took me by surprise. There is a striking difference between textbook descriptions of rash, fever and pneumonia; and seeing a small child connected to a breathing tube to help her damaged lungs obtain air. Like most physicians, I was hit by a wave of emotion- anger at the opportunistic anti-vaccine lobby for causing so much unneeded suffering, fear for the long term effects including brain damage and death that this girl might suffer and above all else, sadness that so many innocent children will continue to be hurt. (Rebekah Diamond, 5/5)

When I first began using the 鈥渧irus鈥 analogy to describe the rapid spread of misinformation and its potential to do serious harm, I didn鈥檛 realize how fitting, or timely, that comparison would become. The recent outbreaks of measles, one of the most contagious diseases in the world, make that connection alarmingly real. (Alan C. Miller, 5/3)

Academics depict the peer-review process as the gold standard for intellectual honesty, ensuring published scholarly work is unbiased and accurate. But ideological conformity makes peer review a far thinner defense than advertised.In January I published a book about the mental-health and violence risks of cannabis. Several dozen scholars signed a petition expressing in unison their objection to my work. Thus I鈥檝e recently spent an inordinate amount of time reading papers seeking to prove that marijuana is a cure-all whose deleterious consequences are a figment of our collective imagination. The shoddiness of much of the work has shocked me. (Alex Berenson, 5/5)

When the Food and Drug Administration announced last month that it couldn鈥檛 guarantee the long-term safety and efficacy of vaginal mesh products 鈥 medical devices that have been on the market for decades 鈥 the collective response from tens of thousands of women harmed by the products sounded something like this: Duh. The mesh, which is used to hold pelvic organs in place when muscles become too weak to do the job, has long been tied to life-altering injuries, including nearly 80 deaths as of 2018. In the past decade, seven companies have spent a collective $8 billion to resolve more than 100,000 patient claims 鈥 making litigation over vaginal mesh (or pelvic mesh, as it is sometimes called) one of the largest mass tort cases in United States history. (5/4)

Physicians, once among the most trusted professionals in the United States, now face a credibility crisis. Only one-third of Americans say they have a great deal of trust in physicians, down from around two-thirds in the 1970s. This lack of trust is leading to a burgeoning appetite for medical misinformation, causing many Americans to avoid vaccines and cholesterol-lowering statins. To quell this rising tide, I believe that my physician colleagues and I should learn from the most trusted professionals in America for 16 straight years: nurses. (Haider Warraich, 5/6)

While constitutional lawyers, ethicists and theologians 鈥 in descending order of importance in the abortion debate 鈥 have been arguing in the 46 years since the Supreme Court attempted to settle the debate, some technologists have been making a consequential contribution to it. They have developed machines that produce increasingly vivid sonograms of fetal development. This concreteness partially explains the intensification of the debate. ...The 鈥渉eartbeat bills鈥 are wholesome provocations: One of their aims is to provoke thinking about the moral dimension of extinguishing a being with a visibly beating heart. Furthermore, pro-life people are being provoked in different ways.(George Will, 5/3)

These mix-ups often have at their center patient, family and health-care provider misunderstanding regarding the meaning of a single term: 鈥渄o not resuscitate,鈥 (DNR) for short. The term DNR means that a patient should not receive cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest (i.e., when the patient has died; is unresponsive, has no pulse and is not breathing).But many patients and health-care providers misinterpret a DNR order to mean that no life support should be given in the event of clinical deterioration (i.e., the patient has not yet died but is getting much sicker). (Amber Barnato, 5/5)

I write this as I鈥檓 about to give birth to my baby girl. I鈥檓 full of excitement and disbelief at how much I already love this tiny stranger poking my rib cage. But I鈥檓 also tormented by a deep-seated fear. I鈥檓 terrified that my daughter will inherit my eating disorder, that my own decades-long struggle with anorexia will ruin my child鈥檚 life. Of course, parents don't cause eating disorders. Although they used to be the main object of blame, increasing evidence suggests the real culprits are things such as altered neurological function, certain personality traits (including perfectionism, rigidity and tunnel-vision toward goals), and the way semi-starvation changes the brain. (Kate Willskey, 5/4)

The Democratic Republic of Congo (DRC) is experiencing the second largest Ebola outbreak in history. This week has been the worst by far, with more than 100 new cases in the last 5 days. Since the outbreak began last summer, there have been more than 1,500 cases, with just over 1,000 deaths. (Tom Inglesby and Jennifer Nuzzo, 5/3)

On Wednesday, the Court of Arbitration for Sport ruled that female athletes with naturally elevated levels of testosterone could not compete as women unless they made efforts to reduce the hormone in their bodies. The ruling came in a case brought by the middle-distance runner Caster Semenya against the International Association of Athletics Federations that challenged longstanding myths about the presumed masculinity of testosterone and its role in the body. Her loss demonstrates just how entrenched those myths have become. (Katrina Karkazis and Rebecca M Jordan-Young, 5/3)

Pan, D-Sacramento, is a pediatrician with a master鈥檚 in public health from Harvard. His legislation, which passed the Senate Health Committee on April 24, would have public health officials 鈥 rather than doctors 鈥 decide who qualifies for a medical exemption to being vaccinated. The bill is needed to close a loophole in Pan鈥檚 2015 law that eliminated the personal belief exemption and gave California some of the toughest immunization legislation in the nation. (5/5)

The consequences of limited access to hormonal contraception are unplanned pregnancies. Unsurprisingly, the women who cannot afford doctors鈥 visits to obtain birth control cannot afford the medical costs associated with pregnancy. As a result, the government frequently foots the shockingly large tab for their medical care. In fact, in 2010, Texas pregnancies cost taxpayers $2.9 billion. (Marc Hyden and Courtney M. Joslin, 5/3)

As a physician practicing on L.A.鈥檚 skid row, I鈥檝e seen a lot of deaths among homeless people, but this one broke my heart. My outreach nurse announced the news after a call from the coroner鈥檚 office: There鈥檇 been another death on skid row. 鈥淲ho now?鈥 I asked. Her answer was devastating. It was J, whose full name I am not using to protect her privacy. As a physician practicing on L.A.鈥檚 skid row, I鈥檝e seen a lot of deaths among homeless people, but this one broke my heart. (Susan Partovi, 5/4)

After the county decreased mental health services in 2009, the average number of daily psychiatric evaluations in the emergency department nearly tripled within the first year, according to a study published in the Annals of Emergency Medicine. Also, the average length of stay in the emergency department for patients in a mental health crisis increased by more than 50 percent during the same period. (Lorin Scher, 5/5)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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