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Adam Tufts: A Systematic Approach to the Invisible Epidemic of Iatrogenesis

The story is simple. An unassuming patient waltzes into the doctor’s office. After months of their dentist harping on them, they’ve finally carved out time to make a wisdom tooth removal appointment. It’s a routine procedure. So they enter the waiting room, their mind at ease. Why would they worry? After all, they are surrounded by professionals who have undergone years of the most rigorous training and have spent even more time afterwards accruing experience with previous cases. The patient is called into the operation room. All is calm. Then the surgeon starts to perform.

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Tiki Kazeem: AI Integration in Medical Science: Transformative Benefits and Ethical Implications

Resource availability is often the limiting factor in modern medicine. That resource may be scientific knowledge or lab operating costs. In the case of 82-year-old Austrian blood cancer patient, Paul, that limiting factor may be time. With the typical cancer drugs failing one by one, and with nothing to lose, Paul’s doctors enrolled him in a clinical trial that used robotic automation and a field of artificial intelligence called computer vision to match people to cancer drugs based on individual biological differences (1). The idea behind this was similar to a traditional doctor’s approach; the machine learning models, trained to identify minuscule changes on the cellular level, were testing different drugs to find out what was effective. But instead of months of chemotherapy on an already frail physique, the computer system could do this all at once, requiring only a small tissue sample from Paul. Miraculously, one of the drugs identified by this process was successful, putting Paul into complete remission two years later. According to current knowledge, that drug was not shown to be effective in his type of cancer. But AI was able to predict something that doctors may never have known. In Paul’s case, AI saved a life by dramatically reducing the time and energy spent on drug testing. As AI increases in prevalence, it is essential to understand its prospective role in healthcare research and outcomes. It has the potential to expedite healthcare processes such as treatment and drug development by providing information that humans alone cannot possess. At the same time, there are critical ethical considerations to take into account when determining how best to implement AI in medical science.

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Daniel Park: Legal Compliance, Ethical Responsibility, and Profitability in the Pharmaceutical Industry

In an era where the line between profit maximization and ethical healthcare practices is increasingly scrutinized, the pharmaceutical industry finds itself under close examination – at the heart of it lies the intricate balance companies like Pfizer must navigate among legal compliance, ethical responsibility, and profitability. This article aims to dissect this balance that has profound implications for the healthcare ecosystem. By critically analyzing Pfizer's settlements and analogous legal confrontations within the sector, this exploration seeks to illustrate patterns and practices indicative of the ongoing struggle between corporate ambitions and regulatory mandates. Moreover, it traverses the nuanced interplay between regulatory frameworks, corporate ethics, and their overarching impact on public health and market dynamics, offering a narrative that serves as a critical lens for examining the delicate balance between advancing medical innovation, ensuring fair market practices, and safeguarding access to essential healthcare services. This analysis contributes to the ongoing discourse on the ethical and legal dimensions of pharmaceutical business practices, underscoring the imperative for a balanced approach that serves both the interests of the industry and the welfare of the public.

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Risha Chakraborty: The Critical Need for Bias Intervention Training for Healthcare Professionals 

Anti-racism interventions for healthcare professionals have grown increasingly necessary since the turn of the 21st century. The Civil Rights Act of 1964 spurred concerted efforts among national and state legislation to identify and eliminate racism in healthcare settings, but addressing medical professionals’ implicit biases has remained the responsibility of medical schools and hospitals. Such institutions instruct students and residents with curricula derived from racist roots, causing the majority of healthcare professionals to retain race-based misconceptions of the physiology and psychology of African-Americans today (1, 2, 3). A 2021 systematic review of 37 anti-racism intervention training workshops found that the curriculum disseminating knowledge of racist stereotypes is lacking (1). However, stereotype replacement and counter-stereotypical imaging are two evidence-based strategies that successfully reduced implicit racial prejudice as measured by an implicit association test in college students, accenting the need for a standardized organization of stereotypes contributing to medical professionals’ implicit biases (4).

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Hannah Nashed: The Good Samaritan Laws

The man lay still on the pavement, a soaked shirt and pair of shorts clinging tightly to his stiff form. His skin was cold and pale —his heart had stopped. John had been on a run when he saw the man fall off his paddleboard. It had taken John 2 minutes to realize that the man was in danger and 4 minutes to pull him out of the water. Now, John had two choices: attempt CPR or wait for the ambulance. In just 6 minutes, the stranger in front of him would die, while the ambulance would take at least 10. There was no other choice. John tilted the man’s head back, laced his fingers together, and pushed hard in the middle of the man’s chest. The stranger woke up the next day in the hospital, alive but with several broken ribs as a consequence of John’s attempted CPR. The man tried to press legal charges, but John was protected under the Good Samaritan Law.

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Adam Tufts: The Legal Histories of End-of-Life Care

We lead heavily legislated existences because we crave order; we want to uphold our fundamental rights to liberty, the pursuit of happiness, and especially life. However, a great legal, medical, and philosophical quandary arises when one seeks to surrender this basic right to life which undergirds the entire legal framework of the United States. To what legal obligations is one still bound when on the verge of death? Or when they actively pursue death? Multitudes of legislators and judiciaries have reckoned with these inquiries for decades over an extensive series of court cases. Looking at these legal and medical histories, a variety of semantic differentiations help to facilitate discussion on the broad topic that is end-of-life care.

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Meera Vashisht: Forced and Coercive Sterilization of Native American Women

It is time that the fatal repercussions of biases from our nation’s health care providers against Native Americans and other ethnic minorities is better scrutinized. Native American women have the highest maternal mortality rate of any ethnic group living in the United States. Indigenous women are approximately three times as likely as White women to die of pregnancy-related causes, and hemorrhage and hypertensive disorders during the gestational period are among the biggest contributors1. According to the CDC, sixty percent of maternal deaths are preventable, and it is well overdue to implement greater preventive efforts, including funding more and better research, as well as responding to factors that contribute to these disproportionate maternal mortality rates2, 3. This study deals with institutional racism within the US health care sector and its impact on Native American women during and after childbirth, as well as the related social determinants of health, social injustice, and structural racism that continues to permeate within this community .

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Isabel Rancu: Fighting Fentanyl— From Rural South Carolina to National Efforts

Two years ago, Dr. Doug McGuff was working a shift at an ER in Upstate South Carolina when a group of first-year college students were rushed in, unable to breathe. From the first responders, he gathered that they had been found using marijuana, a mild psychoactive drug capable of inducing hallucinations; however, he knew that the marijuana alone could never be responsible for such an aggressive reaction. As Dr. McGuff worked to save the lives of his patients, he knew he was witnessing an episode of the same public health crisis documented around the country- a crisis that plagued patients from San Francisco to Baltimore. He was racing against a silent killer, one found in mere microgram quantities within the bloodstream of his patients: fentanyl.

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Evelyn Jiang: Stem Cell Tourism: Balancing Hope and Harm

With its potential to treat a wide range of debilitating diseases and injuries, stem cell therapy has captured the interest of the medical community and patients alike. However, most stem cell applications are still in their infancy and have yet to demonstrate clinical benefits. Within the US, the stringent FDA regulatory framework limits the availability of stem cell therapies that have not undergone rigorous clinical testing and approval processes. This framework is necessary to ensure the safety and efficacy of stem cell therapies for patients but also means that the development and approval of new stem cell therapies can be a lengthy and expensive process. In the interim, the provision of unproven stem cell interventions has developed into an unregulated global industry: desperate patients who are promised medical benefits beyond what the scientific literature can substantiate pay large sums of money to private clinics in countries with less rigorous regulations, such as Mexico and Thailand. This form of medical travel is called "stem cell tourism" and has been criticized for numerous ethical, legal, and health concerns. As reckless policies may drive patients away from clinical researchers, promote illegal activity, and tramp on other forms of medical travel, it is critical to strike a balance between recognizing the hope that stem cell treatments can offer and the harm that unproven treatments can cause. Thus, effective solutions can be devised only by understanding the nuances and challenges of this industry.

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Dinesh Bojja: AI in Healthcare

The release of ChatGPT in November 2022 resulted in the biggest and fastest boom in artificial intelligence (AI) technology. Within a week, 1 million people had signed up to use the technology; by January 2023, ChatGPT boasted over 100 million users, a feat that took giants like TikTok, Instagram, and Google far longer to achieve (9 months, 2.5 years, and 5 years, respectively). With the AI buzz only growing, everyone from start-ups to researchers to individuals is looking for their own way into the sphere. The Wall Street Journal reports that over $2.6 billion was invested into AI startup technology last year—a trend likely to continue, as AI is considered one of the most secure investments in modern technological innovation.

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Sindi Daci: Telehealth—A Sustainable System Attempting to Address Issues in the Healthcare Industry

The COVID-19 pandemic disrupted the normal performance of our healthcare system. Problems that were always present in the healthcare system such as high healthcare costs and low quality of care, were further exacerbated by this pandemic. In response, many solutions to pandemic related challenges emerged including the transition to the telehealth system. Telehealth refers to the distribution of healthcare services using telecommunication technologies without any in-person visits (Mayo Clinic). Telehealth existed prior to COVID-19, but was amplified by the pandemic due to concerns over virus transmission during in-person meetings. In addition to solving pandemic related challenges, telehealth also addressed the persistent problems present in the healthcare system. As a result, telehealth has gained prominence over the past few years.

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Shreya Nuli: A Political Counter-Narrative of Alternative Medicine’s Rise

Amidst tremendous technological advances, industrialization, and expansion, 19th century America found itself a new nation with a mosaic of interplaying healthcare systems. Although the new republic entered the century as only a democracy of 16 states trailing along the Atlantic coastline, it quickly became a mass spanning the entire continent, inviting more than 30 million immigrants from Europe. The resulting melting pot of social structures, cultural values, religious beliefs, and health practices all contributed to a novel way of life. Specifically, the developing American medical system reforged, enriched, and tailored the premises of old world practices to adapt to the new democracy (Baker, 2006).

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Evelyn Jiang: To Fib or Not to Fib: Deception in Dementia

When a distraught Alzheimer’s patient pounds on his bedroom door demanding to be brought home, staff members at the Lantern of Chagrin Valley assisted living home in South Russell, Ohio are well prepared to respond—the door is opened, a nursing aide brings the patient to the nearest bus stop, and the patient is left alone to wait for his bus (MacFarquhar, 2018). At the same time, in a Boston care center, a similarly distraught patient is placated by a timely phone call from her daughter. As she moves to sit down, they discuss the past weekend, meal plans, and gardening. 

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Dinesh Bojja: Chimeras—Taming the Modern Medical Monster

The Chimera. Feared in Greek Mythology as a terrifying monster, an amalgamation of various animals: the head of a lion, the body of a goat, the end of a dragon, and with fire-breathing abilities to boot. Though chimeras are a myth of ancient times, scientists in the 21st century have begun to revere them again—now as a vessel for accelerating research. Other members of the scientific community, on the other hand, fear that chimeras may be harnessed wrongfully, compromising ethics for the sake of healthcare and the sciences.

Chimeras, broadly speaking, are organisms that contain cells from two distinct genotypes—not necessarily from two different species. The first reported chimeras, dating from the mid-to-late 20th century, were humans with two sets of DNA; through blood testing, individuals found that they contained cells with different DNA in various parts of their body, usually from a fraternal twin they absorbed in the womb.[1] This was revolutionary, as it marked the potential for individuals to contain DNA from two different human genotypes, and also sparked scientists’ interest: could interspecies chimeras exist?

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Meera Vashisht: Ending HIV/AIDS within Native American Communities

Battling HIV and AIDS, a highly stigmatized disease, is an issue the Indian Health Service has been dealing with for decades. With 574 federally recognized American Indian and Alaska Native tribes, creating culturally appropriate prevention for each tribal identity presents a host of problems (14). Every tribal community has a distinct and unique culture, belief system, and set of practices. With this required nuance among tribes, prominent issues cannot be addressed in a uniform way - issues like preventing the spread of HIV/AIDS. Data from the National Native American AIDS Prevention Center shows that Native Americans comprise 6% of all new HIV infections while representing less than 1% of the US population (1). Moreover, our current data on Native Americans and AIDS offers misleading information, often making it appear as if HIV infections within Native communities has become so low that it has declined. This is a false construct. Compounding issues with the current data, many living within Native communities have been racially misidentified, leading to undercounting of indigenous populations within HIV surveillance systems, inevitably contributing to underfunding to the Indian Health Service (3).

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Meera Vashisht: Remembering Just Enough to Stay Home

The relationship between Native American peoples and the United States Government’s health care policies has been problematic since its inception, with many unresolved issues continuing to present day. Without question, the Federal Government has a legal obligation and responsibility to provide care for Native peoples following the forced relocations and displacement of indigenous populations. Unfortunately, government initiated programs have continually fallen short of agreed-upon promises.This study provides a short analysis of the historical founding of what is today known as the Indian Health Service (IHS), as well as the Congressional acts, laws, treaties, and reasonings behind Native health care initiatives, plus how these plans have largely failed, and continue to fail, indigenous communities. Presently, Native populations have been heavily impacted by inadequate access to a fully comprehensive health care plan, and inequities are still being faced by Native Americans who desperately rely upon government sanctioned health facilities from the IHS, as further evidenced during the most recent Coronavirus outbreak.

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Sindi Daci: CRISPR—Help or Harm to Health?

In 1973, the science community reached another breakthrough during a period of booming innovation. Genetic engineering emerged, promising to revolutionize science and medicine. Genetic engineering was enhanced and developed in order to capture the growing demand for finding potential cures. It led to the creation of CRISPR/Cas9, another form of gene editing. These enhancements to genetic engineering were highly effective, but equally controversial. Unanticipated consequences like the potential to create designer babies with ideal traits, and the modification of human embryos were met with extreme hesitancy. These problems surrounding genetic engineering threaten to diminish its potential benefits. Therefore, extensive regulations are needed in order to ensure that both ethical and legal standards are met before the technology becomes widespread in humans

Biologically, genetic engineering involves modifying the genetic makeup of organisms through Recombinant DNA (rDNA). The rDNA is equivalent to a cut and paste system, where enzymes first cut or fragment a designated DNA sequence, and then insert and paste pieces of DNA from another

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Sindi Daci: Biomedical Cloning—One Step Closer to a Revolution

Consider the following two questions:

How would you like to have another you…a clone with traits superior to your own?

Alternatively, how would you like to have an entire lifesaving organ created from just a single one of your cells?

These two questions fundamentally revolve around the age-old idea of cloning, but they highlight different uses of cloning. Biomedical cloning, also referred to as therapeutic cloning, is the cloning of patient cells that can then be used to create tissues and organs.

It is important to note that while human embryos have been cloned, there has never been a verified case that a viable human has resulted from the procedures. Therefore, given that parts of this area in science are unexplored, this paper will examine the reported potential procedures, risks, and complications associated with cloning.

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Sofiya Bidochko: Covid-19 Vaccination

COVID-19 vaccines are crucial to saving lives, protecting healthcare systems, and ending the pandemic. They inject hope into the minds of fearful people—hopes of protection, survival, and eventual normalcy. However, these injections of hope have not been equally distributed across the world. Rather, the vaccine supply—severely limited by a lack of raw materials and manufacturing facilities—has been bought out by high-income countries that have supported vaccine development efforts and paid hundreds of millions of dollars.

In May of 2021, according to tweets from the UN Under-Secretary-General Melissa Fleming, more than 80% of the approximately 1.3 billion coronavirus vaccines administered worldwide were in high-income countries, leaving the other countries greatly unprotected. Countries such as the US and Israel—which have paid over a billion dollars combined—have had enough vaccine supply to fully vaccinate every citizen and offer boosters while developing nations still cannot offer each citizen their first dose. This discrepancy has caused the latter to face constant catastrophic surges of the virus, completely overwhelming healthcare systems. Additionally, it has global consequences, as highly unvaccinated nations are breeding grounds for worrying variants.

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