Is It Time to Reevaluate Off-Label Usage?

by Aaron Johnston, WFU JD Candidate ’21

When I was just starting to move out of the “weed-out” engineering college courses—calculus, physics, circuits, and chemistry—and into the core tenets of bioengineering, one conversation with my professor has always stuck out in my mind. I had to write a final paper in the form of a National Institute of Health-style proposal. The goal was to think outside the box and attempt to put something together from the building blocks we had at the time. After one class, I wandered up to the front of the room, apparently with a half-concerned, half-perplexed look on my face.

          “What’s wrong?” my Professor asked.

          “Well, I wanted to run this methodology by you to see what you thought. I’m not sure it will work.” I started sketching out my revolutionary idea. I knew it wouldn’t live up to an NIH proposal, but nevertheless, I was proud of it.

          “. . . and then I’ll use BMP-2 to . . .”

          “Wait, BMP-2? I’d be careful about BMP-2, people have been having issues with it.”

          “But I thought BMP-2 was great for stimulating bone growth in mesenchymal stem cells.”

          “It is, but one thing you will eventually learn is that once people are afraid of something, research is stifled. Go take a look at Medtronic.”

I didn’t think much about that conversation at the time: it was right after new studies about BMP-2 had come to light. Four years later, however, upon entering my first torts class in law school and having our first discussion of products liability, the thought of Medtronic came to mind again. If BMP-2 was such a great, new, innovative method of stimulating bone growth, what could have possibly gone wrong? It turns out, a lot.

Continue reading “Is It Time to Reevaluate Off-Label Usage?”

Triggered

by Allison Spears, WFU JD Candidate ’22

The silence creeps in as the psychiatrist, Dr. Good, approaches my family in the waiting room. An uncomfortable pause and sideward glances are exchanged between us. The room feels like ice and smells like stinging alcohol. Nobody knows what to say or do at this moment. I mean, how could we? I know I never wanted to have to face something like this in my life. I can’t even imagine how my parents are feeling. The reality of my sister’s condition was frightening. Even more so because we were all in the dark for so long while she was struggling with something that we didn’t even know existed. The feeling was equivalent to how it feels when you are about to take the first plummet on a rollercoaster. My stomach felt like it was going to come up and out of my mouth. We all felt that way – uneasy and uncertain. Who would have known one event could put her in a downward spiral in the blink of an eye? I think we all blame ourselves.

***

Continue reading “Triggered”

Let’s Continue to Reap the Benefits of Telehealth After the COVID-19 Public Health Emergency

by James Hughes, WFU JD Candidate ’22

Due to the infectious nature of COVID-19, our health care system has been forced to evolve in order to appropriately serve patients during this deadly pandemic. Before the public health emergency, roughly 13,000 Medicare beneficiaries received fee-for-service telehealth services per week, while almost 1.7 million Medicare beneficiaries utilized telehealth services in the last week of April, according to Centers for Medicare & Medicaid Services (“CMS”) data. Further, telehealth coverage should be a permanent fixture in our health care system, and the federal government should support telehealth coverage beyond the COVID-19 public health emergency.

Before the public health emergency, the U.S. Department of Health and Human Services (“HHS”) did not provide Medicare reimbursements for audio-visual telehealth visits unless the patient lived in a qualified rural area or was within the confines of certain medical facilities. Reimbursement has historically been the primary obstacle to telehealth services. The Telehealth Services During Certain Emergency Periods Act of 2020 allowed for HHS to modify or waive rules for telehealth under Medicare during the public health emergency, and recently, the American Medical Association asked President Trump, HHS, and Congress to extend some of the telehealth policies used during COVID-19 beyond this public health emergency.  

Continue reading “Let’s Continue to Reap the Benefits of Telehealth After the COVID-19 Public Health Emergency”

Homelessness and COVID-19

by Nathalie Freeman, WFU JD/MA in Bioethics Candidate ’21

This year over half a million people in the United States are experiencing homelessness.  Between 25% and 50% of these homeless people work, and during the COVID-19 pandemic, many of these individuals are serving as low-wage essential workers.  Even without considering the current pandemic, individuals who consistently stay in homeless shelters, or live on the streets, have a lower life expectancy, higher rates of addiction, and more underlying health conditions.  With COVID-19 sweeping the country, homeless people are more vulnerable to the virus than housed individuals due to cramped conditions in homeless shelters, lack of access to basic sanitation materials, pre-existing comorbidities, and a general lack of access to health care.  Additionally, a large portion of the homeless population is elderly and already suffering from pre-existing conditions, like chronic heart or lung disease, which make them more likely to succumb to the coronavirus. 

Continue reading “Homelessness and COVID-19”