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When somebody mentions going to the doctor, the common response is, “Are you feeling alright?” Typically, visiting a doctor is associated with feeling unwell. However as more people face health challenges every day, a modernized approach to healthcare known as personalized medicine is gaining prominence. The conventional healthcare model primarily concentrates on treating the disease or symptoms manifested in the patient. It often overlooks the complex web of factors that contribute to the development and progression of the disease. Recent technological advancements have made it possible to detect diseases in their early stages, offering an opportunity for early intervention and prevention.

Personalized medicine takes into account an individual's unique genetic makeup, environmental factors, and lifestyle choices to create a tailored medical plan. This approach aims to make healthcare more personal, predictive, preventative, and participatory. Each person inherits a unique combination of genes from their parents, resulting in an individual with varying susceptibility to different diseases. Moreover, an individual's life experiences further add to the complexity of disease susceptibility.

The personalized medicine approach has the potential to transform the entire healthcare system, with a heightened focus on primary care. In primary care settings, comprehensive information about a patient's health, genetics, and lifestyle is gathered to assess their risk for specific diseases. Collaboratively with the patient, the physician creates a personalized plan for disease prevention and management.

Consider the example of a patient struggling with obesity. During their checkup, various tests are conducted, including genetic markers, BMI measurements, and other baseline assessments. Lifestyle questionnaires delve into diet and physical activity. With this wealth of information, the medical team can work alongside the patient to develop a tailored strategy for managing obesity.

While personalized medicine appears to be a promising addition to our healthcare system, several barriers hinder its implementation. The shortage of primary care physicians has led to high workloads, making it challenging for the physicians to dedicate the necessary time to develop personalized strategies for each patient. Patients may also avoid visiting doctors due to financial constraints or personal preferences. Additionally, the introduction of numerous tests can complicate insurance costs, potentially making healthcare more expensive and subject to disputes over necessity.

To bring about this drastic shift in healthcare, it is critical to reevaluate and restructure parts of the current healthcare system. The current model is unsustainable for the rising complexity of chronic diseases that require strategies for prevention even before symptoms manifest. With more than two-thirds of US healthcare expenditures directed toward chronic diseases, personalized medicine offers a solution to alleviate the burden of noncommunicable diseases. It falls upon the collective demand for change to transform this concept into a system capable of saving countless lives.

Edited by: Sam Shi

Graphic Designed by: David Axon


Sources

  1. Snyderman, R. (2012), Personalized health care: From theory to practice. Biotechnology Journal, 7: 973-979. https://doi.org/10.1002/biot.201100297

  2. https://www.washingtonpost.com/health/2023/10/17/primary-care-saves-lives/

  3. https://time.com/6257775/patient-burnout-health-care/

  4. https://health.ucdavis.edu/precision-medicine/what-is-precision-medicine.html

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Robotic innovation in medicine has emerged as a pivotal advancement, revolutionizing patient care and surgical procedures by enhancing precision, improving outcomes, and expanding the scope of what is medically possible. In the early hours of 2022, Haytham Almunir was suddenly struck by a devastating stroke that left his hand paralyzed and his speech incoherent. It was later at UC Davis that the brilliant neurosurgeon, Dr. Ben Waldau, unveiled the harsh reality: a carotid stenosis, an insidious artery condition obstructing essential blood flow to his brain. After weighing different options, Almunir consented to the urgent placement of a stent, which holds the artery open. This operation was novel—it was the first stent at UC Davis to be placed by a new endovascular robot. Robots offer critical advancements to the field of surgery; surgeons are optimistic that robotic surgery assistance can reduce the chance that patients return with complications post-surgery. Surgeons maneuvered the robot to navigate a write past constriction in the artery and open it in order to add the stent. Almunir surprisingly shared, “Once I knew about the robot, I felt even more confident in the quality of my surgical care.”

The introduction of robots to UC Davis transformed surgeries throughout the year. In November 2022, UC Davis Health introduced a robot to facilitate cranial procedures, including deep brain stimulation implants for conditions like Parkinson's disease. This marked an expansion of robotic technology, which was already being utilized for spinal surgeries and endovascular procedures. UC Davis Health is now leading the way by providing the first comprehensive robotic neurosurgery program in the region. These robotic tools are being integrated into a wide range of neurosurgical procedures for patients of all ages, from adults to children and even infants. These technological advancements in healthcare are promoting interdisciplinary collaboration in research, education, and patient care, with different departments coming together to enhance the quality of surgical services. Not only does robot implementation enhance surgeries, but it also facilitates the learning of neurosurgery residents. The addition of the first comprehensive robotic neurosurgery program at UC Davis ultimately reflects how technological development enhances patient care, physician education, and overall health outcomes. In this groundbreaking era of healthcare, robotic neurosurgery serves as a valuable partner to neurosurgeons, allowing for better care to patients than ever before.


Edited by: Sanjana Anand

Graphic Designed by: Acelo Worku


References

  1. Asche, K. (2023, June 4). UC Davis Health offers first comprehensive robotic neurosurgery program in the region. news. https://health.ucdavis.edu/news/headlines/uc-davis-health-offers-first-comprehensive-robotic-neurosurgery-program-in-the-region-/2023/02

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Smartwatches and fitness trackers have become exponentially more popular over the last few years, however, they present several ethical issues regarding privacy of health data. In 2021, a Pew Research Study found that 21% of Americans use smartwatches or fitness trackers (1). By the end of 2023, it is expected that there will be approximately 225 million smartwatch users (2). While there are dozens of different brands, the most common watches include the Apple Watch and Fitbit. Not only has this technology become a trendy way to check texts and time, but it also provides important health information. However, the increased use of wearable technology poses a critical question: is the personal health information stored by these devices kept secure?

The healthcare benefits of these smart devices are expansive. They can measure physical activity, heart rate, sleep, blood pressure, calories, stress levels, alert EMS after a fall, and more. There have even been several cases, such as with Heather Hendershot, where the health features have helped save lives by detecting abnormalities or automatically alerting EMS. For Hendershot, her Apple Watch alerted her of an extremely high blood pressure, and she was later diagnosed with hyperthyroidism, “a condition where the thyroid gland produces excess thyroxine hormone” (3).

Despite all of these benefits, using smart watches presents risks since third-party companies are granted access to health data. While some of the data is used for research, much of what and where the data goes is undisclosed (4). The use of personal health data without the direct consent of the owner of the technology leads to several ethical and legal problems. For example, in 2011, Fibit faced a class-action lawsuit for selling sleep information from their users to outside companies without the owners’ permission (4). Another ethical issue arises with the possibility of breaches in personal health data, which have been shown to be detrimental to the user. These breaches of privacy can lead to direct marketing from companies targeted at smartwatch users and other forms of exploitation.

There are some regulations to protect the privacy of health data, such as the General Data Protection Regulation, which sets standards for all sensitive data, and the Health Insurance Portability and Accountability Act, which regulates standards for Protected Health Information (5). However, to properly protect health data from information breaches and selling, more controlled regulations are needed.

Currently, wearable health information-providing technology serves many benefits to its users, yet presents several glaring ethical dilemmas. Should technology companies be able to sell the health data received from their products without the permission of the users? Given the health benefits of smartwatches combined with the risks of health information leakage, should you buy a smartwatch?


Edited by: Madi McMichael

Graphic Designed by: William Sun


Citations

  1. Holko, Michelle. "Wearable fitness tracker use in federally qualified health center patients: strategies to improve the health of all of us using digital health devices." NPJ digital medicine vol. 5,1 53. 25 Apr. 2022, doi:10.1038/s41746-022-00593-x. Accessed 21 Oct. 2023.

  2. Ruby, Daniel. "Smartwatch Statistics 2023: How Many People Use Smartwatches?" Demand Sage, 6 Mar. 2023, www.demandsage.com/smartwatch-statistics/. Accessed 21 Oct. 2023.

  3. Orellana, Vanessa Hand. "My Apple Watch saved my life: 5 people share their stories." CNET, 9 Sept. 2020, www.cnet.com/tech/mobile/apple-watch-lifesaving-health-features-read-5-peoples-stories/. Accessed 21 Oct. 2023.

  4. Peres da Silva, Jason. "Privacy Data Ethics of Wearable Digital Health Technology." Digitalhealth.med.edu, Brown University, 4 May 2023, digitalhealth.med.brown.edu/news/2023-05-04/ethics-wearables. Accessed 21 Oct. 2023.

  5. "GDPR and HIPAA Compliance – Do They Overlap?" TotalHIPPA, www.totalhipaa.com/gdpr-and-hipaa/#:~:text=The%20biggest%20similarity%20between%20GDPR,Protected%20Health%20Information%20(PHI). Accessed 21 Oct. 2023.

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DMEJ

   Duke Medical Ethics Journal   

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