DMEJ
Duke Medical Ethics Journal
Spring 2025 Blog Highlights
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Nicholas Hoffmann • April 13th
In today’s world, science moves at a breakneck speed, constantly influenced by political and social needs. Groundbreaking medicines are developed every year, giving people an arsenal with which to fight a seemingly ever-expanding number of diseases. In light of recent crises such as COVID-19, one question has come to loom large: when it comes to drug approval, how fast is too fast? The U.S. Food and Drug Administration (FDA), tasked with protecting public health through the regulation of items such as drugs and food, sits at the center of this ethical balancing act — carefully walking the line between speed and safety. However, as commercial and societal pressures intensify, so have the ethical dilemmas surrounding the FDA’s role.
Daniel Santo • April 6th
The U.S. prison system can house about 1.9 million people, making it the world’s largest incarcerated population [1]. However, despite the mandate under the Eighth Amendment prohibiting cruel and unusual punishment, incarcerated individuals frequently experience inadequate healthcare. This issue has raised significant ethical concerns regarding human rights and systemic disparities in access to care. Prisoners, regardless of their crimes, have the right to proper medical treatment. However, a combination of underfunding, staff shortages, and systemic barriers often leads to substandard care.
Jacqueline Rodriguez • March 29th
Healthcare pricing has long been a subject of confusion and frustration for Americans. Despite being one of the most significant financial burdens on families, healthcare pricing remains notoriously obscure, leaving consumers at a disadvantage when it comes to understanding and navigating costs. In an effort to address this issue, President Donald Trump issued an executive order on February 25, 2025 mandating that hospitals and insurance companies disclose more detailed pricing information to patients; this executive order represents progress towards a more transparent and patient-friendly system. However, it has sparked debate about its effectiveness in lowering healthcare costs and empowering patients.
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Suraj Chatoth • March 29th
Changing policies on regulation and communication for independent healthcare organizations may have serious implications for the public health sector, as the Center for Disease Control and Prevention (CDC), who are at the forefront of a rapidly changing healthcare industry. Communication with the public and data availability are recent developments that have brought public health concerns and controversies in the public eye.
Jacqueline Rodriguez• October 28th
Diversity, Equity, and Inclusion (DEI) have become central to the conversation of improving medical education and healthcare. Medical schools and healthcare institutions have adopted DEI initiatives to address racial and socioeconomic disparities, aiming to create a more representative workforce. However, these programs have sparked many controversies and the current presidential administration has taken a hard stance against these policies, arguing that they prioritize identity over merit and lead to discrimination. This tension embodies a core question: Is DEI an essential tool for equitable healthcare, or does it amount to unfair discrimination?
Romit Chanduri • March 29th
Public health programs are critical in creating healthcare systems because they prioritize prevention over treatment, resulting in more sustainable and cost-effective healthcare solutions. As healthcare systems throughout the world confront increased pressure from aging populations, chronic disease, and limited access to resources, preventative measures have emerged as a viable policy tool for lowering long-term healthcare costs, improving population health, and addressing inequities. This shift to preventative medicine delivers a multifaceted strategy that includes legislative reforms combined with public health initiatives and active engagement from government agencies to provide aid to healthcare professionals and the necessary communities.
Jason Lily • March 29th
We often think of justice in terms of courts, verdicts, and prison sentences. But what happens when someone enters the prison system and becomes, in many ways, invisible? One of the most overlooked aspects of incarceration in the U.S. is healthcare. Not just access to it, but the quality, the ethics, and the enormous disparities between policy and practice.
Sarah Croog • March 29th
The recent turnover of administration, particularly the confirmation of Robert F. Kennedy Jr. as the United States Secretary of Health and Human Services, has reignited the already intense debate over vaccines. RFK Jr. is well known for his strong opposition to vaccines, having founded Children’s Health Defense, an organization that promotes vaccine skepticism and sells merchandise with slogans such as “Unvaxxed Unafraid” and “No Vax No Problem” [1]. His appointment as the nation’s top health official has brought renewed attention to the ethical concerns of vaccine mandates – an issue that has been contentious long before his confirmation.
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Abida Chowdhury • March 3rd
South Asian Americans face significant mental health challenges, yet systemic barriers within the U.S. healthcare system hinder their access to appropriate care. The South Asian American population is large, with about 5.4 million South Asians living in the United States today. South Asian Americans have higher rates of depression, anxiety, and suicide than the general U.S. population but the lowest rates of seeking mental healthcare (5). Despite these alarming trends, U.S. mental health policies fail to address South Asian-specific needs due to a lack of research, cultural and linguistic barriers, and inaccessible insurance structures. This blog examines these challenges and proposes policy solutions to address these disparities.
Matthew Ahlers • March 3rd
Recent national polls reveal that 80% of adults believe the cost of prescribed medication is unreasonable [1]. The prices of many lifesaving drugs have skyrocketed; for instance, Mylan’s EpiPen, an emergency treatment for severe allergic reactions, has seen a 600% increase in cost [2]. Unfortunately, such cases are not uncommon as the U.S. government spends around $1,200 per person on prescription drugs—the highest amount globally and 2.56 times higher than comparable countries [1]. The majority of Americans want lower drug prices, yet pin-pointing the exact cause of price inflation is challenging due the complex nature of the problem.
Riya Sangwan • March 3rd
At the root of scientific discovery is the accumulation of thought, skill, and work of people and communities everywhere — research. However, regulating this multibillion-dollar industry requires both financial and ethical infrastructures. In terms of medical research, federal infrastructures like the National Institutes of Health (NIH) and other substructures, like Institutional Review Boards (IRBs), exist to regulate these aspects of medical research. But, what happens if they lose funding?
Jaida Ciampi • March 3rd
In vitro fertilization (IVF) has become a focal point of political unrest, especially, because the procedure raises a series of complex and nuanced ethical questions that cannot be easily categorized in binary terms, as some politicians may suggest. IVF, one of the most effective fertility treatments, is one in which doctors collect mature eggs from a woman's ovaries, fertilizing them with sperm to create embryos, and then freeze many of those embryos for future use (1). The embryos are stored by replacing the water in their cells with a protective fluid and freezing them using liquid nitrogen (4), a procedure that is highly controversial over its morality. Since the overturning of Roe v. Wade, opposition to IVF has gained traction, with some anti-abortion groups questioning the ethics of embryo creation and destruction. This division highlights the broader moral dilemma facing lawmakers: balancing the potential benefits of IVF in helping individuals start families against the ethical concerns surrounding embryo creation and destruction.
