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26. Carl Schneider, JD: Patient Decision-Making, Questioning Informed Consent, and Why IRBs Should Be Abolished

In this colorful conversation, Daniel Belkin and Mitch Belkin speak with Carl Schneider, JD about informed consent and the problematic nature of IRBs. We discuss the difficulties of patient education and whether patients actually want medical knowledge in order to guide their decision-making. We discuss the onerousness of IRB regulation, event licensing, the costs of inhibiting knowledge generation, as well as the paternalism of IRBs. We cover how “protections” for vulnerable groups counterintuitively harms these groups by preventing both the generation of knowledge and the development of treatments. Professor Schneider argues that IRBs should be abolished and the system of informed consent ought to be reconsidered.

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Who is Carl Schneider?

Professor Carl Schneider is a lawyer and bioethicist. He is a Professor of Ethics, Morality, and the Practice of Law at University of Michigan. After attending University of Michigan Law School, he served as law clerk to Justice Potter Stewart of the United States Supreme Court. Schneider has authored several books, including The Censor’s Hand: The Misregulation of Human-Subject Research and The Practice of Autonomy: Patients, Doctors, and Medical Decisions.

References

If you enjoyed this episode, be sure to check out our episode with Simon Whitney.

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25. Adam Cifu, MD: On Ending Medical Reversals and Reimagining Medical Education

In this conversation, Daniel Belkin and Mitch Belkin speak with Adam Cifu, MD, about how to improve medical education, the importance of evidence-based medicine, and medical reversals. We discuss his collaboration with Vinay Prasad, MD, why we should swap the order of medical school curricula, and landmark trials that changed his clinical practice.

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Who is Adam Cifu?

Adam Cifu a general internist and professor of medicine at the University of Chicago. He is a clinical educator, a podcast host, and the author of over 100-peer reviewed articles as well as two books: Ending Medical Reversal: Improving Outcomes, Saving Lives (2015) and Symptom to Diagnosis: An Evidence Based Guide (4th Edition, 2019).

References

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24. Sekar Kathiresan, MD: Pioneering Single Dose Medications to Cure Cardiovascular Disease

In this conversation, Daniel Belkin and Mitch Belkin speak with Sekar Kathiresan, MD, about using gene editing medications to treat cardiovascular disease. We discuss Dr. Kathiresan’s company Verve Therapeutics, which has pioneered a lipid nanoparticle delivery system of a CRISPR-based gene editing technology. We delve into the pathophysiology of cardiovascular disease, the role played by LDL and the LDL receptor in atherosclerosis, the genetics underlying monogenic and polygenic risk for myocardial infarction, CRISPR and the future of gene editing technologies, and Verve’s ongoing phase I trial of a PCSK9 gene editing medication (VERVE-101) in humans.

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Who is Sekar Kathiresan?

Dr. Sekar Kathiresan, a cardiologist, geneticist, and the CEO and co-founder of Verve Therapeutics. Verve Therapeutics is a company pioneering a new approach to the treatment of cardiovascular disease with single-dose gene editing medications. Prior to co-founding Verve, he served as the director of the Massachusetts General Hospital Center for Genomic Medicine and was a Professor of Medicine at Harvard Medical School. 

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23. Joel Topf, MD: Acute Kidney Injury, Contrast-Associated Nephropathy, and Precious Bodily Fluids

In this conversation, Daniel Belkin and Mitch Belkin speak with Joel Topf, MD, about contrast-associated nephropathy. We discuss Acute Kidney Injury (AKI), the value of creatinine as a marker for AKI, how to evaluate volume status, the evidence around contrast-induced/contrast-associated nephropathy, recommendations on fluids to prevent AKI in patients with Chronic Kidney Disease, and comparing venous and arterial contrast with respect to the risk of AKI.

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Who is Joel Topf?

Dr. Topf is a clinical nephrologist in Detroit, who is a partner and medical director at St Clair Nephrology and an assistant professor at Oakland University William Beaumont School of Medicine. He is the co-creator of NephMadness and NephJC. He hosts multiple podcasts, blogs at pbfluids.com, and tweets @Kidney_boy. 

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22. John Cochrane, PhD: The Economics of Affordable Healthcare

In this conversation, Daniel Belkin and Mitch Belkin speak with Professor John Cochrane about the economics of the American healthcare system. We discuss the lack of clarity around US healthcare pricing, as well as how employer-sponsored health insurance and the persistence of massive cross subsidies contribute to dysfunction in the US healthcare market. Professor Cochrane argues that the best way to solve these problems is to simplify regulation and remove regulatory hurdles which prevent innovative entrants from improving healthcare and making it more affordable.

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Who is John Cochrane?

Professor John Cochrane is an economist specializing in finance and macroeconomics. Formerly a professor at the University of Chicago, Cochrane is now the Rose-Marie and Jack Anderson Senior Fellow at the Hoover Institution at Stanford University. He blogs regularly as The Grumpy Economist at https://johnhcochrane.blogspot.com/.

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