Bill of Health 2024 Year-In-Review

As we near the end of 2024, here are some of our most widely viewed articles on the Bill of Health blog. 

Reproductive health, aging/longevity, and psychedelics were among readers’ favorite topics this year. Popular articles touched on insurance coverage for psychedelic therapy, polygenic embryo screening, AI in drug development, and medical assistance in dying.

The single most-read article this year was Outlive by Peter Attia: A Book Review, which explored ways to increase life expectancy, with more than 15,000 views.

Catch up on any coverage you may have missed during the holiday break; we will publish again mid-January.

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Canaries in the Coal Mine: HUD’s Failure to End Childhood Lead Exposure in Federally Assisted Housing

by Anna Aguilar and Sidney Lee

In 1971, Congress tasked the U.S. Department of Housing and Urban Development (HUD) with establishing procedures to “eliminate as far as practicable” the dangers of lead poisoning. Yet, HUD has repeatedly fallen short of accomplishing this. More than 50 years later, for children in federally assisted housing in the United States, lead exposure is hardly a thing of the past. Government inaction by HUD has consistently marred efforts to eliminate lead poisoning. HUD typically only takes action to prevent lead poisoning in federally assisted housing when compelled by Congress or a government watchdog. Protecting the health of children should not be reserved only when an agency is compelled to do so – especially when delay places children in jeopardy.

Any amount to lead exposure is hazardous, and young children – especially those under age six – are at particular risk. Even small amounts of lead can cause severe and irreversible harm to the brain. For the 3.6 million children currently living in homes with lead-based paint, each day is a gamble with their health.

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COP29 and the UNFCCC’s Health Turn: Progress or Peril?

by Thalia Viveros Uehara and Alicia Ely Yamin

Conclusion of the Digital Symposium Climate Change and Health:

Mobilizing Public International Law into Action

COP29 in Baku underscored what many had feared — a summit defined by missed opportunities. Perhaps this was to be expected, given that it was the second COP in a row held in a petro-state, with more fossil fuel lobbyists in attendance than climate and environmental activists. The pitiful outcome of $300 billion pledged (by 2035) felt more like an insult than a compromise, particularly when compared to Africa’s $163 billion annual expenditure on debt servicing. 

But the disappointment surrounding financing outcomes was merely a symptom of deeper power imbalances, what critical legal scholar Martti Koskenniemi describes as the “structural biases” of global governance institutions. COP29 marked yet another shift in the fragile equilibrium of the underlying logic of the United Nations Framework Convention on Climate Change (UNFCCC), steering it further toward the ultimate commodification of climate action. What does this mean for the “health turn” that the UNFCCC has recently begun to witness?

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The False Promise of Smart Pills in a Loosely Regulated Market

by Spencer Andrews

We’ve all had the experience: you receive a targeted ad on your phone or computer which mysteriously seems to read your mind. This happened to me recently when I, a busy law student, began receiving a wave of ads selling supplements which purport to improve brain focus, clarity, and memory. I had been thinking about ways to increase my productivity, and just in the nick of time, a miracle drug appeared to answer my need. As it turns out, the product being advertised was of a little-known class of substances known as nootropics. And as you might expect, nootropics are hardly a miracle drug.

What is a Nootropic?

The word nootropic is colloquially used to describe a wide range of natural and synthetic substances thought to have cognitive enhancing properties. Romanian psychologist and chemist Corneliu Giurgea coined the term nootropic in the 1970s. He first used the term after synthesizing piracetam, a compound which he claimed would improve cognitive functions like memory and learning. Clinical studies have since shown that piracetam is not a dependable cognitive enhancer nor does it have long-term efficacy against cognitive impairment. Nonetheless, it has shown modest efficacy as an anti-depressant, and most recently, it has demonstrated some promise as a neuroprotective drug for patients undergoing coronary bypass surgery. Notwithstanding piracetam’s clinical success, or lack thereof, the term nootropic has since evolved into something else entirely.

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Reproductive Health at Risk: Climate Change and Agrotoxins in Latin America

by Cristina Rosero-Arteaga

The climate emergency in Latin America is intensifying a long-standing yet underrecognized health crisis: reproductive harm due to agrochemical exposure, particularly for rural women. As shifting climate patterns threaten to exacerbate these harms, it is crucial to bring these issues into the focus of climate action. The region’s human rights framework — including landmark cases before the Inter-American Court of Human Rights and reports by special procedures — has already addressed the realities of agrotoxins and their impact on health rights. In light of human rights obligations, building on these legal advancements by developing climate policy, like national adaptation plans, is essential to give effect to paragraph 12 of the Paris Agreement’s Preamble, which calls for respecting and promoting human rights, gender equality, and the empowerment of women.

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Would You Sell Your Ancestors? The ethical paradigms of Ayahuasca (Part II)

artwork by Daiara Tukano 

by Daiara Tukano and Maria Fernanda Gebara

Last June, we had the honor of speaking at “Law and Policy of Psychedelic Medicine,” the 2024 Annual Conference hosted by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. You can watch our panel here.

Part I of this post highlighted the ethical considerations surrounding the use of Indigenous medicines. Part II considers paths forward to true ethical engagement.

Part II: Towards ethical integration

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Would You Sell Your Ancestors? The ethical paradigms of Ayahuasca (Part I)

artwork by Daiara Tukano 

by Daiara Tukano and Maria Fernanda Gebara

Last June, we had the honor of speaking at “Law and Policy of Psychedelic Medicine,” the 2024 Annual Conference hosted by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. You can watch our panel here. Speakers from around the world discussed the legal and ethical aspects of psychedelic use.

In two posts, based on the Conference discussions, we aim first (Part I) to highlight the ethical considerations surrounding the use of Indigenous medicines and second (Part II), to consider paths forward to true ethical engagement.

Part I: Ethical Considerations

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Pace Law Review Symposium Edition: “Bioethics After Dobbs”

by James Toomey

On June 24, 2022, the Supreme Court decided Dobbs v. Jackson Women’s Health Organization, overturning the canonical precedent Roe v. Wade and holding that the federal constitution does not protect the right to an abortion. Dobbs has once again thrust abortion to the center of the national political conversation, as states around the country move to ban, restrict, or shield abortion access, while activists on both sides aspire towards a national approach one way or the other. At the same time, lawyers, scholars, advocates, and activists are exploring the implications of Dobbs in a variety of areas—from assisted reproductive technology (ART) to other rights grounded in substantive due process.

Bioethics — the branch of applied ethics focused on ethical questions in biology and medicine — is uniquely situated to offer insights on many of the questions raised in the wake of Dobbs. It is, after all, a field that has long debated questions of the relationship between physicians and patients, the nature of personhood, and the relationship between autonomy and health care.

On April 5, 2024, the Pace Law Review hosted a symposium on “Bioethics After Dobbs” at the Elisabeth Haub School of Law in White Plains, NY. The papers from that symposium have been published in a special edition of the Pace Law Review and are freely available to the public.

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Trump’s 2024 Triumph: A Wild Card for Seniors’ Health Care Coverage?

by Abeer Malik

In an ideal world, everyone has a “safety net” — a reliable layer of support that catches us when life’s challenges become overwhelming. For many Americans, the Affordable Care Act (ACA) has been a crucial piece of that safety net, providing access to affordable health care, expanded coverage options, and support for innovative medical care delivery methods that lower health care costs. During Donald Trump’s previous tenure as president, his repeated attempts to repeal and replace the ACA signaled a clear intent to overhaul federal health care insurance programs, even though the efforts ultimately fell short.

With Trump’s 2024 re-election, while broad health care debates are reignited, it is crucial to zero in on what this means specifically for aging Americans.

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A Brief Quantum Medicine Policy Guide

by Mauritz Kop, Suzan Slijpen, Katie Liu, Jin-Hee Lee, Constanze Albrecht & I. Glenn Cohen

 

I. Introduction: Harnessing Quantum and AI in Precision Medicine

The convergence of artificial intelligence (AI) and quantum technology (QT) in precision medicine promises to revolutionize healthcare by enabling hyper-personalized treatment.

Fundamentally, for our purposes, quantum technology leverages unique properties of quantum physics—such as superposition and entanglement—to solve problems beyond classical capabilities. Second-generation (2G) quantum technologies harness these principles to achieve quantitative (speed, fidelity) and qualitative (novel functionality) advantages over other methods. Quantum-classical hybrids (frameworks, algorithms or devices that integrate both quantum and classical computing resources such as qubits and digital bits) combine elements from both macroscopic and microscopic worlds to solve complex problems.

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