
Assisted dying can't be sanitised. Stop trying
I spent the beautiful early summer weekend sitting on a bench in the sunshine, talking about death. I was with a close friend who works as a hospice chaplain. Much of her job involves dispensing spiritual consolation and makeshift blessings.
But the main thing that troubles the dying, she says, has nothing to do with faith. As people face the end of their life, the same question comes up again and again: 'How do I know how to die?' They are afraid they will somehow get dying 'wrong' — which sounds absurd, but makes sense when you realise how little experience of death most of us have.
You can make the obvious observation here: how much experience of death is it possible to have when

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Daily Mail
42 minutes ago
- Daily Mail
Truth behind popular energy drink that is 'flagged as cocaine' in drug tests
A viral claim suggesting that Celsius energy drinks can cause false positives for cocaine in drug tests has sparked widespread confusion. The controversy began when a Detroit Tigers sports reporter tweeted on June 8 that Major League Baseball (MLB) teams are advising players to avoid the popular drink. 'Celsius has an ingredient known to flag as cocaine in MLB drug testing, and although it's not officially banned, it's strongly discouraged,' they wrote in a now-deleted post. The post quickly spread across social media, likely due to how popular Celsius has become in the US. It is third-largest energy drink company in the nation. But the drug testing body from MLB has since come out to say the claims are not true. The National Sanitation Foundation (NSF) said: 'We are not aware of any specific ingredient in Celsius that would cause a positive drug test result, nor have we communicated such concerns to any MLB club or player.' Still, it comes as a time when Americans are becoming increasingly concerned about ingredients in their food and drink. Celsius drinks contain about 1,810 mg of taurine, far exceeding the typical daily intake of 40–400 mg. Taurine may promote the growth of bacteria linked to colorectal cancer, which are often more abundant in affected individuals' guts But there is no scientific evidence supporting the notion that Celsius ingredients could be read as cocaine in a drug test. Drug tests for cocaine detect a specific metabolite called benzoylecgonine, a substance not found in Celsius or any of its listed ingredients. Celsius contains common energy drink ingredients like caffeine, green tea extract, and guarana seed extract, as well as artificial sweeteners. These are not classified as banned substances, and there is no scientific evidence that they can trigger a false positive for cocaine. Celsius, however, is not on the list of certified energy drinks for professional athletes. Products like C4 and Red Bull do carry the NSF certification and are commonly recommended to athletes for added assurance. Obtaining NSF Certified for Sport status involves rigorous testing, including lot-by-lot analysis for banned substances, label accuracy, and manufacturing audits. Celsius may not pursue this certification due to the significant cost, time, and effort required, especially if their target market includes non-athlete consumers who don't prioritize NSF certification. has reached out to Celsius for comment but has not received a response. However, the National Collegiate Athletic Association (NCAA) has not banned Celsius specifically, but it does enforce strict limits on caffeine intake for student-athletes. 'Some collegiate athletes may have questions about whether one ingredient in CELSIUS products – caffeine derived from guarana extract – raises any issues under NCAA rules,' Celsius stated on its website. It states that a urine caffeine concentration above 15 micrograms per milliliter will trigger a positive result, typically the equivalent of consuming 500 mg of caffeine within a few hours of competition. A single can of Celsius contains 200 to 270 mg of caffeine, meaning two cans consumed in a short time frame could easily exceed the NCAA threshold. These limits are in place to reduce health risks from excessive stimulant use, including jitteriness, rapid heart rate, and dehydration. Celsius energy drinks contain guarana, taurine, and L-carnitine, none of which are banned by the NCAA or US Anti-Doping Agency (USADA). However, guarana is a concentrated source of caffeine, and excessive consumption could push athletes over the NCAA's caffeine threshold. A 12-oz can of Celsius typically contains about two eight-ounce cups of coffee. The FDA recommends healthy adults limit caffeine to 400 mg daily (roughly two cans of Celsius), but individual sensitivity varies. For some, even one can may cause jitters or other effects. Caffeine's half-life of three to five hours means repeated consumption can lead to accumulation. Celsius has faced a class-action lawsuit over alleged misbranding, such as misleading claims about preservatives.


The Independent
43 minutes ago
- The Independent
Weight-loss drugs were said to be a game changer. Turns out the benefit might be thinner than thought
Common GLP-1 weight loss drugs - including Wegovy and Ozempic - may not work for everyone in a 'real-world' setting, Cleveland Clinic researchers said Tuesday. The reason is that patients may take lower dosages or discontinue their treatment, negatively impacting the ability to control blood sugar levels in those who are pre-diabetic. The findings may have implications for people considering using the drugs, that are taken by more than eight million Americans every year. They've offered an alternative to traditional and taxing weight loss methods, such as diets and fitness. 'Our study shows that patients treated for obesity with semaglutide or trizepatide lost less weight on average in a regular clinical setting compared to what is observed in randomized clinical trials,' Dr. Hamlet Gasoyan, a researcher with Cleveland Clinic, said in a statement. 'According to our data, this could be explained by higher rates of discontinuation and lower maintenance dosages used in clinical practice, compared to randomized clinical trial settings.' Gasoyan was the lead author of the study published on Tuesday in the Obesity Journal. A request for comment from the drugmakers Novo Nordisk and Eli Lilly was not immediately returned to The Independent. The study focuses on drugs with the active ingredients semaglutide and tirzepatide; they include the U.S. Food and Drug-administration approved type 2 diabetes medications Zepbound and Mounjaro. The authors studied their effects on weight loss and blood sugar regulation in a real-world setting. They noted that previous randomized clinical trials have shown the efficacy of those medications. The authors monitored the health of nearly 7,900 adults who were severely obese. Of those, more than 1,300 had pre-diabetes at the study's start and were at a higher risk for developing type 2 diabetes: a chronic condition that affects a person's ability to use insulin and keep blood sugar at normal levels. Participants took the shots between 2021 and 2023. The researchers sorted patients who discontinued their obesity medications into two groups: those who did it within just three months and by three months to a year. The study's follow-up period ended last December. The most common reasoning for discontinuation of treatment in the real-world setting was due to the steep cost of the drugs and insurance, side effects and shortages. Notably, since the study's, prices have started to fall. Of the participants, more than 20 percent discontinued their medications early and 32 percent discontinued their medications late. Furthermore, the authors noted than more than 80 percent had been on the lower dosages needed to sustain a therapeutic effect. For semaglutide, that's equal to or less than 1 milligram and equal to or less than 7.5 milligrams for tirzepatide. Following a year of treatment, the average weight reduction was 3.6 percent among participants who discontinued their treatment early, compared to 6.8 percent for those who discontinued their treatment late. But, those who did not discontinue treatment and were on the highest dosages necessary lost the most weight, at up to 13.7 percent with semaglutide and 18 percent with tirzepatide. Participants had higher odds of achieving 10 percent or greater weight reduction after one year of treatment if they did not discontinue their medications or did so late, were on the highest dosages needed for a therapeutic effect, received tirzepatide, and were women. Tracking the maintenance of blood sugar levels in those with pre-diabetes, the researchers said just a third of those who discontinued their treatment early experienced normal blood sugar levels compared to 41 percent who discontinued their treatment late and 67.9 percent who did not discontinue treatment. Lastly, the researchers observed that while patients who discontinued obesity medications lost significantly less weight compared to those who did not, their weight trajectories remained relatively stable. They said that would be the subject of additional research. 'Our findings about the real-world use patterns of these medications and associated clinical outcomes could inform the decisions of healthcare providers and their patients on the role of treatment discontinuation and maintenance dosage in achieving clinically meaningful weight reductions,' explained Gasoyan.


The Independent
2 hours ago
- The Independent
Takeaways from AP's report on financial interests of RFK Jr. adviser who runs wellness platform
Calley Means has built a following by railing against the U.S. health system, often hammering on alleged financial conflicts within the medical establishment. Means, a top aide to Health Secretary Robert F. Kennedy Jr., was hired as a White House adviser in March. He has used that position to accuse physician groups, federal agencies and government scientists of financial interests that bias their work. Means, however, has his own stake in the sprawling health system. He's the co-founder of an online platform that offers dietary supplements, herbal remedies, exercise equipment, light therapy lamps and other wellness products. The Associated Press found that Means' heated rhetoric against the medical mainstream dovetails with the interests of his company TrueMed, which features vendors who are prominent supporters of Kennedy's 'Make America Healthy Again' movement. Because of his status as a temporary government employee, Means is exempt from publicly disclosing his financial details. The AP reviewed more than two dozen interviews, speeches, articles and podcast appearances by Means both before and after he joined the government. Here are some takeaways from the AP's reporting: Attacking prescription drugs, promoting wellness alternatives Means' company, Truemed, helps users take tax-free money out of their health savings accounts, or HSAs, to spend on things that wouldn't normally qualify as medical expenses, such as meal delivery services and homeopathic products — remedies based on a centuries-old, debunked theory of medicine. As a top messenger for the administration, Means has been promoting a new government report that calls for scaling back prescription drugs for depression, weight loss and other conditions. By criticizing the use of drugs and other rigorously tested products, health experts say Means is furthering the interests of his company, which offers alternatives to traditional medicine. 'It reeks of hypocrisy,' said Dr. Reshma Ramachandran, a health researcher at Yale University. 'In effect, he is representing another industry that is touting nonregulated products and using his platform within the government to financially benefit himself.' In a written statement, Means said his government work has not dealt with matters affecting Truemed and has focused on issues like reforming nutrition programs and pressuring companies to phase out food dyes. 'Pursuing these large-scale MAHA goals to make America healthy has been the sole focus in my government work,' Means said. Undisclosed interests The full extent of Means' potential financial conflicts are unclear because of his status as a special government employee. Unlike presidential appointees and other senior officials, special government employees do not have to leave companies or sell investments that could be impacted by their work. Also, their financial disclosure forms are shielded from public release. 'It's a big problem,' says Richard Painter, former White House ethics lawyer under George W. Bush. 'I think it's a loophole." Plugging products and business associates While promoting the administration's accomplishments, Means has not shied away from plugging his own brand or those of his business partners. When asked to offer health advice to listeners of a sports podcast, Outkick The Show, in April, Means suggested they read his book "Good Energy,' which he co-authored with his sister, Dr. Casey Means. He also recommended blood tests sold by Function Health, which provides subscription-based testing for $500 annually. The company was cofounded by Dr. Mark Hyman, a friend of Kennedy and an investor in Truemed, which also offers Hyman's supplements through its platform. Like dietary supplements, the tests marketed by Function Health are not clinically approved by the Food and Drug Administration. 'It ends up favoring these products and services that rest on flimsy grounds, at the expense of products that have actually survived a rigorous FDA approval process,' said Dr. Peter Lurie, a former FDA official who is now president of the Center for Science in the Public Interest. Steering medical dollars into health savings accounts Means says he has not worked on issues impacting HSAs since joining the federal government. Federal ethics laws forbid government employees from taking part in decisions that could impact their financial situation. But before joining government, Means said the mission of his company 'is to steer medical dollars into flexible spending.' 'I want to get that $4.5 trillion of Medicare, Medicaid, everything into a flexible account,' he told fitness celebrity Jillian Michaels, on her podcast last year. Truemed collects fees when users and partnering companies use its platform. Means also founded a lobbying group, made up of MAHA entrepreneurs and TrueMed vendors, that listed expanding HSAs as a goal on its website. Means said in a statement that the group focused only on broad topics like 'health care incentives and patient choice — but did not lobby for specific bills.' Benefits of HSAs questioned Expanding HSAs has been part of the Republican health platform for more than 20 years. The tax-free accounts were created in 2003 to encourage Americans in high-deductible plans to be judicious with their health dollars. But HSAs have not brought down spending, economists say. They are disproportionately used by the wealthiest Americans, who have more income to fund them and bigger incentives to lower their tax rate. Americans who earn more than $1 million annually are the group most likely to make regular HSA contributions, according to an analysis by the nonprofit Center on Budget and Policy Priorities. Most Americans with HSAs have balances less than $500. HSA expansions in Trump's 'One Big Beautiful Bill' are projected to cost the federal government $180 billion over the next 10 years. 'These are really just tax breaks in the guise of health policy that overwhelmingly benefit people with high incomes,' said Gideon Lukens, a former White House budget official during the Obama and Trump administrations. ___