WASHINGTON (AP) — A prescription refill program that quietly launched in Utah earlier this year has kicked off a big medical debate: Is artificial intelligence ready to take over tasks that, until now, could only be performed by doctors?

The program allows Utah residents to skip the doctor’s office and get their prescriptions refilled online by an AI chatbot called Doctronic. It’s a seemingly simple step toward making healthcare more convenient for patients and prescribers.

But it’s also a precedent-shattering milestone that has set off alarm bells for doctors, lawyers and public health experts. The pilot program has laid bare a host of questions about the role of AI in medicine, including how it should be regulated, whether doctors should be able to veto it, and what kind of safety measures are needed to protect patients.

At the center of the debate: state and federal laws limit prescribing to licensed medical professionals. Proponents say those laws, which have underwritten American medicine for over 100 years, should be updated to include AI chatbots and other new technologies.

“We have crossed a threshold in terms of giving something that is not human a medical license, whether or not we want to call it that,” said Dr. Eric Bressman of the University of Pennsylvania.

AI cannot practice medicine under current laws

Bressman and other experts say they aren’t opposed to AI prescribing. But they say it should have to meet rigorous standards akin to human doctors, who undergo years of testing and training before being licensed to practice medicine.

In Utah, Doctronic was able to launch thanks to a “regulatory sandbox” that allows state officials to waive laws for AI companies offering promising technology.

The refill program is currently overseen by a five-member board of AI specialists, none of whom are doctors, who say they have implemented numerous safeguards. During the program’s initial phase, for example, human doctors review all Doctronic refill orders. The company expects to soon transition to fully automated refills.

The head of the state’s medical licensing board says he and his colleagues learned of the program when its January launch was reported in the news. In a March letter to the state, 11 board members called for the program to be halted, citing the risks of automatically renewing medicines that can have side effects or drug interactions.

“We were essentially told: ‘Yes this is going on. And no, you don’t have a say in it,’” said Dr. Alan Smith, a family physician who heads the board but said he was speaking only for himself.

Complicating the picture is the fact that medical technology is traditionally regulated at the federal level, while medical professionals are overseen by states.

Doctronic executives consider their AI part of the state-regulated practice of medicine. But the federal Food and Drug Administration is supposed to oversee AI that directly impacts medical care or decision making, a line that some experts believe Doctronic has crossed.

Some states are clearing the way for AI in healthcare

In an interview, Doctronic’s executives wouldn’t say whether they have sought permission from the FDA.

“Our goal here is really just to meet patients where they need healthcare,” said Dr. Adam Oskowitz, who co-founded the company with a tech industry entrepreneur. “We try not to get too deep into the weeds on the regulatory side.”

In Utah, residents can visit a Doctronic website built for the refill program. After confirming their identity, the AI chatbot asks users about their prescriptions and medical history, verifying that they have a valid prescription by tapping into a national pharmacy database. If there are no issues, the AI can renew the prescription and send it to a local pharmacy. If the request requires more attention, the chatbot transfers the patient to a doctor who works for Doctronic’s telehealth service.

Oskowitz envisions a future where many routine medical tasks, including ordering tests and analyzing results, can be offloaded to Doctronic, allowing doctors to manage thousands more patients than they can today.

Other states are also waiving rules for AI, including Texas and Wyoming.

Meanwhile, lawmakers in Iowa, Idaho and elsewhere have introduced legislation to formally license AI medical services. Many of the bills are based on a template from the nonprofit Cicero Institute, a pro-AI think tank founded by Joe Lonsdale, co-founder of the artificial intelligence software company Palantir.

Pushback against medical AI mainly stems from the economic fears of doctors and other health workers, says Cicero’s director for health policy.

“Whoever goes first is going to take the slings and arrows because there’s economic interests, concerns about the workforce and what that’s going to mean for jobs,” said Cicero’s Adam Meier.

Doctors see potential risks to AI prescription refills

Smith, the medical board chair, says the risks to patients are real. He points out that Doctronic’s list of 190 refillable medications includes blood thinners, which can become dangerous if patients develop stomach ulcers or other conditions that cause internal bleeding.

“Many times when I see people after six months I find that their medical history or situation has changed,” Smith said. “Just because something was prescribed before does not mean it’s appropriate now.”

The American Medical Association has voiced similar concerns, warning that “prescription renewals aren’t routine checkboxes.”

Zach Boyd, who heads Utah’s AI office, said Doctronic has thus far been overly cautious, often elevating uncontroversial decisions to doctors. In response to safety concerns, several medications have been removed from the list eligible for refills, including a drug for irregular heartbeats.

Utah has released some initial data on the program and Doctronic plans to publish peer-reviewed studies later this year. Currently the only publication about its technology is a paper written by company scientists that was not independently reviewed.

The study looked at whether Doctronic could correctly diagnose medical conditions based on records from 500 telehealth consultations. In the study, Doctronic’s diagnoses matched that of human doctors 80% of the time.

The FDA is taking a hands-off approach

Bressman says Utah should have demanded data on prescription refills up front, not after Doctronic was up and running.

“Mostly they’re accepting the company’s word on good faith that they’re up to the task,” he said.

The current approach to AI mirrors the haphazard medical standards of the early 20th century, Bressman says, before medical schools, medical boards and other authorities agreed on national benchmarks for training and licensing.

National guidelines on medical technology would typically come from the FDA, but the agency has indicated it plans to take a hand-off approach, at least under the current administration.

An FDA spokesperson said the agency has not authorized any AI chatbots but “is committed to encouraging medical innovation and helping bring promising new technologies to patients, while keeping safety at the center of every decision.”

For now, Doctronic and other companies are likely to expand across states with different regulatory approaches.

“Companies may benefit in the short term by expanding their business models and kind of having the technology go beyond the evidence,” says Daniel Aaron of University of Utah’s law school. “But in the long-term, I think they risk compromising public trust and fueling backlash.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Nigel Farage faces a battle to remain an MP with the Tories set on reclaiming his Clacton seat if he faces a sleaze probe-induced by-election.

The embattled Reform UK leader is facing growing questions over his financial affairs and is subject to a Parliamentary investigation over a £5million gift from Thailand-based party donor Christopher Harborne.

At the weekend he was again reported to the Westminster sleaze watchdog over the support given to him by long-term associate George Cottrell.

The Sunday Times reported that Cottrell, who has a fraud conviction in the United States, provided funding for staffing and security, and the use of a London townhouse.

Critics have said that this should have been declared under Parliamentary rules, but Mr Farage has claimed he is the victim of an ‘establishment hit job’ and insisted he had committed ‘no wrongdoing’.

If the probe is ruled against the Reform leader and suspends him from the Commons for more than 30 days he would be subject to a recall petition by voters, which could trigger a summer by-election. 

A Tory source said: ‘If a by-election in Clacton comes, we will be ready.’

Mr Farage could face a challenge on his right flank, with Restore UK leader Rupert Lowe, a former Reform MP, vowing to throw ‘everything’ at winning as well, having come third in the Makerfield by-election.

The Sunday Times said Mr Cottrell recruited and paid three staff to work on Mr Farage’s social media before the general election, and has continued to allow him to use a five-storey Georgian property he rented near Buckingham Palace.

Under rules in place at the time of Mr Farage’s election in 2024, new MPs were required to register any gifts worth more than £300 they received in the previous 12 months, except where the gift ‘could not be reasonably thought by others’ to relate to their political activities.

Labour and the Lib Dems have called for Parliament’s standards commissioner Daniel Greenberg to examine the support from Mr Cottrell.

The Reform leader on Sunday issued a statement insisting he had not broken any rules.

He said: ‘I have done no wrongdoing, followed the rules and I am now considering legal action against The Sunday Times.

‘It’s now clear the establishment will stop at nothing to hurt Reform – we want to smash their cosy consensus.’

Reform UK’s Treasury spokesman Robert Jenrick said Mr Cottrell is an ‘old friend’ of Mr Farage and has ‘no formal role within Reform’.

The Times today reported Mr Cottrell handed out a business card printed with his name, the Reform UK logo and Mr Farage’s official email address, despite having no formal role in the party.

After becoming the MP for Clacton in 2024, Mr Farage registered a £9,000 trip to Belgium donated by Mr Cottrell, and belatedly added £15,000 for a US domestic flight, but no other support.

Asked if Mr Cottrell paid for Mr Farage’s security and staff in 2024, Mr Jenrick told the BBC’s Sunday With Laura Kuenssberg programme he did but this was ‘before he became a Member of Parliament’.

Mr Cottrell was jailed for eight months in the US in 2017 after pleading guilty to a charge of wire fraud after admitting attempting to defraud criminals on the dark web by masquerading as a money launderer.

He was arrested as he and Mr Farage travelled back to Britain following a trip to the US.

Mr Cottrell reportedly remains a close adviser to Mr Farage after first becoming involved in Ukip as a volunteer in the run-up to the Brexit referendum.

Labour has called for a financial watchdog probe into whether Mr Farage’s advocacy for cryptocurrency has benefitted Reform mega-donor Mr Harborne, after reports he lobbied the Bank of England governor to scrap plans for a state-run, digital currency.

Labour peer Baroness Harriet Harman has accused Mr Farage of trying to ‘delegitimise’ the parliamentary standards process with his claim of an ‘establishment hit job’.

‘He’s attacking and trying to delegitimise the system, and if it comes to a finding by the commissioner that he has been in breach of the rules, the way he’s conducted himself whilst he’s being under investigation will be taken into account as an aggravating fact when it comes to the penalty,’ the former chair of the parliamentary standards committee told BBC Radio 4’s Today programme.

She added: ‘This is the opposite of an establishment hit job. This is so that the public can know that the establishment, in terms of people with lots of money, are not buying their members of parliament.’

The funeral ceremonies are taking place less than three weeks after Iran and the US signed a preliminary agreement to end the war and reopen the crucial Strait of Hormuz waterway, through which 20% of global oil and gas shipments pass.

The two countries also gave themselves two months to reach a final deal that covers Iran’s nuclear programme, US sanctions and a permanent truce.

Mediator Qatar said Iranian and US negotiators made “positive progress” at indirect talks in Doha last week following a four-day exchange of strikes and that their next meeting would be scheduled after the conclusion of the events for Khamenei.

On Tuesday, there will be a funeral procession and prayers in the central city of Qom, the centre of Iran’s Shia Muslim clerical establishment.

The ceremonies will then move to the Iraqi shrine cities of Karbala and Najaf on Wednesday.

They will end on Thursday, when Khamenei will be buried at the Imam Reza shrine in his home city of Mashhad, in north-eastern Iran.

Norway’s Crown Princess Mette-Marit has been pictured for the first time since undergoing a life-saving lung transplant in new photos after Norway qualified for the FIFA World Cup quarter-finals last night.

The princess, 52, was dressed casually in a grey coat, red football scarf, jeans, and thick socks, and wore no makeup in images of her watching Norway defeat Brazil 2-1 on TV with Crown Prince Haakon at their official residence in Oslo.

Another photo showed the royal couple looking out of a window, as the streets of Oslo erupted in celebration following the national team’s impressive win over Brazil.

The images shared on the Norwegian royal family‘s official Instagram account mark the first time Mette-Marit, 52, who suffers from a rare form of pulmonary fibrosis, has been seen since her surgery last month.

The Royal House of Norway confirmed the lung transplant had been successful in a statement on June 17, noting ‘everything has progressed well so far’.

While Mette-Marit and Haakon enjoyed the nail-biting FIFA World Cup qualifier from the comfort of Skaugum Estate, their eldest daughter, Princess Ingrid Alexandra, cheered the national team on from the stadium stands in New Jersey.

Accompanied by her brother Prince Sverre Magnus, Princess Ingrid Alexandra congratulated the players during a surprise visit to the dressing room, as seen in a video posted on the Norwegian royal family’s Instagram account.

Footage showed the princess hugging a topless Erling Haaland after he fired his nation into the quarter-finals of the World Cup, as fans declared ‘king and queen united’.

Another photo showed the royal couple looking out of a window, as the streets of Oslo erupted in celebration following the national team’s impressive win over Brazil.

Princess Ingrid Alexandra, 22, is next in line for the throne and will eventually become Queen of Norway, so her presence in New Jersey was significant.

She first appeared at the tournament in the group-stage win over Senegal, when she replaced her father at short notice.

Crown Prince Haakon cancelled his visit after his wife went in for surgery, meaning that Princess Ingrid Alexandra stepped up, and she’s been a lucky charm in both games, with Norway – and particularly Haaland – shining on their first World Cup appearance in 28 years.

Meanwhile, King Harald and Queen Sonja – who was hospitalised for heart issues in May – supported the national team from their summer retreat in Mågerø on the island of Tjøme, as Norway advanced to the quarter-finals. 

The World Cup represents Princess Ingrid Alexandra’s first official public appearance since Crown Princess Mette-Marit’s lung transplant last month as the palace confirmed she was being treated at the Oslo University Hospital Rikshospitalet. 

‘We are delighted that everything has progressed well so far,’ Are Holm, a lung specialist at the hospital, said.

‘In accordance with standard practice for all recent transplant recipients, Her Royal Highness the Crown Princess will remain admitted to Oslo University Hospital Rikshospitalet for several weeks to come’.

Mette-Marit was diagnosed with the illness, which causes scarring of the lungs and serious breathing difficulties, in 2018.

Norway’s Crown Prince Haakon joins fans for the famous ‘Viking Row’ celebration

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King Harald and Queen Sonja of Norway watched last night’s match from their summer retreat Magero

Norway’s Princess Ingrid Alexandra and her brother, Sverre Magnus, travelled to New Jersey to watch the match 

Her condition had deteriorated significantly over the past six months, and her doctors announced on June 5 that she had been placed on the waiting list for a lung transplant.

Doctors said the procedure was a last resort when a patient is believed to have less than two years to live without new lungs.

Earlier this month, the future Queen suspended her official duties, and Norway’s Royal Court said ‘there will be a longer period of rehabilitation and training’ during which ‘there will initially be no updates.’

Crown Prince Haakon, who will one day succeed his father as king, will cut back his public engagements to spend time with his wife, the palace said.

Last month, Mette-Marit made a rare public appearance for the constitution parade – one of the first times the royal has been spotted wearing an oxygen mask to aid her breathing at a public event.

Together with her husband, 52, and son, Prince Sverre Magnus, 20, the family watched the children’s parade from their residence, Skaugum in Oslo, Norway.

The trio put on a brave face, waving towards cameras with wide grins, amid an incredibly challenging time for the Norwegian royal family.

The announcement of Mette-Marit’s transplant came just two days after an Oslo court sentenced her 29-year-old son from a previous relationship, Marius Borg Hoiby, to four years in prison for two counts of rape and 32 other offences.

An Oslo court also found him guilty of assaulting his former girlfriend, Nora Haukland, issuing threats and committing traffic offences, although he was acquitted of two other rape charges.

Hoiby had been charged with sexually assaulting four women who were asleep or otherwise unable to resist between 2018 and 2024.

The conviction marks a fall for Hoiby, who grew up in the public eye after his mother married Crown Prince Haakon in 2001, when he was just four years old.

Although he does not hold a royal title or carry out official duties, he has long been closely associated with the Norwegian royal family.

Judge Jon Sverdrup Efjestad handed down the sentence after hearing evidence linked to 40 charges, including four alleged rapes, assaults, breaches of restraining orders, drug offences and driving violations.

One charge relating to a restraining order violation was overturned.

The court heard how Hoiby’s drug addiction spiralled in recent years, while investigators presented more than 800 messages and a series of self-made videos of sexual encounters as evidence during the trial.

Hoiby has denied the most serious charges, and his lawyers have said they will appeal.

As temperatures rise, so does the risk of heat-related illness, especially for people taking certain prescription drugs.

The body uses several mechanisms to regulate temperature: sweating, blood flow to the skin and fluid balance. But some commonly prescribed drugs interfere with these processes, making it harder to stay cool.

Here are a few you should know about this summer:

1. Antidepressants

Two specific types of antidepressants – selective serotonin reuptake inhibitors (SSRIs) and tricyclics (TCAs) – may make summer harder to cope with. They could even cause heat intolerance due to how they affect the body’s ability to sweat.

Both these antidepressants are believed to partly work by affecting neurotransmitter levels in the brain – primarily serotonin and noradrenaline. However, they may also affect other neurotransmitters.

For instance, TCAs can block acetylcholine, a neurotransmitter important for sweating. This may cause some patients to sweat less. On a hot day, this could make it hard to cool down.

However, TCAs also increase noradrenaline levels, a neurotransmitter that stimulates sweat glands. This can increase sweating. In fact, both SSRIs and TCAs can increase sweating in users. Data shows up to 14% of antidepressant users experience this side-effect.

SSRIs may also interfere with the hypothalamus – the brain region that controls body temperature and tells the sweat glands to start producing sweat. But this signal may be affected by the increased serotonin levels.

Since sweating is a key cooling mechanism, any disruptions to this process can lead to heat-related illness. Excess sweating may also cause dehydration if fluids aren’t replaced.

2. Antipsychotics

Antipsychotics are used to treat psychosis, which can occur in schizophrenia and bipolar disorder. They do this by blocking the neurotransmitter dopamine – which in turn affects levels of the neurotransmitter serotonin. This can disrupt the hypothalamus’s ability to sense and respond to body temperature changes.

As a result, someone taking an antipsychotic might not feel overheated or thirsty when it’s hot out. This can cause low blood pressure and reduced heart function. The body then tries to compensate by narrowing the blood vessels and holding in heat. This, in turn, reduces sweating and makes it harder to cool down properly.

Additionally, antipsychotics have anticholinergic properties. This means they block the action of acetylcholine, making it harder to sweat.

3. Heart medications

Beta-blockers are used to manage heart failure and arrhythmias. They do this by lowering the heart rate and reducing how forcefully the heart pumps. But this can limit blood flow to the skin, making it harder for the body to release heat on hot days.

Diuretics are also commonly used in the treatment of high blood pressure or heart failure. But as these drugs increase urine output, this may lead to dehydration and electrolyte imbalances during hot weather. With less fluid available, the body may struggle to sweat properly. If you become severely dehydrated, you might actually stop feeling thirsty. Blood pressure can also drop, which may cause dizziness or fainting – especially when standing up.

Ramipril and losartan, also used to manage blood pressure, can increase the risk of dehydration as well. These drugs block a system in the body that helps control blood pressure, fluid balance and thirst. This may reduce your natural urge to drink, increasing dehydration risk when it’s hot.

4. Stimulants

Stimulants – such as the amphetamines used for ADHD – affect many brain chemicals, including dopamine and noradrenaline. This can increase body temperature, boost metabolism and change how the body sweats – all of which can make it harder to cool down, especially when exercising or in hot weather. This can also potentially lead to dehydration, overheating or even heatstroke. Stimulants may also reduce the feeling of tiredness, which can cause people to overexert themselves without realising the danger.

However, some recent research shows people with ADHD who take stimulants may actually have a lower chance of heat-related illnesses – but larger trials are needed to investigate further. The researchers hypothesise that this protective effect may be due to factors such as lower body weight and users staying hydrated.

5. Insulin

Warm temperatures cause the body’s blood vessels to dilate (widen) in order to help us cool off. But this action means insulin is absorbed into the bloodstream faster, as there’s enhanced blood flow to the area where insulin is injected, making blood sugar drop more quickly. This can lead to hypoglycemia (low blood glucose level), which may lead to dizziness, shaking, sweating, irritability and even potentially loss of consciousness or seizures.

Faster insulin absorption can also make it harder for people with diabetes to notice signs of low blood sugar in the heat, since common symptoms may be mistaken for being hot.

Heat can also degrade insulin, reducing its effectiveness and making it unsafe. This is why insulin should be stored in the fridge until use – especially in summer. Damaged insulin will change appearance – turning cloudy or changing colour.

Avoiding heatstroke

Older adults, people with chronic conditions (especially those with heart or lung disease) and those taking multiple prescription drugs are especially vulnerable to heat-related illnesses.

Fortunately, there are steps you can take to stay safe during summer if you’re taking one of these common prescription drugs.

First, check labels for storage instructions. Avoid leaving medications in hot places, such as in cars or on windowsills. Insulin isn’t the only drug affected by heat – inhalers and EpiPens can also malfunction or become less effective.

Second, stay hydrated when it’s hot – unless your doctor has advised otherwise. Dehydration can actually worsen the effects of many medicines. For example, anti-inflammatory painkillers (such as ibuprofen) are more likely to cause kidney problems and bipolar medicines (including lithium) can become toxic if you’re dehydrated.

Avoid peak heat hours and stay in cool environments when possible. Watch for warning signs of heat-related illness – such as dizziness, confusion, nausea or excessive sweating.

Last, don’t stop taking your prescription medication without medical advice. If it’s affecting your ability to cope with the heat, speak with your doctor or pharmacist.

The road was closed for around two hours while the incident was dealt with

A woman has been taken to hospital following a five-vehicle crash. Emergency services were called to the crash on Barford Road in Little Barford, near St Neots, just after 10.50am on Sunday (July 5).

The crash involved five vehicles. The East of England Ambulance service took one woman to hospital.

An ambulance spokesperson said: “We were called just after 10.50am on Sunday to a road traffic collision on Barford Road in Little Barford. An ambulance was sent to the scene and one patient, an adult woman, was transported to Hinchingbrooke Hospital for further treatment.”

Bedfordshire Police also reported one person for “driving without due care and attention”. A police spokesperson added: “Emergency services were called shortly before 11am to reports of a five-vehicle collision on Barford Road, Little Barford, on Sunday.

“Police and ambulance attended, one person was treated for minor injuries and the road was closed for just over two hours while vehicles were recovered.”

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