Teaching bioethics to future health professionals: a case-based clinical model

In summary, I believe that ethics teaching based on actual cases, presented in a small-group format led by a clinician and an ethicist, offers the best prospect for achieving these goals. The physician serves as a role model and ensures that information and options are medically accurate. The ethicist helps to identify morally relevant features, can articulate ethical principles, and direct students to the appropriate literature. This method does not guarantee that the behavior of future health professionals will always be humane or ethically sound. But it is likely to get future health professionals to think about what they are doing when they encounter cases that resemble those discussed in teaching conferences devoted to clinical ethics.     

Prodrugs as self-assembled hydrogels: a new paradigm for biomaterials

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Highlights► Development of prodrug-based self-assembled hydrogels as a new class of biomaterials. ► Design of prodrugs that can self-assemble to form hydrogels. ► These hydrogels overcome limitations such as low-drug loading and burst release of drugs. ► Locally injectable self-assembled hydrogels exhibit potential as effective therapeutics.     

Teaching global bioethics

We live in a world with enormous disparities in health. The life expectancy in Japan is 80 years; in Malawi, 40 years. The under-five mortality in Norway is 4/1000; in Sierra Leone, 316/1000. The situation is actually worse than these figures suggest because average rates tend to mask inequalities within a country. Several presidents of the IAB have urged bioethicists to attend to global disparities and to broaden the scope of bioethics. For the last six years I have tried to do just that. In this paper, I report and reflect on my attempts to teach bioethics in ways that address global health and justice. I then discuss ways to address key ethical issues in global health: the problem of inequalities; the nature of the duty to assist; the importance of the duty not to harm; the difference between a cosmopolitan and a political view of justice. I also discuss how teaching about global health may help to shift the emphasis in bioethics--from sensational cases to everyday matters, from autonomy and justice, and from access to healthcare to the social determinants of health. At the end of my paper, I reflect on questions that I have not resolved: how to delineate the scope of bioethics, whether my approach over-politicises bioethics, and how to understand the responsibilities of bioethicists.     

Reproductive failure: a new paradigm for extinction

Extinction was recognized as a scientific fact 200 years ago, although no adequate paradigm has emerged to explain the process. Prevailing theory has focused on ‘cause(s)’ of extinction but has neglected ‘effect’ and ‘mechanism’. These omissions preclude the formulation of a functional paradigm necessary for remedial action in response to the impending anthropogenic mediated, worldwide extinction crisis. The new paradigm is defined as the multi‐generational, attritional loss of reproductive fitness. Stabilizing selection continuously adapts species to specific ecosystems, which often results in highly evolved species prone to extinction when environments shift. Some species survive by tracking the declining palaeoclimates in which they presumably evolved, often becoming relicts prior to extinction. Compelling new evidence shows that even mass extinctions are largely a result of environmental change leading to widespread, attritional reproductive decline, rather than a result of instantaneous global catastrophes.     

Quantum computing: a new paradigm for ecology

A global technology arms race is underway to build evermore powerful and precise quantum computers. Quantum computers have the potential to tackle certain quantitative problems quicker than classical computers. The current focus of quantum computing is on pushing the boundaries of fundamental quantum information and commercial applications in industrial sectors, financial services, and other profit-led sectors, particularly where improvements in optimisation and sampling can improve increased economic return. We believe that ecologists could exploit the computational power of quantum computers because the statistical approaches commonly used in ecology already have proven pathways on quantum computers. Moreover, quantum computing could ultimately leapfrog our understanding of complex ecological systems, if the hardware, opportunity, and creativity of quantitative ecologists all align.     

Targeting virulence: a new paradigm for antimicrobial therapy

Clinically significant antibiotic resistance has evolved against virtually every antibiotic deployed. Yet the development of new classes of antibiotics has lagged far behind our growing need for such drugs. Rather than focusing on therapeutics that target in vitro viability, much like conventional antibiotics, an alternative approach is to target functions essential for infection, such as virulence factors required to cause host damage and disease. This approach has several potential advantages including expanding the repertoire of bacterial targets, preserving the host endogenous microbiome, and exerting less selective pressure, which may result in decreased resistance. We review new approaches to targeting virulence, discuss their advantages and disadvantages, and propose that in addition to targeting virulence, new antimicrobial development strategies should be expanded to include targeting bacterial gene functions that are essential for in vivo viability. We highlight both new advances in identifying these functions and prospects for antimicrobial discovery targeting this unexploited area.     

A call for a new paradigm of island biogeography

MacArthur and Wilson’s equilibrium theory of island biogeography quickly became the paradigm of the field in the 1960s and has strongly influenced this and other disciplines of ecology and conservation biology for the past three decades. Recently, however, a growing number of ecologists have begun to question whether the theory remains a useful paradigm for modern ecology. We now have a much better appreciation for the complexity of nature and we study patterns that span a very broad range in spatial, temporal and ecological scales. At such scales, assumptions that communities are in equilibrium, that species, islands and intervening landscapes or seascapes are equivalent or homogeneous with respect to factors influencing immigration and extinction, and that in situ speciation can be overlooked become very tenuous. With this in mind, this and other papers of this special feature discuss the principal, conceptual shortcomings of the equilibrium theory and offer some modifications or alternatives to the theory that we hope will eventually lead to a more comprehensive understanding of the forces structuring insular communities.