The Ethics of Smart Pills and Self-Acting Devices: Autonomy, Truth-Telling, and Trust at the Dawn of Digital Medicine.

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care.

Nano-microbicides: challenges in drug delivery, patient ethics and intellectual property in the war against HIV/AIDS.

As we continue to be embroiled in the global battle against the human immunodeficiency virus (HIV), there has been an ongoing evolution in the understanding of the molecular mode of sexual transmission of HIV. This has gone hand-in-hand with a paradigm shift and research focus on the development of microbicides - compounds designed for vaginal (and possibly rectal) administration that are envisaged to put safe, affordable and accessible protection into the hands of women. However, an effective microbicide is not yet available; innovative approaches for the design of topical vaginal microbicides are urgently needed. The potential of the advancing field of nanomedicine has been earmarked in the increasing efforts to address the major health problems of the developing world. In this review, advances in the design of innovative microbicide nanocarriers and nano-enabled microbicides, henceforth referred to as 'nano-microbicides', are presented; elaborating on nanotechnology's role in the antiviral arena. The role of nanotechnology in the antiviral arena and the unique issues facing the generation of intellectual property relating to nano-microbicides in the ongoing global 'tug-of-war' of 'patients versus patents' are also explicated.

Chocolate, an effective means of oral drug delivery in rats.

Oral gavage is an important procedure for drug discovery and efficacy studies using rodents. However, there are welfare issues related to the use of the method by inexperienced persons or for long-term studies. The authors describe an effective method of administering drugs to rats by mixing the drug with chocolate to provide a consistent and reliable method of oral drug delivery to large groups of rats for a long period of time.