Viewpoints & Perspective Pieces

I was approached by the editor of ‘Medical Device Technology’ in 1993 to discuss the possibility of my writing a monthly column on aspects of biomaterials and related technologies. Consistent with my philosophy of saying ‘yes’ to most invitations, I readily took up this challenge, even though my workload involved many other commitments. It was an interesting experience, thinking of topical subjects within my comfort zone, and writing a suitable text, to rigorous publishing deadlines that, we academics, were not used to. Although in scientific journals I discourage catchy or theatrical titles, I felt that this would be an appropriate feature in a column that was intended to attract attention. I compiled over a hundred essays in a 15-year period and I am encouraged to note that many are still relevant today. In the early years the magazine was only published in print form but included on-line versions later on.

The subject matter of my columns ranged from educational, fundamental biomaterials science to critical analyses of device failure mechanisms, biocompatibility and toxicology, innovative device technologies, health economics, ethics and regulatory dilemmas. There is insufficient space to refer to all the columns here (although they are listed in my CV), so I include some of the most significant.

Clinical Applications of Biomaterials

Research in biomaterials science should always be directed towards clinical application, even if the relevance is only at the horizon. Several columns discussed some clinically-related issues, including those concerning the treatment of incontinence (Below the Belt: The Technology of Incontinence, 1995  (1)), the blood-brain barrier (Beyond the Barrier: Devices Inside the Brain, 1995 (2)), Parkinson’s disease (One Step Back and One, Possibly Two, Steps Forward: The Different Approaches to Parkinson’s Disease, 2001 (3)) and heart transplantation (The Technologies of Heart Transplantation, 2008 (4)).

Philosophical, Legal and Ethical Aspects

There are some aspects of medical technologies that touch upon philosophical and / or ethical aspects of medicine; for various reasons these aspects tend to lead to regulatory arguments and, usually, litigation. As I discuss in Chapter 3 of Reconstructing the Body, ethics concerns those matters in which there is no right answer; what we do in ethical discourse is to use best judgements. Included in my essays here are situations in which human or animal tissues are used in devices (Medical Devices of Human Origin, 2001 (5)) and (Sows Ears, Silk Purses and Goat’s Milk, 2003 (6)), controversies over biological safety testing (To Test or Not to Test: The Value of Biological Safety Testing, 2002 (7)) and the regulation of tissue engineering in Europe (A European Regulatory Position for Tissue Engineering – At Last, 2007 (8)).

Basic Biomaterials Science

Judging from the feedback I received about these columns, readers like articles about new concepts and materials, but they often prefer to be educated about some of the basics that they either did not know, or had forgotten. I would often write about some basic biomaterials science but include a twist to the story at the end. I wrote about metallic systems (Unalloyed Pleasures: The Realities of the Materials of Tomorrow, 1994 (9)) and (The Delicate Balancing Act of Metallic Biomaterials, 2009 (10)). I included several essays about polymers and plastics, sometimes generically (Silicon, Silicone and Silica: The Importance of the Right Ending, 1996 (11)) and sometimes specifically (Polyurethane Paranoia: Flexible Friend or Deadly Foe, 1995 (12)). Carbons and functional ceramics were gaining increased attention, so they were extensively covered (Carbon Nanotubes in Medical Technology, 2007 (13)), (Staying Calm Under Pressure: The Secret of Bioceramics, 1996 (14)) and (Quantum Dots in Medical Technology, 2006 (15)).

Health Economics and Emerging Technologies

I have occasionally commented on relevant health economic issues, including the economic arguments with risks and benefits (From Sterile Debate to Burning Issue: The Economics and Safety Dichotomy, 2001 (16)) and the escalating costs of major interventions such as cardiac surgery (Good News and Bad News: The Costs of Mending a Broken Heart, 2003 (17)).

Towards the end of my tenure as a columnist (the magazine was absorbed into another publishing house in 2010), I concentrated more on the newly emerging medical technologies. My essays included one on stem cells in regenerative medicine (Stem Cells in Medical Technology, 2005 (18)), one on drugs released from devices (Doses of Drugs in Devices, 2009 (19)), and one on biomaterials in biotechnology (The Interface Between Biomaterials Science and Biotechnology, 2007 (20)).