In January 2014, a letter and original research article were published in Nature describing a process whereby somatic mouse cells could be converted into stem cells by subjecting them to stress. These "stimulus-triggered acquisition of pluripotency" (STAP) cells were shown to be capable of contributing to all cell types of a developing embryo, and extra-embryonic tissues. The lead author of the publications, Haruko Obokata, became an overnight celebrity in Japan, where she was dubbed the new face of Japanese science. However, in the weeks that followed publication of the research, issues arose. Other laboratories and researchers (including authors on the original papers) found that they were unable to replicate Obokata et al.'s work. Closer scrutiny of the papers by the scientific community also suggested that there was manipulation of images that had been published, and Obokata was accused of misconduct. Those who should have been supervising her work (also her co-authors on the publications) were also heavily criticised. The STAP cell saga of 2014 is used as an example to highlight the importance of trust and replication in twenty-first century biological science. The role of trust in the scientific community is highlighted, and the effects on interactions between science and the public examined. Similarly, this essay aims to highlight the importance of replication, and how this is understood by researchers, the media, and the public. The expected behaviour of scientists in the twenty-first century is now more closely scrutinised.

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The aim of this commentary is to provide clinicians with the tools needed (or, at least, knowledge of where to find them) to navigate the often-turbulent seas of medical ethics. The cases described and questions asked in this issue are not only relevant to pediatric epilepsy but also typical of quandaries faced frequently by health care professionals (HCPs). By examining these cases and extrapolating the ethical questions raised, the clinician will find that there are several ethical approaches that can be taken and may lead to a variety of ways forward. However, by employing the ideas highlighted in this commentary, it is my hope that HCPs will be able to identify these various points of view, evaluate their options, and act in ways that are ethically justifiable.

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