What does it mean to push the frontiers of biomedicine if those advances do not or cannot benefit the patients who most need them? What does it say about the world’s top research universities if the women studying and working at those institutions are not safe from sexual harassment? How useful is the work of scientists and scientific agencies if researchers are unable to communicate effectively with citizens and their elected representatives? Essays in the Winter 2023 edition of Issues grapple with the obligations of scientific knowledge—and, crucially, offer ways to address the tensions and problems that can arise from advances in science and technology.