Editorial

Monash Bioeth. Rev. (2015) 33:89–90 DOI 10.1007/s40592-015-0041-z EDITORIAL Editorial Justin Oakley1 Published online: 27 October 2015 Ó Monash University 2015 We begin this issue of Monash Bioethics Review with three valuable contributions to current debates about the ethics of various forms of organ procurement. Australia’s rate of organ donation from deceased donors has increased in recent years, but there are signs that this growth is now slowing and is beginning to plateau out. Australia’s deceased donation rate is moderate by international standards, and it is considerably lower than rates in many European countries. Several years ago the Australian government introduced a range of initiatives designed to improve donation rates, but these measures have thus far fallen short of expectations. In light of this rather tepid community response to such initiatives, Isdale and Savulescu argue for several important policy changes which could significantly increase Australian rates of organ donation from deceased donors. One initiative proposed by Isdale and Savulescu is for a government scheme offering financial incentives, beyond compensation, for individuals to consent to become a deceased organ donor. Koplin also discusses the ethics of offering financial incentives to organ donors, focusing specifically on debates about regulated markets for the procurement of kidneys from live donors. Many participants in such debates regard Richard Titmuss’ pioneering work on how non-commercial systems of blood donation promote altruism and social solidarity as irrelevant to the ethical issues raised by live organ donation. However, Koplin argues that such dismissals are unjustified, and he proceeds to demonstrate various ways in which Titmuss’ arguments can be instructively extended to help reinforce a case against markets in procuring kidneys from living donors. In his commentary on Koplin, Shearmur raises several concerns & Justin Oakley 1 Monash University, Clayton, Australia 123 90 J. Oakley about drawing on Titmuss’ arguments regarding the value of social solidarity in the context of blood donation, when evaluating the ethics of organ markets. Our next article addresses an ethical issue of pressing current concern. Smith and Silva argue that the recent Ebola outbreak in West Africa demonstrates how ethical guidelines for developing plans in response to pandemics are inadequate for meeting the challenges posed by this and other emerging infectious diseases. The following two articles discuss some ethical challenges arising in the latter stages of life. Kendal and Maher argue that doctors who allow persistent vegetative patients to die should be legally protected by adequate legislation and practical guidelines. Jongsma and van de Vathorst focus on research ethics rather than clinical practice, arguing that advance directives can justifiably be used as a way of involving dementia patients in research on this condition. The next two contributions also address questions in research ethics. McWhirter, Nicol, and Savulescu develop some practical proposals to improve the applicability of research and clinical innovations using genomics to Aboriginal and Torres Strait Islander peoples. Palacios-Gonzalez critiques some key arguments against creating human-nonhuman chimeras with the capacity to produce human gametes, particularly in a research context. Rounding out this issue are another commentary, a review essay, and two book reviews. Cratsley’s Commentary on an article by Quigley, published in this journal last year, brings to bear conceptual and empirical considerations to further clarify notions of coercion which commonly feature in public health ethics debates about ‘nudging’ people to make better health care decisions. Munthe’s review essay, discussing a new book on the precautionary principle often invoked in discussions of emerging technologies and public health initiatives, argues that foundational normative considerations play a fundamental role in determining how this principle can be justifiably applied in such contexts. A unique new feature of Monash Bioethics Review, announced in last year’s inaugural Springer double issue of this journal, is that all articles (and commentaries) are open for commentary (with such commentaries being peer reviewed). It is pleasing to see that this is proving to be an attractive feature of the journal, with two such commentaries published in this issue. The submission of further such commentaries is welcomed. Finally, I would like to thank the peer reviewers for their valuable assistance with the contributions to this issue of the journal. 123  (...truncated)