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The papers in this issue of the Journal of Medical Ethics address various aspects of five familiar areas of bioethical enquiry: transplantation, genetics, euthanasia, research ethics and professional practice. That these areas, despite all that has been written about them, continue to provoke productive scholarly attention, testifies not only to their existential relevance but also to their moral complexity. Countless human lives will be affected, for better or worse, by how moral decisions in these areas are taken, communicated and implemented. It is of the greatest importance therefore that the ethical thinking informing not only such decisions but also the practices of which they are part, should be both principled and appropriately contextualised. To that end, familiar moral attitudes, assumptions and arguments require repeatedly to be challenged from a variety of perspectives, not ultimately to discover any definitive unravelling of moral complexity, but rather to inform more thoughtful and nuanced responses to the diverse manifestations of that complexity. As Calbresi and Bobbitt have observed: ‘a moral society must depend on moral conflict as the basis for determining morality’. 1 The papers in this issue, written from a variety of cultural, as well as ethical, legal and clinical perspectives, each can assist in that process.
For over half a century the subject of organ transplantation has attracted ethical debate. One such ongoing debate, provoked by the severe scarcity of organs for transplantation and a concern to increase their supply, has been about why willing live donors should continue to be prohibited from offering their own organs for sale. Against allowing this, it has often been argued that prohibition protects people in poverty from being driven to, and then harmed by, this desperate last resort. …
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