When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors-if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.

Lainie Ross presents a rigorous critical investigation of the development of policy governing the involvement of children in medical research. She examines the shift in focus from protection of medical research subjects, enshrined in post-World War II legislation, to the current era in which access is assuming greater precedence. Infamous studies such as Willowbrook (where mentally retarded children were infected with hepatitis) are evidence that before the policy shift protection was not always adequate, even for the most vulnerable groups. Additional safeguards for children were first implemented in many countries in the 1970s and 1980s; more recent policies and guidelines are trying to promote greater participation. Ross considers whether the safeguards work, whether they are fair, and how they apply in actual research practice. She goes on to offer specific recommendations to modify current policies and guidelines.
Ross examines the regulatory structures (e.g. federal regulations and institutional review boards), the ad hoc policies (e.g. payment in pediatric research and the role of schools as research venues), the actual practices of researchers (e.g. the race/ethnicity of enrolled research subjects or the decision to enroll newborns) as well as the decision-making process (both parental permission and the child's assent), in order to provide a broad critique. Some of her recommendations will break down current barriers to the enrolment of children (e.g. permitting the payment of child research subjects; allowing healthy children to be exposed to research that entails more than minimal risk without requiring recourse to 407 panels); whereas other recommendations may createnew restrictions (e.g., the need for greater protection for research performed in schools; restrictions on what research should be done in the newborn nursery). The goal is to ensure that medical research is done in a way that promotes the health of current and future children without threatening, to use the words of Hans Jonas, "the erosion of those moral values whose loss . . . would make its most dazzling triumphs not worth having."

Lainie Ross presents a rigorous critical investigation of the development of policy governing the involvement of children in medical research. She examines the shift in focus from protection of medical research subjects, enshrined in post-World War II legislation, to the current era in which access is assuming greater precedence. Infamous studies such as Willowbrook (where mentally retarded children were infected with hepatitis) are evidence that before the policy shift protection was not always adequate, even for the most vulnerable groups. Additional safeguards for children were first implemented in many countries in the 1970s and 1980s; more recent policies and guidelines are trying to promote greater participation. Ross considers whether the safeguards work, whether they are fair, and how they apply in actual research practice. She goes on to offer specific recommendations to modify current policies and guidelines. Ross examines the regulatory structures (e.g. federal regulations and institutional review boards), the ad hoc policies (e.g. payment in pediatric research and the role of schools as research venues), the actual practices of researchers (e.g. the race/ethnicity of enrolled research subjects or the decision to enroll newborns) as well as the decision-making process (both parental permission and the child's assent), in order to provide a broad critique. Some of her recommendations will break down current barriers to the enrolment of children (e.g. permitting the payment of child research subjects; allowing healthy children to be exposed to research that entails more than minimal risk without requiring recourse to 407 panels); whereas other recommendations may create new restrictions (e.g., the need for greater protection for research performed in schools; restrictions on what research should be done in the newborn nursery). The goal is to ensure that medical research is done in a way that promotes the health of current and future children without threatening, to use the words of Hans Jonas, 'the erosion of those moral values whose loss . . . would make its most dazzling triumphs not worth having'.

Ross presents an original and controversial examination of the moral principles that guide parents in making health care decisions for their children, and the role of children in the decision-making process. She argues against the current movement to increase child autonomy, in favour of respect for family autonomy, and proposes significant changes in what informed consent allows and requires for paediatric health care decisions.