Ethics approval processes in Aboriginal and Torres Strait Islander health exist to ensure that research involving Aboriginal and Torres Strait Islander people is conducted in an ethical and culturally appropriate manner. However, despite the existence of long-standing guidelines and a national commitment to uphold and promote ethical research involving Aboriginal and Torres Strait Islander people, there remains continued concern that current ethics approval processes do not fully uphold key values and principles, fail to adequately incorporate Aboriginal and Torres Strait Islander perspectives and input, and do not ensure adequate representation of Aboriginal and Torres Strait Islander voices.

This discussion paper presents key findings from a scoping review of academic and grey literature of research ethics in Aboriginal and Torres Strait Islander health that was guided by the following objectives:

• to provide an overview of current ethics approval and governance processes for Aboriginal and Torres Strait Islander health research in Australia.
• to identify key gaps in ethical processes and practices, and areas of reform needed, including the development of a set of recommendations for further advocacy and action.

Key recommendations:

• A national Aboriginal and Torres Strait Islander Ethics Committee was called for in 1987. This should be established to oversee the conduct of national and multijurisdictional health research.
• State-based Aboriginal human research ethics committees (AHRECs) be established in all states and territories.
• Increase infrastructure to support Aboriginal and Torres Strait Islander community-controlled organisations in all states and territories to support the critical functions of all state based AHRECs.
• Nationally endorsed and accredited training in Aboriginal and Torres Strait Islander health research be developed and implemented to build the capacity of the Aboriginal and Torres Strait Islander health research sector.