Abandoning the Dead Donor Rule

J Med Ethics. 2023 Oct;49(10):707-714. doi: 10.1136/jme-2021-108049. Epub 2022 Oct 3.

Abstract

The Dead Donor Rule is intended to protect the public and patients, but it remains contentious. Here, I argue that we can abandon the Dead Donor Rule. Using Joel Feinberg's account of harm, I argue that, in most cases, particularly when patients consent to being organ donors, death does not harm permanently unconscious (PUC) patients. In these cases, then, causing the death of PUC patients is not morally wrong. This undermines the strongest argument for the Dead Donor Rule-that doctors ought not kill their patients. Thus, there is nothing wrong with abandoning the Dead Donor Rule with regard to PUC patients. Importantly, the harm-based argument defended here allows us to sidestep the thorny debate surrounding definitions of death. What matters is not when a patient dies but whether their death constitutes some further harm.

Keywords: death; ethics- medical; tissue and organ procurement; transplantation.

MeSH terms

  • Brain Death / diagnosis
  • Death*
  • Humans
  • Tissue Donors
  • Tissue and Organ Procurement*
  • Unconsciousness