April 12, 2024

Should we scrap the dead donor rule?

Hi there,

Our lead stories this  week deal with donation after cardiac death. Frankly, I find this a bit perplexing, as there are several schools of thought on whether it is ethical to remove organs from someone after his heart has ceased to beat. Passions run high when lives are at stake. The donor’s life, first of all. Is he dying a natural death or is he being killed for his organs? And then all those thousands of people whose lives could be saved if they get kidney or a lung.

The premise of these debates is a fundamental principle, “the dead donor rule”. Surgeons agree that vital organs can only be taken from donors who are dead. Otherwise they would be murderers.

But no principle is so fundamental that bioethicists somewhere will not challenge it. Writing in the latest Journal of Medical Ethics, two Americans argue that the revered dead donor rule ought to be scrapped. They contend that “killing by itself is not morally wrong although it is still morally wrong to cause total disability”. Their point is that simply being alive is no big deal. If you are alive, but cannot move, speak, think, or feel, the notion of “life” is meaningless. So why not transfer your organs to someone who can make better use of them?

On the other hand, several doctors in Canada and the US argue that donation after cardiac death is so controversial that transplant surgeons ought to declare a moratorium until these ethical issues have been settled once and for all.

It’s a fascinating topic. I hope that you will take time to comment on the articles.


Michael Cook