Walter Sinnott-Armstrong and Frank Miller's article is an intelligent, interesting and important discussion.1 Its central thesis is that what makes killing wrong is not that killing causes death or loss of consciousness, but that killing causes an individual to be completely, irreversibly disabled. The first of two main implications is that it is not even pro tanto wrong to kill someone who is already in such a thoroughly disabled state. The second is that the dead donor rule in the context of vital organ transplantation should be abandoned.

I embrace the second main implication. As the authors argue, the dead donor rule is routinely violated in contemporary vital organ procurement; but what should change are not the standard practices in which the rule is violated, but the rule itself. In general, I believe that the practical implications of the authors’ account of the wrongness of killing are more justified than the account itself. My judgment is possible because their account has mostly the same implications as what I take to be the best account—at least regarding the killing of human beings. I turn now to points of disagreement.

First, the authors argue that the wrongness of killing is a function of harming and that, because ‘a loss of autonomy is a kind of harm, broadly construed…,’ …