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Abandoning the Dead Donor Rule
  1. Anthony P Smith1,2
  1. 1 Philosophy, The University of Utah, Salt Lake City, Utah, USA
  2. 2 English and Philosophy, Snow College, Ephraim, Utah, USA
  1. Correspondence to Dr Anthony P Smith, English and Philosophy, Snow College, Ephraim, UT, 84627, USA; anthony.smith{at}


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.

  • death
  • transplantation
  • ethics- medical
  • tissue and organ procurement

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  • Contributors The paper is the sole work of the author (TS).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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