Attention not consistency: why we need dead donor rule in a thick moral world

In his article, ‘Non-consequentialist and egalitarian objections to the dead donor rule’,1 Lawrence Masek observes that ‘palliative care physicians sometimes may shorten a patient’s life as a result of relieving the patient’s pain, but transplant teams may never shorten a patient’s life as a result of procuring a vital organ’, calling these ‘inconsistent standards.’ He examines various principles used to justify the Dead Donor Rule (DDR): do-no-harm, do-not-kill and double effect and finds counterexamples to each. For example, living kidney donation seemingly violates do-no-harm, lethal palliation violates do-not-kill, etc. Having demonstrated these inconsistencies in application of principles, Masek concludes that ‘the burden of proof belongs to proponents of the DDR’ to defend the rule ‘without relying on principles of ethics that are too strict’.

Let me take on that burden.

The assumption that medical practice needs consistency based on overarching principles is questionable. What appears as inconsistency when judged against…

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