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Beyond inconsistency: defending the moral boundary of the dead donor rule

Lawrence J Masek argues that the dead donor rule (DDR) cannot be theoretically justified without also condemning various widely accepted medical practices, such as kidney and partial liver donation, fetal surgery, domino transplants and lethal palliation.1 He offers an internal critique, contending that the principles used to defend the DDR—‘do no harm’, ‘do not kill’ and the doctrine of double effect—either overreach or become inconsistent.

Masek’s argument is based on contentious assumptions about moral symmetry, intention and the nature of harm. These assumptions trivialise significant moral distinctions and cloud the ethical framework of end-of-life care and organ donation. I would argue that the DDR is not an incoherent remnant of transplant ethics, but rather a substantive moral boundary based on the difference between allowing death and exploiting it for medical benefit.

Masek’s critique of the principle of ‘do no harm’ is extensive. If serious and permanent harm is impermissible unless…

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Posted in: Journal Article Abstracts on 04/08/2026 | Link to this post on IFP |
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