Donation after circulatory death: burying the dead donor rule

Am J Bioeth. 2011 Aug;11(8):36-43. doi: 10.1080/15265161.2011.583319.


Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death.

MeSH terms

  • Anesthesia
  • Brain Death*
  • Cardiovascular System*
  • Death*
  • Ethical Theory
  • Euthanasia, Active, Voluntary
  • Homicide* / ethics
  • Homicide* / prevention & control
  • Humans
  • Informed Consent* / ethics
  • Morals
  • Organ Transplantation* / ethics
  • Organ Transplantation* / trends
  • Public Opinion*
  • Terminology as Topic
  • Tissue and Organ Harvesting / ethics*
  • Tissue and Organ Harvesting / legislation & jurisprudence
  • Tissue and Organ Harvesting / trends
  • Tissue and Organ Procurement / ethics*
  • Tissue and Organ Procurement / legislation & jurisprudence
  • Tissue and Organ Procurement / trends
  • Trust*
  • Wedge Argument