Challenges to the dead donor rule: Configuring a biopolitical response

Although the phrase the dead donor rule was not coined until 1988, Arnold and Youngner consider it to be an unwritten, uncodified standard that has guided organ procurement in the United States since the late 1960s (1993, p. 264). It represents two moral commitments that guide the retrieval of organs. The first is that healthcare professionals may not harm, kill, or hasten the death of a patient in the pursuit of organs. This is, of course, a basic moral commitment of medical practicefirst, do no harmthat is being reiterated in the context of donation and transplantation. The second commitment is that the donor must be dead prior to retrieval and therefore beyond any possible harm that might result from doing so. Whilst this rule is obviously contravened in the cases of live donation of non-vital organs, it is maintained at the end of life. For example, the kidney of a dying patient would not be removed even if the patient wishes to be a (post-mortem) organ donor and doing so would not hasten their death