The “dead donor rule” (DDR) is a legal and ethical mandate that requires vital organ donors to be truly dead before their body parts are procured. A corollary to the rule holds that people cannot be killed for their organs. The DDR promotes trust in the system and protects the vulnerable — but is flexible enough to permit living donations of one kidney and parts of a liver from altruistic donors.

Utilitarian bioethicists have long argued against the DDR and its corollary based on the notion that killing those who are dying or want to donate will relieve the suffering of people who want to live and need an organ. And here we go again. The Journal of Medical Ethics — out of Oxford — has published a long and complicated piece by Ohio bioethicist Lawrence J. Masek arguing that patients who want to donate should be able to be killed during — or as a direct result of — the organ-procurement process.

First, the author pulls a typical switcheroo often seen in bioethical discourse. Here’s a relevant example: We were assured over many years that brain dead is “dead.” Now, that this is accepted widely, many bioethicists are claiming that actually, it isn’t. If they are right, the DDR would preclude organ procurement from such patients. But these bioethicists claim instead that procuring organs from those diagnosed as brain dead also means that we can harvest comatose patients whose brains are clearly functioning.

See how that works? Rather than stick to the rule, expand it and pretend it is not being stretched.

This is Masek’s tactic too. He claims that since taking one kidney in an altruistic living donation harms the patient through reduced kidney function without violating the DDR, it is also okay to take the liver of a patient that will lead to death a few........

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