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Dealing Death and Retrieving Organs


It has recently been argued by Miller and Truog (2008) that, while procuring vital organs from transplant donors is typically the cause of their deaths, this violation of the requirement that donors be dead prior to the removal of their organs is not a cause for moral concern. In general terms, I endorse this heterodox conclusion, but for different and, as I think, more powerful reasons. I end by arguing that, even if it is agreed that retrieval of vital organs causes the deaths of those who provide them, that does not pose any new substantive difficulties for efforts to justify “opt-out” organ procurement systems.

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    It is, of course, arguable that our mortality is a necessary condition of some forms of value as well. See, for a discussion, Nussbaum (1986).

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    It might appear that accepting that death could constitute more or less of a harm to a person as a function of how much of one’s otherwise available life it cuts off implies that the unconsented-to killing of a sexagenarian is less wrong that similarly killing a child, but that conclusion needn’t follow: while 60-year-olds may, at least in general, lose less than 16-year-olds in being killed, the contempt expressed by such an action for its victim may be, for all that, categorical, a rejection of the significance that persons place on their own lives as preconditions for much else that is of value to them, and all value that involves experience or action.

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    Here I take a perspective on death’s harms that is somewhat narrowly focused on the dying person as an individual. Surely, a person’s death might constitute a harm to others over and above the harm of her loss of access to the goods of action and experience. The narrow focus remains important, however, as even people unconnected to others are correctly taken to be harmed gravely by their deaths, at least generally. That they can be harmed in the same fashion by events other than death remains worth underscoring.

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    A reviewer’s comments prompt the following thought: future scientific developments could, in effect, reanimate organisms now uncontroversially regarded as dead. This possibility suggests that there is nothing more “brutally factual” to the concept of irreversibility than to the concept of death itself: technology, and the social understandings and individual intents that guide it, might, it seems, condition what constitutes “irreversibility.” This fascinating point deserves lengthy consideration. Here, I will only make one observation: even if the notion of irreversibility involved in death is not so strong to entail that any change is flatly inconceivable, it seems highly counterintuitive to understand that concept as so weak to allow us correctly to label some process or state of affairs as irreversible simply if we decide to leave it alone.


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I appreciated the opportunity to present these thoughts at a Student Forum at the Bioethics Centre at the University of Otago in May of 2009, chaired by Ms. Kristen Steslow. I’m grateful to the staff and students of the Centre for the stimulating welcome they’ve offered me through my 2009 research leave in Dunedin. Professor Grant Gillett and Simon Walker have been particularly helpful, both in general, and as concerns this essay. As always, I appreciate the philosophical and editorial contributions of Professor Hilde Lindemann.

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Correspondence to James Lindemann Nelson.

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Nelson, J.L. Dealing Death and Retrieving Organs. Bioethical Inquiry 6, 285–291 (2009).

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  • Ethics
  • Organ transplantation
  • Organ procurement
  • Death
  • Opt-out