Rethinking the Dead Donor Rule: A Defense of Normothermic Regional Perfusion

Normothermic Regional Perfusion (NRP) is an organ procurement method that has the potential to save lives by improving the number and quality of transplanted organs. Nevertheless, critics have argued that NRP is unethical because it violates the dead donor rule (DDR), which many regard as the fundamental principle underpinning the permissibility of organ donation. In response, proponents of NRP have tried to demonstrate that donors who undergo this procedure satisfy the criteria of circulatory death. This defense of NRP relies on the claim that death should be defined in terms of "permanence" rather than "irreversibility." In this paper, we argue that NRP is consistent with the DDR, so long as the DDR is understood to apply only to what we call legal, as opposed to biological, death. We nevertheless conclude that this is a hollow victory, as interpreting the DDR in this way also illustrates why it should be rejected.