natural than saying that all the physician did was to return the patient to an untreated disease state and that state caused the death. finally, we thereby avoid the proliferation of definitions of death with differing times in different jurisdictions, different definitions of death for different purposes (the cardiocirculatory definition of death discussed in this article is only valid for dcd), and arbitrary rulings such as declaring anencephalic infants with heartbeat dead. on the pragmatic side, rejecting the rules in question would have advantages for recipients and donors in transplant programs. because there will now be no necessary interval between pulselessness and the declaration of death, there can be a reduction in warm ischemia time, and so an improvement in the quality and quantity of transplantable organs. it will also be possible to give the donor drugs such as heparin and phentolamine, which can hasten death but also maximize organ preservation. finally, it will eliminate the possibility that patients will experience discomfort as they are withdrawn from ventilator support by allowing potentially fatal doses of morphine that are not titrated to signs of distress. the main obstacle to accepting the proposal is securing the acceptance of the public to allow physicians to cause the death of (which is to say kill) patients to obtain transplantable organs. proponents of the proposal contend that robust consent requirements can provide the public with the assurance against exploitation that the dead donor rule and the prohibition on killing are designed to provide. others deny this. thus the question can be posed: "given the difficulties our society is likely to experience in trying to openly adjudicate these disparate views , why not simply go along with the quieter strategy of policy creep? it seems to be getting us where we want to go, albeit slowly. besides, total candor is not always compatible with public policy (calabresi g and bobbitt p. tragic choices. new york: norton,1978)." the debate continues unresolved.