To the Editor: In their recent article,1 Richards and Rogers connect some ideas about patient autonomy, non-maleficence and laws relating to consent with specific antemortem activities, but their main “justification” for these activities is a practice termed donation after cardiac death (DCD). This practice has been introduced in the hope of increasing the availability of organs for transplant. It involves removing cardiorespiratory support and withholding resuscitation, then harvesting organs when cardiac death occurs.2,3