Organ Donation and the Dead Donor Rule: A Synopsis of Pressing Ethical Controversies and Practical Questions

Objectives: As a result of recent biomedical advancements, organ donation continues to save and enhance countless lives globally. Yet, the gap between the organ supply and demand persists, leading to approximately 17 people dying each day waiting for an organ transplant and another person being added to the transplant waiting list every 9 minutes. This gap persists, in part, because of ethical and practical concerns arising from ambiguities surrounding death determination before donation and the dead donor rule. In this study, we discuss challenges related to defining death in the context of organ donation, critical and tolerant views on the dead donor rule, and possible avenues by which some of the ambiguities and ethical tensions related to organ donation may be resolved. Materials and Methods: We reviewed literature opinions and data pertaining to cultural and religious influences affecting societal attitudes toward death determination and organ donation and examined the future of deceased organ donation. Results: Cultural and religious influences affect societal attitudes toward death determination and organ donation. There is a plurality of views on the matter that may be assuaged to an extent by standardized death determination criterion that could be implemented globally or by identifying alternative therapies other than human organ transplant. Conclusions: The debate regarding death and the acceptability of dead donor organs for transplant does not have a straightforward solution, and efforts are needed to overcome social, cultural and religious objections.