**6. Summary**

**5. Social system for organ donation**

Do-not-resuscitate or comfort care being considered Withdrawal of life support being considered Family initiates conversation about donation **Within 1 h of every cardiovascular death**

12 Organ Donation and Transplantation - Current Status and Future Challenges

**Table 3.** Criteria for referral of a potential donor.

**Every ventilated patient with** Glasgow coma scale of <5 Brain death test being considered

of conflict, which can be solved with social agreement.

the efforts of European countries to adopt it [28].

awareness and encourage organ donation.

Strategic efforts by the government and local authorities, as well as individual efforts by medical personnel, are necessary to promote organ donation. These include the revision of laws, simplifying the required procedures for receiving consent, expansion of the donor card system, adoption of a presumed consent concept known as an opt-out system, and the establishment of a DCD system. The strategic processes put in place in Europe and the United States

Despite the effectiveness of these strategies, public acceptance of organ donation is essential before these measures can be implemented in other countries. The establishment of social systems for organ donation depends on public consensus. There are currently two moral values on organ donation: deontologism versus consequentialism. This means where we put our maximum value of some behavior, as it were, the legitimacy of process or the benefit of consequence (**Table 4**). Many procedural details in organ donation and recovery have points

Asking families for organ donations to families is generally regarded as a stressful task by primary physicians. Only a small portion of potential donors are being asked about organ donation as an option of end-of-life decision, and it is decided according to the primary physician's point of view or belief. Despite the important role of the medical staff in recommending organ donation to families, imposing this burden on physicians alone may not be adequate. If we, including local authorities and the general population, agree on the importance of organ donation, its promotion would not be the sole responsibility of individual medical staffs. The authorities have to consider establishing an advanced system that links potential donors to organ donations, known as an "opt-out" system. Many valuable lessons can be learned from

Religious beliefs were found to be important. Officially, nearly all religious groups support organ transplantation as long as it does not impede the life or hasten the death of the donor [31]. However, only a small portion of the public knows about the stance of their religion on organ donation. More active involvement of religious bodies is needed to raise the public's

have resulted in a progressive and gradual increase of organ donation [27–30].


• Effective systems such as opt-out, donation after circulatory death, and donor action programs are needed to promote deceased donations.

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Organ Donation

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