While developed nations honor organ and tissue donors and their families as national heroes, establishing a "culture of remembrance," South Korea's organ donation progress has remained frozen for years—trapped by outdated laws and baseless conspiracy theories. Although the government has belatedly moved to address the issue, the pace of legislation in the National Assembly fails to match the desperation of patients on waiting lists.
According to medical industry sources on May 13, the Ministry of Health and Welfare finalized the "First Comprehensive Plan for Organ Donation and Transplantation (2026-2030)" in October last year, which includes the introduction of Donation after Circulatory Death (DCD). This marks the first comprehensive plan since the June 2023 amendment to the Act on Organ Transplantation. Beyond DCD legislation, the plan focuses on expanding donation registration institutions from private to public sectors over the next five years and strengthening recognition for donors.
For these solutions to work in practice, amendments to related laws including the Organ Transplant Act and the Life-Sustaining Treatment Act must follow. Current law limits organ procurement to living persons (certain organs such as liver and kidneys), deceased persons, and brain-dead patients—leaving donation after cardiac arrest in a legal gray zone.
DCD is broadly divided into five categories: cases where patients arrive at hospitals already deceased; cases where cardiac arrest occurs inside or outside hospitals and CPR fails to restore circulation; cases where cardiac arrest occurs after withdrawal of life-sustaining treatment with family consent for patients who are not brain-dead; and cases where cardiac arrest suddenly occurs before organ procurement from brain-dead patients. In Korea, the third category is considered the most realistic model.
Medical practitioners have already demonstrated its feasibility. In 2020, a team led by Professor Lee Jae-myung of Korea University Anam Hospital's Critical Care and Trauma Surgery Department successfully procured the liver and both kidneys from a 52-year-old patient who died of cardiac arrest following withdrawal of life-sustaining treatment, saving three lives. However, without supporting legislation and institutionalization, not a single additional case has occurred in the six years since.
As the government signals its commitment to institutionalization, attention has shifted to politicians. Rep. Seo Mi-hwa of the Democratic Party of Korea, a member of the National Assembly's Health and Welfare Committee, recently introduced amendments to both the Organ Transplant Act and the Life-Sustaining Treatment Decision Act centered on DCD adoption, igniting the debate. The bills would include patients withdrawing life-sustaining treatment among organ donation candidates and legally enable essential procedures such as donation consent, donor examination, and recipient selection prior to treatment withdrawal. To prevent institutional confusion, the legislation notably defines the time of death after cardiac arrest as "the point when five minutes have elapsed after spontaneous circulation and respiration have irreversibly ceased."
However, society's distorted perceptions of organ donation remain the final obstacle. Previously, Rep. Kim Ye-ji introduced a bill in 2024 that would have prevented families from overriding a donor's expressed wishes during their lifetime, but voluntarily withdrew it. This came after conspiracy theories spread on online communities suggesting that Rep. Kim, who is visually impaired, was "trying to receive eye transplants for herself"—raising concerns that negative perceptions of donation itself would proliferate.
The foundation for a society that honors donors and their families as heroes lies in legislative determination that prevents donors' noble intentions from being buried by institutional gaps.
Joo Dong-jin, Executive Director of the Korean Society for Transplantation and Professor of Transplant Surgery at Severance Hospital, emphasized: "Increasing brain-dead donors would be the best approach, but current numbers are woefully insufficient. The introduction of DCD is urgently needed for organ donation to expand."