Reframing “Good Death” in Taiwan: An Ethical Review of Legislation on Deceased Organ Donation

Taiwan developed legal frameworks for organ transplantation earlier than many other East Asian countries and has achieved relatively successful clinical outcomes. Although its deceased donor rate remains lower than in countries such as Spain and the United States, it exceeds those of Japan, China, and Singapore. This success is often attributed to the efficiency of its transplant network and the strength of its legal infrastructure. However, the sociocultural context of these laws-and how Taiwanese policies engage with prevailing beliefs about death and the body-has received limited scholarly attention. This paper addresses that gap by analyzing legal and policy documents related to deceased organ donation in Taiwan, including legislation, official guidelines, and parliamentary records between 1987 and 2021. It argues that Taiwanese law reframes death with organ donation-whether following brain death or cardiac arrest-as a form of "good death," integrating consent into broader end-of-life decision-making. By clarifying the legal and policy background, the analysis highlights how the government has sought to reconcile biomedical definitions of death with Confucian notions of bodily integrity and socially valued dying. As secularization progresses, this framing may make organ donation more socially acceptable. At the same time, ethical concerns arise from policy discourses that emphasize altruism and social contribution, which may lead individuals to forgo life-sustaining treatments not solely based on personal reasoning, but from a perceived obligation to benefit family or society-potentially constraining expressions of individual preference.