Legal and Ethical Dimensions of Organ and Tissue Transplantation: A Review with a Focus on Türkiye

Organ and tissue transplantation is an essential medical intervention that improves survival and quality of life in patients with end-stage organ failure; however, it also raises complex legal and ethical issues concerning bodily autonomy, consent, determination of death, organ allocation, and commercial exploitation. This review aims to evaluate the main legal regulations and ethical issues related to organ and tissue transplantation and to examine the areas of convergence and conflict between law and ethics. In this context, international biomedical regulations and Turkish law are discussed with particular emphasis on valid consent and informed consent, protection of living and deceased donors, brain death, individual autonomy and the role of the family in deceased donation, justice in organ allocation, religious and sociocultural factors, and organ trafficking. The 2025 legal amendment in Türkiye, which gives priority to the donor’s previously expressed will over contrary views of relatives, has strengthened the legal protection of individual autonomy. However, granting allocation priority to the spouses and first-degree relatives of donors has introduced a new ethical debate concerning reciprocity, justice, and equality. In conclusion, although legal regulations and fundamental ethical principles largely converge in organ and tissue transplantation, dynamic issues such as organ scarcity, justice in allocation, public trust, and socioeconomic vulnerability require continuous legal and ethical evaluation.