In Japan, brain death only became accepted as a legally valid criterion for the end of human life when the “Law on organ transplantation” came into force in October 1997. The Japanese law stipulates a particularly narrow form of the consent solution, according to which organs may only be removed after death if both the donor during their lifetime and the next of kin consent to organ donation. Also, organ donation and transplantation is prohibited for children under the age of 15. Since many Japanese think that a human being is only dead when the heart and the lungs have ceased to function, they are frequently opposed to organ removal from brain-dead patients.

In January 2010 the revised Organ Transplant Act came into force, which contains three substantive changes.

1. If a potential donor did not document her consent or dissent, organs can now be removed if the next of kin consents to organ donation.
2. Organ donation and transplantation for children under the age of 15 is no longer prohibited.
3. Under certain conditions, it is now possible that an organ donor designates her next of kin as priority recipients.