DOCTORS AND DEATH: WHY DECEASED ORGAN DONATION AND ORGAN TRANSPLANTS ARE RARE IN BULGARIA
DOCTORS AND DEATH: WHY DECEASED ORGAN DONATION AND ORGAN TRANSPLANTS ARE RARE IN BULGARIA

Summary/Abstract: The prerequisites for a functional transplant system in Bulgaria, comparable to those in other European countries, are present. Despite two decades of development, Bulgaria continues to lag behind its counterparts in terms of transplant rates. To identify the causes of this disparity, a study was conducted between early 2023 and mid-2024. This included a review of existing literature, observations of hospital practices, and informal discussions with medical specialists, administrators, and representatives of public institutions. It is widely believed that Bulgarian citizens are unwilling to donate organs. However, this assumption remains unproven, as in most potential donor cases, the brain death is not established and the families are not informed about the donation. Brain dead patients exist in a liminal state, between life and death. Faced with this ambiguity, hospital personnel often deny their presence. Cultural attitudes, structural factors, power dynamics, and social contexts, shape the behavior of medical staff and administrators.

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