According to public surveys, organ donations as well as organ transplantation enjoy a high degree of acceptance within Germany. Transplantation is seen as a victory over otherwise untreatable deadly diseases. Positive reports of transplant patients in the news and media form the basis for expectations of further successes of modern medicine. In contrast to the broad acceptance of organ transplantation, organ donation has not yielded unrestricted and unbiased recognition, irrespective of whether the discussion focuses on deceased or live organ donation. In Germany, detailed discussions about end of life decisions, the process of dying and the diagnosis of brain death remain controversial and thus prevent unan-imous acceptance of organ donation. Medical progress requires new definitions of previously unchallenged entities, such as life and death. Organ donation postulates a distinct division between still alive and already dead. Medical knowledge allows for a definite recognition of signs of death, exemplified through the definition of brain death at a certain point. Public acceptance of highly specialized medical achievements in a sensitive field can be difficult where traditional emotions and popular legend come up against scientific facts. The gap can be narrowed with the provision of early information, recognition of organ donation procedures in neighboring European countries and intensified networking amongst donor hospitals, which could result in a better implementation of organ donation.