Throughout the world, the practice of organ donation for transplantation is governed by the dead donor rule, that is, vital organs can be retrieved only from patients who are dead and organ procurement cannot cause the death of the donor. While this principle is constant, the specifics surrounding the laws and cultural practices relating to death and organ donation vary significantly between countries. Key ethical concepts include autonomy, non-maleficence, beneficence, and distributive justice. This chapter covers a number of ethical considerations encountered with DCD liver transplantation including timing of the decision to withdrawal life-sustaining treatment in patients who may be potential donors, comfort care management prior to death, site for withdrawal of life-sustaining treatment, declaration of death, and observation time prior to starting retrieval and organ allocation/sharing. This chapter also provides country-specific information on both laws and practices surrounding DCD organ donation.