Germany could soon transition from an opt-in to an opt-out system for organ donation. That’s if a bill submitted by Health Minister Jens Spahn goes through. 

Everyone in Germany a potential organ donor

Although most Germans are in favour of organ donation in principle, only around 35 percent have an organ donor card, according to the German Federation for Organ Transplantation (DSO). This low donor rate is the reason that, nationwide, more than 10.000 patients are on the waiting list for an organ transplant. 

With Germany falling way behind compared to its European neighbours (the organ donation rate in Spain, for example, is almost five times higher than in Germany), the issue has long been on the political agenda. Most recently, Spahn and Deputy SPD Group Chairman Karl Lauterbach have pushed through a draft bill that would make organ donation an opt-out system. 

Under the proposal, every person in Germany would be considered a potential organ donor after their death. That is unless they have specifically opted out at some point during their lifetime. As Lauterbach points out, “If you really do not want to donate, then you are at least willing to declare yourself a non-donor.” 

Opt-out system a “disproportionate intervention”

To multiple Union, FDP, Left and Green politicians, however, Spahn’s proposal goes too far. They emphasise that donation rates in Germany must be increased, but insist that someone should say “yes” in order to become an organ donor. Silence is not an agreement; they argue. Green party chairwoman Annalena Baerbock said that Spahn’s suggestion was a “disproportionate intervention because there are gentler means.”

Accordingly, the group has submitted an alternative proposal, suggesting that citizens should be interviewed regularly throughout their lives, to see whether they are willing to be added to the organ donor register. For example, anyone having a consultation with their doctor or picking up their driving licence from the citizens’ office would be invited to have a quick chat to discuss the possibility. They also propose introducing a new nationwide online register that would enable hospitals to quickly see whether a person is an organ donor or not. 

Both proposals will be debated extensively by the Bundestag over the coming months before a final vote on the two draft laws. This is expected to be sometime in the autumn.