A draft legislation aimed at significantly increasing organ donation rates has been introduced by North Rhine-Westphalia, in collaboration with seven other German states. The announcement, made by the North Rhine-Westphalia Ministry of Health on Thursday, proposes a new system where all adult citizens in Germany are automatically considered organ donors unless they actively opt out.
The initiative, known as the “presumed consent” or “opt-out” system, is designed to address the critical shortage of available organs for transplant. According to Eurotransplant data, nearly 8,300 patients across Germany were awaiting organ transplants as of January 1, 2025, with over 1,700 residing in North Rhine-Westphalia. While approximately 2,850 organs were donated nationwide in 2024, only around 500 originated from North Rhine-Westphalia.
The proposed law details comprehensive regulations regarding the documentation of objections to organ donation, outlining multiple avenues for individuals to formally express their dissent. These include registration in a dedicated organ donation registry, notation on personal identification documents, or verbal declaration made to family members. The draft also clarifies the role of next of kin in the process.
The legislation, jointly presented by North Rhine-Westphalia alongside Baden-Württemberg, Hessen, Mecklenburg-Vorpommern, Rhineland-Palatinate, Saarland, Schleswig-Holstein and Thuringia, is slated for discussion within the Federal Council (Bundesrat) this Friday. Implementation of the new system would occur two years following its official proclamation, accompanied by a widespread public awareness and education campaign to inform citizens about the changes and their options.