On the Opt-Out System for Organ Donation

According to the German Organ Procurement Organization, 8,199 people were waiting for a donor organ in Germany by the end of 2025. Despite a slight increase, the number of post-mortem organ donors remains low (985 in 2025). Surveys suggest that many people would be willing to donate but do not hold an organ donor card. It remains to be seen whether this can be remedied by the newly introduced option of recording one’s decision online in an organ donor register. Efforts to increase the number of donated organs have repeatedly led to discussions about an opt-out system, which is already practised in some European countries. Under such a system, anyone who has not objected during their lifetime would be considered an organ donor, although relatives could still object to the donation even after cerebral death has occurred. In Germany, attempts to introduce an opt-out system have so far failed.

The German Bundesrat’s move in autumn 2025 to put the opt-out system for organ donation back on the political agenda has reignited the long-standing public debate on this issue. This sensitive and pressing debate touches on fundamental questions of self-determination, state responsibility and solidarity.

This creates an immediate need for guidance for parliamentarians and their staff: What are the arguments in favour of reviewing a proposal that has already failed on several occasions in the past? What are the arguments against it? Following an assessment in terms of constitutional law and four statements from both supportive and critical perspectives, the parliamentary briefing offers the opportunity to discuss the key ethical, legal and social issues with members of the German Ethics Council. This is intended to provide a sound basis for the upcoming complex parliamentary deliberations.

The German Ethics Council has already addressed this set of issues on a number of occasions. In its Opinion “Brain Death and Decisions Regarding Organ Donation”, published in 2015, it addressed the controversy surrounding brain death, and in 2018 it dedicated a Bioethics Forum to the topic “Advantages and Disadvantages of Opt-Out Organ Donation”. The planned parliamentary orientation discussion will focus on current developments.

Please switch to the German version for further information.