On 28 November 2018, an orientation debate took place in the German Bundestag on whether an opt-out system should be established in future instead of the current opt-in system to improve the desolate situation in organ donation. Decreasing donor numbers and long waiting lists give rise to calls for fundamentally different approaches. But what are the ethical challenges raised by the possible new regulations for patients, relatives, medical staff and future donors? On Wednesday, 12 December, the German Ethics Council discussed the advantages and disadvantages of opt-out organ donation at a public evening event that was attended also by several members of the Bundestag.