A renewed fundamental debate regarding organ donation is taking place in the German Bundestag. A cross-party group, led by SPD representative Sabine Dittmar, introduced a draft law in Berlin calling for the adoption of an opt-out system.
This proposed legislation would mean that all adults in Germany would automatically be considered organ donors unless they actively register an objection. The group advocating for this change includes CDU member Gitta Connemann, CSU member Peter Aumer, Green party representative Armin Grau, and Left party representative Julia-Christina Stange.
Dittmar explained that this procedure is already standard practice in many European countries. According to her, the goal is to eliminate the need for a majority of people to actively confirm their consent for donation. Instead, she argued, the burden should fall on the minority who oppose the process.
Currently, German law operates under an extended consent solution, which mandates explicit consent for organs to be removed. If no consent statement exists, medical staff must consult the presumed wishes of the deceased’s relatives. Proponents of the opt-out system pointed to persistently low donation rates and the extended waiting lists for seriously ill patients who require donor organs. Notably, medical organizations such as the German Transplant Society, along with the Bundesrat, have recently expressed support for this approach.
However, the plan has faced opposition, forming a cross-party resistance spearheaded by Kirsten Kappert-Gonther (Greens), Lars Castellucci (SPD), and Stephan Pilsinger (CSU). Kappert-Gonther dismissed the opt-out model as a superficial fix that raises significant ethical concerns. She questioned whether there is international proof that such a system actually increases the number of donations, arguing instead that improvements in hospital extraction structures, public awareness, transparent processes, and simple documentation are far more effective. She emphasized that silence is not consent, and self-determination must also encompass the right not to make a decision.
Conversely, Mario Schiffer, the president of the German Transplant Society, views the opt-out system as overdue and necessary, believing it has the potential to structurally raise the number of organ donations in Germany.
