Stefan Schwartze, the Federal Government’s Patient Commissioner, is advocating for a complete overhaul of organ donation laws ahead of renewed parliamentary debate. He expressed satisfaction that a discussion about regulatory changes has finally been brought back to the Bundestag, stating that a systemic shift has been urgently needed for years.
The SPD politician argues that Germany does not suffer from a lack of information or understanding regarding organ donation. Nevertheless, according to his assessment, all past efforts have failed to increase the number of available organs or the official registry entries. Therefore, Schwartze is personally convinced that a fundamental change is necessary, suggesting that the opt-out model would be highly appropriate.
When faced with criticism that the opt-out system infringes upon self-determination, Schwartze countered that the central principle must remain an informed personal choice. He emphasized that the opt-out system does not obligate or force anyone to donate; a “no” will always be respected without the need for justification.
This advocacy is supported by the German Medical Association (Bundesärztekammer). Its President, Klaus Reinhardt, told publications from Funke Media Group that the opt-out solution offers a chance to narrow the gap between the high general public willingness to donate and the currently low actual donor numbers. While confirming that citizens’ freedom of choice would be upheld, Reinhardt also noted that the system sends a crucial signal of solidarity. Furthermore, for doctors, the regulation would provide a more reliable foundation, as Reinhardt pointed out that organ donations are often currently prevented because there is no documented expression of the patient’s will. He added that the opt-out model could help facilitate the implementation of patient wishes and ease the burden on relatives during difficult decision-making processes.
The Bundestag is set to address this question again in the current legislative term. Several members of various political groups are pushing for a new regulation, which centers on the opt-out model-a system where every person is considered a donor unless they have explicitly opted out. A similar reform attempt failed in 2020. Currently, Germany operates under an opt-in system, meaning organ removal is only possible with the explicit consent of the patient or their family.
The number of organ donations in Germany has remained at a comparatively low level for years. According to the German Foundation for Organ Transplantation, there were 985 post-mortem donors nationwide in 2025, which corresponds to 11.8 donors per million inhabitants. Furthermore, more than 8,200 people were waiting in Germany for a life-saving organ at the end of 2025.
