Overview

• Eight states led by North Rhine-Westphalia won Bundesrat support for a bill presuming consent for organ donation unless adults have recorded an objection.
• Objections could be documented in the national register, on a donor card, in a patient directive or otherwise, with relatives asked about known wishes if no record exists.
• Safeguards in the draft exclude people unable to understand the implications of donation and assign decisions for minors to their parents.
• Despite a slight rise in 2025, supply lags demand: about 8,100 people are on waiting lists, 2,025 organs were donated from January to August, and 2,188 transplants were performed.
• Critics including the Patient Protection Foundation, ethicist Peter Dabrock and parts of the churches warn that presumed consent risks undermining self-determination and trust, as the Bundestag now takes up the proposal.