Overview

• The Bundesrat on 26 September approved an eight‑state initiative led by North Rhine‑Westphalia to introduce presumed consent for organ donation and forwarded the draft to the Bundestag.
• The proposal would treat all adults as donors unless they opt out, with objections documented via the national register, a donor card, a patient directive or another written form.
• If no document exists, relatives would be asked about any expressed will against donation, parents would decide for minors, and procurement would be barred for people lacking decision‑making capacity.
• Germany continues to face a supply gap, with about 8,300 people waiting for organs early in 2025 versus roughly 2,850 organs donated in 2024, while the digital register lists about 375,000 entries.
• Supporters such as NRW minister Karl‑Josef Laumann and Karl Lauterbach say the change could increase donations, whereas critics including Peter Dabrock and the German Patient Protection Foundation warn of ethical and trust risks; the Bundestag’s timetable remains undecided.