The German Bundestag held its first reading on proposals to reform Germany’s organ donation system under the Transplantation Act (Transplantationsgesetz). The parliamentary discussion addresses the chronic shortage of donor organs in the country. In this ethical vote, party discipline (Fraktionszwang) is lifted, allowing members of parliament to cast conscience votes (Gewissensentscheidung).
At the heart of the debate are two competing cross-party proposals: introducing an opt-out presumption model (Widerspruchslösung) versus retaining and upgrading the existing informed opt-in decision system (Entscheidungslösung).
- What happened: Bundestag deputies opened deliberations on two competing legislative initiatives amending the Transplantation Act.
- Central dispute: Transitioning to default organ donation with the right to record an objection (Widerspruchslösung) versus upholding mandatory explicit prior consent (Entscheidungslösung).
- 2025 figures: 8,199 people were registered on Germany’s transplant waiting lists; 985 organ donors were recorded that year.
Two Concepts: Opt-Out Presumption vs. Informed Choice
A cross-party alliance of 254 MPs (including representatives from CDU/CSU, SPD, and the Greens) advocates adopting the presumed consent model (Widerspruchslösung). Under this proposal, organ retrieval from a deceased adult with legal capacity would become permissible unless they had registered an objection during their lifetime. The recorded objection must be readily verifiable, and consultations with surviving relatives are retained.
Karl-Josef Laumann, Health Minister of North Rhine-Westphalia speaking on behalf of the Bundesrat, argued that adults can reasonably be expected to document their position on organ donation. He stated that it is inappropriate to shift this burden onto grieving relatives in end-of-life situations. A majority of federal states support the reform.
Germany participates in the Eurotransplant network. As noted by the Süddeutsche Zeitung, more organs are transplanted in Germany than are retrieved domestically, making the country a net recipient of donor organs from other member nations.
An alternative initiative is backed by 58 MPs led by Michael Brand (CDU) and Lars Castellucci (SPD). They advocate retaining the principle of conscious consent (Entscheidungslösung), arguing that “a citizen’s silence must not automatically equal consent.”
This group proposes stepping up public awareness campaigns and facilitating access to the national electronic donor registry (Organspende-Register). They also call for enforcing provisions adopted back in 2020 requiring citizens to be informed about organ donation when applying for ID cards (Personalausweis) and passports, which responsible state authorities have yet to implement, according to Tagesschau.
Survey Data and Current Situation in Hospitals
According to a representative 2024 survey, 85% of respondents expressed general willingness to donate organs, but only about 45% had formally documented their decision.
In 2025, Germany recorded 985 post-mortem organ donors, while 8,199 patients remained on transplant waiting lists. Both parliamentary groups agree that donor numbers are insufficient.
A previous legislative attempt to introduce an opt-out model was rejected by a majority in the Bundestag in 2020. A subsequent Bundesrat initiative in 2024 lapsed before final consideration due to early parliamentary elections.
A final vote on the competing initiatives in the Bundestag is scheduled for late 2026.
First readings in the Bundestag represent the commencement of the legislative process rather than statutory enactment. Current regulations in Germany remain unchanged: organ removal is permissible only with explicit prior consent (in the registry or on an Organspendeausweis card) or with the consent of next-of-kin. Registration in the central portal at organspende-register.de remains voluntary.