Germany's Organ Donation Law May Change: What Residents Need to Know

Introduction

Germany is one of the few remaining European countries that still uses an exclusively opt-in system for organ donation — meaning residents must actively register their willingness to donate before their organs can be used after death. Now, parliament is debating a significant shift: moving to an opt-out model, where all residents would be considered potential donors unless they explicitly register an objection. For expats and immigrants living in Germany, this debate is directly relevant. If the law changes, it will apply to everyone registered as a resident — regardless of nationality. Understanding how the current system works, and what a change could mean for you, is important.

How Germany's Current Organ Donation System Works

Under the existing opt-in framework, a person must have actively declared their wish to donate organs — typically through an organ donor card (Organspendeausweis) or by registering in the national donor registry. If no such declaration exists at the time of death, the decision falls to the next of kin.

This system has resulted in Germany having one of the lowest organ donation rates in Europe. According to figures from the German Organ Transplantation Foundation (Deutsche Stiftung Organtransplantation), around 8,500 people in Germany are currently waiting for a donor organ, while the number of actual donors has remained critically low — fewer than 1,000 per year in recent years.

For expats and immigrants, the current system can be confusing. Many arrive from countries with different rules and may not know they need to actively opt in. If you have not registered a decision, and something were to happen to you, the decision would rest with your family.

What the Proposed Opt-Out System Would Change

Under the opt-out model being debated in the Bundestag, every resident of Germany would automatically be considered a potential organ donor after death — unless they had registered an explicit objection during their lifetime. This is sometimes called a 'presumed consent' system.

Countries that have adopted this model, including Spain, France, and Austria, have generally seen higher donation rates as a result. Supporters of the reform in Germany argue it would help reduce the gap between supply and demand for donor organs.

Critically, an opt-out system would not mean your organs are taken without any process. Medical teams still assess suitability, and family members are typically consulted even in opt-out countries. However, their ability to override the decision is more limited than under the current German system.

For immigrants and expats, the key implication is this: if the law passes, you would need to proactively register an objection if you do not wish to be a donor — rather than proactively registering consent as you do today.

Where the Debate Stands Now

No law has been passed yet. The Bundestag is in active discussion, and this is a cross-party debate rather than a government vs. opposition issue — members of parliament are expected to vote according to personal conscience rather than party line, as has been the tradition in Germany on bioethical questions.

Previous attempts to introduce opt-out donation in Germany have failed. In 2020, the Bundestag voted against a similar proposal. The current debate reflects renewed urgency given persistently long waiting lists.

The timeline for a final vote is not yet confirmed. Any new law would also include a transition period and public information campaign before taking effect.

Frequently Asked Questions

Does the current German organ donation system apply to me as a foreigner living here?

Yes. Organ donation rules in Germany apply to all residents, regardless of nationality. If you are registered as living in Germany (i.e., you have completed your Anmeldung), the rules apply to you. This includes both the current opt-in system and any future opt-out system if it is adopted.

How do I register as an organ donor in Germany right now?

You can obtain a free Organspendeausweis (organ donor card) at most pharmacies, doctors' offices, and health insurance (Krankenversicherung) providers. You can also register online through the Bundeszentrale für gesundheitliche Aufklärung (BZgA) at organspende-info.de. Carrying a completed card or informing your family of your wishes is the clearest way to ensure your decision is respected under the current system.

If Germany switches to opt-out, how would I register my objection?

The specific mechanism for objection registration would be defined in the new law, but typically opt-out countries maintain a national registry where residents can log their refusal. Details of how this would work in Germany, including whether it would be accessible in multiple languages, have not yet been finalised.

Conclusion and Next Steps

Whether or not Germany's organ donation law changes, this is a good moment to make your wishes known — to your family and, if you choose, through the official registration process. As an expat or immigrant, it is easy to let this kind of decision fall through the cracks amid all the other paperwork of settling in a new country. But it is one of the most personal decisions you can make.

Monitor the parliamentary debate through DW English or Der Spiegel for updates on when a vote might take place. If the law does pass, there will be a public information period — but acting early is always better.

Source: DW English