Thousands of Europeans die each year waiting for an organ transplant. Tens of thousands are on waiting lists across the EU, but there is a chronic shortage of donors to meet that demand. Could switching to an ‘opt-in’ system help?

When a person leaves no instructions about organ donation during their lifetime, then doctors often seek consent from next of kin after they have died. Unsure what their relatives would have wanted, the vast majority reject donation, and healthy organs are buried or cremated.

Most European countries now operate an ‘opt-out’ system, which has boosted organ donation dramatically. However, some countries (including Italy and the United Kingdom) are hesitant. It’s an ethically sensitive debate, because many people have personal or religious reasons not to want to donate their organs after death.

What do our readers think? We had a comment sent in by Dimitris arguing that organ donation should be automatic when somebody with healthy organs dies. Is that ethical, though? Would it be better to assume they don’t want to donate their organs? Or would more lives be saved by implementing an ‘opt-out’ system?

Should everyone be considered organ donors unless they ‘opt-out’? We asked Members of the European Parliament (MEPs) from all sides of the political spectrum to stake out their positions on this question, and it’s up to YOU to vote for the policies you favour. See what the different MEPs have to say, then vote at the bottom of this debate for the one you most agree with! Take part in the vote below and tell us who you support in the European Parliament!

Radical Left
Xabier Benito Ziluaga (GUE/NGL), Member of the European Parliament:

Benito-ZiluagaI don’t see any reason why we should not encourage people to show solidarity by becoming organ donors. It would also be useful to improve European coordination to ensure the safety and security of organ donors. Unfortunately, nowadays there is a black market for organs, and this is a problem that we have to tackle.  Of course, encouraging people to become organ donors should not be interpreted as an obligation. It must only be a suggestion that is made through awareness raising campaigns and increasing safety guarantees for all involved.

Bodil Valero (Group of the Greens), Member of the European Parliament:

valeroI think that could be a solution, because I think it’s very important that we have organ donation. But I don’t want to force everybody to do it, so if they feel bad about it they should still be able to say ‘No’. So, maybe an ‘opt-out’ system is better than the one we have now, where you really have to take the step and say: ‘Yes, I want my organs to be donated’. Because a lot of people wouldn’t take that step. So, yes, maybe it’s better to do it the other way around.

Liberal Democrats
Hilde Vautmans (ALDE), Member of the European Parliament:

Centre Right
Eva Maydell (EPP), Member of the European Parliament:

maydellI consider this аs a very personal decision. Each and every European must decide according to his or her personal beliefs whether to become an organ donor or not.

Hans-Olaf Henkel (ECR), Member of the European Parliament:

Steph McWilliam (EFDD), former UK Independence Party (UKIP) spokeswoman for health (NOTE: We contacted EFDD MEPs for comment but they did not reply in time for publication. The below is from a statement made on UKIP’s website when McWilliam was UKIP health spokeswoman):

We should not have politicians deciding whether or not people should automatically donate organs. It’s a thorny issue and a deeply personal one that raises a number of serious ethical questions over the rights of the individual over his or her body and the ownership of the body in life and in death.

This essentially amounts to state ownership of the body where your organs are registered on a national data base unless you decide they should not be. This debate has no space in politics. We require politicians to run the country and speak on behalf of the electorate but we do not expect them to start rearranging the ethical framework of sensitive debates…

Curious to know more about organ donation? We’ve put together some facts and figures in the infographic below (click for a bigger version).9-ME&EU-organ-donation_2
IMAGE CREDITS: CC / Flickr – Techniker Krankenkasse

Who do YOU agree with on this issue?


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133 comments Post a commentcomment

What do YOU think?

  1. EU Reform- Proactive

    Should everyone be ordered & considered “forced in by the EU”?

    “Many people have personal or religious reasons” to rather follow their individual spirituality & wish to remain as free as possible from all these political nanny-isms created by the EU.

    Any reasonable & “responsible” person has a choice to clarify such choice in their Testament- made in good time.

  2. Paul X

    I suppose many of those people with “personal or religious reasons” have no problem eating parts of animals that have been donated to them after they have been slaughtered?

  3. Oli Lau

    the european citizens aren’t your property…stop acting like it is the case.
    Ask the permission, be respectful.

  4. Blanka Kasza

    Yes with the possibility for the family to opt out if they don’t feel comfortable with it.

  5. Antonios Forlidas

    Europol confirms the disappearance of 10,000 migrant children in Europe. Does anybody know what happened to all these missing children who were trying to save their lives from the wars and disappeared in the civilized christian Europe ? Did they take their organs in the notorious clinics in Kossovo, in Berlin, in Amsterdam ? Who knows?

  6. Stefania Portici

    in una sanità che va verso la privatizzazione ( la UE chiede continuamente tagli tagli tagli alla spesa pubblica e dove si taglia ? Sui servizi essenziali ! Che delinquenza.!!! ) dove si fanno affari anche sulla pelle delle persone la mia risposta è NO. Non vedo l’ora che lo Stato ritorni a fare lo Stato e tuteli la salute , il benessere e la volontà del 99% dei cittadini . in a health care goes toward privatization (the EU keeps asking cuts cuts cuts in public spending and where you cut? Sui essential services! What crime. !!!) where you do business too on people my answer is NO skin. I look forward that the state returns to the state and protect the health, welfare and the will of 99% of the citizens.

    • Stefania Portici

      da noi esiste già la donazione degli organi senza averlo sottoscritto , con il consenso dei familiari ma la sanità è PUBBLICA , siamo in una società ancora sociale e garantisce la trasparenza, la volontà dell’essere umano di donare senza costrinzioni economiche . Se dovesse diventare un sistema privato come ci sta chiedendo la UE ( non lo chiede direttamente ma di fatto ti sta obbligando ) vedrete le battaglie che usciranno fuori !!!

  7. Christos Ioannou

    certainly not. Attaching value in someone’s death, is way to risky imo and would certainly lead to temptation, foremost for doctors. You can choose to call yourself a doctor and not take the Hipocratic oath, or do not repeat the ‘do no harm’ part but if you start weighing saving someones life against saving someone else then you are by virtue of triage, in a state of war, not peace.

    • Spyros Kouvoussis

      you don’t know how the system of organ donation works, do you?

    • Ana Antonio

      I dont think he knows much at all…

    • Christos Ioannou

      Listen, I don’t have anything against people who want to be organ donors. Personally I live in a country where trust is a luxury if not a dream, but even if I did not live here, I would not be an organ donor, and I am also opposed to assisted suicide. In any case I do not care to find out how it works. If I ever wish to donate something I am sure I will be accommodated if its possible to do so. But until then, thank you, but no thank you.

    • Ana Antonio

      Good. Opt out then. Dont let people die just because you can’t be bothered to register as a non donor.

    • Christos Ioannou

      I don’t doubt the system Ana. I doubt the people who use it. A system may be faultless. People are not whether intentional or unintentional. It takes effort to save someones life and honestly all it takes for an organ donor to save someones life can amount to an ambulance driver easing off the gas. Ever thought of that? And if you think people are so noble read the following story, which I will admit is only an allegation at this stage

    • Ana Antonio

      Christos, that ambulance driver would have to have some awesome superpowers to be able to know if the person he is carrying would be genetically compatible with his sick auntie. And then he would have to, somehow, control the rest of the hospital staff to make that specific surgery. That hipothetical situation is absurd. And even if it wasnt, automatic organ donation makes the premisse for such situation to disapear, since there is no shortage of organs in a society where most people are organ donors. Any inconvenience from this system pales by comparison to the horrors of black market and the waste of functional organs while people who desperatelly need them, die.

    • Ana Antonio

      And for the story you shared (wich sounds pretty silly, but lets pretend its true), it just reinforces my argument. Automatic organ donation means no one can make money like this. There is no demand to suply.

    • Christos Ioannou

      Ana Antonio the driver would just be doing as he is told by the paramedic who would say the patient is under control, who was told by the doctor that they are on the lookout for e.g. a heart. And its not just about money its mostly about people and how their judgement and ethics can get blurred, they get lost. You are making good points, I will stand by mine: If saving someones life means someone else dying then there is reason and justification for that someone to die. There are advances in medical science concerning growth of organs which has advanced considerably with stem cell research, to me this is a much more viable route since its the same persons stem cells as well, no rejection issues. And I do stand the same way on receiving as well. I would not want to benefit from someones death. Death is a fact of life and its not about how long people live in my opinion. Anyway I do respect your point of view yet I believe its the right of every person to make his own choice on the matter and not be forced on this issue.

    • Ana Antonio

      Christos, this is not an alternative to stem cell research or lab grown organs, of course that will continue, because it will be so much better for patients. This proposal is just an ajustment of the existing solution. And we agree no one can be forced to donate or recive organs. In some countries people sign in as donors, in my country you sign is as non-donor. This is not to force anyone to be an organ an donor, but becaus we realised that so many people didn’t mind being organ donors, but never bothered to sign in as such. Especially young adults, who dont like to think about death. This makes so many organs avaliable that there ia no need to “look out” for a heart. In fact that is precisely what happens in countries where this system is not implemented. There is broad information about it for everyone to make an informed choice. (Oh, and that story, was Just proved false in court). All the best, Christos. :)

    • Ana Antonio

      Exactly. No room for black market.

    • Ferre Jaime

      exactly, so if in need, can kill someone, and one time in the hospital, kan remove the organs! Good for the powerful people, they have always plenty of organs, no need to pay!

    • Celina Agostinho

      @Ferre Jaime Don’t be paranoid. Statements like those make you look crazy.

    • Ana Antonio

      Ferre Jaime, well, that is exacly what happens now, because of organ scarcity. If organ donation is automatic, there are more avaliable organs. No need to kill people.

  8. Dimitri Fiori

    We have it in France and I dont see why it is so shocking for you. You dont want to save others life instead of being eaten by worms ? Good, just opt out !

    • Tarquin Farquhar

      @Dimitri Fiori
      On this occasion, I agree with the French PoV – although I do hope that organ donors are relieved of their organs only AFTER death.

  9. Celina Agostinho

    That’s the system we have in Portugal. I don’t see why that possibility shocks some of you so much. Nobody’s trampling on your rights: you can opt out if you want. It only means that more organs will be available to people who still actually need them.

    • Ana Antonio

      Well, you can opt out. That simple.

    • Παναγιώτης Καράμπελας

      It’s a matter of basic principles. Our governments consider us as their possession? No. Just as the prosecutor must prove that someone is guilty and not the other way around, it is the individual that will ultimately decide if he/she want to donate his/her organs. We don’t have to start signing papers that opt us out. If someone didn’t want that but neglected to sign the damn papers, then nobody -including his family- can do anything to stop the doctors from taking anything they want. The right is our own and our family’s to decide what will happen to our organs.
      I personaly don’t have any problem becoming an organ donor. But there is a matter of principle here. If we allow our governments to practicaly own our pody parts until we say otherwise, then we would soon be seeing the government claiming our children because we don’t have “the right ideas”, as we see some first such signs in Canada and Norway…

  10. Lucas Benitez

    Spanish system is one of the most successful in the world and saves thousands of lives every year, it should be copied by every country.

    • Michael Bath

      Yes laura.. your right. .I need to get out more and make some friends.

    • Bogdan Vernis

      Yeah, try to use it after your death, genius.

    • Sam van Gestel

      Nature is holy to me, artificial life extension is a sin, we are far to many on this planet already ! And who would get those organs ? Only the rich, the poor can die … So I refuse to be a part of that crooked system… Don’t want no organs, don’t wanna give them too, fair enough, no ?

    • Sam van Gestel

      Because the poor in the world don’t have health insurance … They are the ones selling their organs to get a few dollars to survive, google it if you don’t believe me … On your other questions, I can say that I woudn’t accept chemo either, but for a different reason, my mum died of chemo, before te cancer could kill her… after her dead, I googled a lot, and I learned that it was know for many years that chemo takes away asswell life quality as quantity when admidded on that type of cancer, the oncologist knew that, but they give it anyway, because there’s a lot of money involved in the pharmaindustrie … Patients are just clients to them … My father also died of cancer in december, he lived with it for almost 4 years – without treatment- and only the last month wasn’t so good … About all other diseases, each of us can go as far as one wants, each of us had to draw his/her own line in the sand wich they don’t wanna cross. I know it isn’t easy on a personnal level, everyone wants to live… but on a macro-level, we should think about it, we are almost 7 miljard and destroying our planet, we also become weaker and weaker, super bacterias are on the rise because of the use of far to many antibiotics and so on …

    • Róbert Bogdán

      It’s nobody’s concern what Sam van Gestel should decide to do with her belongings after her death. And because her body is hers, it’s her own property, so that means to me that it’s simply not my business. Even if it would save lives. Maybe her jewelries could save a life in Ethiopia, should we take them away and give them to the poor as well?

  11. Magdalene Papoulia

    After someone “leaves” , why his/her organs shouldn’t be given to someone to continue life? In a way this is a prolongation of life, for those who are desperate to extend their stay on earth the longest possible in any way…. Macabre but true.
    Is it better to burn it all, as it is “in fashion” lately in Greece?

  12. Apostolos Vranas

    I think each country should consider the people automatically as donors unless they opt out themselves. I don’t care what political parties say and it scares me a bit when it is asked by Brussels.
    I am a regular blood platelets donor and I haven’t bothered (shame on me) to register yet as an organ donor. But, being 50+ I have put it in my unofficial will. :-)
    Personal reasons against organ donation? I don’t understand. Religious reasons? What do religions know about transplants?

  13. Profile photo of James Caola
    James Caola

    I voted “other” because I think that instead, when you register for an identity card or passport, you should have to OPT-IN if you wish to donate organs. If you do not choose it, then your organs can’t be harvested without some other legal document granting permission. The state, not even the EU (which I love!) should have that kind of control over our bodies. The opt out solution implies that the state has a right to one’s body: it does not!

    • nando


  14. Róbert Bogdán

    No, our body isn’t community or society or state property. It’s our private property. It would be unjust to use somebody’s body, even after death, without clearly expressed consent, in the name of a greater good.

  15. Hanna Olofsson

    Yes, everyone should be considered organ donors unless they tell otherwise, aka opt-out. Some people may have religious or personal reasons to why they don’t want to donate their organs, and in that case they are able to opt-out. I think there are individuals who don’t really mind if their organs are being donated or not but they don’t bother to opt-in. We should not let this laziness or carelessness or whatever, get in the way of saving lives that actually could have been saved. In my opinion, the EU is not forcing anyone to donate their organs by this opt-out system. You still have a choice to choose whether or not you would like to donate your organs when you die, if you even die with healthy organs. Instead of having to registrate as a donor, you registrate as a non-donor. It is really not that hard. If it is really so important to you, you will opt-out. Guardians will decide for minors whether they would like them to donate or not.

    This is not a matter of how the government owns us. We are not in their possession. This is about saving as many lives as we can, nothing else. You can’t use your organs when you are dead either way. I promise you, no one from the government will play soccer with your kidney, in case you choose to donate it.

  16. niraja

    I agree as donating organs doesn’t mean that you have to kill yourself and donate organs, it just means that after your death your organs would be used to save someones life. I know that we all have the right to freedom in which we can choose if we want to donate our organs for which this is not compulsory, you can just opt out. I personally believe that this is a really great idea to donate our organs

  17. Paul X

    The simplest incentive is if you aren’t signed up as a donor and god forbid you one day find yourself in need a transplant, expect to be at the bottom of the waiting list

  18. Jez Boulton

    In countries where health care is free at the point of use like the UK. Perhaps people should be prepared to give something back. Give and Take.

  19. Александър Михайлов

    That’s how it currently is in my country. I have what is called a personal health book. On the inside of the back cover there is a place that says ‘I decline to donate my organs after death’, followed by an empty signature field that will remain blank for as long as I live

  20. Nando Aidos

    People should be encouraged to be organ donors but should not be trapped in a default system UNLESS there is a strong and effective education process for the WHOLE POPULATION.
    Educate the people first! Then make laws.

  21. nando

    People should be encouraged to be organ donors but should not be trapped in a default system UNLESS there is a strong and effective education process for the WHOLE POPULATION.
    Educate the people first! Then make laws.

  22. Matthew Wolfbane

    “We should not have politicians deciding whether or not people should automatically donate organs. It’s a thorny issue and a deeply personal one that raises a number of serious ethical questions over the rights of the individual over his or her body and the ownership of the body in life and in death.

    This essentially amounts to state ownership of the body where your organs are registered on a national data base unless you decide they should not be. This debate has no space in politics. We require politicians to run the country and speak on behalf of the electorate but we do not expect them to start rearranging the ethical framework of sensitive debates…”

    I’m going to side with Eurosceptics here and agree that politicians have no business telling people what to do with their vital organs.
    The Green suggestion for an opt-out system is also kinda okay, I guess, but I’m more in favour of individual consent by question rather than by default.

    I hope this makes sense.

    • Andrea Morrone

      “politicians have no business telling people what to do with their vital organs” dude you’re gonna be dead, you won’t do anything vital with any organ. You’re gonna be dead ok? What is your fear? You’re afraid someone is telling you how to use your liver after you’re dead? It’s because you’re dead!!!

    • Matthew Wolfbane

      Andrea Morrone Calm the heck down.
      I mean, I get what you’re saying, but at the same time I’m not sure making that an automatic donation would be the best option from an ethical standpoint either.
      To keep it optional works, I guess.

  23. Julia Hadjikyriacou

    I don’t like having to vote for EU parties based on one opinion. I want to vote for ethics or vote against lack of ethics. In this particular issue. It should be voluntary to give consent-not compulsory unless you refuse consent.

  24. Matej Mlinarič

    Absolutely not. There is very serious risk with donating organs and it needs to be voluntary. Beside politicians you want to help someone like that then you can give them yours. Just if you are not willing to do it. Then nobody else should be forced to do it either.

  25. Michael Šimková

    We have opt out in Spain and it is better this way, otherwise many people will not opt in, not because they feel strongly against it, but simply because it is uncomfortable to think about or plan around your own death.

  26. Александър Михайлов

    That is the way it is in my country. There is a document I own, on the last page is a field where it says “I refuse to donate any organs after I am dead”, amd a blank signature field, which will remain blank for as long as I live

  27. Jerzy Zajączkowski

    Transplantology is a contemporary form of cannibalism and will lead to the killing and breeding of humans in order to obtain transplant organs.

    • Nando Sousa

      “Cannibalism: cannibalism in humans is the act or practice of humans eating the flesh or internal organs of other human beings. A person who practices cannibalism is called a cannibal.”

      “Transplantology: Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ.”

      Organ transplantation occurs with the intention of saving a life, not for feeding purposes. The donor needs to agree with the transplant, in case he is still alive, or a responsible needs to authorise in case the donor is dead. Seems like a very civilised practice, can you say the same about cannibalism? I seriously cannot see how the two could be placed on the same level.

      “will lead to the killing… of humans in order to obtain transplant organs” – this is already happening! According to the Telegraph “organ trafficking accounts for five to 10 per cent of all kidney transplants worldwide.”

      Wouldn’t one think that a greater number of organ donations would diminish the need for organs trafficking?

  28. Martin van Boven

    Most definitely not.
    If anything, the integrity of the body after death should gain constitutional protection under national laws to prevent this sort of attempts at pillaging deceased people’s bodies.
    But most importantly, it is a matter for separate nation states to decide upon. It has nothing to do with Europe, just like so many other of the questions you post. Why do you keep trying to frame the mindset of people into acknowledging Europe is there to decide upon everything?

    • Nando Sousa

      Why would the body of a deceased be so sacred to gain constitutional protection?

  29. Julia Hadjikyriacou

    End poverty to snuff out the black market and all forms of exploitation because people are poor, vulnerable and out of sight. A GMI is compulsory in this society. Anything else is conscious cruelty.

    • Nando Sousa

      That would be the perfect scenario but we are far from that! What other measures can we take immediately? BTW, ending poverty would not solve the issue… There is a shortage of organs… What can we do about that?

    • Faddi Zsolt

      Nando Sousa we can change the attitude of living! We can change our lifestyles and live healthy to prevent illness, for example. This should be one of the main goals of the EU, to educate and lead our society to a healthier and better future, not to treat the symptoms!

    • Julia Hadjikyriacou

      Nando Sousa, are you suggesting black market organ selling is the solution to a shortage of organs?? And are you suggesting maintaining poverty so people can steal their organs is the solution to shortage of organs?? Compulsory organ donation is also not a solution. Forcing people against their will to give their organs is not ethical. And who is to say that organ murders won’t take place in society because someone is a perfect match, and their death would mean somebody else lives? Technology is on the case and society will just have to wait. Offering all citizens an optional donor card would increase willing donors. We cannot save everybody on earth today, otherwise war would be illegal too.

  30. Antonio Brugarolas

    Should everyone in Europe make me their universal heir unless they opt-out? The everpresent desire to enlighten us, sheer mortals, with the wisdom emanating from that ivory tower to tell us and impose us what is good and bad is rather irritating and shows resonance of totalitarian regimes.

    • Nando Sousa

      We are already focusing on that, its just not a very quick process as one can imagine, and it’s very costly too!

    • Nando Sousa

      Can you please enlighten me how this compares to cannibalism?

  31. Franck Legon

    No, human body belongs to the person, not the community. This should be sacralized.

    • Nando Sousa

      Based on what? As far asI know the “person” is no longer there when the body is dead!

    • Franck Legon

      The body & the mind is one as far as science can proove, and the law is no one can use your body without your agrement & within legal borders. Of course it is still protected in some countries. Did you know about human organs theft market, forced prostitution, aso ?

    • Franck Legon

      The body & the mind is one as far as science can proove, and the law is no one can use your body without your agrement & within legal borders. Of course it is still protected in some countries. Did you know about human organs theft market, the many murders, forced prostitution, aso ?

  32. André Alves Figueiredo

    In Portugal it already works like this for years. I really don’t understand whats the big issue here. If you don’t want to be donor, you simply opt-out.

  33. Gert Loosen

    Of course everyone should be donor automatically and the narcissistic cruelty of refusing to give away your organs when you don’t need them any more should be severely punished by high taxes f.e.

    • Faddi Zsolt

      I think the opposite! “the fascistic cruelty of forcing the society to accept giving away their organs when they’re dead should be severely punished by death by hanging”. Because until it is automatic, everyone is a potential target of killing.

    • Gert Loosen

      Oh really? I think statistics show that far more people suffer from severe paranoia than are killed to harvest their organs.

  34. Wendy Harris

    No, it’s time we moved beyond Frankenstein science and made replacement organs from our own cells. We are not created to be a package of spare parts for other people.

    • Nando Sousa

      And who’s going to pay for that?

    • Nando Sousa

      Should we all have extra organs stored somewhere for when we need them in a hurry?

    • Wendy Harris

      A heart transplant costs a million pounds – who pays for that?

    • Arnout Posthumus

      also why would we if we have ones already..

  35. Noel Mirković

    In Croatia low gives the permision to doctors to decide it… but… and that’s important, the practice is that the family has the last word about or there is donor card which died person signed and has within documents which gives permision for donation of organs…
    there was a lot of work done with people with goal to initiate talk about that sensitive matter because, practice teach, that problem with perception of donation has to be changed way before something happend. and, as croatian high donor contribution (one of highest on the world) shows that’s the path to gain life when we lose one. It’s slogsn says Život na dar – Life as a gift. Signed donor card is one element, it isn’t registered nowhere, and usualy it’s one giant step easyer for the family to make a decision when asked. What is knewn to me, family decision is always respected, signed donor card is tool to make that decision in hard moment easier.
    For me, that should be done in that way. Without forcing people to be kind to each other because, croatisn model shows it, people are kind if we as socity give them enough “space” to show that kindness.
    Situation in Croatia was before entering in EU that donor organs were permited to “go out” in EU but it wasn’t posibble to recieve donated organs from EU. There was clear vision of a problem, for somebody, which sistematic and well designed procedures can help, and that approach saved or improved a lot of lives outside Croatia. That was win-win situation in which free available organs were sent to first on the EU list if in Croatia nobody needed it, which often was the case. Life is a gift, and when loosing it you can save one or more, why not. In that sense, life is borderless, and we show that, first to us, here, and everybody else.
    Love and respect. Love first.

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