Organ donation law seeing move to opt-out system to come into effect in England

As of 15 March, organ donation in England will officially become an opt-out process. This means that all adults in England, with a few exceptions, will automatically be considered potential organ donors unless they actively choose to be excluded.

This is the realisation of Max and Keira’s law, passed in 2019, and will come into effect on 20th May 2020.


Up until this point, organ donation in England has been an opt-in system. This resulted in interest far outstripping active uptake, with approximately 80% of people in England supporting donation but only 38% opting in to it.

By starting with the presumption of consent, as many as 700 lives could be saved a year. It will also spare the recently bereaved the burden of having to make a difficult decision about the body of the deceased. Currently, less than half of families opt-in for donation if they are uncertain of their wishes.

The law will exclude children below the age of 18, those lacking the mental capacity to understand the system change in the run up to their death and people who have not lived in England for a year before their death.

Recording consent on the NHS Organ Donor Register, an easily navigable online resource, will make it easier for specialist nurses to honour the wishes of the patient, speeding up the time-sensitive process and potentially saving lives.

Opting out is still possible on the Register and, even after the law’s implementation, next of kin will still be consulted about the decision. There is no deadline for registering one’s decision and decisions can be altered on the platform at a later date.


The new law will reduce the waiting time of those requiring a donation. Currently, there are over 6,000 people on the waiting list for a transplant and at least one person every day dies whilst on the list. For context, the average wait time for a kidney, the most common transplant, is 2.5 to 3 years.

Organ donation is a very particular process. With only one in 100 deaths in the UK occurring in circumstances that could facilitate donation, an opt-out system maximises the number of those that result in successful organ retrieval.

As much as anything, the bill is about changing public attitude around donation. Already implemented in Wales in 2015, evidence has shown consent rates have increased substantially as a consequence.


Yvonne Carratt, director at JMP Solicitors, said of the new system: “It will help to save a huge amount of lives because there was such a low opt-in rate with the old law.”

She continues: “It’s important that everyone is aware of the new changes to the law and of all the options available to them, to make sure that their wishes are honoured.”

Former health minister Jackie Doyle-Price said: “Under the new law, being an organ donor will still be your choice – organ donation will remain a priceless gift.”

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