Germany's Drastic Measures To Combat Organ Shortage
Germany is trying to tackle a shortage of donors and address a backlog of about 10,000 patients waiting for organs.
Germany is considering legislation which would make every citizen an organ donor unless they decide to opt-out. The country's health minister presented a draft of the law on Monday.
Currently, the organ transplant system in Germany works the same way it does in Australia -- organs can only come from people who have actively declared their willingness via a will or donor card.
Germany's new system, which was proposed by Health Minister Jens Spahn from Angela Merkel, would mean people will be automatically considered as a donor unless they put themselves on a register saying they object.
Although family members can veto organ donations. There would be no donations from people who aren't capable of grasping the decision's significance, such as in the case of mental disability.
Spahn said this "isn't compulsory organ donation", adding that 20 out of 28 European Union countries have similar systems in place and "everything we have tried so far hasn't led to a rise in donor figures."
Karl Lauterbach, a health policy expert with Angela Merkel's Christian Democrats, supported the proposal.
According to Lauterbach, some 9,400 people were on the organ transplant waiting list last year -- less than 1,000 transplants were carried out and 2,000 on the list died.
But not everyone agrees with the plan.
A group of lawmakers from Germany's Greens Party and the conservative Christian Social Union (CSU) put forward an alternative draft law which they believe will address the country's low organ donation numbers while still keeping the voluntary system.
Under their proposal, people would be asked more regularly if they wish to be organ donors, while an online register of donors would replace the current card system.
Germany's parliament is expected to eventually hold a free vote on the new rules.
Opt-out organ donation systems vary from country to country.
France has what's known as a "hard opt-out" system, where doctors are only required to inform a deceased person's family members about which organs will be procured and not ask their permission.
The laws proposed in Germany are of a "soft" design.
In December last year, a proposal to switch to an opt-out system was put before the Australian Parliament in response to a rise of people buying organs on the black market.
Under Australia's current system, only one in three people are registered donors, and as demand continues to outstrip supply, more people are turning to the black market for transplants.
The illegal organ trade is worth more than $2 billion worldwide, with kidneys the top selling item.
A kidney can cost anywhere between $68,000 and $163,000, while a heart or lung can go for upwards of $400,000.
But the government's own organ transplant division, DonateLife, doesn't support a move to the opt-out system, saying that there's "no clear evidence that it contributes to achieving a higher donation rate".
The organisation's basis is in international evidence, including instances in France and Brazil where opt-out systems managed to lead to a decline in the rate of organ donation.