The development of organ donor numbers in Germany is alarming. 933 postmortem organ donors in 2021 compared to only 869 in 2022 - a decrease of 6.9 percent. This is the lowest value in the past five years. The fact that far fewer organs have always been donated than needed is not new. For people who are dependent on a replacement organ, years of anxiety on the waiting lists are the norm.
It was therefore only logical that the German Bundestag dealt intensively with the question of how to increase the number of donated organs during the past legislative period. The law for better cooperation and better structures in organ donation, which came into force in April 2019, served to identify donors more efficiently in the clinics. The resulting time and financial costs were given greater consideration.
In addition, the state has extensively discussed a fundamental reorientation of organ donation practice. The question of decision solution versus objection solution was finally decided in the Bundestag in January 2020. After an emotional debate, the contradiction solution was clearly rejected. Instead, the majority voted in favor of the Law to Strengthen Decision-Making. The education of the citizens should be intensified from now on - for example in the citizens' office or with the family doctor. In addition to the paper ID, they wanted to create a digital register of donors.
One can find the decision of the Bundestag right or wrong. I myself would have liked a little more commitment, for example through a targeted query of willingness to donate when going to the authorities. Such a solution would respect the individual's right to self-determination and might be just as effective as a milder means than the opt-out solution. At least if you don't want to calculate with donors who just haven't articulated or documented their unwillingness to donate.
But whatever personal attitude you take on this ethically difficult issue, I think it is important to respect Parliament's decision. And implement them. However, there is a huge lack of implementation. Because the digital donor register has not yet started. It would be a great opportunity. The vast majority of Germans have a positive attitude towards organ donation. However, only a fraction documented them in writing. An organ donor card that you always carry with you is a good service.
However, it can be forgotten, lost or simply overlooked in the clinic. If the relatives also do not say that the person concerned was willing to make a donation, a potential donor is not identified as such. His organs cannot help anyone else on the waiting list. A digital register that gives every citizen the opportunity to easily document or change their own decision at any time could become a game changer here. Especially if, for example, general practitioners regularly point this out to their patients.
I think that as long as the existing resolution has not been implemented and has not been able to take effect, there is no point in starting a long debate from the beginning. That doesn't mean that we shouldn't look elsewhere to identify further room for improvement.
In Germany, for example, the potential that can arise from living donations is not sufficiently used at all. For example, unlike in countries like Spain or Switzerland, cross-over living donations are still prohibited in Germany, even though people agree to make such a donation and two people could receive a life-saving organ at the same time. There is enough work to be done to help those awaiting life-saving organs. Going around in circles is not one of them.