The Bundestag is once again debating the rules on objections to organ donations

In a debate that was partly underpinned by personal stories, the Bundestag discussed a new regulation of the decision on organ donation. A cross-party group of MPs submitted a draft for the introduction of an objection regulation to the Bundestag.

It would mean that every adult who has not expressly objected to this would automatically be considered an organ donor after death. So far, an express yes has been required for withdrawals. Another group strictly rejects this and put forward a counterproposal.

Supporters want donations to be the norm

For the supporters of the objection regulation, it is already the third attempt - after a first initiative failed in the Bundestag in 2020 and a second one was no longer put to a vote due to the early election in 2025.

The group with representatives from the CDU, CSU, SPD, Left and Greens argues that many improvements in recent years have not led to a significant increase in donation numbers. A donation should therefore become the “norm”. In the future, organ removal from people who are of legal age and capable of consent should be permitted even if they have “not objected”. Increased information is planned.

There is also a Bundesrat bill in the Bundestag that aims to introduce an objection regulation. North Rhine-Westphalia's Health Minister Karl-Josef Laumann (CDU) said: "The problem is simple, we have far too few organs." Despite new approaches to education and documentation, the situation has not really improved. An adult could be expected to document how they feel about the donation.

“Donor liver could have been her salvation”

Bodo Ramelow from the Left Party spoke to the MPs “as a father” and described the fate of his daughter, for whom he had donated his bone marrow. As a supporter of the contradiction solution, Ramelow appealed to citizens to make a conscious decision on the issue of organ donation.

The Green MP Michael Kellner described the story of a friend who received a liver in 2009 and was able to live for 17 years. She died this year. "A second donor liver could have saved her. But we will still have too few organs in 2026."

The objection regulation is the solution in the vast majority of European countries, said Kellner. Germany is taking a special approach here, but benefits above average from organ donations from abroad. "That's difficult for me to justify ethically."

As opponents argue

A second group of MPs also wants to see more organ donations - but through more information and calls to make decisions. She is strictly against the objection regulation. A core argument is that silence should not be taken as consent.

With an application, the group aims, among other things, to ask all citizens "promptly" after their 18th birthday to express their willingness to donate and to record their wishes - in addition to yes and no, also "undecided".

"Socialization of the body"

Michael Brand (CDU) said that positive consent is needed everywhere, even when using websites. “We now want to turn things around by the state when it comes to organs?” There are many concrete steps that can save lives. To date, there has been a lack of a sensible online campaign to inform and convince.

AfD MPs Christina Baum and Martin Siechert also fear excessive interference by the state in citizens' rights to self-determination. The objection solution was “simply unconstitutional,” said Siechert.

Green MP Sven Lehmann said more donors were needed. But such a sensitive question should remain “a decision that a person must actively affirm.” The contradiction regulation “essentially means nothing other than a socialization of the body”.

What the prospects are

The draft bill for objection regulations is supported by 254 MPs - the contra proposal is initially supported by 58 MPs. What majority will ultimately emerge in the Bundestag with its total of 630 members remains to be seen in the coming months.

Committee discussions on the initiatives now follow before a vote in the plenary session takes place - as is often the case with difficult ethical questions without the usual group discipline.

8,200 people on waiting lists

Organs such as kidneys, livers or hearts for seriously ill patients are urgently needed. Last year, 985 people gave up one or more organs for others after death, according to the coordinating German Organ Transplantation Foundation. This was the highest level since 2012.

At the same time, there were 8,200 people on waiting lists at the end of 2025. In general, the problem is that many people have a generally positive attitude towards organ donation, but have no desire to do so. The burden of making a decision then falls back on relatives of the deceased.

A basic yes or no to organ donation after death can be documented on an organ donor card, in a living will or otherwise on paper. It has also been online since March 2024: on the portal www.organspende-register.de you can digitally document your attitude from the age of 16.

There are currently almost 633,000 declarations, as the operator, the Federal Institute for Drugs and Medical Devices, announced. 82 percent fully agreed to organ removal, although it is only possible for certain organs. 8.7 percent lodged an objection.