UK: Opt-out, Not Opt-in: How Organ Donation Has Changed

On 20 May 2020 'Max and Keira's Law' was introduced in England. The new law means all adults in England will be presumed to be organ donors unless they specifically opt-out from donating their organs or are members of the 'excluded group'.

There is still a shortage of organ donors in England – last year 408 patients on the transplant waiting list died in the UK. The new law is intended to reduce the uncertainty around organ donation and of course to save and improve more lives. One organ donor can save or transform the lives of up to nine other people.

Max and Kiera's Law was named after Kiera Ball, who died aged nine in 2017, and Max Johnson, whose life was saved when he received her heart.

What do you need to do?

If you do not wish to be an organ donor, you should record your decision on the NHS Organ Donor Register.

If you do want to be an organ donor, then it's still best to record your wish on the NHS Organ Donor Register, as this gives you the choice of choosing which (if not all) of your organs you are willing to donate.

Who is in the excluded group?

Those under 18, people who lack mental capacity to understand the new arrangements, visitors to England and people who lived in England for less than 12 months before their death, are all members of the excluded group.

People in the excluded group are not automatically enrolled for organ donation, so if they wish to donate they will need to actively opt-in.

What about my family?

You should talk to your family or friends about your thoughts on organ donation. Even with the new opt-out system, family members or those closest to you will always be consulted before organ donation takes place. They can also express your current wishes and ensure any donation accords with your faiths and beliefs.

It's a good idea to record your wishes in your Will or in a Letter of Wishes. Whilst they will not be binding on anyone, they do provide a clear indication of your views.

If you don't want to make a decision about organ donation, you can nominate up to two representatives to decide on your behalf. To add your representatives to the NHS Organ Donor Register, you'll need to ask them to sign the online 'nominate a representative' form.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.