Health: Lauterbach for a new attempt at organ donation reform

In view of a significant decline in life-saving organ donations in Germany, the debate about far-reaching reform is resurgent.

Health: Lauterbach for a new attempt at organ donation reform

In view of a significant decline in life-saving organ donations in Germany, the debate about far-reaching reform is resurgent. Federal Minister of Health Karl Lauterbach is pushing for a new attempt for fundamentally different donation rules. "The current law has failed," said the SPD politician of the German Press Agency.

Many people are willing to donate organs, but do not document it. "That's why the Bundestag should make another attempt to vote on the objection solution" - meaning that one is initially automatically considered an organ donor, unless one objects. The echo is divided.

Lauterbach said to justify a new attempt: "We owe it to those who are waiting in vain for organ donations." The number of organ donations fell significantly in the past year. According to data from the German Foundation for Organ Transplantation (DSO), there were 6.9 percent fewer donations than in 2021. Last year, 869 people donated one or more organs after their death - after 933 donors in 2021 and 913 in 2020. The number of organs removed fell So now to 2662 after 2905 in 2021 and 2941 in 2020. In 2022 there were just a little more than ten donors per million inhabitants - and around 8500 people are on waiting lists for organs.

According to the DSO, possible reasons for the decline are the corona pandemic and the resulting loss of staff in clinics. This contributed significantly to a 30 percent drop in donation numbers in the first quarter of 2022. The remaining quarters would then have stabilized at the level of previous years. "Nevertheless, the question arises as to why it is not possible to increase the number of organ donations," said the Medical Director of the DSO, Axel Rahmel.

Relatives are often unsure

The DSO explained that the most common reason why organ donations did not take place was lack of consent. In less than a quarter of the cases, a refusal was based on a known written (7.3 percent) or oral (16.3 percent) will of the deceased. When relatives were asked, they often decided against it out of uncertainty, as they did not know what the deceased wanted.

A first attempt at a contradiction solution failed three years ago. Lauterbach and the then Minister Jens Spahn (CDU) had campaigned for it as MPs. Instead, the Bundestag passed a more moderate law on January 16, 2020, according to which organ donations are only permitted with express consent. However, more information should encourage more citizens to make a specific decision about a donation after death. A key part of the reform - a register in which you can save declarations of your willingness to donate online - has not yet been set up.

Patient advocates criticize Lauterbach

The German Foundation for Patient Protection therefore criticized the minister's initiative. "Karl Lauterbach distracts from his own failure," said board member Eugen Brysch the editorial network Germany. "It is not the law to strengthen decision-making in organ donation that has failed, but the implementation by the Federal Minister of Health." For years, the development of the register and an information obligation that is also planned for citizens' registration offices has not progressed. Instead, Lauterbach wanted to enforce the contradiction solution he favored. Rather, he must make a binding declaration when the register goes online.

Bavaria's Health Minister Klaus Holetschek (CSU) welcomed Lauterbach's initiative. "The introduction of the opt-out solution offers the chance that more organs will be donated and thus more people will receive a life-saving donor organ." Even independently of this, efforts must not be reduced to motivate people to deal with the topic and make a decision.

Baden-Württemberg's department head Manne Lucha also supported a new attempt. "People are dying because there aren't enough organs available." That shouldn't be, said the Green politician. The Bundestag should quickly put the topic on the agenda. Organ donations have been declining nationwide for years. "Other than with the contradiction solution, we cannot solve this problem."

From the center of Parliament

The Bundestag usually decides on ethical issues such as organ donations without party guidelines. Legislative proposals come from the middle of Parliament, not from the government. The current law actually stipulated that the new citizen register should start on March 1, 2022. However, this was postponed - in order to avoid a burden on the clinics in the Corona crisis due to technical and organizational preparatory work for a connection, as the ministry said in justification.

The reform went back to the initiative of a group of parliamentarians around today's Foreign Minister Annalena Baerbock (Greens) and the then Left Party leader Katja Kipping. In general, all citizens should be addressed directly on the subject at least every ten years. Anyone over the age of 16 who applies for an identity card or passport should receive information material on organ donation from the office. It is also planned that general practitioners will inform patients about organ donations every two years if they so wish and - with an open mind - encourage them to make an entry in the register.