Organ donation in UK: how to opt-in or opt-out of register - and why donation law differs across UK

Organ donation is when you decide to give an organ to save or transform the life of someone else.

But how do you opt-in or opt-out of being on the organ donation register and how does donation law differ across the UK?

Here’s what you need to know.

What is organ donation?

If you die in a way that means organ donation is a possibility, a specialist nurse will access the NHS Organ Donor Register to see if you have registered a decision.

According to the NHS organ donation page not many people die in circumstances that make it possible for them to donate their organs, which is why “every potential donor is precious”.

How does organ donation law differ across the UK?

In England, the law regarding organ donation has now changed, meaning it will be considered that you agree to become an organ donor when you die, if:

• you are over 18;
• you have not opted out;
• you are not in an excluded group.

You still have a choice whether or not you want to become an organ donor and can register or amend your decision at any time.

In Scotland, the legislation provides for a ‘deemed authorisation’ or ‘opt out’ system of organs and tissue donation for transplantation. The system came into effect in 2021.

The opt out system will apply to most adults aged 16 and over who are resident in Scotland, but it will not apply to everyone.

Under the opt out system, if you die in circumstances where you could become a donor and have not recorded a donation decision, it may be assumed you are willing to donate your organs and tissue for transplantation.

However, your family will always be asked about your latest views on donation, to ensure it would not proceed if this was against your wishes.

You still have a choice if you want to be a donor or not.

You can record your donation decision by registering either an opt-in or opt-out decision on the NHS Organ Donor Register.

Elsewhere, the legislation for Wales is deemed consent, which means that if you haven’t registered an organ and tissue donation decision to either opt-in or opt-out, you will be considered to have no objection to becoming a donor.

The current legislation for Northern Ireland is to opt in to organ and tissue donation. You can do this by joining the NHS Organ Donor Register and sharing your decision with your family.

You can also record a decision not to be a donor. You can also nominate up to two representatives to make the decision for you. These could be family members, friends, or other people you trust.

However, from spring 2023, the law around organ and tissue donation in Northern Ireland will move to an opt-out system.

This will mean that in the event that organ donation is a possibility after you die, it will be considered that you agree to being an organ donor unless you choose to opt-out or are in an excluded group.