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German parliament: Explicit consent still necessary from organ donors

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German parliament debates ‘opt-out’ organ donation law

Germany’s parliament has rejected a health ministry proposal for a new organ donation system. With donor numbers low, the health ministry wanted a presumed-consent system, with the onus on people to refuse to donate.

Can silence be considered consent? And is it reasonable for the state to expect people unwilling to donate their organs after their death to make this clear? These emotive issues were debated in the Bundestag on Thursday morning ahead of free votes on three new possible approaches.
What are the three options up for debate?
  • Health Minister Jens Spahn, a Christian Democrat, in partnership with Social Democrat Karl Lauterbach, proposed a system of presumed consent. This means people would be assumed to be willing organ donors, unless they make it clear they are not willing to donate. The plan also foresees double-checking with relatives after the person’s death. RESULT: 292 votes for, 397 against — motion failed.
  • A rival group of parliamentarians led by the Green party’s Annalene Baerbock wants to retain the system of informed consent, whereby people have to register as willing donors. However, they suggest making it common practice to ask people if they’d like to register on a regular basis, each time they renew their national identity card. RESULT: 432 votes for, 200 against, 37 abstentions — motion passed. (This margin in the decisive final vote was an improvement on the so-called second-reading vote a few minutes earlier.)
  • The AfD has put forward a third option, which was deemed to have little chance of success. This proposes farming out the entire organ-donation system to an independent but state-funded institution. It also recommends a public information campaign to inform about the shortages and increase public willingness to donate. It’s the third and final proposal to be debated and voted on.

Infografik Karte Organspende Europa EN
Why was the debate taking place? 
Germany’s organ donation figures are doggedly low. More than 9,000 people are currently on the organ waiting list, while only 932 people last year agreed to donate, a reduction of 23 compared to 2018. 
With 11.5 donors per million people, Germany’s organ donation rate is almost three times lower than that of the United States, despite the US having rules that are more strict than the current German system.

Infografik Organspende EN
Were politicians tied to party lines?
No. As with all votes on purely ethical issues, politicians have a free vote on the topic. Somewhat unusually, Thursday morning’s emotional debate in the Bundestag saw party allies passionately advocating opposing positions. 
Christian Democrat Thomas Rachel spoke against his government’s proposal, asking the chamber: “Can silence be considered consent?”
Meanwhile, the CDU’s Gitta Connemann saw the issue differently, arguing that a different fundamental question was in play: “Can the state demand a decision from its citizens? A decision for, on in this case, against, donating organs? That’s all this debate is about. Of course it cannot force them to donate … This is about life and death, and nothing is more important. A simple ‘no’ suffices.”
Other politicians drew on personal stories in their comments. The Left party’s Kathrin Vogler alluded to a friend who had been on dialysis, hoping for a kidney transplant, for over a year. “She needs an organ transplant in the near future just to survive … But she said to me: ‘I’m an organ donor myself and have been for years. For me, it’s a no-brainer. But it’s also important to me that I can decide voluntarily. I do not want to be forced to go somewhere to put what I do not want on the record.'”
Claudia Schmidtke (CDU) alluded instead to a young man in the audience, who had benefited from an organ transplant despite Germany’s shortages. He became Germany’s first person to receive a lung transplant from living donors eight years ago, when aged 11. Both his parents had donated parts of their lungs to save their son, Schmidtke said, concluding that the shortage had ultimately endangered three lives in his case.

—— AUTO – GENERATED; Published (Halifax Canada Time AST) on: January 16, 2020 at 07:21AM

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