Transplants declining: Lauterbach wants to regulate organ donation again

Status: 01/16/2023 1:53 p.m

In view of the sharp decline in the number of organ donations, Federal Minister of Health Lauterbach is in favor of a renewed attempt at reform. Its goal is the introduction of the contradiction solution.

Thousands of patients in Germany are waiting for life-saving organs, but recently fewer and fewer people have been donating their organs after death. Federal Minister of Health Karl Lauterbach is therefore pushing for a fundamental reform of the organ donation laws.

“The current law has failed,” said the SPD politician to the dpa news agency. Many people are willing to donate organs, but do not document it. Therefore, the Bundestag should make another attempt to vote on the contradiction solution. “We owe it to those who wait in vain for organ donations,” said Lauterbach.

Attempts at reform have so far failed

The objection solution means that it is assumed that all people are initially willing to donate their organs – unless they expressly object to this. The contradiction solution had already been debated in the Bundestag in the past, but the reform failed in January 2020. Instead, Parliament stuck to the rule that organ donations are only permitted with express consent.

However, additional information and education offers should encourage citizens to decide for or against a donation and to record this in an organ donation card or a living will.

Number of organ donations plummeted

For years, however, the number of donors and transplanted organs has been falling significantly. In 2022, there was a 6.9 percent decline in the number of donors in Germany. This was announced by the German Foundation for Organ Transplantation (DSO). According to this, 869 people donated one or more organs after their death last year – 64 fewer than in the same period last year. This means that there are only around ten donors for every one million inhabitants.

The number of organs removed from people after their death for transplantation fell by 8.4 percent – from 2905 to 2662 organs. These are reported to the Eurotransplant agency and can be referred to patients throughout Europe.

In Germany last year, 2,695 seriously ill patients were given a better quality of life or continued living through one or more organs; in 2021 there were still 2,853 people.

However, around 8,500 people are currently waiting in Germany for a life-saving organ.

The main reason for the decline: the lack of consent

The DSO cites various reasons for this development. Especially at the beginning of last year, high levels of sick leave among clinic staff due to the corona pandemic led to around 30 percent fewer organ removals and transplants.

The shortage of skilled workers generally also plays a role, explained the Medical Director of the DSO, Axel Rahmel. But: “The most common reason why an organ donation does not take place is the lack of consent.”

Half of the medically possible organ donations could not be carried out due to rejections. In a quarter of them, the deceased had forbidden organ removal in writing or orally.

In most cases, relatives prevent a donation

However, the relatives play a major role, as they have to make decisions for the deceased in the absence of written consent. In 42 percent of the cases, according to the DSO, the relatives suspected that the dead had refused organ donation.

35 percent of the refusals were based on the relatives’ own values, as they did not know whether the deceased wanted to donate organs or not.

Rahmel complained that the will of a potential organ donor was often not documented at all. “Relatives often decide against it out of uncertainty because the will of the deceased is not known,” said Rahmel and also called for the introduction of the objection rule.

criticism from patient advocates

The German Foundation for Patient Protection is against changing the law. In 2020, the Bundestag discussed all ethical arguments intensively and voted no, said Board Member Eugen Brysch of the Catholic News Agency.

Brysch accuses Lauterbach of not having implemented the initiatives to promote organ donation decided by the Bundestag at the time. An online register was planned until March 2022, in which one can indicate one’s willingness to donate. However, this platform has not yet been set up.

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