Kidney transplant surgery

Organ donation: whose consent?

A potential donor’s wishes may not be known – read through the background information and decide whether you agree with presumed consent

In the UK, around 1,000 people die each year while waiting for an organ transplant. Those who eventually receive an organ donation wait an average of over three years. Some 11 per cent of people on the waiting list for organ donations are from black, Asian and minority ethnic groups and ideally need transplants from people of the same ethnic backgrounds, as they are more likely to be a good match. However, under 4 per cent of those on the organ donation register are from these groups.

Kidneys can be given by living donors, as can parts of the pancreas, lung and liver, but other organs must come from deceased donors – usually people who have suffered brain death or for whom a decision has been taken to remove life support.

In England and Scotland, if a person consents to organ donation, then their wishes should be respected. If someone’s wishes are not known or cannot be determined, then the decision passes to a relative. The law has recently been changed in Wales, with ‘presumed consent’ being adopted from December 2015. This means that people must opt out if they do not want to donate their organs – anyone who does not opt out will be considered a potential organ donor.

Pros of presumed consent

  • Waiting times for transplants and the number of deaths on the waiting list may decrease.
  • Law is clarified in the event of the death of a relative.

Cons of presumed consent

  • People who have not opted out may become donors even if they were against donation.
  • Forces people to make decisions about death, potentially confronting cultural taboos or conflicting with religious beliefs.


  1. Why do you think many people do not add their name to the organ donation register?
  2. Should family members be able to override donation decisions on behalf of deceased relatives?
  3. How might a change in UK law affect the waiting list for different groups of people?

Lead image:

Tareq Salahuddin/Flickr CC BY


About this resource

This resource was first published in ‘Immune System’ in January 2015.

Immunology, Health, infection and disease
Immune System
Education levels:
16–19, Continuing professional development