England's organ donation law change: What has been the impact of the new system? | Webinars

In 2020, a new 'opt out' system of consent to organ donation was introduced in England. This means that all adults ages over 18 years are considered to have consented to organ donation unless they decide to opt out. 

Since this change was introduced, researchers wanted to find out...

• What do the public think about organ donation?
• What did doctors and nurses think about the new law during the COVID-19 pandemic?
• How are bereaved families affected by the new law?
• What can the UK learn from Spain?
• What should happen now?

On 7th May 2025, researcher Leah Mclaughlin joined us to talk about the findings of this research and what should happen next. 

The webinar

Watch the webinar here 

Your submitted questions

Below are your submitted questions from the webinar, with answers provided by the speaker Leah Mclaughlin.

What is the difference between DBD and DCD organ donation?

There are two ways that a person can become an organ donor. The first is donation via brain death (DBD) and the second is donation via circulatory death (CCD).

To what extent has the research found that the soft opt out has led to polarisation of views about organ donation?

Whether it is due to the soft opt-out system, or the way the system has been implemented, there is a risk of potentially polarising people that should have been engaged with. There is confusion around what people are expected to do around organ donation and what the outcomes are. Many people have opted out based on misinformation and misunderstandings about the system.

What steps are being taken to ensure that people are being adequately informed about their right to opt out?

There is still much work to be done around this. The findings of this research have been presented to the department of health and parliament to advocate for better advertisement of the organ donation register. Many people are not adequately informed that there is a register and what they can do about it. There need to be mechanisms integrated into day-to-day life which promote people to make their organ donation decision and keep it updated.

In one of your slides, you mentioned that Specialist Nurses in Organ Donation (SNODs) sometimes have to switch between opt-in and opt-out in practice - could you explain this further?

Only certain types of organ and tissue donation are included in the opt-out legislation. In practice, there are many other types of donation that come under different legislations, all of which will be discussed by nurses and the family.

In an ideal world, how could the legislation support this work in a more constructive way?

In reality, we are long way from presuming consent in practice. We have not yet been able to manifest the ideals of the act in practice as this will likely be an ongoing process. Our recommendations are to simplify the information that is provided and taking some of the key burdens way from those involved in organ donation. Ideally, organ donation would be a routine and expected part of end-of-life care, so that families can be prepared to have this discussion when the time comes. Additionally, more resources are needed in the NHS to adequately deliver organ donation services.

The research indicates that the deemed consent act did not equip specialist nurses with tools to support families who decline organ donation. What tools or strategies would be effective in assisting these families and specialist nurses?

This should not just be a conversation that is happening at the bedside, rather it should be something that people think about and take action on throughout their life. We need ongoing media campaigns about organ donation, more mechanisms for people to register their decision and greater legal status of the organ donation register.