Opt out scheme

From spring 2020, organ donation in England moved to an 'opt out' system.

It is also referred to as 'Max’s Law'. The government publicly announced that the legislation would be commonly referred to as Max’s Law, in recognition of campaigning by Max Johnson and his family when Max was waiting for a heart transplant and have continued to do since receiving the heart. Max’s heart came from a young girl called Keira Ball, who passed away aged 9 years old.

The law has been changed to help save and improve more lives as every day across the UK someone dies waiting for a transplant. The changes will affect all adults in England unless they have recorded a decision not to donate or are in one of the following excluded groups:

  • Those under the age of 18
  • People who lack the mental capacity to understand the new arrangements and take the necessary action
  • Visitors to England, and those not living here voluntarily
  • People who have lived in England for less than 12 months before their death

People will still have a choice whether they want to be an organ donor when they die. If they don’t, they need to record their decision on the NHS Organ Donor Register, either online or by phoning the contact centre. The person’s family will be involved before donation takes place, so it’s important that the person chooses whether they want to be a donor and discusses what they want to happen with their family.

Faith and beliefs will always be taken into consideration before organ donation goes ahead. NHSBT specialist nurses always speak to the family to see if there are considerations around someone’s faith, beliefs or culture in respect to funeral plans.

If an adult hasn’t opted out of donation and aren’t in an excluded group, it will be considered that they have consented to donate their organs. Even if they don’t record that they want to be an organ donor, it is important to make their family aware of their decision. Specific instructions about which organs they would / would not like to donate needs to be provided when they record their donation decision on the NHS Organ Donation Register.

The opt out system doesn’t apply to children under the age of 18 years old. Where a donation decision is required for someone under 18, the family will be asked to make that decision and provide consent.

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