Karl Lauterbach (SPD) announced in mid-March that it was nothing less than a “milestone”. The Federal Minister of Health presented the new register in which all citizens can enter their decision to donate organs online. The register should gradually replace the paper ID card, said Lauterbach, and increase the number of urgently needed organ donors in Germany.
Today, almost three months later, the first assessment of the “milestone” is manageable: According to the Federal Institute for Drugs and Medical Devices, only 128,000 citizens have registered in the register so far. Anyone aged 16 and over is eligible, i.e. more than 71 million people. It is striking that significantly more than 128,000 have a paper organ donor card: in 2022, around 44 percent of the population stated that they had recorded their decision in writing.
In addition, only 50 percent of the hospitals where organ transplants can take place have “completed the registration process,” according to a spokesperson for the Federal Institute. This means that those who have registered in the register and are in hospital after an accident, for example, cannot be sure that their entry can be accessed by doctors. From July 1, it will be mandatory for hospitals to connect to the system.
The German Hospital Association (DKG) says that if the technology is delayed or temporarily out of service, “replacement procedures” can be used. DKG chairman Gerald Gaß hopes that as many citizens as possible will register as organ donors. “However, the process is still so complicated and bureaucratic that it will deter most donors,” Gaß tells WELT.
ID card readers, an ID card app and multi-stage, cumbersome processes are “anything but helpful” in increasing the number of donors. “In this respect, the register is unfortunately a prime example of dysfunctional digitization in the health care system.” According to the Ministry of Health, costs to date for operations and advertising measures: 11.8 million euros.
Axel Rahmel, Medical Director of the German Organ Transplant Foundation, is also skeptical: “If the pace does not change fundamentally, it will take many years before a significant proportion of citizens have documented their wishes in the register.” It remains to be seen whether a turnaround can be achieved through additional educational work or easier access. International experience in this regard has been consistently sobering.
“From our point of view, the introduction of the opt-out rule would be an obvious step now,” says Rahmel. The rule stipulates that everyone automatically becomes an organ donor unless they actively object during their lifetime. A cross-party group of MPs is also currently forming in the Bundestag, which wants to make a new attempt at the opt-out solution during this legislative period.
“The current figures show that an organ donation register alone will not be enough,” says the vice-chairman of the Union faction, Sepp Müller (CDU), to WELT. There needs to be more willingness to become organ donors. “That’s why we have to be able to expect citizens to deal with the issue.”
Most recently, the then Federal Minister of Health Jens Spahn (CDU) attempted a similar initiative in early 2020 in an unusual alliance with SPD MP Karl Lauterbach. The draft failed in the Bundestag, the majority of MPs voted for a law that was intended to increase people’s willingness to make voluntary decisions – and passed today’s organ donation register as the most important instrument.
