Should not registering for Organ Donation automatically make you a donor?

A new proposal for the Netherlands suggests that  not registering as an organ donor will make you one anyway. Firstly let me get my views on organ donation out of the way before we continue. I am an Organ Donor in the UK, I give blood and do my bit for society. I think that we owe it to ourselves and to others to ‘give back’ in any way that we can be that volunteering or donation. I don’t normally talk about my views on blood or organ donation as I feel that it is a personal choice and that nobody should be judged on it. Ultimately I believe that it should first and foremost be a choice. Now my personal feelings are out of the way lets consider this new proposal.

The Background of Organ Donation

??????????????????????????????????????????????The present system of organ donation in the Netherlands is the same as the UK. If you have signed the register upon your death your organs can be harvested (I really don’t think that is the right word to use, it sounds very ‘horror film’-esque). The use of your organs will then be upon consultation of you family, regardless to your views when alive, when dead the choice is taken from you and given to your family. Organ Harvesting or whichever phrase is more palatable to say isn’t a new concept. Doctors have been examining our insides forever, the guy that invented the knife opened up a whole host of possibilities. Organ Donation is are much more common and successfully carried out nowadays because we have learnt how to remove organs and maintain their viability.

I would like to think that today if you carry a donor card you would have had some form of conversation about it with you loved ones. Your family have to make that decision at the time, not you and not your little organ donation card that you carry around with you in your purse. The spin from the D66 is that you ‘burden’ your family with the decision and the new proposals will remove that unwanted pressure. Nothing like a good spin doctor tugging on the old donor heartstrings! I am pro-choice in everything. I do think it is a choice to make and a choice that you can and should only ever make yourself.

Screen Shot 2015-03-20 at 23.28.19

The Proposal

The new system, as explained here, is sort of an ‘op-out’ only system. Similar to the Work Place Pensions here in the UK everyone is in unless you specifically request to opt-out. Therefore only giving you the opt-out choice.

The proposal is that everyone over the age of 18 will receive a letter about organ donation asking them to sign up. Should they not sign it in refusal or ignore the letter, they will be added to the register regardless…. Here is my argument, isn’t that in itself taking the choice away from people? In my opinion asking someone to sign up but then doing it for them unless they opt-out is taking the choice away from someone. It’s a great way of getting more people signed up but I don’t think this is the best way to do it.

Do I think organ donation is a good thing? Yes. BUT I think that organ donation should ultimately be a choice. Perhaps the Democraten 66 would be better off initiating better education and information into Organ Donation, funding adverts on TV, talking to young people about it and community information drives etc. After the huge criticism following Dutch TV show De Grote Donorshow in 2007 it is clear that the Dutch are trying to raise the profile of organ donation but perhaps they aren’t quite getting it right by making a reality tv show about it (just because they masterminded The Voice, doesn’t make them reality TV experts!)


If you educate people correctly they will ultimately make their own well informed, none forced decision. Have the D66 even given any thought into religious beliefs? They promise that you can op-out at any time but is that good enough? Why should non-believers in organ donation have to go to the trouble of opting-out when they didn’t opt-in?


The Statistics on Organ DonationIMG_7206

2.3% of Dutch people are registered organ donors. This generally means that the decision is up to the relatives in over 97% of cases and in a moment of grief, (bare in mind there is a short window of time between death and the viability of organ transplantation), can your family really make an informed choice?

The D66 want people to make their own decisions. I totally understand that and support it however I think the only way you can have people making such serious decisions and give people an actual choice rather than assuming. I think better education and a more circulated information is the key to this.

In the UK, spends a fortune on Internet campaigning, TV adverts and literature. They have a growing following on facebook and twitter and this has been reflected in the number of people donating. They even text appointments or little reminders like the last one I got telling me that in my area blood stocks of my blood group are low. This is working for them and I don’t see why it wouldn’t work for organ donation in The Netherlands.

In one year over


people joined the NHS Organ Donor Register!

Bringing the total of Donors to:


Compare that with the 380.000 blood donors in the Netherlands this is a mere 2.3% of the Dutch population you can see the issue the D66 are trying to raise. 2.3% of the population cannot offer enough organs to help the growing number of people in need.

Screen Shot 2015-03-20 at 23.26.53

I am a huge supporter of organ donation but the fact that I think needs to be addressed is the concept of choice. The D66 want people to make the right choice but in my opinion this new system doesn’t do that. You should have a choice to donate your organs and not be signed up for something you may not know or fully understand. An opt-out only system in my view is taking the choice away not giving it.

Maria Smith
Maria Smith
Born and raised in England Maria is a Dutch obsessive. Not just in love with the windmills and tulips her passion for all things Orange has spanned over 10 years. Proud feminist and campaigner, Maria works in UK politics whilst dreaming about eventually moving to the Netherlands.


  1. Good article and proper arguments. I disagree however in this particular case. Normally I’m all pro-choice and letting everybody decide for themselves. But if I’m correct most people reject the donor option because they are ‘just not feeling good about it’ or have uneducated fears. Better information and education is only gonna improve that a little bit. And since literally people are dying because people make uninformed choices or don’t pay attention at all to the matter I also think, like D66, that the system should be changed.

    If people still wanna opt out there’s still that possibility.

  2. Why not? If people don’t care enough to make a choice when alive, what should it bother them once dead?
    The choice is not taken from them, they’re offered to not be part of the donors list, up to them to reply to the letter or not. As long as people have the possibility to change the status and register as non-donor anytime they want.
    As you say, the time frame the family has to make the decision is really short and (I speak from experience!) make any choice after a dear one has passed away is not the easiest thing.
    A French doctor once said “being buried with healthy organs is like being buried with a treasure: it’s useless to the deceased though it can be used to the living ones.” I find the comparison quite accurate and a fair point.

  3. I think education really is the key here. We don’t talk about it enough. I was never taught about it at school or anything like that. I think, in all honesty, my knowledge on organ donation comes from tv soaps (as bad as that sounds!), the occasion advert when they are doing a mass sign up drive or from the news. Its all a little hush hush.

    The Netherlands needs a new system, the current one clearly isn’t working like it should be if less than 3% of people donate, I am very much on the fence with this proposal. I can quite clearly see the argument from both sides and the only other way I can see is to educate people. Maybe the research needs to go into WHY people aren’t signing up.

    I do think the idea of sending a letter to everyone is a good move and I think they will find a lot of people would sign up simply if they are asked. Some people are just to lazy to go out and sign up, if the sign up process comes to them I do hope Holland sees an increase in donors 🙂

  4. Why not call it “organ transplantation” to cover both donating and receiving organs? Then the status quo would be that you receive organs if necessary and donate if you can. Opting out could be for donating, receiving, or both.


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