What is the “opt out” system in England?
英格兰的“默认同意”制是什么?

This page provides answers to some of the most common questions about changes to the law around organ donation in England.

本页提供了有关英格兰器官捐赠法律变化的一些最常见问题的答案。

What has changed?

The law around organ donation in England has changed. All adults in England are now considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups.

This is commonly referred to as an ‘opt out’ system. You may also hear it referred to as ‘Max and Keira’s Law’. You still have a choice whether or not you wish to become a donor.

You can record your decision to opt in or out on the Organ Donor Register.

Those excluded will be people under 18, people who have lived in England for less than 12 months or who are not living here voluntarily, and people who lack the capacity to understand the change.

Adults covered by the changes will still have a choice whether they want to be an organ donor and which organs they would like to donate, and their families will still be involved before organ donation goes ahead.

会有哪些修订?

英格兰的器官捐献法即将修订。这意味着,从 2020 年春季起,英格兰的所有成年人去世后都将被默认为器官捐献者,生前做出了不捐献的决定,或者属于除外群体的除外。

这通常称为“默认同意”制。您可能还会听到它被称为”麦克斯和凯拉法”。 您仍然可以选择是否愿意成为捐赠者。

您可以在器官捐献者登记库中登记您是否捐献的决定。

除外群体包括: 未满 18 岁者,在英格兰居住不足 12 个月或非自愿居住在英格兰的人,无法理解这项法律修订的人。

这项修改覆盖的成年人仍然可以选择是否成为器官捐献者以及捐献哪些器官,在进行器官捐献之前,我们还会征求家属的意见。

Why do we need an opt out system?

There has been tremendous progress in organ donation but there is still a shortage of donors. Last year, 408 patients died in the UK on the transplant waiting list.   

To continue our progress, we need a transformation in public attitudes. More than 6 out of 10 families agree to organ donation but to meet the needs of patients we need at least 8 out of 10 families to support donation and agree to save and improve lives.

The latest evidence from Wales suggests that consent rates have increased significantly since they introduced the opt out system in 2015. The government is keen to see the same progress in England.

我们为什么需要默认同意制?

器官捐献领域已经取得了巨大的进步,但仍然存在捐献者短缺的问题。在英国,每年有成百上千人在等待移植的过程中死去。

为了继续推进器官捐献的发展,我们需要改变公众的态度。超过 6/10 的家庭同意捐献器官,但要满足病人的需求,我们需要至少 8/10 的家庭支持捐献,并同意拯救和改善他人
的生命。

威尔士的最新数据显示,自从他们于 2015 年推出默认同意制后,同意率大幅上升。我们希望在英格兰看到同样的进步。

When did the opt out system start?

The new system came into effect in England on 20 May 2020, after the Organ Donation (Deemed Consent) Bill received Royal Assent on 15 March 2019. 

默认同意制何时启用?

“默认同意制”将于 2020 年春季生效。 新制度实施的确切日期尚未得到政府的确认。修订英格兰器官捐献法的立法已通过议会程序,并得到了御准

Will you automatically take my organs if I don’t opt out?

No. Organ donation can only happen in a small number of cases. Around 500,000 people die every year in the UK, but only around 1 in 100 of them die in circumstances where they are able to donate their organs. Organs can only be transplanted very soon after someone has died, and they need to be in a usable condition. Donors can usually only be people who have died in a hospital intensive care unit or accident and emergency department. Due to these constraints, every potential donor is precious.

Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured. Your faith and beliefs will also always be taken into consideration before organ donation goes ahead.

如果我不捐献,你们会自行摘下我的器官吗?

不会。器官捐献只会在少数情况下发生。在英国,每年大约有 500,000 人死亡,但其中只有约 1/100 的人满足器官捐献的条件。器官必须在死者去世后尽快进行移植,而且它们必须处于可用状态,所以捐献者通常只能是在医院重症监护室或事故和急诊室中死去的人。因为这些限制,每位潜在的捐献者都弥足珍贵。

在捐献之前,我们会联系捐献者家属。家属可能会对器官捐献流程有疑问,包括如何尊重捐献者的信仰或文化,这些都会得到解决。选择是否要成为捐献者并让家属知道,这很重要。与家属进行讨论,确保您的选择得到尊重。

Am I losing control of what happens to my body?

No. It will still be for you to choose if you want to be an organ donor. And if you don’t want to donate, it’s really quick and simple to record your decision on the NHS Organ Donor Register. The quickest and easiest way to do this is online, but if you don’t have internet access you can call our contact centre on 0300 123 23 23.

Get the facts about organ donation.

You can update your preferences on the NHS Organ Donor Register quickly and easily at any time. We will not take people’s organs without permission.

Your family will always be consulted before donation takes place. It is important that your family and friends know your choice. This makes it easier for them to honour your choice, whatever that choice is.Your faith and beliefs will also always be taken into consideration before organ donation goes ahead. 

我是不是失去了对我遗体的控制权?

不。您想不想成为器官捐献者,决定权仍在您自己。如果您不想捐献,您可以在 NHS 器官捐献者登记库中登记您的决定,这既简单又快速。最快速、最简单的方法就是在网上完成。如果您无法访问互联网,您也可以致电我们的联系中心:0300 123 23 23。

了解器官捐赠的一些情况

您可以随时在 NHS 器官捐献者登记库中更新您的选择,这既简单又快速。未经允许,我们不会摘下人体的器官。

在捐献之前,我们会咨询捐献者家属。家属可能会对器官捐献流程有疑问,包括如何尊重捐献者的信仰或文化,这些都会得到解决。务必让您的家人和朋友知道您的选择。这样能让他们更容易尊重您的选择,无论您的选择是什么。

Will you still ask my family’s permission?

Yes. Families will continue to be involved before organ donation goes ahead.

There are a number of reasons for this:

  • Out of consideration to the family who are facing the loss of someone close to them;
  • The family may have important information about the person’s decision around donation that is more recent than any decision recorded on the NHS Organ Donor Register;
  • Family support helps ensure important information about their relative, such as their medical, travel and social history is available to our specialist nurses in organ donation. The information that families provide before organ donation goes ahead, together with medical notes and other tests, is vital to understanding whether the person’s organs are safe to transplant into somebody else.

 

Your family will always be approached if organ or tissue donation is a possibility. If you have already made a decision about donation and shared this with your family, they would be expected to support your decision, whatever that is.

If you have not recorded a decision either way and you are not in an excluded group, your family will be approached and asked if they have any information about your organ donation decision. If no information is available, it will be considered that you consent to donate your organs and your family would be expected to support this.

People under the age of 18 and those lacking mental capacity are excluded from the new law, but may still record a decision on the NHS Organ Donor Register. This information will be made available to the family at the time of the discussion. The final decision for organ donation from people in excluded groups is made by the family, but they will be encouraged by the specialist nurse to take any recorded decision into account.

你们还会征求我家人的同意吗?

会。我们将就器官捐献进一步咨询捐献者家属。

原因有以下几点:

• 考虑到家属痛失亲人;

• 家属也许能提供重要信息,这些信息是死者在 NHS 器官捐献者登记库中登记之后做出的捐献决定;

• 在器官捐献中,家属的支持有助于确保为我们的专业护士提供有关死者的重要信息,例如病历、旅行经历和社会经历。家属在器官捐献前提供的信息,加上医嘱和其他检查,对于了解死者的器官移植到他人身上是否安全至关重要。

 

如果有可能捐献器官或组织,我们会联系捐献者家人。如果您已做出是否捐献的决定并告知了家属,您会希望得到他们的支持,无论决定是什么。

如果您未采取任何方式登记,而且您也不是除外群体,我们将联系您的家属,并询问他们 是否能提供任何有关您的器官捐献决定的信息。如果无法提供相关信息,我们将默认您同 意捐献您的器官,希望您的家属支持该决定。

根据新法律的规定,未满 18 岁者和缺乏心智能力者属于除外群体,但也可以在 NHS 器 官捐献者登记库中登记自己的决定。在讨论这个问题时,我们会将此信息告知家属。除外 群体是否捐献器官最终由家属决定,但专业护士会建议他们考虑已登记的决定。

Do these changes affect my children?

The opt out system does not apply to children under the age of 18 years old. In circumstances where a donation decision is required for someone under 18, the family will be asked to make that decision and provide consent.

Information about the law change for those under the age of 18 is available here.

The NHS Organ Donor Register is open to everyone, regardless of age. If a child wants to register their decision, or the parent of a child wants to do that for them, this option is available. The information recorded on the NHS Organ Donor Register would be accessible to the specialist nurses in organ donation who approach the family about the possibility of organ donation.

此修订会影响我的孩子吗?

默认同意制不适用于未满 18 岁者。未满 18 岁者如需捐献,应由家长做出决定并经他们同意。

有关18岁以下青少年法律变化的信息,请点击此处

NHS 器官捐献者登记库面向所有人开放,无论年龄大小。如果小孩希望登记自己的决定,或者小孩家长希望为他们做出该决定,都可以通过此登记库完成。负责器官捐献的专业护士能访问 NHS 器官捐献者登记库中的信息,如果能进行器官捐献,他们将联系家属。

Will my funeral plans be affected?

Our 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. For example, a quick burial or open casket. 

The surgery carried out to remove a donor’s organs is carried out by highly skilled professionals who take the same care and attention, and offer the same respect as they would in any operation to save a patient’s life. The surgical incisions are carefully dressed after the surgery and any end of life care wishes in relation to the washing and dressing of the body are respected.

Many donors go on to have an open casket funeral.

我的葬礼计划会受到影响吗?

对于葬礼计划,我们的专业护士将向家属了解是否需要考虑捐献者的信仰或文化因素。例 如,是尽快埋葬还是开棺供人瞻仰。 

器官摘除手术由经验丰富的专业人员完成,他们将像完成任何拯救患者性命的手术一样给 予捐献者同样的关心、关注和尊重。手术后切口将会小心地包扎好,并将给予身体清洗和 梳妆的临终关怀。 

许多捐献者还会继续进行开棺式葬礼。

What happens if I don’t register a decision?

If you have not expressed your decision to opt out of donation and are not in an excluded group, it will be considered that you consent to donate your organs. So even if you don’t record that you want to be an organ donor, it is important to let your family know what you want.

If you have specific instructions about which organs you would or would not like to donate, you should provide this information when you record your donation decision on the NHS Organ Donation Register

If you die in circumstances where donation is possible, your family will always be asked if some or all of your organs should be donated. Your organs will not be donated without their consent.

If you’ve already registered a decision to donate your organs on the NHS Organ Donor Register, and have not yet told your family, please let them know.

If you have recorded an opt out decision on the Organ Donor Register, then you should make sure your family know what you have decided.

If you want to update or reaffirm your decision, you can complete the Amend your details form or call 0300 123 23 23.

如果我什么都不做会发生什么?

一旦新制度在英格兰生效,如果您未做出不捐献的决定且您不是除外群体,我们将默认您 同意捐献器官。因此,即使您未登记您要捐献器官的决定,也务必让家属知道您的想法。

如果您明确要求捐献或不捐献哪些器官,请在 NHS 器官捐献者登记库中登记您的决定时注明。

如果您死亡时满足捐献条件,我们将询问您的家属您的器官是部分捐献还是全部捐献。未 经家属同意,您的器官不会被捐献。

如果您已在 NHS 器官捐献者登记库中登记您的器官捐献决定而未告知您的家属,请务必告知他们。

如果您已在器官捐献者登记库中登记不捐献的决定,您应该确保您的家属知道您的决定。

如果您想更新或再次确定您的决定,您可以填写修改详细信息表格或致电 0300 123 23 23。

Can I change my mind?

Yes. If you have recorded an organ donation decision on the NHS Organ Donor Register and want to update your details, or change or reaffirm your decision, you can complete the Amend your details form or call 0300 123 23 23.

It is important to share your decision to be an organ donor with your family. This will give them more confidence that they know that you wanted to donate and make it easier for them to honour your decision.

我可以改变主意吗?

可以。如果您已在 NHS 器官捐献者登记库中登记您的器官捐献决定并想更新详细信息, 或者修改或再次确定您的决定,您可以填写修改详细信息表格或致电 0300 123 23 23。 

请务必与您的家属分享您要捐献器官的决定。这能让他们更确定他们知道您想捐献,让他 们更容易尊重您的决定。