What is the “opt out” system in England?
This page provides answers to some of the most common questions about changes to the law around organ donation in England.
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.
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.
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
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。
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.
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。
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 NHS Blood and Transplant’s 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.
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NHS Blood and Transplant 的联系中心：0300 123 23 23。
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。
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.
• 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；
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.
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.
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。
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.