Changing organ and tissue donation

Legislation for a soft opt out system introduced to Parliament.

Scotland will move to a soft opt out system for organ and tissue donation, under legislation introduced to the Scottish Parliament.

 The Human Tissue (Authorisation) (Scotland) Bill will change organ and tissue donation from the current ‘opt in’ system to an ‘opt out’ system. Under the proposed system, if someone has not stated a decision about donation, they may be deemed as having authorised it.

The Bill contains safeguards to ensure people’s wishes regarding donation are followed and that families will be asked about their loved one’s views to ensure donations don’t occur where the person would not have wished it.

The move to an opt out system received 82% support from respondents in a public consultation in 2017. It will add to measures that have contributed towards improvements in organ donation over the last decade in Scotland, which has seen   an 89% increase in the number of deceased organ donors and a 78% increase in organ transplants. 

Public Health Minister Aileen Campbell said:

“We need to do all we can to further reduce the number of people in Scotland waiting for transplants. We have made significant progress over the past decade, and moving to an opt out system will be part of driving a long term change in attitudes towards organ and tissue donation.

“Organ and tissue donation is an incredible gift. Importantly, under the proposed system, people will still be able to make a choice about donation as they can now and there are safeguards to ensure their wishes are followed. I would encourage people to continue to make a decision about donation and to tell their family.

“Organ donation can only occur in tragic circumstances, and every donor, supported by their family, makes a selfless decision that can save other people’s lives.”


Under the proposed system there will be protections for adults without capacity to understand deemed authorisation, adults resident in Scotland for less than 12 months and children under 16 who will not be subject to deemed authorisation and will only be able to donate if they, or someone on their behalf, explicitly authorises it.

Less than 1% of people die in circumstances that enable organ donation to proceed, as a potential donor usually has to be in an intensive care unit and  there may be medical reasons that mean organs are unsuitable for transplantation.

Since 2008 in Scotland, there has been:

  • An 89% increase in the number of people who donated organs after their death (54 to 102 in 2017/18)
  • A 78% increase in the number of lifesaving transplant operations from deceased donors (211 to 375 in 2017/18
  • A 22% decrease in the number of people on the active transplant waiting list (689 to 534 in 2017/18)


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