Organ and tissue donation changes

Latest on proposed opt-out system.

A Bill to introduce a soft opt-out system of organ and tissue donation for deceased donors  will be debated in Parliament today.

Members will be asked to agree to the general principles of the Human Tissue (Authorisation) (Scotland) Bill.

Under the proposed opt-out system, if an adult does not proactively opt in nor out of donation they may be deemed to have authorised donation for transplantation. The Bill includes safeguards to ensure that donation will not go ahead where it would be clearly against the person’s wishes.

The opt-out system will add to the package of measures which have led to significant increases in donation and transplantation over the last decade.

Public Health Minister Joe FitzPatrick said:

“Organ and tissue donation can be a life-changing gift, and has the power to both save and improve lives.

“In Scotland we have seen tremendous progress over the last decade, with the number of donors, organ and tissue transplants all increasing. There has also been a significant increase in the number of people registering their donation decision, with 51% of the Scottish population on the NHS Organ Donor Register – the highest rate of all UK countries.  

“However, there are still too many people waiting for transplants, with an average of more than 500 people waiting for an organ transplant at any one point in Scotland. That’s why we are doing all we can to increase organ and tissue donation, and while no single measure can achieve this, evidence shows that opt-out systems can make a difference as part of a package of measures.

“Families will continue to have an important role in the donation process and will be able to provide information about their loved ones views. I would encourage people to make a decision about donation and tell their family. ”


 The Human Tissue (Authorisation) (Scotland) Bill amends the existing Scottish legislation that supports donation by introducing a new, additional form of authorisation called ‘deemed authorisation’. This means that donation may proceed, where a person was not known to have any objection to donation.

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.

As set out in the consultation it is the intention for a high profile awareness-raising campaign over at least 12 months before the introduction of the new system, and on a regular basis after implementation to maintain awareness

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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