The pros and cons of 'opt out' organ donation

Family refusal on the rise, due to 'ambiguity' of presumed consent legislation

A nurse and surgeons in an operating theatre
The consent rate for organ donation fell to 61% in the 12 months to April 2024
(Image credit: Monty Rakusen / Getty Images)

Despite the introduction of legislation aimed at increasing the rate of organ donation, families are increasingly refusing to donate their relative's organs – often because they're not clear what their loved one would have wanted.

Since Northern Ireland changed its law in 2023, in all parts of the UK it is now assumed that all adults automatically become potential organ donors when they die, unless they have opted out or were members of an "excluded group". The change was intended to make organ donation easier; previously, only those who had formally expressed their consent could be considered donors.

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Harriet Marsden is a writer for The Week, mostly covering UK and global news and politics. Before joining the site, she was a freelance journalist for seven years, specialising in social affairs, gender equality and culture. She worked for The Guardian, The Times and The Independent, and regularly contributed articles to The Sunday Times, The Telegraph, The New Statesman, Tortoise Media and Metro, as well as appearing on BBC Radio London, Times Radio and “Woman’s Hour”. She has a master’s in international journalism from City University, London, and was awarded the "journalist-at-large" fellowship by the Local Trust charity in 2021.