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Mapping consent systems in Europe

European regulations on organ donation: consent models, family involvement, and national registries 

Our research

We have systematically analyzed and compared the laws of each European state on organ procurement for transplantation purposes, taking into account three fundamental aspects: 1. the models of consent, 2. the level of family authority in the organ procurement decision-making (as legally stated), and 3. the availability of donation and/or refusal registries to express organ donation preferences. Our results constitute the first comprehensive map of organ transplantation laws in Europe. We hope this study can be useful for both researchers and policy makers.
Autores/as:
Marina Morla-González
Clara Moya-Guillem
Janet Delgado-Rodríguez
Alberto Molina-Pérez
David Rodríguez-Arias
Gonzalo Díaz-Cobacho

Consent models in Europe

Several European countries are introducing legislative reforms regarding consent for postmortem organ donation. The relative capacity of consent policies (opt-in; opt-out) for increasing organ procurement rates is being discussed. 
Opt-in (or explicit consent): Under an opt-in system, organs may be obtained from a deceased person if the person had expressly consented to such removal during his or her lifetime, either verbally or, depending on domestic laws, through a donor card, a donor registry, their driver’s license or identity card or their medical record. 
Opt-out (or presumed consent): Under an opt-out system, organs may be obtained from a deceased person for transplantation unless the person had expressed his or her opposition before death.
Adapted from: 
  • MORLA M, MOYA GUILLEM C, DELGADO J and MOLINA-PEREZ A.,  European and comparative law study regarding family's legal role in deceased organ procurement. Revista General de Derecho Público Comparado (accepted)
  • MOLINA-PÉREZ A, DELGADO  J, RODRÍGUEZ-ARIAS D (2021), “Defining Consent: Autonomy, and the Role of the Family” Ethical Challenges of Organ Transplantation: Current Debates and International Perspectives",​ Transcript

Role of the Family in deceased organ donation

Families may be decisive as well, depending on their degree of involvement along the decision–making process. Most states, both those with an opt-in system and those with an opt-out system, allow family members to make decisions when the deceased have not expressed any preference in life. However, while some countries only allow family members to communicate or update the preferences of the deceased (i.e., to act as witness), other jurisdictions also allow them to act on their behalf (i.e., to act as surrogates) or even to overrule or "veto" their consent (i.e., to have full decisional authority). Within each country, the role play by families as stated by law (de iure) and the role they actually play (de facto) may differ.
Adapted from: ​
  • DELGADO J, MOLINA-PEREZ A, SHAW D, RODRÍGUEZ-ARIAS D (2019), The role of the family in deceased organ procurement. A guide for clinicians and policy makers. Transplantation, Vol. 103, No. 5, May 2019
  • MORLA M, MOYA GUILLEM C, RODRIGUEZ-ARIAS D, de MIGUEL BERIAIN I, MOLINA-PEREZ A, ORTEGA-DEBALLON I,  European and comparative law study regarding family's legal role in deceased organ procurement. Revista General de Derecho Público Comparado (accepted)

Registries for organ donation

Adapted from: 
  • MORLA M, MOYA GUILLEM C, DELGADO J and MOLINA-PEREZ A.  European and comparative law study regarding family's legal role in deceased organ procurement. Revista General de Derecho Público Comparado (accepted)

Nation Availability Year
Austria https://www.ris.bka.gv.at/Dokumente/BgblAuth/BGBLA_2012_I_108/BGBLA_2012_I_108.html 2012
Belgium http://www.ejustice.just.fgov.be/eli/loi/1986/06/13/1987009088/justel 1986
http://www.ejustice.just.fgov.be/mopdf/2012/08/24_2.pdf#Page37 2012
http://www.ejustice.just.fgov.be/cgi_loi/change_lg.pl?language=fr&la=F&cn=1986061337&table_name=loi 2018
Bulgaria https://www.mh.government.bg/media/filer_public/37/96/379681ed-5e58-43c2-b6a7-460eb3df9b07/zakon-za-transplantaciya-na-organi-takani-i-kletki_28-01-2011.pdf 2004,   last updated 2019
Czech Republic https://www.global-regulation.com/law/czech-republic/507382/transplantan-zkon.html 2002
Croatia https://narodne-novine.nn.hr/clanci/sluzbeni/2012_12_144_3071.html 2012
Cyprus https://www.moh.gov.cy/moh/moh.nsf/222C730B732366FEC2257BD5003A2F59/$file/ΝΟΜΟΣ%20127(Ι)2012_ΠΕΡΙ%20ΑΦΑΙΡΕΣΕΩΝ%20ΚΑΙ%20ΜΕΤΑΜΟΣΧΕΥΣΕΩΝ%20ΤΩΝ%20ΟΡΓΑΝΩΝ%20ΑΝΘΡΩΠΙΝΗΣ%20ΠΡΟΕΛΕΥΣΗΣ.pdf 2012
https://www.moh.gov.cy/moh/moh.nsf/222C730B732366FEC2257BD5003A2F59/$file/NOMOΣ%20102(I)2014_ΠΕΡΙ%20ΑΦΑΙΡΕΣΕΩΝ%20ΚΑΙ%20ΜΕΤΑΜΟΣΧΕΥΣΕΩΝ%20ΤΩΝ%20ΟΡΓΑΝΩΝ%20ΑΝΘΡΩΠΙΝΗΣ%20ΠΡΟΕΛΕΥΣΗΣ%20(ΤΡΟΠΟΠΟΙΗΤΙΚΟΣ).pdf 2014
https://www.moh.gov.cy/moh/moh.nsf/222C730B732366FEC2257BD5003A2F59/$file/Ο%20Περί%20Αφαιρέσεων%20και%20Μεταμοσχεύσεων%20των%20Οργάνων%20Ανθρώπινης%20Προελεύσεως%20Νόμος%20του%202017.pdf 2017
Denmark https://www.retsinformation.dk/eli/lta/2018/1286 2018
https://www.retsinformation.dk/eli/lta/2018/1732 2018
England http://www.legislation.gov.uk/ukpga/2004/30/pdfs/ukpga_20040030_en.pdf 2004
Last reform: Deemed Consent   Act 2019: http://www.legislation.gov.uk/ukpga/2019/7 2019
Estonia https://www.riigiteataja.ee/en/eli/ee/Riigikogu/act/502042019004/consolide 2015   (updated in 2017, 2018, 2019)
Finland https://www.finlex.fi/en/laki/kaannokset/2001/en20010101_20130277.pdf 2013
France https://www.legifrance.gouv.fr/affichCode.do?cidTexte=LEGITEXT000006072665 updated
https://www.legifrance.gouv.fr/affichTexteArticle.do;jsessionid=5832366938CF26062A6B7E35D24F973B.tplgfr24s_3?cidTexte=JORFTEXT000033027728&idArticle=LEGIARTI000033038802&dateTexte=20160814 2016
Germany https://www.gesetze-im-internet.de/tpg/BJNR263100997.html#BJNR263100997BJNG000202310 2007,   last updated 2020.
Greece https://www.kodiko.gr/nomologia/document_navigation/123599/nomos-3984-2011 2011
https://www.e-nomothesia.gr/kat-ygeia/upourgike-apophase-g2ggp-7611018.html 2018
Hungary https://net.jogtar.hu/jogszabaly?docid=99800018.EU 1998
Ireland http://www.irishstatutebook.ie/eli/2012/si/325/made/en/pdf 2012
Italia https://www.normattiva.it/uri-res/N2Ls?urn:nir:stato:regio.decreto:1931-06-18;773!vig= 1931
http://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=19372 1999
http://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=17738 2000
Latvia https://likumi.lv/ta/en/en/id/62843-on-the-protection-of-the-body-of-deceased-human-beings-and-the-use-of-human-tissues-and-organs-in-medicine 1992
https://likumi.lv/ta/id/307176 2019
Lithuania https://e-seimas.lrs.lt/portal/legalAct/lt/TAD/19d1d990225011e6acbed8d454428fb7?jfwid=191fum8213#part_3528cab269d44fbdb4f71ca91f31a9b4 1996,   last updated in 2016
Luxembourg http://legilux.public.lu/eli/etat/leg/loi/1982/11/25/n2/jo 1982
http://legilux.public.lu/eli/etat/leg/loi/2015/06/25/n1/jo 2015
Malta http://justiceservices.gov.mt/DownloadDocument.aspx?app=lom&itemid=12519&l=1 2016
Netherlands https://wetten.overheid.nl/BWBR0008066/2019-04-02 1996   last updated 2018.
Updates to be   in force in 2020 available at:   https://zoek.officielebekendmakingen.nl/stb-2018-95.html
Northern Ireland http://www.legislation.gov.uk/ukpga/2004/30/pdfs/ukpga_20040030_en.pdf 2004
Poland http://prawo.sejm.gov.pl/isap.nsf/download.xsp/WDU20190001405/T/D20191405L.pdf 2005
Portugal http://www.pgdlisboa.pt/leis/lei_mostra_articulado.php?nid=236&tabela=leis&so_miolo= 1993,   last updated 2015
Romania https://www.transplant.ro/(X(1)S(2sm04mntp340iz5ghvshhyf3))/Lege/Lege-2003-104.pdf 2003
Scotland https://www.legislation.gov.uk/asp/2006/4/pdfs/asp_20060004_en.pdf 2006,   last updated 2019
Last   updated 2019:   http://www.legislation.gov.uk/asp/2019/11/enacted?view=extent
Slovakia http://www.ncot.sk 2004
Slovenia https://www.uradni-list.si/glasilo-uradni-list-rs/vsebina/2015-01-2357?sop=2015-01-2357 2015
Spain https://www.boe.es/buscar/pdf/1979/BOE-A-1979-26445-consolidado.pdf 1979
https://www.boe.es/buscar/doc.php?id=BOE-A-2012-15715 2012
Sweden https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/lag-1995831-om-transplantation-mm_sfs-1995-831 1995
Wales http://www.legislation.gov.uk/anaw/2013/5/pdfs/anaw_20130005_en.pdf 2013
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  • Inicio
  • Conócenos
    • Qué es INEDyTO
    • Quiénes somos
    • Contacto
  • Proyectos
    • CONFINES
    • INEDyTO II FINAL DE LA VIDA >
      • Estudios Empíricos >
        • NARRATIVAS
      • Clarificación Conceptual >
        • Mitos sobre el final de la vida
      • Cuestiones éticas y jurídicas
    • INEDyTO I DONACIÓN Y TRASPLANTE DE ÓRGANOS >
      • Actitudes hacia los trasplantes
      • Distribución de órganos
      • Duelo familiar y entrevista para la donación
      • El modelo confiscatorio
      • Mapping consent systems in Europe
      • Modelos de consentimiento
      • Modelos de gobernanza en las políticas de donación
      • Papel de la familia en la donación
    • VIVENCIAS
  • NARRATIVAS
  • TTV-GUIDE-TX
  • SiB
  • Resultados
    • Publicaciones
    • Comunicaciones
    • Divulgación
    • Talleres y Jornadas >
      • Bioethics International WorkShop
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