Facts about the opt out system
Get answers to some of the key questions about the opt out system.
The law is changing to help save and improve more lives.
- Every year up to 50 people will die in Scotland in need of a transplant
- In Scotland, more than 500 people are waiting for a transplant at any time. But there aren’t enough donors to help all of these people.
- Although 77% of people in Scotland support donation, many don’t record this decision on the NHS Organ Donor Register
- Only around 1% of people die in a way that makes organ donation possible, which usually means dying in a hospital. So, every opportunity for donation is very precious.
- The law is changing to introduce a new system of deemed authorisation. This is often referred to as an opt out system.
- This means that if you have not opted out when you die, the law allows for the donation of certain organs and tissue for transplantation
- This does not apply if you are in an excluded group or it has been established that this would be against your views
- You can still choose to register to be an organ and tissue donor. By doing this it can make it easier for your loved ones to honour your decision after your death.
- The opt out system will only apply to the donation of commonly transplanted parts of the body such as kidneys, heart, lungs, liver, tendons
The law change will apply to most adults who are resident in Scotland, however it will not apply to these groups:
- Children (under 16)
- Adults who lack the capacity to understand the new law and to take the necessary actions
- Adults who have lived in Scotland for less than 12 months before their death
If a person in one of the excluded groups set out by the law dies in a way that means they could donate, and they haven’t already recorded a donation decision, then their closest family member will be asked whether they wish to authorise donation.
The new system came into effect in Scotland on 26 March 2021.
There is no deadline to record your donation decision on the NHS Organ Donor Register. You can record your decision or change your mind at any time.
The clearest way to record your decision is on the NHS Organ Donor Register and you can do this either online or by phone.
Online: NHS Organ Donor Register.
Call: 0300 303 2094. Lines are open 24 hours a day, 7 days per week. Calls will be charged at local call rates depending on your phone provider.
No. Donation remains a gift of great generosity and checks are built into the system to help make sure that donation doesn’t go ahead where it would be against your views.
Under the opt out system, organs and tissue can only be used for life-saving or life-enhancing transplantation and organs are only donated when there is somebody on the waiting list who is a match for them.
As part of the donation process, certain routine medical procedures and tests will be carried out shortly before or after death to check that transplantation is likely to be safe, successful and a suitable match for somebody on the transplant waiting list.
These typically include blood tests, urine tests and x-rays. Without these tests and procedures taking place, donation won’t be able to proceed.
Learn more about these medical procedures and tests.
The opt out system does not apply to children under the age of 16 years old. In circumstances where a donation decision is required for someone under 16, the parent will be asked if they want to authorise donation.
As is the case now in Scotland, any child aged 12 and above can register their own donation decision on the NHS Organ Donor Register.
If you do not register a decision and do nothing then you will be regarded, under the law, to have given authorisation to be an organ and tissue donor, unless you are in one of the groups who the law does not apply, or it has been established that donation would be against your views.
No, the decision about whether you wish to donate or not can only be made by you. A power of attorney or guardian appointed under the Adults with Incapacity (Scotland) Act 2000 is not permitted to opt in or opt out of donation on your behalf.
Yes. If you have previously recorded a donation decision and have now decided you want to opt out or change your donation preferences, for example what organs and tissue you do or do not want to donate, you can complete the amend your details form or call 0300 303 2094.
Whatever you decide, make sure your family and friends know what you want as it will make it easier for them to honour your decision.
Yes, however if you withdraw your registration, we will not have a donation decision recorded for you. This means that if you are not in a group excluded from the opt out legislation and you have not registered a donation decision, it will be considered that you agree to be an organ and tissue donor. This is known as deemed authorisation.
If you withdraw and later change your mind, you may record your new organ donation decision at any time. Whatever you decide, make sure your family and friends know what you want as it will make it easier for them to honour your decision.
If you’ve already registered your decision to become a donor, the only thing you need to do is to remind your family and friends about what you want as it will make it easier for them to ensure that your decision is honoured.
If you want to reaffirm your decision, change your donation preferences, for example what organs and tissue you do or do not want to donate, you can complete the amend your details form or by calling 0300 303 2094.
Your family’s role
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.
There are a number of reasons for involving families in the donation process:
- 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. This will include your views around faith and beliefs to ensure that donation would not go ahead if it wasn’t what you wanted.
- Family support helps ensure important information about their relative, such as their medical, travel and social history is available to the specialist nurses. The information that families provide before organ and tissue donation goes ahead, together with medical notes and other tests, is vital to understanding whether the person’s organs and tissue are safe to transplant into somebody else.
If you have not recorded a donation 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 donation decision and about your latest views to ensure donation doesn’t go ahead if it’s against your wishes. If no information is available, it will be considered that you agree to donate your organs and your family would be expected to support this.
If organ and tissue donation is a possibility, all measures to find family members or friends will be explored.
If a person dies in circumstances in which they can donate and they haven’t opted in on the NHS Organ Donor Register, and no family or friends can be found, then donation will not proceed.
Even if they were on the NHS Organ Donor Register, organ and tissue donation is unlikely to proceed if a family member or someone who knew the donor well, cannot be contacted to provide information about the safety of using that person’s organs.
The NHS has a duty to consider the safety of any organs and tissue for transplant. This is why speaking to the family, or someone who knew the potential donor, about medical and lifestyle history is so important.
Your faith and beliefs
Your family will always be approached to ensure donation doesn’t go ahead where it is against your wishes and only proceeds when it is in line with your beliefs.
The specialist nurses will always do what they can to involve faith representatives if a family requests this. Faith representatives can help the family and support the donation process going ahead in line with the individual’s beliefs.
The 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.