Facts about the law change and donation
Here you will find answers to all the questions you have about the opt out system and about organ and tissue donation more generally. Make sure you have the facts to help you make your donation decision.
The law has changed 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 has changed 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.
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.
You can change your donation decision by completing the amend your details form or by calling 0300 303 2094. Your registration record will be matched with your old one and updated.
Everyone has a choice as to whether or not they want to become an organ and tissue donor, and if you agree to donate, you can choose to donate either some or all of your organs and tissue.
By registering to become an organ and tissue donor you have the option to donate organs such as your heart, lungs, liver, kidneys, pancreas and small bowel and tissue such as heart valves, tendons and corneas. All of these forms of donation can greatly enhance or even save the life of someone who is on the transplant waiting list.
No, this is absolutely not true. The transplant laws in the UK absolutely prohibit the sale of human organs or tissue.
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.
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.
Ethnicity, faith and beliefs
We need donors from all communities and ethnicities.
All the major religions and belief systems in the UK are open to the principles of organ and tissue donation and transplantation and accept that donation is an individual choice.
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.
Current clinical guidelines prevent a person who has tested positive for COVID-19 from becoming a potential donor. This is so transplantation can be as safe as possible for an identified recipient.
Yes. A potential organ or tissue donor can only be considered for donation if they have tested negative for the coronavirus (SARS-CoV-2).
Having an illness or a medical condition does not necessarily prevent you from becoming an organ or tissue donor. There are very few conditions where organ and tissue donation is ruled out completely.
The decision about whether some or all of your organs or tissue are suitable for transplant is made by specialist healthcare professionals at the time of donation. The families of a potential organ and tissue donor are always asked a number of questions to assess the potential donor’s medical, travel and social history.
Not necessarily. It is still possible to become an organ and tissue donor if you smoke or drink alcohol. Specialist healthcare professionals decide which organs and tissue are suitable for donation on a case by case basis.
If you don’t or can’t give blood you can still be a potential organ and tissue donor.
There may be specific reasons why it has not been possible for you to donate blood or there may be reasons why you could not give blood because of your health at the time.
The decision about whether some or all organs or tissue are suitable for transplant is always made by specialist healthcare professionals at the time of donation, taking into account your medical history.
There is no age limit for becoming an organ and tissue donor.
For organs, the deciding factor is generally the donor's physical condition, rather than their age. Organs or tissue from people in their early 80s, such as kidneys or corneas, are often transplanted successfully. While there are maximum ages for some organs or tissue, in every case, specialist healthcare professionals will decide which organs and tissue are suitable, so don’t let your age or health stop you from recording a decision.
In Scotland, children between the age of 12 and 16 can record their own donation decision on the register.
If a child is under the age of 12, a parent, their closest family member or a person with parental rights and responsibilities (e.g. their legal guardian) can register a donation decision for their child.