The reform of the German transplantation law almost two years ago was supposed to make many things better, but the discussions about the changes in organ donation continue.

The reform passed by the Bundestag in March 2020 came into force on Tuesday.

It provides for a nationwide online register to be created at the Federal Institute for Drugs and Medical Devices, in which every citizen can register - together with an answer to the question of whether he or she would be willing to donate organs in the event of brain death.

Kim Bjorn Becker

Editor in Politics.

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Eva sleeper

Editor in the "Life" department of the Frankfurter Allgemeine Sunday newspaper.

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In order for as many people as possible to enter their will in the register, the citizen and registration offices should keep asking – whenever someone, for example, extends their identity card or applies for a new passport.

At least that was the plan.

The reality looks different.

The Federal Ministry of Health, now led by Karl Lauterbach (SPD), informed the FAZ in January that the register would not be available when the law came into force.

Due to the additional burden caused by the corona pandemic, the clinics were unable to create the conditions for this.

The German Hospital Society rejects this representation.

Its chairman, Gerald Gass, said the implementation of the register failed because some of the transplant officers in the hospitals were not authorized to call up data from the register.

It does not stop with bureaucratic obstacles.

A few days ago, i.e. shortly before the law came into force, the health ministers of the federal states called for extensive changes.

The fact that ID card offices ask citizens about their attitude towards organ donation is “problematic”, according to a decision by the conference of health ministers at the end of February.

The offices could not provide the “often required information and advice” and were already overburdened.

"The Federal Government is therefore called upon to bring about an amendment to the Transplantation Act, according to which the obligation of the identification offices to ensure that a declaration of organ and tissue donation is submitted to the organ donation register on site no longer applies." Schleswig-Holstein abstained and opposed it in a protocol note criticism of the law.

Advice on organ donation possible since Tuesday

It is noteworthy that the municipalities whose offices are supposed to implement the reform sometimes assess the situation very differently.

Whether the consulting effort is really so great, one should "wait and see first," says Kay Ruge, the deputy general manager of the district council.

The law does not provide for an obligation to provide advice.

"If necessary, the municipalities will have to refer to local advice centers and the Federal Center for Health Education.

Practice will show that.

We don’t see the whole thing as problematic from the outset.”

The German Association of Towns and Municipalities was more critical.

"We support the basic legislative intention that organ donation should be strengthened and that more information should be provided about it, but going through the passport and registration authorities of the municipalities will hardly lead to success here," said a spokesman for the FAZ "Even if there is no legal obligation to provide information experience shows that in administrative reality, inquiries can still arise and this can lead to discussions that lead to delays in the administrative process and are not helpful to the cause overall." It therefore makes sense to change the reform at the appropriate point and passport authorities exempt from the regulation.

Since Tuesday, general practitioners have been able to advise their patients on organ donation issues every two years.

The doctors can settle the consultation with the health insurance companies.

However, they should not go into too much detail – a maximum five-minute conversation is remunerated.