When in doubt for the contradiction - a comment

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

More posts by Christiane Fux All content is checked by medical journalists.

In the discussion about organ donation, there is at least ONE consensus: In Germany there is a tragic shortage of organs. But how one could narrow the gaping gap between the meager 797 donors on the one hand and the almost 10,000 patients on the waiting lists on the other - Germany is still deeply divided about this.

They already exist in 18 countries

Opinions are divided above all on the so-called double contradiction solution. A double contradiction solution means: Anyone who does not expressly refuse this or their relatives do so is automatically considered a potential organ donor. This is already practiced in 18 European countries - recently also in the Netherlands. In Germany, however, it is exactly the other way around: only those who expressly express their will to donate - or who have relatives who confirm their willingness on their behalf - will donate. Making such a decision puts a lot of stress on many bereaved in the extreme situation of loss.

After Health Minister Jens Spahn, Chancellor Angela Merkel has also spoken out in favor of the contradiction solution. There are good arguments for this attitude. But there are also good ones against it.

The concerns

First: The idea of donating organs triggers fears in many. They fear that they will not really be dead when the donor is removed, that they will be abandoned too early as a potential donor or that they will be disfigured as a result of the donation and will no longer be acceptable to the grieving relatives. These concerns must be dispelled, they must not be brushed off the table or reinforced by being forced to contradict them.

Second: The contradiction solution is a deep encroachment on the right to self-determination over one's own body. Silence cannot simply be interpreted as consent, warns the theologian Peter Dabrock, chairman of the German Ethics Council.

Third, when organ donation becomes the norm, it becomes more difficult to openly decide not to donate. Because the moral pressure to donate is increasing - the decision should actually be made freely and individually by everyone.

The arguments for it

First: the contradiction solution works. The number of organs transplanted increased by 20 to 30 percent in countries that imported them. Donating one's organs is becoming the norm.

Second: State interference with personal rights is widely accepted in these countries.

Third: The contradiction solution could have the effect that more people deal with the issue of organ donation in good time and make a decision for themselves. Currently, 14 percent of German citizens have “never” dealt with it, 60 percent only “a little”, according to a representative survey by the Barmer Ersatzkasse. Sit out, adjourn, leave it to the others - that would at least be the less likely way of dealing with this issue.

The question of conscience

Ultimately, everything comes to a head with the question of conscience: If the will of the potential donor is not known - which constellation is the worse?

To remove organs from a dead person who might not have wanted it during his lifetime?

Or having to deny a person the life-saving organs even though a deceased person would actually have been willing to donate.

Time to take responsibility

This question is answered every day in Germany at the expense of the seriously ill. It is time for the state to take responsibility for this and to follow the example of other countries. With the contradiction rule nobody is forced to donate.

It is also time that each individual took responsibility for what should happen to his or her body after death. Even if the thought of dying is uncomfortable and frightening - ticking the “yes” or “no” box on an organ donor card can be expected of every responsible citizen.