Understanding consent for organ donation

Consent is the permission given for something. This page outlines how consent (or authorisation in Scotland) for organ donation after death is established. Please select a category below.

How is consent for organ donation established?

Organ donation can only go ahead with your consent and/or the support of your family

If you die in circumstances in which organ donation is possible, NHS specialist nurses will try to establish:

1. Your decision

The NHS Organ Donor Register is available 24 hours a day, seven days a week. A specialist nurse will check the Register to see if you have recorded a decision. They will then talk to your family.

If you have not recorded an organ donation decision, the starting position for adults in England and Wales is that donation should go ahead.

There are different organ donation systems in place across different countries within the United Kingdom. Get information about the law where you are

Your family will always be asked to support your decision before organ donation goes ahead, and clinicians will never proceed if your family objects.

2. The support of your family

Organ donation will always be discussed with your family if donation is possible. A specialist nurse will work with your family to explore your last known decision and help your family to support this.

Watch our video to see how your family is involved

The best way to make sure your decision is supported is to register it on the NHS Organ Donor Register and talk to your loved ones.

Your family will have the opportunity to provide any additional or more recent information about your decision, and this will always be respected.

If you have not recorded an organ donation decision, the specialist nurse will speak to your family about organ donation as a possibility. If you want to donate, but your family don’t know this, they could overturn your decision. So, talk to them and leave them certain.

How is consent established for children?

If someone under the age of 18 dies in England, their parents would be approached about organ donation and given the opportunity to consent on their child’s behalf. Organ donation would only go ahead with the agreement of the family. 

The deemed consent, or 'opt out' system in England does not apply to children. 

If there was a decision recorded on the NHS Organ Donor Register, this information would be shared with the family. Anyone can register an organ donation decision at any age.

Get more information about the NHS Organ Donor Register

Is carrying an organ donor card a form of consent?

Carrying an organ donor card is a valid form of consent but it is possible that your donor card might not always available to specialist nurses trying to establish your decision.

For this reason, we would always recommend that you register your decision on the NHS Organ Donor Register and talk to your loved ones about the decision you have made.

Should I include organ donation in my will?

By the time your will is read it's likely to be far too late for you to become a donor.

The best way to ensure that what you want to happen is supported after your death is to register your decision on the NHS Organ Donor Register, and talk to your loved ones.

Which organs and tissue are included in my consent?

When you register a decision to donate, you will be asked whether you want to donate some or all of your organs when you die. You can choose to donate your heart, lungs, kidneys, liver, corneas, pancreas, and small bowel. You also have the opportunity to donate tissue. These are all considered routine transplants, and only routine transplants are included under the deemed consent or opt out system in England. 

By selecting to donate all your organs and tissue, you may be able to help up to nine people through organ donation, and even more through tissue donation. 

This information will be available to specialist nurses when they review your record and your decision around donating specific organs and tissue will always be respected.

Non-routine transplants

The current system for organ donation in England does not cover rare or novel transplants such as limb, face or uterus donation. This kind of transplant is not routine and would require specific agreement from your family.

Can I change my mind?

Yes, you can change your mind at any time. If you have recorded an organ donation decision on the NHS Organ Donor Register and want to update your details, change or reaffirm your decision, you can complete the Amend your details form or call 0300 123 23 23.

Can someone make an organ donation decision for me?

If you don't want to make an organ donation decision yourself, or if you have specific instructions, you can appoint someone to make that decision for you.

If you die in circumstances where donation is possible, the person you nominate as your representative will be asked if your organs should be donated.

The nominated representative registration process requires physical signatures from you, your nominated representative(s) and a witness.

Nominate a representative now

What if I do not have a family to support my decision?

If organ donation is a possibility, medical staff will do everything they can to find family members. If no family members are available, a friend of long standing can be consulted.

The Human Tissue Authority (HTA) have set out Codes of Practice, which include a list of those who should be approached about organ donation. This starts with your family, then includes friends and care workers who will have known you and may be able to speak for you.

The NHS has a duty to consider the safety of any organs for transplant. This is why speaking to the family, or someone else appropriate, about medical and lifestyle history is so important.

If you do not have family to support your decision, you can nominate a representative who will be asked if your organs should be donated.

If you have no family or friends available, organ donation may still go ahead if your decision to donate your organs is registered on the NHS Organ Donor Register.

If you have no family or friends available, have not registered a decision to donate your organs and a deemed consent or ‘opt out’ system applies where you live; organ donation will not go ahead.

If you have no family or friends available and have registered a decision not to donate your organs, this decision will be honoured.

What if my family object to my organ donation decision?

If your family, or those closest to you, object to donation even when you have given your permission (either by telling relatives, friends or clinical staff, by joining the NHS Organ Donor Register or by carrying a donor card) healthcare professionals will discuss the matter sensitively with them.

They will be encouraged to support your decision and it will be made clear that they do not have the legal right to veto or overrule your decision. There may, nevertheless, be cases where it would be inappropriate for donation to go ahead if donation would cause distress to your family.

Can I donate my organs or body to medical research?

You can donate some organs and tissues for research purposes if other organs and tissues are taken for transplantation. We can only use your organs and tissue for research after you die if they are not suitable for transplant and we get permission from you or your family. Donating organs for medical research is not part of the deemed consent or opt out system for organ donation in England.

Donating your whole body for medical research

To find out more information about whole body donation for research purposes please contact the appropriate organisation for where you live using the links below.

Whole bodies are not accepted for teaching purposes if organs have been donated or if there has been a post-mortem examination.

Donating your whole body for medical research is not part of the deemed consent or opt out system for organ donation in England.

England, Wales and Northern Ireland

Get the latest advice and guidance from the Human Tissue Authority


Get the latest advice and guidance from the Scottish Government

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