For or against? What does the law say about organ donation in Belgium?

Since June 13, 1986, Belgium has had legislation governing organ donation based on the principle of presumed consent. This means that, unless a person has expressed a different wish, they are considered a potential organ donor after death.

To ensure that personal wishes are respected, individuals are encouraged to register their decision—whether they wish to donate or refuse donation. Discussing these wishes with family members can also help prevent misunderstandings at a difficult time.

The legislation aims to increase the availability of organs and human body material (such as heart valves, corneas, skin, and bones) for transplantation while respecting the rights and choices of every individual.

The main aspects of the law are:

1. Presumed Consent
   Any person officially registered in Belgium (either in the population register or for at least six months in the foreign nationals register) may become an organ donor after death unless they have explicitly registered their refusal during their lifetime.
2. Registration of Consent or Refusal
   Citizens can record their wishes regarding organ and human body material donation in three ways:
   • Online via Masanté.be
   • Through their general practitioner
   • At their local municipal administration
   Individuals can choose to consent to or refuse donation after death, and may also specify preferences regarding certain types of donation.
3. Four Donation Options
   Registration allows people to choose whether they wish to donate:
   • Vital organs, including the heart, lungs, liver, kidneys, pancreas, and intestines, to save or improve lives.
   • Human body material (such as heart valves, corneas, skin, and bones) for transplantation into another person.
   • Human body material for the development of innovative therapies, supporting the creation of new treatments and medicines for diseases such as Alzheimer’s disease and certain cancers.
   • Human body material for scientific research, allowing researchers to study tissues such as tumors, diseased liver tissue, cancer cells, or lymph nodes to better understand diseases and develop future treatments.
4. Role of the Family
   Although consent is presumed, if the deceased person has not officially registered a decision, the medical team consults the family to determine whether they know the person’s wishes. If the family provides evidence that the deceased opposed donation, the donation will not proceed.
5. Donation by Minors
   For minors, consent from a parent or legal guardian is required for organ donation. Parents or legal guardians may also register a refusal on behalf of the child. Once the child reaches adulthood, they may register their own decision.
6. Transparency and Anonymity
   Organ donation in Belgium is anonymous and unpaid. Donor and recipient families generally do not know each other’s identities, and no financial compensation is involved.
7. Medical Costs
   All medical and pharmaceutical costs related to organ donation are covered by the healthcare system. They are not paid by the donor’s family.

Key Figures (Belgium)

• 1,453 patients were on the active organ transplant waiting list on January 1, 2024.
• 1,045 new patients were added to the waiting list during 2023.
• 1,060 organ transplants from deceased donors were performed in 2023.
• 11,754,000 inhabitants in Belgium (approximate population).