Even the draft laws look unusual. Long lists of names fill the first one and a half pages of printed matter 19/11096 and 19/11087. The deputies who support the respective draft are listed, and not only are there very many, they also belong to different parties. Next Thursday, a vote will be taken on the reform of organ donation. Without party discipline.
Two bipartisan drafts are available. The "double contradiction in the Transplantation Act" and the law "to strengthen the willingness to make decisions regarding organ donation". The first draft is that of the Minister of Health. Together with his colleagues, Jens Spahn (CDU) campaigns for everyone to be considered an organ donor in the future – unless "there is a declared contradiction or a will opposing the removal of organs or tissues". A register is to be created for the documentation of the declarations. Except for minors, the relatives are "not entitled to make their own decisions". They should only be asked if they know of a contradiction.
Representatives of doctors pretty much prefer a concept
The alternative is the draft by the Green MP Annalena Baerbock and her supporters. In their draft, the group demands that organ donation "be maintained as a conscious and voluntary decision that must not be enforced by the state". An online register is to be set up in which citizens can submit their declaration. In addition, anyone who applies for an ID card or passport should be given information on organ donation and be able to submit their declaration directly on site – or later at home, using an access code.
Because the factional pressure is lifted, the deputies decide according to their conscience. This leads to the party-politically colorful lists of names among the draft laws. The SPD health expert Karl Lauterbach helped develop Spahn's draft, while the former CDU health minister Hermann Gröhe is in favor of Baerbock's proposal. Former Health Minister Ulla Schmidt (SPD) is also in favor of this model. Spahn supports the clear majority of incumbent ministers with Bundestag mandates: Hubertus Heil (SPD), Anja Karliczek (CDU), Helge Braun (CDU), Gerd Müller (CSU), Andreas Scheuer (CSU), Heiko Maas (SPD). The Chancellor is also in favor of resolving the objection. Justice Minister Christine Lambrecht (SPD), on the other hand, rejects the contradiction solution.
While the Greens are fairly united in supporting the Baerbock proposal, the FDP and Linke are spread across both camps. President of the Bundestag, Hermann Otto Solms (FDP), for example, wants a solution to the opposition, while FDP parliamentary group leader Christian Lindner wants to strengthen the willingness to make decisions. Left-wing party leader Katja Kipping is on the Baerbock list, while group leaders Amira Mohamed Ali and Dietmar Bartsch are on the health minister's list. The AfD in turn has submitted its own application.
Spain is a role model for advocates of a contradiction
Beyond the Bundestag, Spahn has many supporters in the health experts' camp. The German Transplantation Society, for example, considers the contradiction solution to be promising, as do the specialist societies of pulmonary doctors, kidney doctors, urologists, intensive care physicians and emergency medicine specialists, the Federal Medical Association, the German Organ Transplantation Foundation (DSO), which is responsible for coordinating organ donation, and the Eurotransplant Foundation, which distributes the organs.
In the past few days, the two Bundestag camps have once again vigorously campaigned with their colleagues for their respective positions – above all for the undecided MPs. "Silence should not be seen as approval," says a letter from the Baerbock Group. For relatives, the solution to the objection could be even more burdensome than the status quo; they would have no way "to prevent an intervention in the body of a loved one unless the deceased has explicitly declared his resistance to organ donation throughout his life".
Spahn, on the other hand, emphasizes in his letter that other European countries have had good experiences with the contradiction solution. There the social attitude "changed fundamentally", a "culture of organ donation" developed. The decision-making solution, on the other hand, is "medicine that has not yet worked". More addressing, clarification and information alone was not enough.
Spain is the model country for the proponents of a contradiction solution. Today, with around 35 donors per million inhabitants, it is one of the international leaders. But: The contradiction solution was introduced there in 1979, but the number of donors only increased ten years later when the organ donation was structurally reorganized in the clinics. In Sweden, on the other hand, the contradiction solution has been in effect since 1996, whereupon the donor quota fell for the time being and is still rather low compared to Europe, with just under 18 donors per million inhabitants. In their letter, the group led by Annalena Baerbock argues that the key to higher donor numbers is not the contradiction solution, but a smooth organization in the clinics.
In the European network, Germany contributes the least number of organs
The introduction of the contradiction solution is not a panacea, says the German cardiac surgeon Bruno Meiser, board member of Eurotransplant, but an important signal. For the people in the country because it makes organ donation normal, but also for the other European countries. "All other seven Eurotransplant countries have now established the contradiction solution," says Meiser. Germany is at the bottom of the group with its low organ donation figures of currently 11.2 donors per million inhabitants. In 2019, German patients received seven pancreases, 92 kidneys, 20 hearts, 32 lungs and 52 livers from abroad; But Germany can hardly ever help with an organ. In addition, accompanying measures are important, emphasizes Meiser, as passed by the Bundestag in April 2019 with the amendment to the Transplantation Act. This is already showing first signs of success: At the beginning of the week, the DSO reported that hospitals had contacted her more in the past year in order to realize organ donations. In fact, the sharp decline in organ donation in Germany in recent years has been blamed less on the reluctance of the population than on the reluctance of hospitals to try to donate organs.
Spahn said Tuesday Süddeutsche Zeitung, so many patients would die every year "who have waited hopelessly for a donor organ in vain with hope and despair. They die because we do not have the courage to break new ground. I think we owe it to the sick that everyone deals personally and bindingly with the subject of organ donation. " Baerbock also sees a need for action. Too many people were still waiting for a suitable donor organ, she told the SZ. "Our proposal for the recurring survey when applying for ID starts right here. It increases the number of potential organ donors, respects our constitution and upholds the personal decision of each individual." There are great constitutional concerns with the opposition regulation. "It wouldn't help anyone."
. (tagsToTranslate) Health Policy (t) Jens Spahn (t) Organ Donation (t) Politics (t) Süddeutsche Zeitung