Organ and tissue donation law in Scotland

Deemed authorisation

The Human Tissue (Authorisation) (Scotland) Act 2019 was passed by the Scottish Parliament in July 2019. The legislation provides for a 'deemed authorisation' or 'opt out' system of organs and tissue donation for transplantation. The system came into effect on 26 March 2021.

The opt out system will apply to most adults aged 16 and over who are resident in Scotland, but it will not apply to everyone.

Under the opt out system, if you die in circumstances where you could become a donor and have not recorded a donation decision, it may be assumed you are willing to donate your organs and tissue for transplantation.

Your family will always be asked about your latest views on donation, to ensure it would not proceed if this was against your wishes.

You still have a choice

You still have a choice if you want to be a donor or not.

The best way to record your donation decision is by registering either an opt-in or opt-out decision on the NHS Organ Donor Register.

Whatever you decide, share your decision with family and friends, as they will still be involved in the donation process.

Knowing what you would want to happen makes it easier for your family or friends and helps them to honour your decision.

Excluded groups

See which groups are excluded

Under the new system there will be protections for:

Adults without capacity to understand the deemed authorisation law
Adults who have lived in Scotland for less than 12 months before their death
Children under the age of 16

If a person in one of these groups set out by the law dies in a way that means they could donate, and they haven’t already recorded a donation decision, then their closest family member will be asked whether they wish to authorise donation.

Medical tests and procedures

Get information about routine tests and procedures

As part of the donation process, certain routine medical tests and procedures may be carried out shortly before death. These can only take place if they will help doctors to check that transplantation is likely to be safe, successful and a suitable match for somebody on the transplant waiting list. Without these tests donation may not be able to proceed.

These typically include blood tests, urine tests and x-rays. These are a routine part of the donation process and if you haven’t opted out of donation it will be assumed that you are willing for them to be carried out. These medical tests and procedures will always be discussed with your family before they are carried out.

On very rare occasions there may be a need to carry out further, more invasive medical tests and procedures, but only if the routine medical tests and procedures would not give enough information for a safe and successful transplant.

However, it won’t be assumed that you agree to these procedures, which means they will only go ahead with your family’s agreement.

More information about what these tests and procedures involve

What do I need to do?

Record your donation decision on the NHS Organ Donor Register
Tell your family and friends what you have decided

Your choices

Register to become a donor

If you want to be a donor, you should register to be a donor (opt in) on the NHS Organ Donor Register.

Register not to become a donor

If you do not want to be a donor, you can register not to be a donor (opt out) on the NHS Organ Donor Register.

If you don't record a donation decision

If you don't record a donation decision (opt in or opt out) it may be assumed that you are willing to become a donor.

Updating your details or decision

If you have already registered a donation decision, you can update your personal details, reaffirm your decision or update your decision on the NHS Organ Donor Register.