In the UK in the year to 31 March 2007, 440 people died waiting for a donated organ (UK Transplant, personal communication). At the same time bodies were buried or cremated intact—it seems likely that this was not because those people objected to donating their organs but simply because they never got around to making their wishes known. Surveys show that 90% of the UK population support organ donation,1 yet our current law assumes, when people die, that they are in the minority who do not wish to donate. By changing the default position to presumed consent—assuming people want to donate unless there is evidence to the contrary—we can help save and transform more lives while respecting the wishes of those who want to donate and protecting the rights of those who do not.

Although 90% of the population support donation, only 23% have registered their wish to donate,2 and so the decision falls to the …