Donor registration after the 2020 law
Since 1 July 2020, if you never respond to two letters from the government, you are registered as a potential organ donor by default. That is the practical effect of the switch from an opt-in to an opt-out system, set out in the Donorwet (Donor Act, formally the Wet op de orgaandonatie as amended): every adult resident registered with a Dutch municipality is asked, in writing, to record a choice in the Donorregister (donor register). Anyone who does not respond to two letters from the government is registered as "geen bezwaar tegen orgaandonatie" — "no objection to organ donation" — and treated, on death, as a potential donor.
This explainer covers what the four registration options actually mean, how the system works in practice, what the most recent numbers show, and how to check or change your own status.
The four options
When you register at mijn.donorregister.nl with DigiD, or by paper form, you choose one of four options.
- Ja, ik geef toestemming. Yes, I consent to organ and tissue donation after my death. You can specify all organs and tissues, or limit your consent to particular organs.
- Nee, ik geef geen toestemming. No, I do not consent to donation. This is binding. The family cannot reverse it, and doctors cannot override it.
- Mijn partner of familie beslist. My partner or family decides after my death. The decision is delegated to the people closest to you.
- Een specifiek persoon beslist. A specific person, named by you, decides after my death.
If you do not actively choose any of these, the register lists you as geen bezwaar — "no objection" — and treats you as a donor. This is the default that the 2020 law introduced, and it is the most common source of confusion. "Geen bezwaar" is not a fifth option; it is what happens when you make no choice at all.
What the law actually changed
Before July 2020, only those who had explicitly registered as donors were considered donors; everyone else's case was decided by the family. The opt-out system reverses the default but preserves the registration channel. Those who actively register as donors are still recorded as such. Those who actively register a "no" are still respected. The change affects the previously unregistered group — historically the majority of the adult population — by giving them a registered status whether or not they responded to the letters.
The Rijksoverheid notes that active registrations in the Donorregister rose by more than 50% in the years after the law took effect. Many people who had ignored the question for decades took the opportunity to make a deliberate choice — including, for many, a deliberate "no."
What the numbers say
According to the Donorregister's own statistics, as of 1 May 2026 the register holds 14,128,941 people [verified via donorregister.nl]. The breakdown:
- Yes, willing to donate: 4,756,989
- No, unwilling to donate: 4,380,802
- Family decides: 1,489,920
- No objection (default): 3,501,230
Specific-person delegation is a smaller category included in the totals. The number of people who have actively chosen "no" is now roughly equal to the number who have actively chosen "yes" — a striking finding, and a reminder that the opt-out system is not the same as universal consent.
For transplantation outcomes, the Nederlandse Transplantatie Stichting (NTS) publishes annual figures on actual donations and transplants. Specific 2025 numbers are available via their dashboards [unverified — NTS dashboard not directly fetched in this draft]. A single organ donor can save up to eight lives; a tissue donor can help up to fifty people.
How to check or change your registration
You can review and change your choice at any time, free of charge, as often as you like.
- Go to mijn.donorregister.nl and log in with DigiD.
- Or request a paper form via donorregister.nl and return it by post.
Your most recent registration is the one that counts. There is no waiting period and no need to involve a notaris, a doctor or a witness. If you change your mind tomorrow, the register reflects that tomorrow.
It is worth checking your status even if you think you know it. People who registered before 2020 sometimes assume their choice transferred unchanged; people who never registered sometimes assume their silence still means "decision deferred to family." Neither assumption is reliable. The screen at mijn.donorregister.nl shows what the hospital will actually see.
What happens at the hospital
Organ donation is only possible in narrowly defined medical circumstances — most often, when death has been declared in an intensive care unit while the body is on life support. Tissue donation (cornea, skin, bone, heart valves) is possible in a wider range of settings, including death at home, within a few hours.
When death occurs in hospital, staff check the Donorregister. If donation is possible, they discuss the procedure with the family. The family is informed of the registered choice; they cannot override it. If the registration is "geen bezwaar" or "family decides," the family's decision is sought at that moment.
After organ retrieval, the body is restored and handed over to the uitvaartondernemer (funeral director). The funeral can usually proceed within the normal time frame, sometimes with a delay of hours rather than days.
Why telling your family still matters
A registered "yes" is binding. A registered "no" is binding. But the moment when these choices are acted on is one of the hardest a family will face. Knowing in advance what you chose, and why, removes a question they would otherwise have to answer in the worst hour of their lives.
This is true even if your registration delegates the decision to them. Family members asked to decide for the first time, with no preparation, often defer to "no" out of caution. A short conversation, years earlier, changes that.
In the app
In the Personal Portal you record your current donor registration status alongside your other medical decisions, with a link to mijn.donorregister.nl to verify or update it. Your family sees the choice — and the reasoning — when they need it.
Closed beta — access by invitation.
Sources
- Donorregister — official register, registration tool and current statistics. https://www.donorregister.nl
- Rijksoverheid — orgaandonatie information, including the 2020 Donorwet. https://www.rijksoverheid.nl/onderwerpen/orgaandonatie
- Nederlandse Transplantatie Stichting (NTS) — transplantation and donation statistics. https://www.transplantatiestichting.nl