Donor Registration

Imagine: your next of kin are facing one of the most difficult moments of their lives. They have to say goodbye, and then the question of organ donation also comes up. Do they know what your wish is? Donor registration is a topic that many people keep putting off. Understandable, because thinking about your own death simply isn't the most enjoyable conversation topic. Yet it's one of the most valuable choices you can make. Not just for people on the waiting list, but also for your own loved ones. In this guide, you'll read exactly how the Donorregister works, what choices you have, and what you can still do today.

What exactly is the Donorregister?

The Donorregister is a national database that records whether you want to donate organs and tissues after your death to patients who are urgently waiting for them. Think of organs such as the heart, kidneys, lungs, liver, pancreas, and intestines. But also tissues: blood vessels, bone tissue, heart valves, cartilage, tendons, skin, eye tissue, and nerve tissue. So it involves much more than just the well-known organs.

The register falls under the Organ Donation Act, which was drastically amended in 2020. Since that legislative change, everyone in the Netherlands is automatically listed in the Donorregister as soon as they turn 18 and are registered with a Dutch municipality. Shortly after your 18th birthday, you receive a letter from the government requesting you to record your choice. If you don't fill anything in? Then you'll eventually end up in the register with the entry 'no objection to organ donation'. In practice, this means your organs and tissues can go to a patient after your death.

That's something to be aware of: doing nothing is also a choice. And that choice has consequences.

What choices do you have?

In the Donorregister, you can choose from four options. Each option has different consequences for what happens after your death.

Yes, I want to become a donor. You indicate that your organs and tissues are available after your death. With this option, you can also be more specific: you can indicate exactly which organs and tissues you do want to donate and which you don't. Maybe you want to donate your kidneys, for example, but not your eye tissue. You can record that nuance.

No, I don't want to become a donor. You indicate that you don't want to give up any organs or tissues after your death. This choice is clear and definitive. Your next of kin can no longer change this.

My partner or family decides after my death. You consciously leave the choice to your loved ones. If your partner is reachable and present at the hospital, the doctor discusses the choice with your partner. If there's no partner, your family decides. If your loved ones disagree among themselves? Then the donation doesn't go ahead.

A specific person decides after my death. You designate someone who makes the decision after your death. This can be a friend, family member, or someone else you trust.

In addition, you can separately indicate whether your organs and tissues may potentially be used for scientific research, if transplantation turns out not to be possible for whatever reason.

What does 'no objection' actually mean?

This is perhaps the most confusing part of the current donor law, and the point where a lot of confusion exists. If you don't fill in an active choice in the Donorregister, you're automatically registered as 'no objection to organ donation'. In practice, this comes down to the same thing as 'yes', with one important difference: you didn't make that choice yourself.

An evaluation of the donor law shows that more than three million Dutch people are currently registered as 'no objection' in the register. About half of them consciously chose this. But the other half simply never made a choice, are still in doubt, or actually want to leave the choice to loved ones.

For next of kin, this can create a difficult situation. They see in the register that it says 'no objection', but they don't know whether that was a conscious choice. The doctor always discusses this with the family. If loved ones can demonstrate that the deceased presumably didn't want to donate, the donation can still not go ahead. But that places an enormous burden on the shoulders of people who are already in a vulnerable situation.

This is precisely why it's so important to make an active choice yourself, whatever choice that may be.

How do you record your choice (or change it)?

Recording or changing your choice is fortunately very simple and only costs a few minutes.

Online via donorregister.nl. This is the fastest way. You log in with DigiD and can immediately fill in or change your choice. It's sorted within a few clicks.

Via a paper form. Not very digitally inclined? No problem. You can pick up a donor registration form at your municipality or at a library nearby. You can also request the form by phone from the Donorregister.

Important: you can always change your choice. Do your insights or circumstances change? Then you simply adjust your registration. The most recent choice is always the valid choice. There's no limit to how often you can adjust your registration.

Good to know is also that young people from age 12 can already voluntarily fill in a choice. Children between 12 and 16 can choose, but parents can still block a 'yes'. From age 16, you decide entirely for yourself.

Donor registration and your funeral: how does that work?

This is a point that not everyone realises: organ donation is only possible if you pass away in a hospital. If someone dies at home, on the street, or somewhere else outside the hospital, then organ donation is not an option. The organs need to remain supplied with blood until the transplant, and that's only possible in a hospital setting.

Only when a doctor determines that a patient can no longer recover and will die within a few hours, may the doctor consult the choice in the Donorregister. Doctors always first do everything they can to save someone's life. Your registration in the Donorregister has absolutely no influence on that.

After an organ donation, the body simply returns to the next of kin. The doctors ensure that the body looks well cared for. Next of kin can say goodbye in the usual way and arrange the funeral as they wish. Organ donation therefore does not stand in the way of a dignified funeral.

The operation in which organs are removed takes on average about six hours. With tissue donation, this can take longer. After six to eight weeks, the organ donation coordinator contacts the next of kin (if they wish) and shares which organs were successfully transplanted. This always happens anonymously.

Practical tips to take action today

Knowing is one thing, but you only make the difference when you actually take action. Here are a few concrete steps you can take right away.

Check your current registration. Go to donorregister.nl and log in with your DigiD. See how you're currently registered. Maybe you're already listed as 'no objection' without knowing it.

Make a conscious choice. It doesn't matter which choice you make, as long as it's your choice. 'No' is just as valid as 'yes'. What matters is that you've consciously thought about it.

Talk about it with your loved ones. This is perhaps the most important tip. Even if your choice is clearly recorded in the register, it's incredibly valuable if your partner, parents, children, or good friends know how you feel about it. That makes a difficult moment just a little more bearable for them.

Include it in your funeral wishes. If you're already working on recording your wishes around your funeral, then also include your choice about organ donation. That way everything has its place and your loved ones know exactly where they stand.

Educate yourself even if you're in doubt. On orgaandonatie.nl and on the website of the Dutch Transplant Foundation, you'll find extensive information, frequently asked questions, and personal stories that can help you make a choice.

Don't be afraid because of health issues. Many people think they don't qualify as a donor because they have an illness or use medication. That's not true. Whether someone is suitable as a donor can only be assessed by doctors at the time of death. So you can always fill in a choice, regardless of your health situation.

Conclusion

Donor registration is not an administrative formality. It's a personal choice that can have a major impact on the lives of others, and on the peace of mind of your own loved ones. Whether you wholeheartedly say 'yes', consciously choose 'no', or leave the decision to someone you trust: the most important thing is that you make that choice consciously and discuss it.

Take some time today to check your registration at donorregister.nl. It costs you five minutes at most, but it can save your loved ones a lot of uncertainty at a moment that's already hard enough.

And do you want to get all your wishes around your funeral sorted right away? Compare funeral insurance here and make sure your loved ones won't face any surprises down the road.