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HEALTH

What Germany’s new digital organ donation register means for residents

Germany is rolling out an online registry for peoples' preferences regarding organ donation. How is it supposed to work?

Published: 18 March 2024 15:09 CET
Organ donation card
An organ donor card, held at the Ministry of Health. An online register for citizens' declarations of willingness to donate organs allow doctors to access an patient's preferences even when the 'Organspendeausweis' is not available. Photo: picture alliance/dpa | Michael Kappeler

A central registry for organ donation was launched on Monday, which allows users to save their preferences online and more easily update them in the future.

According to surveys, the majority of people have a positive attitude toward organ donation after death. But when it comes to officially opting-in as an organ donor in writing, many people hesitate. 

Those in support the new registry hope that it will ensure that medical professionals can more readily identify a patient’s organ donation preferences.

How does organ donation in work Germany?

Last year, 965 people donated one or more organs after their death. That was 96 more than in 2022 (a year in which donations had declined), according to the German Organ Transplantation Foundation.

However, there were almost 8,400 people on the waiting lists for a transplant during the same period.

In order for organ donation to be considered at all, two specialists must independently confirm the complete and irreversible failure of the cerebrum, cerebellum and brain stem, i.e. brain death.

Germany is an “opt-in” country regarding organ donation. This means that individuals need to explicitly register their consent to be organ donors, usually with their physicians.

In contrast, under “opt-out” systems for organ donation, individuals are considered eligible organ donors unless they register to be remove their consent.

Research has shown that opt-out consent systems dramatically increase the number of successful organ transplants performed each year, and reduces waiting list numbers.

READ ALSO: Dead Olympic coach saves 4 lives with organ donations

Sweden, Luxembourg, Bulgaria, Greece, Iceland and all regions of the UK are among European countries that have an opt-out system in place. Spain is an example of a hybrid model in which the country operates with “presumed consent” but families are also consulted and have the final say.

Making the switch to an opt-out organ donation system was a topic of debate in Germany in 2020, but ultimately the Bundestag voted against it.

Instead the Bundestag passed an initiative by a group of MPs, and led by current Foreign Minister Annalena Baerbock (Greens), to “strengthen the willingness to make decisions in organ donation”.

To this end, anyone who applies for an identity card from the age of 16, renews it after 10 years or obtains a passport should receive information about registering as an organ donor. Family doctors are also encouraged to inform patients about organ donation every two years in an open-ended manner.

Additionally, the new online registry has been created.

Why is it important to have a digital database?

Ultimately, the new registry aims to make it easier for doctors to quickly and reliably clarify a possible willingness to donate.

A decision can still be documented on a piece of paper, in a living will or on organ donor cards, which are available in doctors’ offices, pharmacies and for download from the Internet.

But while papers and cards often can’t be found in an emergency, an entry in the digital registry provides clarity and security, argues Health Minister Karl Lauterbach (SPD). “Above all, it relieves relatives of the burden of making a difficult decision in an emergency.”

When no decision has been formally expressed by the deceased, spouses, adult children or siblings are consulted.

How do I register?

The portal, which has been set up by the German Institute for Drugs and Medical Devices, can be found at www.organspende-register.de.

From Monday, it will be possible to register there with an ID card that has an online function (eID). Since 2017, all residence permits and personal ID cards in Germany have been issued with an electronic chip containing your personal data. 

By July 1st, clinics that remove organs will be able to search for and retrieve declarations in the registry. By September 30th, it should also be possible to register via health insurance apps. This is important because some people’s ID card may not be activated (although you can do that if you wish do – more details here.

READ ALSO: How German health insurance costs are set to rise from 2024

You can register voluntarily from the age of 16. Registrants may choose from five options:

  1. “Yes, I allow organs and tissues to be removed from my body after the medical determination of my death”;
  2. “Yes, I allow this, with the exception of the following organs/tissues”;
  3. “Yes, I allow this, but I only want to release certain organs/tissues for donation”;
  4. “My next of kin shall then decide on yes or no”;
  5. “No, I object to the removal of organs or tissues.

Entries can be changed or deleted. Whether on paper or digitally, the most recently selected preference is applied.

With reporting by Paul Krantz

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

Published: 23 April 2024 12:55 CEST
How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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