Wishes about organ donation and the twist in advance care directives.

Operation being performed
Photo by Engin Akyurt on Unsplash

In Australia, your advance care directive wishes about organ donation won’t be followed if you haven’t taken one crucial extra step.

You need to register your donation at, even though you’ve clearly stated in your advance care directive that you want to donate your organs.

DonateLife explains.

It seems a little surprising that this clear wish can be overruled. But a spokesperson for DonateLife explained.

“There are a number of reasons a family might over-ride a registration. Sometimes the family can’t accept that death has occurred and sometimes the family is adamant that their loved one had changed their mind about donation,” she said.

“Medical professionals always keep in mind the family who is grieving and their coping mechanisms.”

Allowing family over-ride is standard practice in most countries in the world, including Spain, which is the world leader in organ donation.

“In the hospital, most families say yes to donation if you are registered – the trend is 9 out of 10 – and they know what you want. This number drops dramatically to just 4 out of 10 if they don’t know,” the spokeswoman said.

“By registering and talking to your family about organ and tissue donor, your family knows what you want at the end of your life.”

There are two steps to take to register wishes about organ donation.

It takes about one minute to get the job done. You just need your Medicare card or you can do it through MyGov.

So if you want to donate your organs, take these two steps:

  • First, register as an organ and tissue donor at This can be done in three taps on your Medicare app.
  • Second, let your family know you want to be a donor.

There are currently around 1,800 people on the organ waitlist who need Australia’s help. This includes around 70 people waiting for life-saving heart and 1,450 people waiting for a kidney.

Your driver’s licence is no longer the place to register wishes about organ donation.

It doesn’t feel that long ago since we just ticked a box on our driver’s licence to register for organ donation. But the ability to register was taken off the driver’s licence back in 2005. South Australia is the only Australian state to retain it.

This was removed because it was difficult for donor coordinators to obtain donation information from each state and territory. So the national system was developed – the Australian Organ Donor Register.


To register for organ donation, go to:

1 minute for a lifetime - register for organ donation at

And whether the discussion is about organ donation or something else relating to end-of-life, it’s best to make sure that your advance care directive contains no surprises for your family, or those who will be expected to implement it.  

This means end-of-life conversations are important.

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