

I live in Flanders, Belgium and we have an opt-out system of sorts. Everyone is a donor, unless official objections were made. That sounds great, but doctors need to ascertain if there are no objections, even informal ones.
So it kind of boils down to doctors still having to ask your next of kin. But - according to data from UZ Leuven, one of our biggest hospitals - asking ‘are there any objections to the normal course of events’ works better than ‘do you wish to donate you loved ones organs’. Especially during a time of grief. It says Belgium has about 30 donors per million, whereas Germany and The Netherlands have about 15. (Data from 2024)
Because of this system you can still also officially state that your organs are to be donated if possible. And apparently you can do so from the age of 12 onwards. If you do so, no questions are asked and no one is able to object.
Tl;dr In Belgium we have an opt-out system, but it’s not bulletproof. And it doesn’t result in an enormous amount of donations. There are still waiting lists, though there are more donations than in some of our neighbouring countries. Reality is messy!
That’s not even a nice way to get salmonella poisoning.