You'll know exactly how to manage your donation status so the state doesn't decide for you by the time you finish this guide. Since July 2020, every person over 18 who has lived in the Netherlands for at least three years is included in the national database. It's a frequent topic in the Kennis van de Nederlandse Maatschappij (KNM) exam. If you haven't taken the time for the donorregister nederland keuze invullen (filling in a choice in the Netherlands donor register) process, you're already registered as a donor by default. This doesn't mean you're forced to donate, but it shifts the responsibility of stating a refusal onto you.
The new 'Geen bezwaar' law
The law changed to increase the number of available organs for life-saving transplants across the country. Previously, if you did nothing, you weren't considered a donor. Now, the system assumes geen bezwaar (no objection). This means if you die, a doctor can use your organs unless you've specifically stated otherwise in the system. You should've received a letter from the government about this change when you first registered at your home address. If you ignored that letter and a follow-up reminder sent after six weeks, the status geen bezwaar was applied to your name automatically. This legal change affects everyone living here, including those here for work or long-term study.
Learning how Dutch society handles individual rights and collective health is a core part of your civic integration. The government wants to make donation the default to save lives in various hospitals. However, they also respect your right to refuse at any time. You can change your status whenever you want, even years after your arrival in the country. If you move to a different city, your registration follows you because it's linked to your BSN (Citizen Service Number). Don't assume that an old donor card from your home country has any legal weight here. Only the national register counts when you're in the care of a Dutch medical team.
Review the four choices in the register
You've four specific options when you register your decision regarding your body. The first choice is Ja, ik geef toestemming (Yes, I give permission). You can list which organs you want to give or simply select all of them with one click. Alternatively, you can select Nee, ik geef geen toestemming (No, I do not give permission). This is a clear refusal that doctors must respect regardless of the situation. Another possibility is letting your nabestaanden (next of kin) decide at the moment of your death. Finally, you can name one specific person who'll make the final call for you. This person must be informed by you beforehand so they know they carry this responsibility.
Log in with DigiD at donorregister.nl
The easiest way to set your preference is through the official website. You'll need your DigiD (digital identity) to log in to the secure portal. This system verifies your identity to prevent anyone else from changing your medical preferences without your knowledge. Once logged in, the system shows your current status immediately for you to review. Many people assume they're already listed as "No" because they haven't signed a physical card in the past. It takes less than 12 minutes to update your profile and save your choice. If you don't have a DigiD, you can request a paper form from your local gemeente (municipality) office.
Specify which organs or tissues you want to exclude
You don't have to donate every part of your body. The register allows you to pick and choose specific parts that you feel comfortable sharing. You might be fine with donating your heart but not your skin for personal reasons. Perhaps you want to exclude your eyes or certain tissues. The list includes the liver, kidneys, lungs, pancreas, and various tissues like bone or heart valves. This level of control helps people who've religious reasons for keeping certain parts of their body intact. Be specific when you fill out the digital form on the website. Clear instructions prevent your family from having to guess what you wanted during a difficult time.
The final talk with the family
Doctors never take organs without talking to the family first. This is a standard medical procedure in every Dutch hospital to ensure transparency. Even if you're registered as having no objection, the doctor will sit down with your partner or children. They'll explain the situation and check if the family knows about any recent changes in your wishes. If your family is certain you didn't want to be a donor despite what the register says, they can explain this to the medical team. They must have a very strong reason to overturn the register's status. They might mention a private conversation or a letter you wrote recently.
Having a clear choice in the register makes this conversation much easier for your grieving relatives. They're already dealing with a loss and shouldn't have to debate your medical ethics in a waiting room. If you've chosen a specific person to decide, the doctor will call that person immediately to discuss the next steps. If the family and the register disagree, it creates a difficult situation for the huisarts (GP) and hospital staff. Most people find that discussing their choice during a quiet evening is better than leaving it for an emergency room. Open communication ensures that the system works exactly as you prefer without any surprises.
Bottom line
If you don't register a choice, the Dutch government marks you as having no objection to organ donation. You must use your DigiD to select one of the four options to ensure your personal wishes are respected by doctors. If you prefer not to use the internet, you can always ask your gemeente for a paper registration form to mail back.
