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(lemmy.nz)
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Germany is currently considering a third way: they ask you.
Everyone in Germany has health insurance, so the idea is that the health insurance simply asks you directly to decide. Most people are in favor of organ donation, but never actually get an organ donor card or talk to their relatives. Asking them to decide won't get anywhere near the donor rates of an opt-out scheme, but it could drastically increase them.
In Ontario, Canada people can opt in when renewing their health card (a card used to access public healthcare) or driver's license, and it probably does positively impact the rate of opting in, but it really doesn't seem to address the need. I've been a registered organ donor since I was 16, but most people I've brought it up with aren't.
I suppose if choosing an option is mandatory instead of voluntary then that would change things for the better. Is that what Germany is doing?
That sounds promising, I think you're right that it would be a significant improvement in donor rates over the opt-in system.