Starting point of the debate about the so-called dissent solution is the shortage of donor organs. In 2019, there were only 932 organ donors, with approximately 3,800 transplanted organs compared to approximately 9,000 people on the waiting list. In order to increase the number of organ donors, Health Minister Jens Spahn (CDU) and health expert of the SPD Karl Lauterbach, in July 2019, introduced a bill to the German Bundestag (which was ultimately rejected), according to which “every person is considered an organ or tissue donor, unless there is a declared objection to or a will that opposes the removal of the organ or tissue.” This is essentially the dissent solution. If the next of kin are also granted the right to object to the organ donation then this is refereeed to as an extended or double dissent solution (analogous to the extended or double consent solution).

The main argument of the proponents of the dissent solution is that it increases the number of organ donors. Furthermore, it is stated that according to a representative survey by the German Federal Centre for Health Education (BZgA) in 2018, even though 84% of those questioned had a positive attitude toward organ donation, however only 36% were in possession of an organ donor card. According to the proponents of the dissent solution, the current decision solution therefore reinforces the disparity between potential and actual organ donors. Finally, proponents often point out that the dissent solution takes emotional pressure off the next of kin because they do not have to deal with the question of organ donation if the will of the deceased is unknown to them.

The main objection raised by opponents is that the dissent solution would impermissibly interpret a non-declaration or the omission of an objection as consent. The dissent solution would, therefore, infringe on a fundamental principle of medical ethics, namely the informed consent of a patient which must always be based on a deliberate and free decision. Furthermore, people who criticize the dissent solution argue that it represents an unlawful violation of various fundamental rights and values, such as human dignity, personal rights, and religious freedom. Finally, opponents point out that the dissent solution does not necessarily lead to a higher number of organ donors as this depends on various other factors as well.