Severe organ shortage plagues many countries across the world. Perhaps one way out could be treating everyone as a potential donor unless they explicitly refuse to consent, Sir Liam Donaldson, England's Chief Medical Officer has suggested.
He has noted that current severe shortage only leads to the deaths of hundreds of patients on waiting lists each year.
According to figures, 70 per cent of people want to donate their organs after death, but only 20 per cent are on the NHS organ donor register.
Sir Liam said: "There are simply not enough organs donated to meet the need for transplant, with one person dying every day while waiting for a transplant.
"Compounding this are issues surrounding consent, which often reduces this number further."
To meet demand for organs, the number of people on the NHS donor register would need to treble, Sir Liam said.
"I believe we can only do this through changing the legislation to an opt-out system with proper regulation and safeguards," he said.
Under current laws, donors must explicitly "opt-in". Donaldson wants it reversed. Simply all patients would be presumed to have given their consent unless they specifically say "No."
The government rejected similar proposals when it reformed the system in 2004. Opponents of "presumed consent" say it would be unethical for doctors to be given such powers.
They say apathy should not be interpreted as a desire to donate organs. Some patients oppose donation for religious and moral reasons.
Critics point to the public outrage sparked by the organ retention investigations at Bristol Royal Infirmary and Alder Hey children's hospital in Liverpool.
However, surveys suggest up to seven out of 10 people support the idea of donating their organs. But only a fifth of the population, 13 million people, have actually added their names to the NHS register.
Doctors say more patients are going abroad for transplants and coming home with serious complications.
"These 'transplant tourists' often face low standards of safety and quality of care," Donaldson wrote in his annual report, at www.dh.gov.uk. "The risks of damaged organs, infections and death are markedly increased."
The British Medical Association, which represents doctors, said the proposal would help save lives.
"We must increase the number of donors available and the BMA believes that a system of presumed consent with safeguards will help to achieve this," said Dr Tony Calland, chairman of the BMA medical ethics committee.
But the National Kidney Federation said the changes would not automatically lead to a rise in transplants.
"To make a difference we need more surgeons, we need more intensive care unit beds, we need the government to put more money behind transplantation and we need more willing donors," said Chief Executive Timothy Statham.
Chief Medical Officer of Scotland Harry Burns too felt that the public was not ready as yet for a situation where all people were treated as organ donors unless they opted out. He said people were not yet prepared for a system of presumed consent.
Dr George Fernie, a member of the British Medical Association's Scottish Council, said: "Surveys have shown that 90 per cent of the population supports organ donation, yet only 23 per cent have signed up to the organ donor register. And so the decision falls to the family when they have just been told their relative has died or is dying.
"Not surprisingly, when they do not know their relative's wishes, a large number [40 per cent] opt for the default position, which is not to donate."
He added: "The BMA believes that a change to a system of presumed consent for organ donation addresses this problem."