I think an opt out system is the way to go. Families are forced to make a tough decision at a very emotional time and I'm sure many people think allowing donation to go ahead is like giving up on a loved one who they hope can still pull through, no matter what the doctors say. My husband had to wait 10 years for a kidney and is eternally grateful to the family who gave their permission, but if the onus was taken off the next of kin and put onto those who don't want to donate then more lives would be saved or improved drastically. It is harder than ever to find a donor card now - they seem to want you to sign up online, but I think there are probably a lot of people out there who aren't against donation, they just haven't got around to it , don't know how to sign up or think it's a bit morbid to discuss with family.