In Spain, 47 people per million become organ donors after they die. That makes Spain a world leader. Croatia comes a distant second with 39 donors per million people. Spain has a successful “opt-out” system. That means that every person is a donor unless you specifically make it known that you don’t want to donate your organs. The system is so successful because despite the presumed consent system, in practice coordinators do all they can to find out whether a patient is happy to donate before they die, and also whether their relatives or loved ones are comfortable with this. And organ donation does not happen if patients and/or relatives express discomfort.