The Dutch senate [official website, in Dutch] on Tuesday narrowly approved legislation [text, PDF, in Dutch] revising organ donor registration to make automatic registration for organ donor status the default.

Under the bill, people would have to opt-out if they wish. The Netherlands would join eight other European nations with similar policies.

All adults not currently enrolled as a donor in the Netherlands would receive two letters from the government informing them of their impending status change and how to decline enrollment if they so choose. If they do not reply after the second letter, they would be added to the donor registry. Thereafter, a person can change their status at any time.

Critics of the bill claim that it gives the government an impermissible amount of power over individuals’ end of life decisions. As a result, the bill passed each house of parliament by the slimmest margins: 75-74 in the lower house and 36-38 in the senate. In the Dutch system, the senate can accept or reject bills passed in the lower house but may not amend or propose legislation of its own. The bill must now be signed by the King and the health minister before becoming law.