Macedonia has a new way of deciding one of the most personal questions there is - what happens to the body after death. Parliament has passed amendments to the Law on the Removal and Transplantation of Parts of the Human Body, under which every adult citizen, through a declaration at their GP, will decide for themselves whether they want to be an organ donor.

The law was passed with 58 votes "for" and 6 "against". The declaration will be logged in the national electronic health system "My Appointment", and the citizen will be able to change the decision at any time. With this, the system shifts to a model of informed consent and personal choice - instead of assumptions about what the deceased would have wanted.

The amendments also widen the circle of living donors: alongside existing relatives, relatives up to the fourth degree - that is, first cousins too - are now included, with a safeguard retained through an ethics committee that checks whether the act is voluntary and free of coercion.

The idea is good, but the real test is yet to come. Organ donation in Macedonia has lagged for years, not for lack of laws, but because of mistrust, lack of information and a weak transplant system. A declaration at your GP means nothing if the patient waiting for a kidney has nowhere to get one in time. The law is a step; the question is whether a system that actually saves lives will stand behind it.