The Queensland government this week took its first steps towards the possible introduction of the "opt-out", system, which would alleviate a chronic shortage of organ donors.
If accepted Queensland will become the first Australian state to assume people want to donate their organs after death, unless they officially registered their objections beforehand.
The system is being debated in the UK and is already in force in other European countries such as France, Spain and Norway where donation rates are up to three times those in Australia.
Premier Anna Bligh said a bipartisan committee set up to examine the issue would get crown law advice on whether the state could adopt an opt-out system independent of other states and territories.
"I see merit in Australia adopting an opt-out system and believe that Queensland should actively explore it," Bligh told state parliament.
"I recognise there are significant legal, clinical, ethical, social and cultural issues that would need to be carefully considered, but this is not a reason for us not to explore it."
The committee is due to report back to state parliament by October.
Queenslanders Donate, which promotes organ and tissue donation, says more than 30,000 men, women and children have received life-saving or life-enhancing transplants in Australia.
But 1,700 people were still waiting for life-saving organ transplants, 50 of them children.
Even more sobering figures showed that more than one person will die every week waiting for their organ transplant, despite more than one million people having recorded their names on the Australian Organ Donor Register.
Queenslanders Donate says a person is ten times more likely to require a transplant than become a donor.
Janelle Colquhoun, a Queensland delegate to last month's national 2020 summit, has been waiting seven years for a pancreas and kidney transplant.
Colquhoun said the opt out system would not deprive people of their right to choose.
"I know many people think that having to opt out is taking away their freedom to do what they want upon their death," Colquhoun said.
"But firstly, having the chance to opt out gives you the chance to say `No, I don't want to do this'.
"And secondly, unless we choose the hardline opt out system, still family can decide that they also don't wish for organs to be donated."
Clinicians from the National Clinical Taskforce on Organ Donation considered the opt-out approach in January, but stopped short of recommending it - a point raised this week by Opposition Leader Lawrence Springborg.
Springborg said he also had ethical concerns.
"There are some ethical issues there about whether it's right to put clinicians in an environment where they're basically telling people that because your loved one didn't opt out, we're going to take and harvest their organs," Springborg said.
Doctors have given the scheme a cautious thumbs up, but warned that it will take a massive education campaign for it to gain widespread public acceptance.
"We are not averse to the opt-out model," said Australian Medical Association Queensland (AMAQ) president Ross Cartmill.
"We just have some concerns about how such a model would be administered and how the community would be educated on that option.
"But above all, we are keen that the community get engaged with the concept of organ donation and that individuals should be making a decision and discussing it with their families."
Pioneering transplant surgeon, National Clinical Taskforce member and long-time organ donation advocate Professor Russell Strong agreed.
He said despite the publicity generated by high-profile donors such as cricketer David Hookes, organ donation was often a subject left in the "too hard basket", along with making a will and organising your own funeral.
Coach of the Victorian cricket team and a former batsman for Australia, David Hookes died after an altercation outside a Melbourne pub in 2004.
Hookes was an organ donor and up to 10 people received transplanted organs from him.
Prof Strong is now retired but remains the medical director of donor organisation Queenslanders Donate.
He said research showed more than 90 per cent of people believed organ donation was a good idea - usually when they were the ones receiving the organs.
But when a loved one died and they had to make a decision about donating their organs to save others it was often a different story.
"Most people think it's a good thing because they might need a transplant one day, but they don't think - well, I might be a potential donor," Prof Strong said.
"Our next of kin have to make a decision at one of the worst times of their lives when some tragedy has occurred and their relative has become a potential donor and they are not sure of the wishes of that particular person.
"It's not something that people like to talk about around the dinner table."
In Australia, the success of organ and tissue transplants was high by world standards, he said.
"Most of our donors in Australia tend to be towards the younger age group and the results of transplantation here are virtually unsurpassed anywhere in the world," Prof Strong says.
"Here in Brisbane, the survival rate of heart-lung recipients is about 10 per cent higher than anywhere else in the world."
Kidney and liver transplantations were similarly successful, he said.
Prof Strong also wanted to lay to rest any concerns of families who feared viewing the mangled corpse of their loved one whose organs and tissues had been harvested.
"They are sutured up as if they had had a normal operation," he said.
But none of the 53 recommendations of the National Clinical Taskforce advocated the opt-out system because it was felt governments were unlikely to accept it.
"I was one who supported (the idea) that we considered this aspect, but I think they (the taskforce) thought it was in the too hard basket and the governments wouldn't take the initiative and therefore, what is the point of doing it," Prof Strong said.
"But in the last two-and-a-half years, I've changed towards thinking this (opt-out system) is something we should be exploring more."
