The state government of New South Wales says changes are necessary in the existing proceedings regarding organ donation sign ups and families overruling prospective donors' decisions.

ABC reported over two million NSW residents have indicated via their driver's license that they wish to donate at least some of their organs if they die. But the state government says it has the lowest organ donation rate in Australia.

Health Minister Jillian Skinner says it happens frequently that families of potential donors are overruling their loved ones decision to share their organs once they have passed on.

"People who tick the box expect they are ticking the box about having their organs donated, but the reality is that (in) 50 per cent of cases families say no and it just doesn't happen," Ms. Skinner told ABC.

Ms. Skinner points to the families frequent overruling as the main reason behind NSW's very low donation rate, the lowest in Australia.

"(W)e compare very badly with countries overseas," she stressed.

The NSW government is set to release a discussion paper on the proposed changes on the policies and guidelines on organ donation. Ms. Skinner said the community should have a chance to air their side on what is proper to implement, specifically, the community is asked to indicate whether they want their families to overturn their wish to donate organs (assuming they do want to donate).

Opposition spokesman Andrew McDonald, who supports the proposed changes, says an adjustment to the current proceedings would increase the rate of organ donation.

Advocacy group Transplant Australia is also supporting the proposed changes for implementation. The organisation's chief executive, Chris Thomasm, told ABC a decision to donate is carefully considered and should be respected.