“Greater love has no one than this: to lay down one’s life for one’s friends” (John 15:13). The next best thing is probably donating part/s of one’s body to save another’s life or significantly improve their quality of living.

Any initiative aimed at promoting and facilitating body organ donations is, therefore, laudable and, indeed, necessary. Nationalist MP Ivan Bartolo ought to be commended for moving a private member’s bill aimed at introducing the opt-out system, being seconded by Health Minister Jo Etienne Abela.

Bartolo believes that adopting the opt-out system could save lives. The demand is certainly there and the supply continues to be inadequate. Still, before rushing to make law what is being proposed, one ought to look further into the matter. There are many considerations to be made, including of a medical, health, ethical and legal nature.

An attempt to introduce the opt-out system in Malta had been made in 2015 but the idea was discarded after a public consultation exercise found support among just eight per cent of respondents.

There is still a lot of work to be done to fine-tune both the opt-in and opt-out systems to allow those making such an altruistic decision to have their wishes respected

The Catholic Church, too, had opposed the proposal and continues to resist the opt-out system, insisting body organ donations should remain a ‘gift’, a decision freely made by the donor. That stand may well change in future, as had happened in 1963 when the Church lifted its historic ban on cremation.

In a position paper issued in 2015, the Church had recommended efforts to encourage people to opt in as organ donors. That is, surely, one correct way forward. However, any initiative conducive to the possibility of more body organs being donated ought to be considered. So, before shooting down the opt-out system, as the Church is doing, it would, perhaps, be better to see what ‘safeguards’ are needed to prevent abuse of whatever kind.

Many deem donating body organs an act of charity. Some would want parts of their corpse to be donated to others who need them. There are also people willing to have their body or organs made available for medical research after their death.

Those who strongly believe in such acts of charity usually sign in; many do not, for various reasons, even if they do not object to the idea.

Still, as studies clearly show, families may resist having organs removed from the corpse of their next of kin, even in an opt-in system, let alone in those countries recognising opt-out.

Also, simply changing the donation system does not seem to guarantee an improvement, quantity-wise.

A study published online in late 2022 by three Spanish philosophy, bioethics and medical ethics researchers concluded that improved infrastructures, coordination and training, communication with the public and modifiable factors influencing family authorisation might prove more effective for ensuring more body organs are donated than moving from opt-in to opt-out.

More recently – last November – a researcher found that shifting from an opt-in to an opt-out system can be successful if it happens together with an information campaign to raise awareness and introducing a register recording individual organ donation decisions.

The above does not mean the opt-out idea should be dropped. It merely indicates there is still a lot of work to be done to fine-tune both the opt-in and opt-out systems to allow those making such an altruistic decision to have their wishes respected.

What is imperative is that the momentum is maintained. The fact that both sides of parliament are on the same wavelength promises that the best way forward can and will be found.