Organ donations

Increasing the rate of organ donation in our small country is a complex challenge, not only because of the emotional aspects of the decision that individuals and their families face but also because of the organisational and clinical demands of recovery, allocation and transplantation.

As things currently stand in Malta, the law regulating organ donations is the 2016 Human Organs, Tissues and Cell Donation Act. Many organs are now harvested for donation, including the kidney, cornea, heart, liver, lung, pancreas, intestine, bone, skin, heart valves, tendons, ligaments and saphenous veins.

Whereas many countries now have an opt-out system, in Malta we still retain the opt-in system, whereby organs can be retrieved from the dead body only if permission from the family of the deceased is given. Even the presence of a donor card signed by the deceased does not give the doctors the right to remove organs from the body.

With an opt-in system, donors are often asked to register with the appropriate authority and obtain an organ donor card after providing adequate information, enabling informed consent.

Malta is one of the few European countries that does not have a transplant authority. Photo: Shutterstock.com

On the other hand, with the opt-out system, the law allows, indeed requires in some countries, doctors to take organs from the dead body if they can be used for transplantation purposes without the permission of the family. In other words, there is ‘presumed consent’. The only restriction is that, in cases where the deceased indicated, when alive, his or her wish not to donate organs, doctors must respect these wishes.

Once various studies conducted have shown that the clear majority of Maltese would be willing to donate one of their organs compared with those who are against the idea, perhaps it is time to review the situation here.

Malta is one of the few European countries that does not have a transplant authority and this should be a priority if we are to have an organisational structure and produce an efficient system suited to our needs.

Those who oppose an opt-out system principally do so because of their strong belief that a donation should be altruistic, without any pressure, and after having reached a conscious decision following adequate information. The latter information may be lacking if the State has a ‘presumed consent’ policy.

The measure of life is not its duration but its donation. We are a piece of someone else’s puzzle. We may never know where we fit but others will fill the holes in their lives with pieces of us.

MARK SAID, LL.D. – Msida