A Nationalist MP is pushing for Malta to introduce an opt-out system for organ donation, years after the idea was first proposed then discarded.
Ivan Bartolo, who donated one of his kidneys to a stranger five years ago, believes flipping the existing system to an opt-out one would significantly increase donation rates.
“If you don’t want (to be a donor) you can just sign a form saying so. Many people are willing to donate but don’t register out of laziness,” Bartolo said.
The Nationalist MP and former Mosta mayor was speaking during a radio interview with academic Andrew Azzopardi on 103 Malta’s Heart.
Following a change in the law in 2016, anyone wishing to become an organ donor must sign up to the Organ Donation Register. Anyone aged 16 and above can sign up to the register.
Bartolo’s proposal is to essentially reverse the system, making everyone aged 16 and over automatically an organ donor, unless they sign a register requesting to be excluded.
The PN MP has long called for the change and in 2022 had even written to Health Minister Chris Fearne to lobby for organ donation laws to be amended.
Opt-out organ donation systems such as that advocated by Bartolo have been adopted by an increasing number of countries, from Spain to Singapore, Austria and Belgium.
However, it remains unclear whether Bartolo’s wishes reflect public opinion.
A public consultation exercise that the government carried out in 2015 before introducing the Organ Donation Register found that just 8 per cent of respondents favoured some form of opt-out system. The vast majority of consultation respondents– 66 per cent – said they wanted an opt-in system, requiring donors to sign up to a register.
Empirical evidence is also lacking. While several countries that adopted an opt-out system have reported a subsequent surge in organ donations, a 2021 research paper that looked at several such datasets concluded that data was “often contradictory and largely inconclusive, suggesting other factors may be in play.”
Locally, doctors transplant donated kidneys, hearts and corneas to patients who need them. When organs are not available for transplant, medical authorities try and source them from Italian or UK counterparts.
Bartolo has direct experience of organ donation, having chosen to donate a kidney to a strange five years ago.
Speaking on Saturday, Bartolo recalled that his donation journey began when he met a woman whose son needed a kidney donation during a 2015 house visit.
“I wondered what I could do. That summer, I thought of him and bought a rosary bead. Minutes later, the woman’s son called me and said he was in Lourdes and had bought me a rosary bead.
“I am a spirtual person, and I decided that could not be a coincidence,” Bartolo recalled.
The MP was unable to donate a kidney to the woman’s son – the two were not a suitable match – but Bartolo pressed ahead with his donation plan.
He was mayor of Mosta at the time.
The process took two years, after which Bartolo donated a kidney to a stranger.
As a teetotaler who does not smoke, the donation has not impacted his daily life too much, Bartolo said on Saturday.
But it has led to at least one inconvenience: receiving blood every six months at hospital’s renal unit.
“They’re extremely helpful and patient with me,” he said, “because I have a fear of blood.”