Organ opt-out: would it really work?

Deputy Prime Minister Chris Fearne speaks in favour of the opt-out system for organ donations but expresses doubts on whether medical professionals will proceed anyway if there is strong family opposition

The ability to donate organs has opened a gateway to new beginnings for many in need. Today, a vast array of organs, including the cornea, heart, lung, kidney, intestine, and liver, can be offered by donors to save or dramatically improve the lives of recipients.

This remarkable advancement not only showcases the strides made in medical procedures and organ preservation, but also highlights the profound impact of human kindness, offering a second chance at life to those on the waiting list.

In Malta, only 5% of people are registered organ donors, a slight increase from 3% in 2018. There is an ongoing discussion about changing Malta’s organ donation laws to an opt-out system, where individuals are considered potential donors unless they explicitly refuse. This approach aims to increase donor numbers, as seen in countries like the UK and Spain. Under Maltese law, anyone over 16 can register their organ donation wishes on the National Organ Donor Register.

Speaking on television, Deputy Prime Minister Chris Fearne explained that, a few years ago, a law was enacted in Malta for the first time, allowing individuals the option to register as organ donors during their lifetime. Prior to this legislation, when a potential donor passed away, medical professionals were required to engage in discussions with the deceased’s relatives to seek their consent for organ donation.

Before this legislation, no laws permitted individuals to legally record their wish to donate organs, except through verbal communication, which wasn’t legally binding. As the law stands today, even in cases where relatives are uncertain, the clarity of the donor’s wishes in the register enables doctors to proceed with organ donation. For those who have not explicitly made their wishes known, medical professionals can still consult with the deceased’s relatives, who may consent to the donation.

Deputy Prime Minister and former Health Minister, Chis Fearne, at the launch – in 2016 – of registration forms to ensure that people’s expressed wishes to donate their organs will be respected once they die.

The current discussions are about legislation that would allow doctors to proceed with organ donation, even if the deceased’s relatives disagree, provided the deceased had not explicitly refused to donate. This could potentially increase the donor pool, explained the Deputy Prime Minister, although he expressed his doubts about how willing doctors would be to proceed against strong family opposition due to religious or cultural reasons.

“Whilst there might be an increase in organ donors, it presents a challenge for doctors when relatives are opposed due to religious or cultural reasons, despite potentially having a larger pool of donors on paper. Personally, I support the initiative as, the more donors we have, the better. Our current system adequately addresses all situations, but striving for additional steps to save even more lives – even if just one more life is saved – is commendable,” concluded the Deputy Prime Minister.

The Church remains steadfast in its opposition to the transition to an opt-out system for organ donation, a stance that has remained consistent since the concept was initially proposed nearly ten years ago. According to a 2015 position statement by the Achbishop’s Curia, the Church views organ donation as an act of voluntary kindness, emphasising that it should occur as an expression of “uncompelled generosity”.

The statement elaborates that genuine gifting requires the donor’s consent; without such consent, the exchange deviates from being about giving and receiving to one of taking and acquiring organs. It underscores the importance of altruism and the voluntary donation of organs and tissues as central to upholding human dignity and integrity.

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