Campaigners need to ramp up organ donor call with just 18,000 on register

Over 18,000 people are registered as organ donors, three years after Malta introduced a donor registry – with six having registered their explicit wish not to be organ donors.

That amounts to just 4% of the Maltese population, a considerably low number.

But before the introduction of the register, the Transplant Support Group had issued 25,000 persons with a donor card. Since the introduction of the donor registry in 2016, donor cards have since been phased out, and persons who held those cards were asked to register their intent again.

“Efforts are ongoing to encourage more people to register as organ donors. During the past few weeks, the Deputy Prime Minister and Minister for Health personally visited a number of companies to encourage more people to donate. A campaign which was received well from employers and employees alike,” a spokesperson for the health ministry said, commenting on the figures.

But the low-take up of the initiative is also the reason why campaigns such as that launched by the family of Drew Abela, a registered donor who saved seven others, fail to increase awareness of organ donation in a country which still has an opt-in donation system.

READ MORE ‘We told doctors, save whatever you can’: how one family coped with the loss of their son

The opt-in system requires donors to register before their death, apart from next-of-kin consent. In September 2018, a petition was started by Michel Camilleri calling on the government to change the law to an opt-out system which would automatically register everybody over the age of 18 as a potential donor, unless they specifically state otherwise.

Countries such as Spain, Italy and Belgium have had opt-out systems for over eight years now. In fact, in 2017 Spain had the highest rate of donation, followed by Portugal, Croatia, Belgium, France and Italy all countries who have similar systems in place.

The UK is the next country to follow suit. The new opt-out law, commonly known as the Max and Kira law, will be put into place in 2020. The law’s name reflects the story of Max Johnson, a nine-year-old who received the heart of Kira Ball, also nine, who unfortunately died in a traffic accident in North Devon.

In 2011, a study published in the Malta Medical Journal by psychologist Mary Anne Lauri and Dr Joseph Zarb Adami on doctors’ attitudes towards organ donation, stated that Maltese doctors were wary of making organ donation mandatory. The doctors had argued that introducing the opt-out system would remove the element of altruism from the act of donating an organ – and may make it very difficult for most doctors, who would have to essentially remove organs, at times without the relative’s consent.

Eight years later Prof. Lauri told MaltaToday that she still thought introducing an opt-out system would have a negative reaction. “By introducing an opt-out system, you would be changing the meaning of organ donation… and taking the right to decide away from the family.”

Prof. Lauri said that in order to implement the opt-out system, it would require an intensive campaign. “People won’t understand what the opt-out system means, and the people who will speak out against it will create a lot of fears with negative consequences.”

Prof. Lauri also said misconceptions on organ donation still exist, even though the Catholic Church has adopted a positive narrative on organ donation. “People were afraid that if organs were removed from their body after death, they would not be able to go to heaven.”

Perhaps the most striking qualm is certain doctors’ unwillingness to take organs from donors without the explicit permission of living family members – doctors may not take organs from an individual if their family is against it, even if that person is a registered donor. Prof. Lauri said it was subjective as to whether the rights of the individual superseded the rights of the living family after their death, within the medical community.