Labour MP warns automatic organ donation could backfire

Health Parliamentary Secretary calls for a system that would honour the express wishes of people to become or not become organ donors after the death, while allowing their relatives to make a choice if the patient hadn't opted in or out

An organ donation system whereby everyone would automatically be placed on the donor register, unless they choose to opt out, could backfire, Labour MP Deborah Schembri said.

“That could be one of our most altruistic laws, but we are moving ever closer to informed consent in every aspect of life,” Schembri said. “Moreover, countries like Spain that have adopted this system tend to have a very high rate of people who opt out of it. People don’t like having organ donation imposed on them by the state.”

She was speaking at a public consultation session at the University about the government’s White Paper on organ donation. The session was attended by fewer than 30 students, none of whom offered a word of consultation, except for a representative of the Pulse Policy Forum   who was present on the panel.

The White Paper includes four different organ donation systems, one of which will be adopted once the government drafts the law.

The soft opt-in system would be based on both the potential donor’s express wish to become a donor as well as the consent of his/her next of kin following the donor’s death.

The hard opt-in system would be based solely on the organ donor’s decision to become a donor, abolishing the consent of the next of kin.

The soft opt-out system would render organ donation permissible, unless the deceased specifically opted out during his or her lifetime. However, permission would still need to be obtained from the donor’s next of kin.

The hard opt-out system would render organ donation permissible, unless the deceased specifically opted out prior to his or her death. In this case, the deceased’s next of kin will have no say as to whether their relative’s organs should be donated or not.

Health Parliamentary Secretary Chris Fearne indicated his personal preference for a soft opt-out system with a hard-opt in system.

“People’s express wishes to become or to not become organ donors will be respected, while the next of kin will make a choice if their relative hadn’t opted in or out,” Fearne explained.

The current organ donation is practically a soft opt-in- soft opt-out system. Donor cards issued by the Transplant Support Group can be overruled by the deceased’s next-of-kin. However, doctors often ask a brain-dead patient’s next of kin whether they would like their relative to become an organ donor.

“They accept around 90% of the time,” Fearne pointed out.

Indeed, Malta ranks among the highest donor rates in the world, with some 2,000 people signing up to be organ donors every year. Last year, around 30,000 people were registered for organ donation. Yet, the list of patients waiting for an organ transplant remains substantial.

Near the end of 2014, around 80 to 85 patients were still waiting for a kidney, while 15 patients – throughout the year – successfully received kidney transplants. A heart, and 13 cornea transplants were also performed. 

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