The dearth of donated organs could probably be blamed on the failure to convey the concept at grassroots level, leading to a lack of knowledge about the subject, the chief medical officer has told MPs.

“Organ donation sounds bombastic. We need to have a more positive delivery [of the concept],” Denis Vella Baldacchino told a joint meeting of Parliament’s standing committees on health and social affairs on Wednesday.

Discussion about organ donation within the committees is taking place in preparation for a White Paper on transplants for public consultation.

Dr Vella Baldacchino said the donation of organs by the living was a noble act but it was invariably accompanied by psychological pressure, such as thoughts about letting a person die or what would happen to the donor if something went wrong later.

Organ donation sounds bombastic. We need a more positive delivery of the concept

On the other hand, a corpse left behind relatives who needed closure. If they were well informed they would hardly put up any opposition. Taking organs on the strength of law could prove psychologically negative for them.

Asked what would happen if a person died without having made a will and was effectively inherited by the state, he said he would have to order burial and probably could decide on the organs, but this was not well defined at law.

Public Health Superintendent Richard Zammit said more emphasis needed to be placed on increasing the number of non-living donors, although living donors should not be dismissed.

In 21 of 31 countries, every person was considered as a donor unless they expressly opted out.

An idea for increasing donations was to have a person’s intentions stated on their driving licence cards.

Another floated at the meeting was for the authorities to make use of the current mass roll-out of new ID cards to signify intentions on the electronic chip, although asking such questions of a person in the best of health could instil a level of fear.

Bridget Gafà, a lawyer at the Department of Health, said the donor card had been in the Maltese system for several years but still lacked legal power.

A clinician still had to turn to the deceased’s relatives and they could decide to refuse organ donation, in spite of the dead person’s expressed wishes. The card must be invested with the power to have the donor’s wishes respected.

Overseas it was the clinicians who made the decisions under law. Malta already had its own list of willing donors, organs available and people who could qualify for transplants.

The ethics and morality of organ donation and transplantation were subject to debate, and she would not go the legal way unless those two aspects were tackled first, Dr Gafà said.

A prime concern in organ donations from living people was invariably how long the donor would be out of work and what remuneration they could legally expect. Official guidelines would give the issue more transparency and the power of law.

Dr Zammit said although organ transplantation in private establishments was prohibited, in order to ensure patient safety, the way medical science was evolving could mean changes in this area.

The Department of Health was currently contemplating including ITU in private establishments’ licences, he added.

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