Statistics suggest that Malaysians are increasingly more accepting of organ donation. There were 8,885 new pledgers registered in 2007, and this number increased each year until it reached 50,333 new pledgers in 2015.
YBhg Dato’ Dr Hj. Azman bin Hj. Abu Bakar, Director of Medical Development Division, revealed that there are 618 successful cases of organ transplant, through deceased organ donors, since 1975.
Yet, the need for organ donation in Malaysia remains high. “There are still a lot more to do to improve our deceased organ donation rate, because the number of waiting list increases tremendously each year,” he said.
Family concerns over actual organ donation
One can decide to “opt-in” to donate their organs, after they are declared brain dead. In Malaysia, there is another additional layer of approval needed.
Dato’ Dr Hj. Azman cited the Human Tissues Act 1974 [Act 130], which stated that “consent for removal of organs or any body parts can be given only by the surviving spouse or any surviving next-of-kin of the deceased”.
Getting the family’s written consent can be challenging. “In Malaysian culture, we have our extended families participating in decision making. Not only among the spouses, we also consult decisions made by the elderly, the mak cik, pak cik, and others,” asserts Dr Hirman Ismail, Honorary Secretary to the Malaysian Society of Transplantation.
Religion is one of the major family concerns over their deceased relatives’ wishes to donate their organs. Dato’ Dr Hj. Azman replies and says that “all major religions recognise organ donation as a noble thing and support the cause.”
From the Islamic point of view, the Fatwa on Organ Donation was readily available since 1974, by the Malaysian Fatwa Council.
“Ironically, the fatwa was issued before the actual organ transplantation was done in Malaysia in 1975,” Dr Hirman said. “Over the last few years, we have made a strong collaboration with the religious authorities, such as JAKIM (Malaysian Islamic Development Department), IKIM (Institute of Islamic Understanding), and multiple mufti offices to debunk misconceptions of organ donation.”
Another family concern towards organ donation is the handling of burial process among the deceased. Families are afraid if the deceased would be disfigured, or the possibility of delayed burial processes.
To respect the deceased, cultural practices come into place where the body must be fully intact in perfect condition, to be buried or allowed for open casket funeral to be done.
Healthcare professionals play a pivotal role in organ donationDr Hirman Ismail asserted that “forcing people is not the way, opt-out system is under consideration yet not available at the moment, thus the only way is through public education.” Jom Ikrar, for instance, is an organ donation awareness programme from the Ministry of Health that specifically targeted among healthcare professionals.
Healthcare professionals, especially doctors who are primary caregivers to the public, could improve communication to their patients about pledging as an organ donor, and the importance of discussing their intention with their family members.
In 2012, the Ministry of Health re-strategized the “Strategic Plan for Organ Donation Awareness”, which Dr Hirman Ismail himself presented to Tan Sri Lee Lum Thye, the then-chairperson of Public Awareness Action Committee in Malaysia.
“Among some of the priorities were to increase activities among youth, who are usually more open to changes,” he remarked, “with a special focus on increasing awareness among the healthcare professionals by providing support– to go hand-in-hand with public awareness”.
Dato’ Dr Hj. Azman added that such programmes will not be sustainable without support from healthcare professionals. He advised that, “every category of healthcare staff need to be mindful and support [increasing awareness of organ donation].”
Healthcare professionals working in the hospitals, regardless in public or private sector, may actively identify potential cases for organ donation, and refer to the Tissue Organ Procurement (TOP) teams in respective hospitals.
For hospitals without the TOP team, you may refer such cases to regional centres in the country; Hospital Sultanah Aminah Johor Baharu for southern region, Hospital Pulau Pinang for northern region, Hospital Raja Permaisuri Bainun Ipoh for central region, Hospital Sultanah Nur Zahirah Kuala Terengganu or Hospital Tengku Ampuan Afzan, Kuantan for East Coast, Hospital Queen Elizabeth for Sabah and Hospital Umum Sarawak for the whole state of Sarawak.
Furthermore, healthcare professionals working in primary care can play advocacy roles to educate the society regarding the importance of this cause.” MIMS
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