Legislative and ethical framework on organ donation and transplantation in Malaysia Hirman Ismail MD (UKM) MPH (Nottingham) Head of Transplantation Unit, Medical Development Division & Honorary Secretary to the Malaysian Society of Transplantation Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | [email protected]IMAM 18TH Annual Scientific Conference, 20 August 2016, Seremban
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Legislative and Ethical Framework of Organ Donation and Transplantation in Malaysia
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Legislative and ethical framework on organ donation and transplantation in Malaysia Hirman Ismail MD (UKM) MPH (Nottingham) Head of Transplantation Unit, Medical Development Division & Honorary Secretary to the Malaysian Society of Transplantation
IMAM 18TH Annual Scientific Conference, 20 August 2016, Seremban
Source: Global Observatory on Donation and Transplantation, www.transplant-observatory.org, 2016
Situational analysisHuge gap demand and supply “Market force” has driven overseas commercial transplantsWe are placed among the lowest in the world in terms of deceased organ donation rateAwareness is improving especially among the Malay Muslim Racial discrepancy is still evident Living donation programme has not been optimised
Immunosuppressant policySince 2012, no free supply of IS to overseas transplant patients To discourage cross boundaries unethical practices, exploitation and crime Current patients are being informed about the policy
Limiting related living organ donation to 2nd degree and below & legal spouse Unrelated living organ donation requires MOH approval Any cases involving foreigners requires approval as well
A more comprehensive law to cover both living and deceased donation (unlike Human Tissue Act 1975)Covers a wide range of issues including ethics like certification of death, prohibition on organ trading and advertising, consent and authorisation, accreditation and credentialing, organ allocation Draft currently being reviewed by AG Chamber
Conclusion The potential of organ donation and transplantation has yet to be optimisedThe risk of unethical practices is present like in many other countries (due to shortage of organs) The control measures through law and policy exist but need to be enhanced through the new proposed law Ensuring self sufficiency of organ is everyone’s responsibility (increasing supply and reducing demand)
References Jennifer Dolling. (2009) Opting In To An Opt-Out System: Presumed Consent As A Valid Policy Choice For Ontario’s Cadaveric Organ Shortage [Unpublished thesis]. Graduate Department of the Faculty of Law University of Toronto. Available from : https://tspace.library.utoronto.ca/bitstream/1807/18276/1/Dolling_Jennifer_M_200911_LLM_thesis.pdf [Accessed 16 June 2016]Medical Practice Division. (2013) Online Public Engagement on Proposed New Law on Organ Transplantation. [Unpublished Report]. Ministry of Health Malaysia Shepherd et al. 2014. An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel study. BMC Medicine.12:131. Available from : http://www.biomedcentral.com/1741-7015/12/131 [Accessed 17 June 2016]Medical Development Division, 2007. National Organ Tissue and Cell Transplantation Policy. Putrajaya: Ministry of Health Malaysia. Medical Development Division, 2011. Unrelated Living Organ Donation: Policy and Procedures. Putrajaya: Ministry of Health Malaysia. Ministry of Health Malaysia, 2012. Policy on Unrelated Living Organ Donation. [Circular Letter by the Director General of Health], 4 January 2012, available at: http://www.moh.gov.my/attachments/1763 [accessed 6 February 2012]World Health Organization, 2010. WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation. New York: WHO.