Organ donation benefits all
I WRITE in support of the statement by Health director-general Datuk Dr Noor Hisham Abdullah, “Ministry: Clinical criteria determine recipients of organs” (The Star, Feb 13) and Tan Sri Lee Lam Thye’s letter, “Bad press hits organ donation” (The Star, Feb 14).
I would like to reiterate that there is no distinction of race or religion in the practice of medicine and in the care of the sick and needy.
Transplantation surgery in Malaysia follows a well-documented, world-accepted protocol with sound scientific and ethical basis. This protocol is designed with two purposes:
(1) To exclude possible bias/ favouritism of the interested party and guarding the safety and rights of the possible donor; and
(2) Based on sound scientific criteria, to match the recipient to an organ which is likely to confer the best benefit with least risk, sometimes referred to as “beneficial donor”.
Under each, there is a whole series of scientific and sociological tests such as tissue typing, blood group, biochemistry, and sociological and psychological assessment. None of this ever involves race or religion.
Malaysia is lucky in that from day one in 1975, we have a whole series of dedicated and upright doctors who had developed and maintained transplantation work to its highest possible scientific and ethical standards. As one of the senior transplant surgeons in this country, I can personally testify to the DG’s statement that the public can be reassured the Health Ministry (MOH) and other transplant units always uphold these ethical and scientific standards.
The organ pledger and donation rates have always been low in Malaysia. In 2004, Malaysia ranked No. 4 (counting from the bottom of the list) in the IRODat (International registry of Organ Donation and Transplant) and USRDS registries. That was our peak year with 194 transplants done, giving a rate of seven trans- plants per million population (IRODat, 2004). By 2013, we were No. 1, right at the bottom for cadaveric and living donor transplants, and almost disappeared from the list (IRODaT, 2015). We are now even behind countries in Eastern Europe, Thailand and 98 others. This is mainly because of the very poor pledger rate of only 1.2% of the population compared with 15% to 34% in Europe.
Muslim donors in Malaysia fared even lower. Between 1997 and 2012, there were a total of 382 cadaveric donors in Malaysia, out of which only 25 (7% or less than two a year) were Muslims (Transplant Resource Centre annual report 2013, MOH).
More research is needed to investigate the underlying causes which, in my opinion, are more related to the general worldview rather than religious reasons.
In the last 25 years of personal contact and interview with hundreds of pairs of donor-recipients, no Muslim patient has ever questioned whether a Muslim can donate or receive an organ from a non-Muslim. Receiving an organ was viewed as a blessing from God, a gift of life for which the patient is eternally grateful.
Those who say Muslims cannot receive or donate organs to non-Muslims are doing a disservice to the patients with end-stage organ failure, among whom there are more Muslims by population ratio.
For those who are interested, take pride that Malaysia was one of the earliest country to issue a fatwa permitting organ transplantation – from Perlis in 1965. Detailed authoritative account is available from a Health Ministry publication, “Organ Transplantation From The Islamic Perspective” in collaboration with Jakim in 2011 (http://www.moh.gov.my/images/gallery/orga/edu/awam/Organ_TranIsmEN.pdf ). This is the most well written summary on this subject.
DATUK DR S. H. LEE General and Transplant Surgeon Gleneagles Kuala Lumpur