Materia Medica Malaysiana

Organ transplant law under review

MALAYSIA—The Ministry of Health is currently reviewing the Human Tissues Act of 1974.

The Act, the first and only statute of its kind in the country, governs the transplantation of cadaveric tissues. It is based on and almost identical to England's Human Tissues Act of 1961.
Discussing the shortcomings of the Act, former health minister Dato' Chua Jui Meng said it was significant that the word “tissue” was not defined under the Act.
This raised complex and ethical questions as to the scope of its definition, he said. There is also no definition of "the person lawfully in possession of the body." This is significant as he is the person who is empowered by the Act to authorize the removal of tissue.
There is also no articulation in the Act of a hierarchy of relatives who are deemed to be the next-of-kin. The articulation of such a list will prove difficult In a multi-cultural society like Malaysia, where the hierarchy of relatives with the right to claim decision-making powers will vary between cultures.
The definition of death is not listed in the current Act. Section 3(2) of the Act only requires that two fully registered medical practitioners satisfy themselves by personal examination of the body that life is extinct.
The Act needs to be amended to include brain death as a method of determining death and to specify that doctors certifying brain death should not participate in the subsequent procedures for the removal and transplantation of the organs and tissues.
Chua was speaking at the launch of the Certificate in Medical Law and the book titled Issues in Medical Law and Ethics published by the International Islamic University.
“The current Act does not ban the sale or purchase of organs and there is also no provision for any sanction in the event of a breach of any section. The Ministry will therefore make amendments to the Act to prohibit commercial transactions and advertisements of human organs and tissues. The Act will also be amended to include criminal sanctions in the event of a breach of any provision,” he said.
The Act will be amended to allow only gazetted hospitals to conduct transplant procedures and only well-qualified practitioners to register as transplant specialists to safeguard public interest and to maintain a safe and equitable transplantation program.
A register of organ transplantations will be provided in the Act to monitor and coordinate the harvesting and allocation of donated organs and tissues under consistent and equitable rules.
There is presently no legislation in the country governing the removal of organs from live donors, Chua also pointed out.
In the absence of any clear legal authority, it is presumed that live donations are legally permissible by way of valid consent obtained from the donor. While awaiting the formulation of an appropriate law on this, the Ministry of Health is in the process of developing guidelines on organ donation and transplantation from living donors.
From the time of the first corneal transplant until December 31 2003, a total of 7,671 organ and tissue transplants have been performed in the country. These included 4,170 tissue graft, 1,267 cornea, 1,007 kidney, 634 bone marrow, 483 bone, 45 liver, 43 heart valve, 15 heart and 7 skin transplants