A group of University of Malta academics and senior clinical staff at Mater Dei Hospital have expressed support for the Government’s proposed changes to Malta’s organ donation law, provided that ethical safeguards remain fully applicable.
In a position paper responding to the public consultation on proposed amendments to the Human Organs, Tissues and Cell Donation Act, the group is receptive to amendments that would extend Malta’s current framework – which allows organ donation only after brain death – to include donation after circulatory death.
However, the authors listed several essential ethical requirements including the voluntary nature of donation, strict adherence to the dead donor rule, and a clear separation between end-of-life decisions and organ procurement. It also maintains that consent must always be obtained from the patient or appropriate next of kin.
Donation after circulatory death is already practised in a number of countries and has been shown to increase organ donation by as much as 50 per cent. In Malta, where more than 90 patients were waiting for kidney transplants alone by the end of 2025, the groups states that the proposed changes could significantly improve access to life-saving transplantation.
The Position Paper focuses on controlled donation after circulatory death, which applies to critically ill patients who do not meet the criteria for brain death and who die following the withdrawal of medically futile and inappropriate life-sustaining treatment. Death should be declared only after a mandatory ‘no-touch’ observation period to ensure medical and ethical certainty.
The authors – comprising a multidisciplinary group of academics in philosophy, ethics, and theology and senior clinical specialists in intensive care, nephrology, and neurosciences – also stress that decisions about end-of-life care must always be made solely in the patient’s best interests and must never be influenced by the possibility of organ donation.
They insist that clinicians responsible for end-of-life care must remain separate from organ procurement teams, and no donation may proceed without clear and informed consent.
With robust ethical, legal, and procedural safeguards in place, the group believes that the proposed amendments are morally permissible and socially valuable, offering a responsible way to increase organ availability while respecting the donor’s dignity and maintaining public confidence in Malta’s transplantation system.
