The Malta Independent 23 July 2026, Thursday
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A legacy of hope – A nation united to save lives

Monday, 6 April 2026, 07:47 Last update: about 5 months ago

Ivan Bartolo

I felt proud of my country when, in Parliament, we passed the second reading of the bill on organ donation after death declared by circulatory criteria (known as Donation after Circulatory Death - DCD).

When we speak about our country, we are not referring only to territory or institutions, but to the values that unite us as a people - compassion, respect for human dignity, and the willingness to work together for the common good. With courage and determination, we must ensure that these ideas do not remain only on paper, but become a reality that makes a concrete difference in people's lives.

This measure will complement what is already practiced in our country - namely, organ donation after death declared by neurological criteria (Donation after Brain Death - DBD).

Despite human limitations, some people feel the need to do something meaningful in their lives - or even after their death - for others. Advances in medical science, particularly in transplantation, have made it possible for individuals to donate organs after death or even during their lifetime.

When we presented the Private Members' Bill, it sparked discussion - and this is a positive sign. Now we have reached a stage where we must move beyond words and take action, looking ahead with purpose.

We are witnessing encouraging developments in transplant medicine, making it possible for people to regain life through organ transplants. Through this proposal, more individuals will have the opportunity to offer renewed hope and health to those in need after their passing, rather than their organs being lost forever.

One truly understands the urgency of this issue only by being a patient on a transplant waiting list.

In our country, around 100 people are waiting for a kidney transplant, 50 for a cornea, and 360 patients are undergoing dialysis. Each dialysis patient costs the Government approximately €24,000 annually. Increasing the number of transplants would not only reduce costs but, more importantly, significantly improve patients' quality of life and dignity.

Steps like these continue to enhance and elevate our country - where, through concrete action, we can save lives. A small island in the Mediterranean can truly stand as a model of solidarity.

This is a sensitive, complex, and highly important subject - both medically and ethically: the certification of circulatory death and its implications for the use of organs from deceased individuals.

This issue touches the very core of who we are as a society - how we understand death, how we respect human dignity, and how we balance medical progress with ethical values.

First, it is important to understand what circulatory death is. Traditionally, death was defined as the permanent cessation of vital functions - when the heart stops beating and breathing ceases. Today, due to medical advancements, there are two main categories for determining death: brain death and circulatory death.

Circulatory death refers to the irreversible cessation of blood circulation and respiratory function. This means the body no longer receives oxygen and nutrients, and organs can no longer function. However, the key word here is "irreversible." Not every cardiac arrest results in death - modern technology can sometimes restart the heart.

Therefore, the certification of circulatory death must be based on clear, scientific, and uniform criteria. This is where one of the most delicate aspects arises: the use of organs after death. Organ donation can save lives - it is an extraordinary act of solidarity. However, for this system to function, public trust is essential.

If the public begins to doubt whether death is being properly certified, or fears pressure to procure organs, that trust can be undermined. And without trust, the entire system risks failure.

For this reason, three fundamental principles must guide us:

First: the principle of independence.

The medical team declaring death must be completely independent from the team involved in organ donation or transplantation. This ensures there is no conflict of interest.

Second: the principle of consent.

The individual, or their family, must be clearly and transparently informed about the process. Consent must always be free, informed, and respected.

Third: the principle of dignity.

Even after death, the human body must be treated with full respect. A person must never be reduced to a "medical resource." They remain a human being deserving of dignity.

We have systems in place to ensure that protocols are followed, and we have consistently provided transparency to the public.

We have also taken into account the cultural and religious aspects of our country. In a diverse society, people's understanding of death may vary. Some communities may have specific concerns about the moment of death or interventions after death. These perspectives have been respected and included in all public discussions.

This brings us to another essential point: education. The public must be clearly informed about what circulatory death is, how it is certified, and what happens afterward. When people understand the process, they are more likely to trust and support it.

I emphasize that this is not just a medical or legal issue - it is a deeply human one.

It concerns how we give meaning to the final moment of life and how, even after death, we can offer hope to others without losing respect for the person who once was.

Let us work together to build a system that is fair, transparent, and humane - a system that safeguards human dignity while enabling lives to be saved.

 

Ivan Bartolo is a Nationalist MP
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