Despite growing awareness, misconceptions persist – particularly around brain death and the belief that organs are taken without consent. Medical experts say this could not be further from reality.
“There is no element of coercion in organ donation,” said anaesthetist and intensive care specialist Dr Yap Mei Hoon at Universiti Malaya Medical Centre (UMMC). “Even if a person has pledged to donate, the final decision lies with the next of kin.”
This distinction is crucial in Malaysia, where family consent remains a key factor in whether a donation proceeds.
As highlighted previously, close to 90% of potential organ donations do not go ahead due to family refusal, often shaped by uncertainty, emotion or misunderstanding.
Yap said one of the most persistent misconceptions is the idea that brain-dead patients may still recover. “In reality, brain death is confirmed through a very strict and structured process,” she said.
The diagnosis is not made lightly: it involves multiple layers of clinical assessment, carried out by two independent specialists who are not involved in transplantation.
Tests are conducted twice, at set intervals, to confirm the complete and irreversible loss of brain function before death is officially declared.
Only after death is confirmed does the conversation about organ donation begin – and even then, it is approached with care.
“Families are given time to process what has happened,” said Farahliza Ismail, coordinator at UMMC’s organ donation and transplant management unit. “We do not raise the topic immediately because they are often in shock and grief.”
Instead, discussions are introduced gradually, with clear explanations and without pressure, allowing families to make informed decisions at their own pace.
“When families are given time and proper information, they are better able to understand what organ donation means and what it can do for others,” Farahliza added.
Not every patient is eligible for donation. Even after brain death is confirmed, organs must undergo thorough screening to ensure they are safe and suitable for recipients.
“We have to assess each organ carefully through blood tests, imaging and functional evaluation,” Yap outlined. “The safety of the recipient is always the priority.”
If the family agrees to proceed, a highly coordinated process begins. Multiple specialist teams may be involved, working within tight timeframes, as each organ remains viable only for a limited period.
Matching recipients is handled at a national level by the National Transplant Resource Centre, ensuring a transparent and fair allocation based on medical criteria.
Throughout the process, doctors stress that the dignity of the donor remains paramount.
After surgery, the body is carefully prepared and returned to the family, with all incisions closed and no visible signs that might cause distress. Cultural and religious practices are also respected at every stage.
“We want families to feel reassured that their loved one is treated with dignity,” Farahliza said.
For medical teams, organ donation is often seen as part of end-of-life care – a way for one life to offer hope to others.
But for families, it is rarely a simple decision. Which is why, experts say, open conversations before a crisis occurs can make all the difference – so that understanding and clarity can help turn an overwhelming loss into a lasting legacy.