BEL311 (2)

CONFIDENTIAL LG/OCT2010/BEL311

UNIVERSITI TEKNOLOGI MARA FINAL EXAMINATION

COURSE

COURSE CODE

EXAMINATION

TIME

ENGLISH FOR ACADEMIC PURPOSES

BEL311

OCTOBER 2010

3 HOURS

INSTRUCTIONS TO CANDIDATES

1. This question paper consists of two (2) parts: PART A: SECTION 1 SECTION 2

PART B: (1 Question)

(7 Questions) (7 Questions)

2. Answer ALL questions from all parts in the Answer Booklet.

3. Do not bring any material into the examination room unless permission is given by the invigilator.

4. You are allowed to bring in your English-English dictionary.

5. Please check to make sure that this examination pack consists of:

i) the Question Paper ii) an Answer Booklet - provided by the Faculty

DO NOT TURN THIS PAGE UNTIL YOU ARE TOLD TO DO SO

This examination paper consists of 9 printed pages © Hak Cipta Universiti Teknologi MARA CONFIDENTIAL

CONFIDENTIAL 2 LG/OCT2010/BEL311

PART A: READING COMPREHENSION (20 MARKS)

Read the following articles and answer all the questions in the answer booklet provided.

SECTION 1: Article 1

The Ethics and Law on Organ Transplantation in Malaysia

I Organ transplantation is a form of treatment for serious and life-threatening

diseases which has proven to be successful. It involves replacing diseased and

defective organs and tissues with healthy ones from donors. Recent

advancements in surgical procedures and the availability of anti-rejection drugs

have contributed tremendously to the success of organ transplantation. These 5

developments have made the transplant procedure a possible treatment for those

suffering from various organ failure states. The commonly transplanted organs

are kidneys, heart, eyes, lungs and pancreas while transplantable tissues are

liver, bone marrow, skin and heart valves. Presently, organs for transplantation

can come from either a living person - the live donor, or a dead person - the 10

cadaveric donor.

II Live donors are an important source of tissues and organs for transplantation.

Donors can be parents, siblings or close relatives who are genetically related to

the recipients; or spouses and very close friends who are "emotionally related" to

the recipients. They are collectively known as "live-related donors". Kidney, parts 15

of the liver and certain tissues, such as bone marrow, skin and blood can only be

obtained from live donors. Some of the ethical problems that need to be solved for

live donations are questions of consent. There is a need to know whether the

organs are given freely and not under duress, and whether the risks are explained

to the donors. Another concern would be to ensure that no payments are involved 20

in the procurement of the tissues and organs.

HI Cadaveric organ donation is the donation of organs after the death of an

individual. This would provide organs and tissues for all types of transplantations

being performed in the country. Removing the organs from a dead person is

usually not a problem, especially if the donor has given express consent prior to 25

© Hak Cipta Universiti Teknologi MARA CONFIDENTIAL


his death. Organs can also be taken from the deceased if no express consent has

been given on condition that relatives do not object to it. An important ethical

question in cadaveric organ donation involves the exact definition of death. In

other words, at what stage death has occurred. Traditionally, a patient is

pronounced dead when he stops breathing. However, in cadaveric organ 30

transplantation, organs are best removed when the heart is still beating but the

patient is already technically dead, with irreversible loss of brain stem function - a

situation called brain death. Generally, doctors accept that being brain dead is the

same as being dead. However, the patient can be pronounced brain dead only by

doctors who are not part of the transplant team or the team looking after the 35

recipient, using very strict criteria.

IV As far as the law is concerned, transplantation of cadaveric tissues in this country

is governed by the Human Tissues Act 1974. This Act, which is the first and only

statute of its kind in the country, is based on, and almost identical to England's

Human Tissues Act 1961. Our Human Tissues Act 1974 allows for the removal of 40

tissues from cadavers for therapeutic, medical education and research purposes.

Removal of cadaveric tissues is allowed under two circumstances, namely:

• First, at the express request of the donor. The request may be given at

anytime in writing or may be stated orally during the deceased's last

illness in the presence of two witnesses; and 45

• Second, in the absence of objection from the deceased and with the

consent of the next-of-kin. The person responsible for the body should

take all reasonable steps to find out if the deceased had any objection

and obtain consent from the next-of-kin.

V There is presently no legislation in the country controlling the removal of organs 50

from live donors. When there is no clear legal authority, live donations are legally

allowed if there is valid consent obtained from the donor. This loophole in the

system encourages human trafficking as the source of organs. With the increase

in the number of patients in need of organ transplants, together with the scarcity

of available organs, there is nothing to stop individuals from selling their organs 55

for a big sum of money. Since it is possible to live with just one kidney, and with



the demand being so high, kidneys are among the most popular organs for

commercial transactions.

VI Rapid advancements in transplant technology over the years have made

shortcomings in our Human Tissues Act 1974 become more evident. Accordingly, 60

the Ministry of Health is now in the final stages of reviewing the Act to address the

weaknesses and bring it up-to-date. The Ministry is also in the process of

developing guidelines on organ donation and transplantation from living donors.

The amendments to the Human Tissues Act 1974 and the Guidelines on Organ

Transplantation from Live Donors will herald a new era of organ transplantation in 65

Malaysia.

Adapted from: Chua Jui Meng, NCD Malaysia 2004

Volume 3, No.1

Answer the following questions in complete sentences where appropriate.

1. State whether the following statements are TRUE (T) or FALSE (F).

a) "Live-related donors" must be genetically related to the organ recipient.

b) Bone marrow cannot be procured from cadaveric donors.

c) Malaysia's Human Tissues Act 1974 is identical to England's Human Tissues Act 1961.

d) Under the Human Tissues Act 1974, removal of cadaveric tissues is only allowed if the donor requests for it.

(2 marks)

2. What do the following words mean as used in the passage?

a) states (line 7)

b) express (line 43)

c) trafficking (line 53)

d) herald (line 65)

(2 marks)

> Hak Cipta Universiti Teknologi MARA CONFIDENTIAL

CONFIDENTIAL 5 LG/OCT 2010/BEL311

3. The statement"... to ensure that no payments are involved in the procurement of the

tissues and organs." (lines 20-21) means

a) You can receive money for donating an organ.

b) You cannot procure organs and tissues if there is no financial transaction

involved.

c) You cannot receive any compensation for donating an organ or tissues.

d) You cannot receive payment unless you donate an organ or tissues.

(1 mark)

4. What are some of the ethical problems related to procuring organs or tissues from living

donors? List two (2).

(2 marks)

5. "This loophole in the system encourages human trafficking as the source of organs."

(lines 52-53). What does "this loophole" refer to in the above statement?

(1 mark)

6. Why are kidneys the most popular organ for commercial transactions?

(1 mark)

7. Why is it necessary for the Ministry of Health to review the Human Tissues Act 1974?

(1 mark)



SECTION 2: Article 2

Saving lives, one pledge at a time

I More than 100,000 people have pledged to donate their organs, but due to a lack

of awareness, many of these potential donors are lost. According to Tan Sri Lee

Lam Thye, the Chairman of the Health Ministry's public education sub-committee

on organ donation, when the pledger is certified brain dead and his family

members are approached by the hospital authorities, they refuse and accuse the 5

doctors and nurses of being heartless at their time of mourning. Although a

person has pledged his organs, doctors cannot harvest them or take his tissues

and bones without the consent of his family or next of kin. Because of this, several

problems have arisen in connection with organ transplantation.

II The first problem is that, the organ pledger does not inform his family of his 10

pledge to donate his organs when he dies. It is important that he does this so that

his noble intentions will be honoured. It is, therefore, deemed necessary for a

public forum to discuss this issue because it is sensitive, especially with Malaysia

being a multiracial country. Malaysians are now very open and very forthcoming

about donating organs, including the Malays. In recent cases, most of the organ 15

donors were Malays and many benefited from the organs donated. There have

also been cases where the organs of non-pledgers were donated due to the

generosity of their families. Since the 1970s, 215 people have donated their

organs. The harvest included 128 kidneys, 20 hearts, 25 livers, 4 lungs, 86 heart

valves, 143 corneas, as well as skin and bones. 20

HI Another problem is the disparity between the supply of organs and the need for

organ transplants which is increasing throughout the world. This explains the need

for a pledge to donate organs. Despite the support of major religions, low organ

donation rates still prevail because among other things, there is distaste among

people thinking about their mortality, and fears of dismemberment after death. 25

Hospital staff hesitate to burden grieving relatives with a request for organ

donation from their dead loved ones. Relatives may be too shocked at the time of



their loved ones' death, and are simply incapable of making any decision. Public

understanding of brain death is also limited. While on artificial respiratory support,

the deceased's heart continues to beat for a time, the body feels warm and looks 30

as if alive. This makes it difficult for relatives to accept that their loved one is

actually dead. Preferences for organ donation may not have been discussed

beforehand among family members making it even more difficult for the relatives

to decide.

IV Apart from this, organ donation rates are low due to a constant barrage of 35

negative and fallacious stories about organ donation. Only a few television shows

or movies portray transplantation in a positive manner and even fewer of these

bother to give an accurate description of the process of procurement and surgery.

While these shows may be fiction, even viewers who can totally ignore

unbelievable and absurd story lines seen on the screen may develop a negative 40

impression that organ donation is potentially harmful. It is also unfortunate to see

messages on organ thefts being passed around the globe by e-mail and word of

mouth. Asking people to consider organ donation is already a difficult task and

therefore, it should not compete with false and outrageous organ donation stories.

V Hence, a public forum to discuss the issue on organ donation will definitely help. 45

This will not only ensure that an organ pledger's wish is fulfilled but will also

increase the number of pledgers and organ donations among non-pledgers. The

nation needs about 1,200 kidneys, 450 hearts, 450 corneas and 200 livers a year

to save patients' lives. The Health Minister stated that it was disheartening that

despite many fatal accidents occurring in the country every year, the number of 50

organs saved for donation was negligible due to objections from victims' families.

Therefore, a change in mindset is very much needed. Society needs to view

organ donation as a standard aspect of patient care. With this change in mindset,

it is hoped that donating organs will become the custom for Malaysians to save

the lives of others after death rather than letting their organs go to waste. 55

Adapted from: Annie Freeda Cruez New Straits Times, 2 June 2008



1. What do the following phrases refer to?

a) noble intentions (line 12)

b) negative impression (lines 40-41) (1 mark)

2. State four (4) reasons for the low rate of organ donation. (2 marks)

3. What can happen if an organ pledger does not inform his family of his intention to donate his organs when he dies?

(1 mark)

4. In your own words, state the main idea of paragraph IV. (2 marks)

5. What view should society take concerning the pledge for organ donation? (1 mark)

6. In your opinion, do you think the public forum will be effective in dealing with the issue of organ donation? Give two reasons to support your opinion.

(2 marks)

7. In your opinion, why do you think the Malays have now become more willing to donate their organs?

(1 mark)



PART B: WRITING (20 MARKS)

QUESTION 1

You are a member of the health committee of the university and you have been asked to

write an article for the campus bulletin in conjunction with Organ Donation Awareness Week.

Based on these two articles "The Ethics and Law on Organ Transplantation in Malaysia" and

"Saving lives, one pledge at a time", you have developed the following opinion about the

issue:

"Organ donation should be encouraged among Malaysians"

Using information from the two articles, write an article of about 300 - 400 words to support

your opinion. Include three main ideas with supporting details for your article. (You must use

information that you have gathered from reading the two articles but marks will be deducted

if you copy sentences from the articles.) In-text citations and proper acknowledgement of

references used must also be included.

END OF QUESTION PAPER


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BEL311 (2)