Free Choice on an Engaging Issue: Organ Trading

Title of Article: Organ Trading Model in Next 1 to 3 Years
Author: Ng Wan Ching
Print Media: The New Paper, under the News Section
Date: 14 August 2008

Synopsis:

The article reports on a dialogue which our Health Minister, Mr. Khaw Boon Wan, held with a group of medical professionals to discuss the possibilities of organ trading in Singapore in the near future. He explained a system which could be implemented to allow this while protecting donors from exploitation. This includes:
1) Restricting trading to kidneys and no other organs, as it was the safest and least problematic,
2) Intervening by matching donors and receipients through a third party panel set up, to avoid direct transactions, and
3) Health screenings, full disclosure of information and pre- and post- operative care.
He also suggested that all donors should be paid the same amount for giving their kidneys but richer receipients would pay more to help subsidize the poorer receipients. Mr. Khaw then suggested that a better system could be implemented in the next one to three years.

Commentary:

With the recent well-publicized charges put against certain individuals in Singapore for engaging in organ trading, which is currently illegal, this issue is all the more relevant in a changing world today.

Several hundred Singaporeans require transplants of organs every year, be it kidney, heart, liver or cornea. To cope with this demand, the Human Organ Transplants Act (HOTA) was passed. The Act assumes that all non-Muslim Singaporeans who die in hospital are willing to donate their organs unless they have opted out of the Act previously. People who opt out, or those who are not covered under the Act (Muslims who have not opted in, people under the age of 21 and above 60) will be given less priority on the waiting list should they require an organ donation in the future. However, the HOTA is still inadequate to provide for the many patients requiring an organ.

However, the idea of organ trading for Singapore is being proposed to help solve this problem. This works on the fact that people would be more likely to donate should they be paid for it.

Firstly, because of the current shortage of human organs, I would support the implementation of such a programme in Singapore. Patients requiring an organ would have to pay much money in order to continue on life support systems if they do not receive one. For example, those needing a heart transplant would have to go on a mechanical heart, which is not only bulky but expensive to use. Kidney failure patients would need to go for regular dialysis, which is not cheap either. It would also be many years of ongoing pain should they lack an organ or require a new one.

Not many people in Singapore can afford a large sum of money in order to just survive, nor would many want to suffer in pain, and thus would greatly welcome the opportunity to receive an organ if it would cost less and be transplanted quickly in the least time possible.

However, this would lead to the problem of people exploiting the poor and uneducated so that they can receive the organs they need. For example, it has been reported in the newspapers that Indonesians are paid to come to Singapore to donate their organs, and that they often do not know about the risks which come along with such surgeries.

Mr. Khaw's proposal seems to be going in the right direction, as it has made arrangements to prevent such exploitation from occuring. Not only should price and matching be made by an external body created for such a purpose, I feel that they should go one step further and only allow Singaporeans to be involved in such transactions.

This is because our largely educated population would know of the risks which follow, and would thus be easily informed about the entire process. Not only this: by restricting this to Singaporeans, it will also prevent foreigners from taking advantage of such a system and taxpayer's money.

I also agree with the proposal to make more affluent patients pay a standard price for the organ while poorer and more needy patients pay less or be fully subsidized, so that all donors receive a fixed amount of money, which is mostly paid for by the richer patients. This would be infinitely preferable to allowing donors to name their price, as only the richer patients would be able to afford it, and leave a lack of organs for the poor.

However, the largest problem still remains, and that is how to provide an ample amount of organs for all who need it. Altruistic donations, where family members donate to each other, are exceedingly rare in Singapore, numbering only in the dozens. If patients' blood and kin refuse to donate or dare not take such a risk for the very ones they are close to, then what is to say that by dangling a small sum of money we will be suddenly flooded by an influx of donors?