Neo Jia Yu, 16

School: Mayflower Secondary School

Topic: Conservative culture a root cause of low donation rates?

Award: Distinction, Senior Category, 2022

Organ Donation

What does it truly mean to be a part of a conservative society? Truth be told, it varies from country to country and has different variations, like National Conservatism, Religious Conservatism and Social Conservatism. But generally, they are averse to change or innovation and hold traditional values. They are also against divorce, same-sex marriage, abortion and other controversial issues like the role of women in society. However, when it comes to the topic of organ donation, are they truly a part of the same boat as the aforementioned topics? Or is it an entirely different ball game altogether?

Firstly, the argument of a conservative culture being the root cause of a country’s low organ donation rates doesn’t hold water when you compare the statistics of both conservative countries and non-conservative countries. For example, Japan has legalised same-sex marriage, and has allowed abortion since the 1940s. In addition, in 2018, the two largest cities in Japan, Yokohama and Tokyo, are headed by women. However, Japan has the lowest organ donation rate at 19 organ transplants per million people, according to Comparethemarket. Similarly, the US has the highest rate of organ donation at 123 organ transplants per million people. However, according to a Gallup poll in 2020, 34% of Americans identify as conservative. Same-sex marriage and abortion have also been a fiercely debated topic among the United States for a very long time.

Likewise, with Singapore, there is a general middle ground between opinions about conservative issues. According to a Straits Times article, Singaporeans remain largely conservative on issues such as homosexuality, abortion, casual sex and prostitution, but deem the likes of divorce, euthanasia and the death penalty as more acceptable. The organ donation rate is also in the middle of the pack. Hence, when strictly comparing the statistics, this highlights the fact that being a conservative country isn’t necessarily the main reason for the low rate of organ donation.

Granted, as I mentioned earlier, the beliefs of conservatism are not universal and have different connotations in a myriad of countries. Nevertheless, it still has the general idea of being against drastic changes from traditional values and I still feel that the view of Singapore’s conservative culture being not the main reason for its low organ donation rate is still valid.

That begs the question. If not the conservative culture, what else could it be? Maybe the reason for this particularly complex question could be one of mankind’s most primal emotions. Pain and fear. Similar to how the most common excuse for people not donating blood is that they’re afraid of needles, pain (naturally) makes people vastly reconsider the decisions that they make. The risk of death is also something that is very hard to ignore when one is thinking about being an organ donor. Coupled with the fact that the list of side effects of organ donation is not exactly lacking in any way shape or form, it’s no wonder why donating an organ is a very complicated decision. Ever wondered why, despite these risks, more youths are interested in donating their organs, but the organ donation rate is still low? Regardless, if the myriad of surveys say that people are willing to donate their organs, once they are properly faced with the prospect that they might get harmed in the process, they suddenly aren’t as keen to do so. Like what the acclaimed Merchant Of Venice states in its rich and sagely text, ‘If to do were as easy as to know what were good to do, chapels had been churches and poor men’s cottages prince’s palaces.’ For example, in a UK study, a survey was conducted among 18-30 year olds related to organ donation. Out of the 116 participants, nearly two thirds either agreed or strongly agreed to donate their organs, there was a significant decrease in how many people actually signed up to the Organ Donor Registry. This was despite the fact that most of the participants were educated about organ donation, showing that even if you know the processes behind organ donation, this doesn’t necessarily lead to a significant increase in actual donation rates. Or in other words, easier said than done, especially on the topic of organ donation. Essentially, fear and pain undoubtedly makes people put more thought into their decisions, especially when it comes to losing an organ willingly.

On the other hand, Singapore’s conservative culture is mostly upheld by people from the older generation. This is evident from an article done by TODAY, where youths were surveyed and the results show that an overwhelming number of youths accept and tolerate them. As the younger generation has been shown to be now more averse to social changes thanks to the likes of social media, they are also able to use social media to be able to gain mostly accurate information and hence, be able to make a more comprehensive decision. In addition, the power of social media can also expose youths to social issues, such as organ donation or rather lack thereof. However, elderlies are comparatively less tech-savvy than the younger generation and either don’t use the internet for information or don’t use the internet at all. As such, they are still stuck in the past of believing that the process of donating organs or other medical processes are way more dangerous than it actually is or that it is against their religion to do so. An instance of elderies not trusting the health advice that the government prescribes is the issue of vaccinations. In July 2021, 200 thousand elders were not vaccinated. Though the numbers of vaccinated elders are steadily increasing, it took an astronomical amount of campaigning and convincing to do so. Their main reason for refusing the vaccination was the perceived negative side effects from the vaccine. Similarly with the issue of organ donation, the elderlies in Singapore are wary of the topic of organ donation. This cautious notion would be shared among the family and soon, a sizable chunk of people start to associate organ donation with danger and pain and they then spread it to their colleagues and friends, etc. Hence, due to the elderly population that makes up the conservative part of Singapore lacking trust in Singapore’s healthcare is one of the reasons that organ donation rates are stagnating.

Secondly, the issue of religion is a particularly prominent roadblock for the elderlies that make up the conservative culture. According to the Singapore 2020 Census, Buddhists accounted for 35.1 per cent and Taoists accounted for 13.1 per cent of residents aged 55 years and over in 2020. This means that a sizable chunk of the elder population are religious in some way. The problem arises because of the fact that apparently a lot of Buddhists believe in the concept of rebirth. This would result in them not wanting to give away their organs as they would want to have a complete body when they get reborn. Similarly, Muslims are dubious about donating organs as it contradicts their belief in departing from the world in one piece. Though both religions actually do allow organ donation. On the topic of Buddhism, according to donatelife.net, organ and tissue donation is considered an individual’s decision. Buddhism does not promote or prohibit donation, but if an individual decides to become an organ donor, it is widely lauded as an act of compassion. In the case of deceased donation, the death process is an important, highly respected time for Buddhists, and the requests of the deceased takes precedence. Similarly with Islam, in 2019, the Fiqh Council of North America (FCNA) announced that organ donation and transplantation is permissible within the Islamic faith and among American Muslims, making a clear religious ruling for Muslims living in North America. Organ donation is permitted in the Islamic faith as long as Shar’i guidelines are met and that measures are in place to protect human dignity. Living donation is permitted in order to keep the recipient alive, or an essential function of their body intact. In the case of deceased donation, permission must be given by the deceased before their death or by their heirs after death.

However, despite these rebuttals to the false beliefs, many people still believe that organ donation is not advised. Hence, it is because of religious people in Singapore’s multicultural society refusing to believe the new information and instead clinging onto their old ways, hence the low donation rates.

Ultimately, it takes an insurmountable amount of effort to precisely pin down the exact root cause of the low organ donation rates. Though some are easier to notice than others, some are also harder to sieve out from the rest. In this case, conservative culture definitely has a noticeable impact on the rates, but personally, I feel that other causes would fit the role of a root cause better than conservative culture in Singapore, like misinformation and religion.

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2022 are those of the participants and are not endorsed by the National Organ Transplant Unit (Ministry of Health). To learn more about organ donation and organ transplantation in Singapore, please visit www.liveon.gov.sg