Tan Zi Rui, 18

School: Victoria Junior College

Topic: Increasing discussion on organ donation

Award: Third Place, Open Category, 2022

Initiating Conversations, Giving Others A New Lease Of Life

“It takes lives to save lives”, as said by Oscar Auliq-Ice. Organ donation is a very honourable act that plays a vital role in saving the lives of others, allowing patients with debilitating illnesses to live on for a better life. However, despite it being so important, it is still rarely discussed in the community and amongst family members. Why is this so, and how can we initiate more conversations on it, both in society and amongst individuals?

In Singapore, many patients are racing against the clock to get a life-saving organ transplant. Every year, more than 400 patients are waiting for a suitable organ, and the average waiting time is very long, from about 5 to 17 years, as per statistics from Singapore hospice. With organ donation rates in Singapore generally being low, it is possible that a large number of these patients could unfortunately lose their lives if they do not get a transplant in time. This is why it is extremely important for organ donation to become a topic that is more openly discussed by people in society. With this, more people will be encouraged to become organ donors themselves, to improve the quality of life of patients and even prolong their life.

However, why is organ donation still rarely being talked about?

On an individual level amongst families, organ donation is often seen as a “taboo” subject. Especially in Singapore, which has a more conservative Asian society, families often refrain from talking about organ donation due to it being linked to the inauspicious topic of death, where they do not want to bring bad luck to their family members.

In addition, the health risks of organ donation are a cause for concern for living donors. From the National Kidney Society, living donors have reported long term health issues such as high blood pressure or nerve damage. The possible health threats might deter individuals from donating their organs while they are alive, thus further discouraging them from having conversations about organ donation with their loved ones.

On a community level, religious and cultural beliefs cause society to refrain from talking about organ donation. There are no major religions that forbid organ donation completely. However, some believe in the resurrection of dead bodies and that they must be intact upon being buried. These beliefs of the general society are also taken on by families, in addition to organ donation being seen as ‘taboo’.

Furthermore, some people in society might also not see a reason to donate organs due to the lack of incentivisation. Not all people in society are truly altruistic, where some people might not be willing to donate their organs as it does not bring any major benefit to themselves, even though it can save the lives of others. In combination with religious and cultural beliefs, families as well as the general community are thus discouraged from discussing the topic of organ donation.

The lack of conversations on organ donation has created a void, where people are unsure of whether to donate. Families often have little transparency on the wishes of their family members regarding organ donation, as they may have never discussed it with them before. Together with religious and cultural beliefs, many families might thus act conservatively by assuming that they would not have wished for their organs to be donated. This further exacerbates the problem of low organ donor rates in Singapore, making it even harder for patients to get the organ transplants they need to survive.

With it being vital to have more discussions about organ donation, how can one then initiate conversations on it?

At an individual level, firstly, educational awareness campaigns can be started in the formation years of students to address the “taboo” nature of organ donation. Students can be educated on how organ donation should not be something that is seen as “taboo” but rather that it has many benefits like saving the lives of others. This is essential to initiating more positive conversations on organ donation amongst students and their families, thus helping to encourage more people to become organ donors themselves. It is important that this is done when students are young, as their views on organ donation will become more entrenched as they grow older, making it harder to educate them on why it is important. However, an option to opt-out of these campaigns should also be given for families that feel uncomfortable about allowing their child to learn about organ donation at a young age.

Furthermore, information booths on organ donation can be made within hospitals. These booths can provide important information such as the Human Organ Transplant Act (HOTA), as well as statistics such as the long wait times for patients to get an organ transplant as per the Singapore Hospice. Slogans such as “Become a Hero Today” can also be placed in brochures at these booths to further encourage individuals to become organ donors. This is especially relevant in hospitals where there are patients suffering from serious illnesses, and individuals can more clearly see how they can play an important role in saving the lives of others if they donate their organs. Thus, individuals will be more effectively encouraged to have conversations on organ donation amongst themselves.

Lastly, the government can encourage organ donation to be a part of legacy planning. They can give information regarding the HOTA when individuals are writing their wills, and encourage them to plan their wishes regarding organ donation after death. This influences family members to have more conversations amongst themselves about whether they would be willing to donate their organs, so that families have more transparency on their wishes.

At a community level, firstly, healthcare institutions such as the Ministry of Health (MOH) can talk to religious organisations regarding the religious and cultural beliefs they have on organ donation. These institutions can bring up how organ donation is really important in giving others a new lease of life, and also possibly encourage the idea that by donating an organ, it allows part of an individual to continue to live in someone else even after death. This could possibly influence religious organisations to have positive conversations with the community on how organ donation should not be something that is frowned upon, encouraging more discussions in the general society, even with current beliefs.

In addition, organ donation can be further incentivised to initiate more conversations in the community. As per NDTV, in Iran, organ donors have extended health coverage for at least a year, and have discounted rates at government hospitals for years after donating an organ. In Israel, first priority is given for transplants to living donors and their family members, which has led to the increase in organ transplants in Israel by a whopping 60 percent. Singapore can implement systems similar to this, such as lowering future medical fees for living donors, or giving priority to family members of living donors for any organ transplants they might require in the future. With more personal benefits, more people will be encouraged to become living organ donors, which thus encourages conversations on organ donation in the community.

Lastly, the MOH can initiate focus group discussions in the community to find out more about the ground level sentiments regarding organ donation. These discussions can be done at community centres or online, where people can be invited to share more about why they refrain from talking about organ donation, or why they might not be willing to become an organ donor themselves. The input of the community can be taken into consideration when proposing potential solutions to increase organ donation rates, and these interviewees can give feedback on whether they think these solutions would be effective. More conversations regarding organ donation will thus be initiated in the community, and this also helps the MOH to make more successful solutions.

With these suggestions, ideally, more discussions on organ donation can be started in the community and amongst individuals to expose more people to this topic. This will hopefully encourage more people to become heroes by becoming organ donors themselves, giving patients a new lease of life to be able to Live On.

References

1. “Organ donation”, Singapore Hospice Council https://singaporehospice.org.sg/organ-donation/#:~:text=Organ%20donation%20allows%20your%20legacy,for%20a%20life%2Dsaving%20transplant.

2. Jalelah Abu Bakar, “ ‘Are you sure he is dead?’ Doctors struggle with families’ lack of understanding of HOTA”, 5 May 2019, Channel NewsAsia. https://www.channelnewsasia.com/singapore/human-organ-transplant-act-doctors-families-understanding-887136

3. Bruzzone P, “Religious aspects of organ transplantation”, PubMed. https://pubmed.ncbi.nlm.nih.gov/18555116/

4. “Religious views on organ donation”, Wikipedia. https://en.wikipedia.org/wiki/Religious_views_on_organ_donation

5. “Long term risks of donation”, National Kidney Foundation. https://www.kidney.org/transplantation/livingdonors/long-term-risks

6. “Human Organ Transplant Act”, Ministry Of Health. https://www.moh.gov.sg/policies-and-legislation/human-organ-transplant-act

7. Simar Singh, “Organ Donation Programmes Across The World”, NDTV. https://sites.ndtv.com/moretogive/organ-donation-what-other-countries-are-doing-1297/

8. “About Organ Donation”, Live On. https://www.liveon.gov.sg/about-organ-donation.html

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