Oh Yu Han, 18

School: Dunman High School

Topic: Increasing discussion on organ donation

Award: Special Mention, Open Category, 2022

Embracing our Legacies

Organ donation is a life-changing act of altruism and generosity. Despite it being a beautiful opportunity to save others’ lives, deceased organ donation rates in Singapore are strikingly low at 6.6 per million population, leaving more than 400 people waiting on the organ transplant list for a new lease of life. This can largely be attributed to objections from family members, as many of them face ambiguity around their deceased kin’s consensual status. The low news coverage of this significant statistic also points toward worryingly low levels of public awareness. Evidently, organ donation is not talked about enough in Singapore, at both an individual and community level.

Under the Human Organ Transplant Act (HOTA), all Singaporean citizens and Permanent Residents aged 21 and above are deemed donors with presumed consent. Yet, this remains unknown to many. In our society governed by Asian conservative values, mentions about death are thought to bring bad luck. Religious beliefs surrounding the sanctity of the body, such as the Confucian idea of keeping an intact body during funeral rites, may also deter important conversations surrounding organ donation. Beyond religion, strong family systems present in our society reinforce attachments to loved ones, causing family members to choose the safer bet of objecting to HOTA when faced with doubt about their family members’ consent. Under such reasons, the Medical (Therapy, Education and Research) Act is even lesser known, for the same fears would render donating organs for research out of consideration. Thus, organ donation is rarely discussed and consent is rarely clarified before tragedy strikes.

Contrary to popular belief, decisions on organ donation need not necessarily only be made when in the depths of grief. Conversations need to start early on this issue, especially since lives are at stake. Donor consent should be confirmed early so family members are aware and can focus on fulfilling their loved ones’ wishes when the time comes. It not only helps to prevent devastation and grief by saving lives but also allows donors’ families to extend the legacy of the donor in touching others’ hearts.

How then, can we initiate such discussions on an individual and community level?

Keeping in mind that since organ donation is a fully altruistic act that comes without incentive, it may not come into the attention of pragmatic Singaporeans amidst their busy fast-paced lives. This is much unlike other government support measures like the Baby Bonus Scheme or HDB housing grants that will factor into citizens’ consideration at important stages of their lives. Of course, this does not mean that organ donation should be financially incentivised. With organ donation remaining a taboo topic in current society, incentives would likely be regarded as commercialisation, leading to societal repugnance against such “organ-selling”. This simply means that the best bet for a feasible and sustainable solution to increase willingness of organ donations would be to raise awareness and change mindsets.

One option is to start young. Since HOTA may also apply to those below the age of 21, as long as the person’s parent or guardian has consented to such removal, conversations on organ donation may be facilitated in school to introduce young adults to the importance of organ donation. This can take place as part of the Character, Citizenship and Education (CCE) curriculum to prompt thoughts on organ donation. Since young people are less likely to hold on to traditional beliefs and generally more willing to donate, bringing this important topic into their attention can encourage young adults to discuss organ donation with their families. To tackle fears and doubts surrounding the infringement of religious beliefs, healthcare institutions like the National Kidney Foundation and the National Organ Transplant Unit can partner with religious groups to moderate dialogues and reassure the public that organ donation aligns with their religious beliefs.

In addition, celebrations of organ donation can be extended to the community level. Currently, events such as the Donor Appreciation Ceremony are exclusive to donor families and transplant recipients. Wider recognition and appreciation of organ donation can be encouraged by having a consistent date of celebration, such as how National Donor Day is observed annually in conjunction with Valentine’s Day on 14 February in America to raise awareness about organ and tissue awareness. Similarly, Singapore honours blood donors by celebrating World Blood Donor Day annually on 14 June. Even in light of COVID-19 pandemic restrictions, the Singapore Red Cross and the Health Sciences Authority have taken a digital approach through engagement on social media to attract digital natives in the younger generation. Such initiatives can be a point of reference in embarking on efforts to raise awareness on organ donation.

Following cultural changes in the erosion of traditional superstitious beliefs, and the general trend towards greater open-mindedness in our younger generation, we can be optimistic that organ donation will become a more widely-accepted topic among Singaporeans. What matters most are the efforts toward starting such conversations and stepping out of one’s comfort zone to embrace the possibility of extending our legacies.

References

1. Muthiah, M. D. (2021). A Multiethnic Asian Perspective of Presumed Consent for Organ Donation: A Population-Based Perception Study. Frontiers. Retrieved 26 May 2022, from https://www.frontiersin.org/articles/10.3389/fpubh.2021.712584/full

2. Baker, J. A. (2021, February 4). ‘Are you sure he is dead?’: Doctors struggle with families’ lack of understanding of HOTA. CNA. Retrieved 26 May 2022, from https://www.channelnewsasia.com/singapore/human-organ-transplant-act-doctors-families-understanding-887136

3. Policy options for increasing the supply of transplantable kidneys in Singapore | SMJ. (2016). Singapore Medical Journal. Retrieved 26 May 2022, from http://www.smj.org.sg/article/policy-options-increasing-supply-transplantable-kidneys-singapore

4. Organ Donation in Singapore (under HOTA, or For Science). (2021, July 15). SingaporeLegalAdvice.Com. Retrieved 26 May 2022, from https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/

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