Li Jia Zhen Joelle, 14

School: Dunman High School

Topic: Generating positive mindset change on organ donation

Award: First Place, Open Category, 2023

Harmonising Hearts: Breaking Barriers, Inspiring Organ Donation Awareness

Organ Donation: From Hesitation To Hope

Are you aware that through the gracious act of organ donation, one person has the incredible power to save up to 8 lives and enhance the lives of 75 others? Organ donation by definition is a life-saving procedure in which a donor, deceased or living, courageously embarks on a path of altruism, empowering their recipients by bestowing them a second chance in life through the donation of their organs. Such an act is indeed heroic and noble, with living donors willingly walking on a tightrope so as to carry out these selfless acts of compassion. However, some feel daunted in the face of organ donation, perceiving it in a negative light, hesitant to give their organs to beneficiaries, despite the purposeful gains it brings. But why do some feel this way? And what does it take for us to change?

Impacts: The Uphill Battle Of Instilling A Positive Mindset On Organ Donation Conflicting Beliefs

First of all, cultivating a positive mindset on organ donation may pose a challenge when one’s own culture and beliefs depict otherwise. Culture and traditions are typically cultivated from a young age. With such religious teachings morphing into lifelong beliefs and practices, this influences their perspective on various aspects of life, including organ donation. Broaching such a taboo topic like organ donation would force one to confront deeply ingrained narratives that they know all too well. This would place one into a state of unfamiliarity, evoking discomfort and hence, developing a resistance to change. Additionally, as staunch believers, some may confine themselves in their presumed norms, shunning existential ideas that contradict their beliefs. A compelling case study that exemplifies this struggle is the controversy surrounding the hypothesis of brain death and organ transplantation within certain religious communities, such as the case of Jahi McMath in 2013. Jahi's family, based on their religious beliefs, rejected the declaration of brain death, resulting in a legal and ethical debate and impeding the possibility of organ donation. This case study underscores the complexity of navigating cultural beliefs and the need for respectful dialogue and education to foster a more positive mindset on organ donation.

Internal Turmoil

Secondly, one’s psychological concerns may stymie one’s path to cultivating a positive mindset on organ donation. Take for instance the first point, in which it states that one’s cultural and religious beliefs may affect one’s mindset. On the surface, many may convince themselves that their decision against organ donation is supported by their external beliefs. However, sometimes, it could just be one’s inability to comprehend the finality of the loss, thus creating a facade to shield oneself from the traumatic event that occurred, which is the death of a loved one. This in turn, protects and cushions the ramifications of one’s psychological turmoil, acting as a soothing remedy to numb the grief and pain. Hence, refusing to donate a loved one’s organs would seem as if they are able to hold on to the little pieces that remain of the deceased. In a study done by Nottingham University Hospitals NHS Trust in 2017, one may feel an influx in emotions including ‘death anxiety defences’ or ‘feelings of immortality’, strengthened by grieving families observing the deceased in a physiologically maintained state in intensive care. Furthermore, this may blur the line between the notions of ‘gift of life’ supported by transplant policy and altruistic and societal norms, verse ‘sacrifice’ of the body, and the wish to protect the dead body. This case study highlights the innate difficulty for morning families to make clear-headed decisions on organ donation with a positive mindset in view of their grievances.

An Opaque System

Finally, some may have trust issues established by insufficient information and misconceptions. With the act of organ donation only being successfully carried out in recent centuries, many may feel that donating an organ is too daunting. To donor families and donors alike, such a pathway that is both shrouded in ambiguity and is relatively undiscovered, may seem like an endless slippery slope. Hence, harbouring a mindset that “safer is better” , one would subconsciously seal off from any possible reformation for fear of an unpleasant experience. Additionally, many individuals are often unaware of the meticulous executions involved in the organ transplantation. Potential loopholes like unanswered queries and wrongful discernment will undeniably trigger feelings of doubt and a lack of trust in the seemingly opaque system. For instance, in 2010, the Guardian reported on a wrongful donation of the organs of 25 donors in the United Kingdom. Due to faulty software used to transfer data to a new computer system in 1999, this resulted in 800,000 cases being incorrectly filed, with some showing that the individual had opted in, when in fact, they had chosen otherwise. As this incident took more than a decade to be resolved, many loved ones had already given consent for organ donation based on the false premises of the deceased’s wishes. Such large-scale mishaps further proves what many are wary of, affirming that fact that organ donation systems may, at times, fail to be foolproof and secure. Consequently, with organ donation being a sensitive issue that should be handled delicately, such grave problems would pose an aversion, driving one to repulse organ donation altogether as trust is no longer intact.

What’s Next?

Understanding the reasons behind apprehensions is crucial, as is the need to initiate change. By promoting education, dispelling misconceptions, sharing success stories, and fostering open discussions, we can shift attitudes, cultivate a positive mindset, and inspire more people to embrace the profound impact of organ donation.

Fostering Collective Community Action

Similarly to “adopt a river” initiated by the PUB, I believe that a programme like “adopt a foundation” would also achieve similar success. By engaging with companies and getting them to “adopt” an organ donation foundation, in which they would be responsible with volunteering and enhancing the lives of those at the organisation, it creates a sense of belonging and ownership, in which one would feel compelled to help those in the foundation. Together with a sense of duty and an immense satisfaction of doing good, this forms fond memories for the volunteers to reflect on, further enhancing people’s mindset towards organ donation. Furthermore, considering that many individuals in the working class have ageing parents, developing a deep-rooted and positive outlook on organ donation is imperative for them to be knowledgeable on the topic as the sole caregivers. This enables them to guide and facilitate their parents in making informed discussions on the topic of organ donation.

Encouraging Action Through Incentivisation

Additionally, a donor can be incentivised in several forms: monetary or non-monetary. Firstly, the financial aspect can come in the form of tax rebates or a sum of cash to affirm their actions. Secondly, the non-financial aspects like annual complementary health screenings, priority when sorting medical treatment or presenting donors with awards and certificates may appear enticing to some. This form of commendation merely serves as a push factor that encourages donors to solidify their decision under the pretence that they would be well-accounted for after carrying out the heroic act of organ donation. However, the system should be based on an opt-in basis, with some donors genuinely making an altruistic donation thus, this would be able to preserve sincerity and selflessness that is embedded in the act of donating one’s organ. By emphasising the importance of voluntary, altruistic acts, positive mindset change regarding organ donation can be championed. Linking the concept of incentives to generating a positive mindset change can also allow for organ donation to be perceived as a meaningful and benevolent act that will benefit our society as a whole.

Inspiring Community Inclusivity

Finally, organ donation organisations can also collaborate with ActiveSG to promote organ donation. Engaging in community exercises can allow donors, recipients and the public to have a shared experience of keeping fit together. This helps to foster a sense of camaraderie, forging unity between participants over shared stories. Interactions can also help to dispel one’s misconceptions with the public being able to gleam an insightful glimpse into the journey to organ donation. The participant’s fighting spirit and can-do attitude would tug at the public’s heartstrings, being able to personally experience the miracles of organ donation, this inculcates a positive mindset on organ donation.

Conclusion

“The measure of life is not by its duration but its donation” quoted by Peter Marshall. In Singapore, there are over 400 individuals on the organ transplant waiting list as of 2019, with the estimated waiting time of a deceased donor transplant spanning over seven years. Such long waiting times would inevitably arise health complications, leading to a deterioration of their health. Hence, it is vital that the community steps up to selflessly carry out such silent altruistic deeds, bearing in a positive mindset cultivated from the knowledge that one’s act of service and generous gift of life could well cost another’s next gasp of air.

References

1. https://pubmed.ncbi.nlm.nih.gov/32737237/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693122/

3. https://www.theguardian.com/society/2010/oct/19/organ-donors-review-health

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2023 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