Goh Jing Wen, 16

School: Juying Secondary School

Topic: Generating positive mindset change on organ donation

Award: Special Mention, Open Category, 2023

Introduction

Organ donation has been proven to save and improve the lives of many. It is estimated that a single donor can save up to seven lives. According to the Ministry of Health, 504 deceased donor organ transplants were carried out in 2018, 88 percent of which were corneal transplants. There were 6 heart transplants, 19 liver transplants, and 38 kidney transplants. These transplants undoubtedly made a difference in society, helped improve the lives of the recipients, and probably inspired many more to do the same. Although Singapore has been successful in increasing its donation rates, the overall supply is still not enough to supply the demands. According to SingHealth, the organ donation rate in Singapore is among the lowest in the world, at 4.48 deceased donors per million people. The average wait time for a transplant is nearly a decade, due to competition for a donor's organs - there are 400 people on the waiting list and a new person is added every ten minutes. Unfortunately for many, time is not on their side, and an estimated seventeen patients die each day while waiting for a donor. The demand for organ donations and donors has been increasing year after year, but the rate of organ supply is unable to meet the demand. So, even with the positive impacts that organ donation can have, why do people still hesitate to support organ donation? And why can it be so daunting?

Religious and Cultural Barriers

Singapore has one of the most diverse populations in the world, with a mix of different cultures and religions. However, this diversity may lead to these people having different ethical ideologies and beliefs about the topic. Although the majority of religions support organ donations as an act of charity and love, some individuals might find the act of donating their organs to be 'unclean' as they were tampered with before burial or will engage in superstitious activities if the body is not buried as a whole. To them, the importance of their beliefs lies far above the act of charity, and changing their mindsets cannot be done even with the help of statistics.

A Broken Connection with Loved Ones

Singapore's Human Organ Transplant Act (HOTA) introduced the opt-out system to allow citizens to indicate that they do not wish to donate their organs if they feel uncomfortable doing so. However, individuals seem to be abusing this system. According to the Monthly Index of Medical Specialties (MIMS), up to 15 percent of Singaporeans refuse to donate their organs after death. In some cases, upon a loved one's death, their family member may oppose the donation of their loved one's organs, claiming that they did not know of the existence of HOTA and may view the process as a violation of their deceased relative’s will. According to Frontiers, 12.6 percent of the surveyed individuals think that their deceased relative did not agree with it or did not ponder over the topic seriously. This could be because family members have an emotional and psychological attachment to their deceased relative and are not ready to part ways or to watch their loved one’s organs be transplanted into another’s body as they still want to spend as much time with them as possible before the burial or cremation. However, an organ transplant is like a ticking time bomb, once the time is up, the organs become unviable. This might create a stressful situation for the family members to decide within a short period of time, and it will not be surprising if their answer was ‘ No’. On the other hand, while it is not truly unlawful for a doctor to go ahead with the transplant procedure for a patient who did not opt-out, it may create fear and distrust within the community.

Prevalent Confusions

Since organ donation is a sensitive subject for many, an unwillingness to talk about anything related to death is not uncommon, especially in Asian cultures. According to a survey done by NTU students, out of the 302 individuals surveyed, 32% knew nothing about organ transplantation laws. The lack of exposure to the subject growing up may result in the public relying more on stereotypes instead of facts. According to the Singapore General Hospital, some myths that people have about skin donation include doctors not willing to save them because they are tissue donors or that an open casket funeral will not be possible as the body will appear bloody and skinless after a skin donation. These myths can spread from person to person, instilling fear and reluctance to become a donor. To add on, to achieve a positive mindset change means we would have to address and assure the concerns and misunderstandings of all global individuals, which could be overwhelming for some, and even intimidating for others. Furthermore, some individuals may not be certain of the process of an organ transplant and may not trust that the healthcare system will handle their deceased relative’s organs with respect. This can cause people to be sceptical about or even opposed to organ donation.

The Battle for Positive Mindset Change

There are many more reasons why a person may have a negative mindset about organ donation, and the concerns will vary from person to person based on their backgrounds and knowledge. But are there any ways to have a positive mindset change?

Spreading Awareness

It is important to note that common misconceptions and concerns can be addressed easily through education and campaigns. Organisations can engage with communities, religious organisations, and cultural groups to understand their beliefs and values regarding organ donation. This can help identify any barriers to organ donation and find ways to address them while respecting their beliefs and values. Working with trusted community leaders and advocates can also help to build trust and promote positive attitudes towards organ donation. Organisations can also use technology, like social media or advertisements, to get more supporters involved with the campaigns or to even share valuable information with the public, resulting in more people becoming donors or supporting donations. Furthermore, with over 4.76 billion people using social media daily, if everyone plays a part in spreading awareness about organ donations on multiple social media platforms, more individuals can be properly educated on the topic of organ donation.

In December 2020, four NTU students launched a 4-month-long public education campaign on organ donation called ‘Don’t Hold Back’, which encourages youths to initiate early conversations with their loved ones about their decisions to be deceased organ donors. Through the use of social media, the light-hearted nature of their videos created a ripple effect that encouraged more family members to share their views on organ donation. According to their report, the campaign successfully increased the number of conversations about deceased organ donation by 4.8%. The contents of the videos also allowed its viewers to see organ donation from a different perspective, that of a parent and a youth, thus allowing them to develop a more positive mindset on organ donation.

The Power of Storytelling

Humans are emotional creatures. We are easily motivated and influenced by our thoughts and feelings. Emotions drive us through the process of decision-making and push us to take certain actions. Similarly, authors use different forms of imagery and language features to create a play on emotions, allowing us readers to step into the shoes of the main character, thus better understanding the message of the story. Personal narratives help to connect people on an emotional level, which can be particularly effective in changing the views and attitudes of a person. Hearing about the personal stories of donors and recipients can inflict a sense of sympathy and compassion on others, fostering a sense of community and solidarity. Following the donors and recipients on their journey towards better health and a better life allows us to feel as if we are going through the journey with them, which creates a sense of hope and optimism for the viewers. These can also build a positive social norm around organ donations, normalising the act of donating our organs, thus prompting people to be more open-minded. Additionally, storytelling can help break down the common misconceptions and anxieties about the process of organ donation. By diving deeper into the behind-the-scenes world of medical procedures and the potential outcomes of an organ donation, viewers would be more understanding and accepting of the system.

These stories can be presented in the form of documentaries, biographies, or even simple YouTube videos that are free to be viewed by the public. It is also important to preserve the legacy of our world’s heroes to ensure that their honourable sacrifice is not forgotten.

Conclusion

With these factors in mind, it is safe to say that generating a positive mindset change may be challenging, but not impossible. Providing accurate information about organ donation and addressing misconceptions can help alleviate fear and increase understanding. Thus, by addressing the root causes of these negative mindsets, we can inspire more people to support the act of giving.

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