Isaac Ivan Seow, 14

School: St. Joseph’s Institution

Topic: Generating positive mindset change on organ donation

Award: Special Mention, Open Category, 2023

Quashing The Irrationalities, Augmenting The Vitality: Sharing Life

1. Introduction

Organ donation – an issue regarded as taboo within this cosmopolitan lion city – has been and is still eminently undiscussed in modern context, due to its correlation with a morbid and macabre topic: Death. Parents persistently dodging their children inquiries and curiosity sparked about this matter, or simply dismissing their children by going off their personal conservatism beliefs, further perpetuates the scanty number of donors each year.

Statistically speaking, even with the implementation of both legislations – Human Organ Transplant Act (HOTA), Medical (Therapy, Education, Research) Act (MTERA), we still have one of the lowest donor rates at 4.48 deceased organ donors per million population. A disproportionate amount in comparison to the five hundred patients yearning to receive their new lease of life. While aimlessly shrivelling and deteriorating piece by piece at home, we spend our years in gratification merrymaking with our friends outside. This is something we, Singaporeans, should be conscience-stricken of.

In an idealistic utopian world where people voluntarily donate their organs to another, he can liberate the lives of up to eight individuals and enhance seventy-five more. However, that is almost near unattainable, especially today, where the media plays a great role in indoctrination of its youth, alongside the technological advancement of organ donation negating donor’s altruism, which can all subsequently negatively morph the mindset of the population, contributing to this exiguous arsenal of organs.

Fret not, this essay aims to debunk plausible rationales people uphold, leading to their dispute about the idea of sharing their life with another, as well as suggest some solutions on how we can plant a seed of credence in the mind of people.

2. Mistrust in Doctor and Procedure

In a modern society today, we are always told to be vigilant and aware before signing on any contract or form. This scepticism could have been carried to the organ donation campaign where some do believe that their organs extracted could have been donated to a patient ungrateful for a new chance and way of living, or even supplied to a “bad person” who self-inflicted the harm, while others are curious to know if their organs are donated to a true identity or not, since the donor and recipients tend to be anonymous.

Apart from the system itself, a possible deterrent some are overwhelmed by is the fear of health and risks concerns that could possibly stem from after the procedure, in turn resulting in their own health predicament. A study found that 48% of the public that was surveyed had voluntarily wanted their organs donated while they are still alive and well. However, according to the “Live On” organisation, live liver donation poses a higher risk of death as compared to kidney donation. Other risks include bleeding, infection and allergic reactions. Many are traumatised by having to face such repercussions, especially when he could be enjoying himself by negating those in dire need of help. This could have been an explanation for the disparity between donors and non-donors.

3. Lack of Reciprocality

In contemporary times, reciprocality is highly manifested in our society, and therefore a highly sought after item for displaying benevolence. No one enjoys the feeling of being taken for granted for their act of kindness. For Singapore’s case, most donations are not out of altruism, but rather under HOTA where it is made compulsory for all those above twenty one years old after death, unless opted out. Looking through the lenses of avaricious and materialistic Singaporeans, being prioritised as patients in need of organs, is insufficient to reciprocate for being an organ donor.

In worse case scenarios, we even have extremists who wonder why they have to donate for “free” when they can make money out of it. This opens up the issue of exploitation, which in this case is twofold – exploiting the poor and those lacking a basic human need. This commodification of body parts and commercialisation of it should not be tolerated. Although not witnessed in Singapore, exploitation of organs, be it consensual or trafficked, is more prevalent in developing countries, due to its impoverished state.

Going back to the issue of reciprocality, one’s mindset and moral beliefs tend to align with their actions – a greedy one tends to do things out of pure self-interest and gain. This could have led to the insufficient organ supply.

4. Religion, Cultures and Beliefs

Similar to popular belief, one’s culture and religion does play a great role in restricting organ donation. Living in a multiracial country, you often meet many of a different ethnicity and culture than your own. However, many are unaware of their religion’s doctrine on this issue of organ donation, formulating their own stigma surrounding this topic. The fact of the matter is that “almost all religions are in favour of organ donation and transplantation, as long as they do not impede the life or hasten the death of the donor”. Most religions do believe that it is up to one’s self conscience on whether they want to donate.

On the flip side, you have Confucianism which states that all individuals are to ensure body intactness after death, emphasising on filial piety, which many Buddhists adopt the ideology of. Moreover, Gypsies believe that one year after a person dies, the soul retraces its steps, and the body must remain intact as the soul maintains a physical shape.

With all these beliefs confined in relative’s minds, deceased potential donors are least likely to get their organs donated. Even with the most miniscule misstep taken, doctors can aggravate the despair felt of losing a loved one, further augmenting the melancholia of those involved in this issue. A much more judicious approach has to be taken in order to knock down the barrier of insensitivity to others’ feelings. After all, bodily autonomy should persist even after rigour mortis has set in. Use of coercion into forcibly donating organs is a violation of basic human rights which should not be tolerated.

Overall, in a multicultural society, religion and personal beliefs indeed are often in the limelight in quantifying the amount of organ donors and should not be simply disregarded.

5. Systemic Changes

Now, what can we do as a society to change the mind of these people and encourage them to actively donate their organs? Well, first of all, would be to mandate the HOTA policy such that citizens will state black and white, before their death, suggestively at the age of 21, whether they would like to donate their organs once they pass on or not. Since family members are more in favour of donating their own organs than their relatives. This is especially beneficial as it not only pulls in the many willing organ donors, but also unequivocally abolishes any family doubts on whether their loved one would want their organs donated.

In order to address the issue of reciprocality, many argue that incentives are the key to success. However, a proper administration has to be conducted in order for smoother running of this change. An example of an indirect monetary incentive would be “funeral benefit” which is popular in many countries, where a fixed lump sum of money covers all funeral expenses. Many have seen this as an appropriate way of giving back to their loved ones as compared to direct monetary gains which is societally repugnant.

6. Spreading Awareness

Secondly, we can have more organisations like “Live On” collaborating with not only schools, but also the public, to debunk each and every myth out there about organ donation. The dominant driving factor for the meagre rates of organ donation is due to all preconceived notions of how it is challenging to become a donor, or that their race and ethnicity plays a crucial role in deciding whether their organ is suitable or not, however, rest assured a patient can always be matched to your donation.

Just like any other campaigns conducted, slogans can be made such as “Share your life today” or “A second chance is in your hands” which can be easily remembered and passed around. With collective effort and deep awakenings, more donors will step forward and assist in alleviating the paltry supply of organs.

7. Conclusion

All in all, against a backdrop of a new generation, where ideologies are easily inculcated into still developing minds, it subsequently can be challenging to change people's minds on this issue, eternising the prolonged deficiency of organs. Obstinate ideologues who believe that the chasm between them and organ donation is the irrational fear where the mind is playing a trick on them – be it their religion, mistrusts or lack of reciprocality, it will indeed be an obstacle we as a society have to overcome. This can be done through supplementary campaigns and collaboration with the public, to spread awareness on this issue. If not, a systemic change with the HOTA policy.

Organ donation is a subject that must be broached more often within our nation, by eliminating the one factor that impedes it – lack of knowledge.

References

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3. Facts and Myths About Organ Donation | Jefferson Health. (n.d.). Jefferson Health - Greater Philadelphia & South Jersey Region. Retrieved April 11, 2023, from https://www.jeffersonhealth.org/your-health/living-well/facts-and-myths-about-organ-donation

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7. Religious Attitudes About Donation: Transplant Services Center - UT Southwestern, Dallas, TX. (n.d.). UT Southwestern Medical Center. Retrieved April 11, 2023, from https://www.utsouthwestern.edu/education/medical-school/departments/transplant-services-center/faqs/religious-attitudes.html

8. Policy options for increasing the supply of transplantable kidneys in Singapore | SMJ. (n.d.). Home Page | SMJ. Retrieved May 25, 2023, from http://www.smj.org.sg/article/policy-options-increasing-supply-transplantable-kidneys-singapore

9. Assessing Global Organ Donation Policies: Opt-In vs Opt-Out - PMC. (n.d.). PubMed Central (PMC). Retrieved May 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128443/

10. State incentives to promote organ donation: honoring the principles of reciprocity and solidarity inherent in the gift relationship - PMC. (n.d.). PubMed Central (PMC). Retrieved May 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121056/

11. Mélanie. (2018, May 19). State incentives to promote organ donation: honoring the principles of reciprocity and solidarity inherent in the gift relationship | Journal of Law and the Biosciences | Oxford Academic. OUP Academic; Oxford University Press. https://academic.oup.com/jlb/article/5/2/398/5001540

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