Hannah Lim Chun Xuan, 16

School: Chung Cheng High School (Yishun)

Topic: Little interest in organ donation is due to its complexity

Award: High Distinction, Senior Category, 2024

Organ donation and transplantation is a medical procedure in which an organ is removed from the donor’s body and placed in the body of a recipient, to replace a damaged or missing organ. Human organ transplantation is one of the most remarkable successes in the history of medicine. It represents a critical aspect of modern healthcare, offering hope and a second chance in life for those suffering from organ failure. However, most people have little knowledge and interest due to its perceived complexity. Is someone obliged to donate their organs just because they are compatible? Why is organ donation of paramount importance in saving more lives? This essay seeks to provide a fair and equal presentation of organ donation and transplantation and why it is of little interest to people as it is too complex.

Firstly, the complexity of organ donation and transplantation is due to the ethical considerations involved. The ethical justification and consideration for the transplantation of organs from living donors starts with the consideration of the recipient reaping potential benefits balanced against the risks and impact on the donor. Utility, justice, and respect for people are three foundational ethical principles that create a framework for the equitable allocation of scarce organs for transplantation. The process includes the donor’s compatibility with the recipient, the surgical procedures, recovery and financial aspects that both parties may experience. Since organ donation and transplantation includes various ethical justification and considerations, it makes it a complex decision for people to comprehend and make, especially without any prior knowledge.

Secondly, the complexity of organ donation and transplantation is also affected by legal aspects. In the local context, the Human Organ Transplant Act (HOTA) allows for the kidneys, heart, liver and corneas to be removed, for the purpose of transplantation, in the event of death from any cause. HOTA covers all Singapore Citizens and Permanent Residents 21 years old and above, who have good mental health, unless they have opted out, irrespective of religion. There are many laws implemented to safeguard patient safety and welfare which can result in the complexity of this process. This includes consent by families, organ allocations and definition of death. With the lack of familiarity and knowledge on organ donation and transplantation, many people find it difficult to understand organ donation and transplantation.

Thirdly, cultural and religious beliefs also contribute significantly to the complexity of organ donation and transplantation. Different cultures and religions have varying perspectives on the body, life after death, and the ethical implications of organ transplantation. Such beliefs include the attachment of symbolic life-affirming importance to one’s organs and that all body parts must be present on the Day of Judgement and organ donation would interfere with that testimony. Family’s cultural and religious beliefs will influence and affect people’s choices on donating and receiving organs. This makes it a complex decision for people to decide on organ donation and transplantation.

Additionally, medical aspects of organ donation and transplantation make the process complicated. Organ transplantation is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. This will result in more surgical procedures and possibly harm and pain inflicted or in serious cases, leading to death.

Moreover, organ transplant is a complicated and demanding procedure for doctors as well. It requires medical expertise and precision to prevent any complications throughout the process. Doctors are required to carefully consider various factors to find a compatible donor for the recipient to prevent transplant rejection, prescribe just the right balance of immunosuppression medication, postoperative care and also psychological considerations for the recipient’s and donor’s families to help them cope with the changes in their lifestyles and their losses respectively. If two patients are a compatible match with the donor’s organ, doctors have to make the decision on who gets the organ.

Lastly, the cost of organ transplantation also contributes to the complexity of organ donation and transplantation. Organ transplantation is a complex and specialised medical procedure that involves pre-operative evaluations to ensure compatibility, surgery, post-operative care, and often a lifetime of follow-up treatment and medication. Many low-income families may be worried about bearing the high cost. With the large amount of debt to pay off, this may negatively impact the family’s quality of life and standard of living. Thus, the cost of organ transplantation also complicates their decision on organ transplantation.

Thus, ethical considerations, legal and medical aspects, cultural and religious beliefs, and the cost of organ transplantation are important factors which may contribute to the complexity of organ donation and transplantation causing it to be of little interest to people as it is too complex for patients, families and donors.

In addition to the genuine complexity associated with organ transplantation, there are also certain myths that further contribute to its complexity. Misinformation and misconceptions about the process of organ donation and transplantation can create a sense of unease and apprehension among potential donors and recipients alike. One common myth is the fear that organ donation may compromise the quality of medical care for the donor or that medical professionals may prioritise organ retrieval over patient care.

However, in this modern day and age, organ donation and transplantation are relatively less complicated and are of more interest to people due to wide publicity and efforts implemented. In the local context, the National Organ Transplant Unit (NOTU), oversees both living donor and deceased donor organ transplants and is also responsible for the promotion of altruistic act of organ donation and transplantation activities in Singapore. Such organisations are of paramount importance in promoting and spreading awareness of organ donation while encouraging people to participate in the Human Organ Transplant Act (HOTA) and Medical (Therapy, Education and Research) Act (MTERA). This allows people to understand the procedure better and reduce the complications of organ donation and transplantation.

Firstly, ethical considerations in the streamlining of policies and procedures to decrease complications in legal aspects of organ transplants such as the Human Organ Transplant Act (HOTA) in Singapore simplifies the procedure of organ donation and transplantation. This ensures transparency in organ allocation, minimising legal aspects and ethical considerations to simplify the overall organ donation process. By addressing systemic issues, policymakers and healthcare professionals can contribute to a more efficient and user-friendly system, making organ donation more appealing to the public.

Secondly, to minimise the cost of organ transplantation, patients in Singapore may have access to government-subsidised healthcare through programs like MediSave, MediShield Life, and MediFund, which can help offset some of the costs. Singaporeans can consult with healthcare professionals to discuss potential costs, and explore available financial assistance or insurance options to better understand the overall expenses involved in the process.

Thirdly, efforts to develop and improve the organ transplantation procedure. The advancements in medical technology have the potential to simplify organ donation processes to increase the success rate of organ transplantation. Advanced diagnostic tools enable more precise matching between donors and recipients, minimising the risk of rejection, allow a more efficient allocation of organs and enhance overall transplant outcomes. Research to develop a safer and more effective and targeted immunosuppressive medicine is ongoing to minimise the negative impact of organ rejection.

Furthermore, efforts should be made to collaborate with religious leaders and cultural influencers to promote organ donation within the framework of their beliefs. By ensuring that organ donation and transplantation is more culturally sensitive and solving misconceptions amongst people through education and awareness campaigns, people would be more interested in organ donation. Addressing these misconceptions is crucial to fostering a better understanding of organ donation and the concerns about the perceived complexity of the process.

Next, to dispel myths and overcome the perceived complexity of organ donation, education and awareness campaigns play a crucial role. The public needs accessible, accurate, and comprehensible information to understand the importance and benefits of organ transplantation. Collaborative efforts involving healthcare professionals, educators, and community leaders can bridge the knowledge gap and promote a more informed perspective. Schools and community organisations such as NOTU have provided organ donation education and awareness programs to further improve students’ knowledge on organ donation and transplantation. Youths gain a better understanding of the process, benefits and ethical considerations to dispel myths and address any concerns, making the idea of organ donation more approachable for the general public.

In conclusion, there are many factors that contribute to the complexity of organ donation and transplantation such as legal and medical aspects, cultural and religious beliefs, resulting in people having little interest. However, efforts by NOTU are ongoing to change people’s perception of organ donation and transplantation through education and awareness campaigns, fostering trust, transparency and understanding in this process. By addressing the perceived complexity of organ donation and transplantation, the organ donation community can work towards creating a more informed and engaged public, saving countless more lives in the process.

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2024 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