Khloe Lee (Li Rouyi), 16

School: Chung Cheng High School (Yishun)

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

Award: Merit, Senior Category, 2024

When it comes to the topic of organ donation and transplantation, most will agree that donating an organ to potentially save a life takes great courage and nobility. It is commonly viewed as an act of selflessness and bravery that can impose an extraordinary impact to improve somebody else’s life. Despite the majority’s positive outlook towards organ donation and transplantation, there are some who do not share the same views. Why? There has been speculation that the lack of interest in organ donation and transplantation is due to its complexity and intricacies, which I personally agree with.

First and foremost, people might not be interested in organ donation and transplantation due to emotional barriers. How do these barriers arise? Cultural and religious beliefs may shape an individual’s perception and emotions on organ donation. Organ donation and transplantation may conflict with their personal practices and beliefs, causing them to be hesitant when it comes to donating their organs. There may be considerations that involve the sanctity of the body and beliefs about the continuity of consciousness beyond death. For example, people who practice a form of Buddhism, known as Tibetan Buddhists, believe that the spirit of the deceased may remain in the body for as long as a week after death. Hence, organ donation may be seen as an interruption to the rebirth of the spirit. Another religious group that turns away organ donation are the Pure Land Buddhists which branches off Mahayana Buddhism as they believe that the soul of the deceased should be able to leave peacefully towards the path of rebirth. Furthermore, the choice to become an organ donor may occur during a time of grief or loss of a loved one, making decision-making challenging. Families may experience fear, discomfort and uncertainty when it comes to this particular issue. Some struggle in expressing their thoughts on becoming an organ donor with their family as it is emotionally challenging. The fear of being stigmatised and disapproved by their loved ones for daring to donate their organs causes them to shun organ donation and transplantation as a “taboo topic” due to factors such as conservative views and religious beliefs. Therefore, emotional barriers may affect a person’s interest in organ donation.

Secondly, some people may have concerns about potential conflicts of interest or a distrust of the medical system. These concerns could have arisen from various factors. For some, the idea of donating organs after death might raise questions on how their organs would be used and if their personal wishes would be followed and respected. There is doubt surrounding whether their organs would be used to save lives or if saving and harvesting organs would be prioritised and as a result, leads to ethical dilemmas and mistrust in the medical system. Certain communities may also become more distrustful due to inequality in healthcare access and treatment as well as past injustices. For example, marginalised groups such as the indigenous communities and refugee communities worry about the equal and just distribution of donated organs and the kind of care transplant recipients get. As a result, the lack of interest in organ donation may be caused by distrust in the medical system.

Thirdly, the reason why people have little interest in organ donation and transplantation is because of how complex the procedure is. Organ donation is undeniably complicated, encompassing medical, ethical, cultural, and logistical complexities that generally contribute to a lack of interest among the general population. The process of organ donation is lengthy and complex, such as donor evaluation to lower the risks of tissue rejection, organ procurement, the surgical procedure and post-operative care. The risks posed by the surgical procedure may also be a reason why patients with failing organs do not want to undergo transplantation. Instead of undergoing transplantation, they would seek alternative ways to buy time. For example, according to a qualitative study done by Science Direct, some patients with kidney failure choose to persist with dialysis rather than seek transplant. The duration of dialysis treatment is three to five hours, two to three times a week. Although this method is indeed much more taxing and costly in the long run, the stakes involved are not as high for people with contraindications like present health issues, when compared to kidney transplantation which may also bring no significant change in improving their health. There have been many reported organ donation horror stories of unsuccessful transplantations and while these horror stories have a fairly low chance of being repeated, people are still on edge about organ donation. With all these complications and complexities to bear, it is no wonder people have little interest in organ donation.

Finally, the lack of interest when it comes to organ donation and transplantation could also stem from ignorance. In fact, with a deeper understanding of organ donation and transplantation, it might not sound as complex as it seems to be on the surface. To counter negative sentiments, resources and support should be provided to help families initiate open discussions, clear up misconceptions and gain deeper understanding on the significance of organ donation. By improving education and raising awareness on organ donation, it may help convey the importance and benefits of organ donation, resulting in more people being interested in organ donation and engaging with the topic. For instance, my interest in organ donation grew when I managed to find out more about it when my school invited speakers from the National Organ Transplant Unit (NOTU) to share more about the Live On Foundation. The same goes for my fellow classmates as we became more well informed of what organ donation is all about through the talk. Hence, I do believe that the lack of interest in organ donation is not caused by its complexity but mostly because of the lack of understanding surrounding this topic.

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