Goh Ce Feng Shane, 17

School: Tampines Meridian Junior College

Topic: Encouraging living donations is key to improve donation rates

Award: Fifth Place, Open Category, 2024

Challenges and Risks - Why Living Donations isn’t the key to Improve Organ Donation Rates

Living Donations are seen as an alternative to deceased organ donation since there is a lack of supply from waiting for deceased organ donors. The National Kidney Foundation in the US reports that despite the increasing acceptance and success of living kidney donations, the pool of living donors remains relatively small compared to the number of people in need of kidney transplants. In the US, for example, there are over 100,000 people on the kidney waiting list, but only around 6,000 living kidney donations occur annually. Encouraging living donations can indeed improve organ donation rates as it helps to increase the pool of available donors, potentially saving more lives. While living donations have their benefits, they pose significant risks and challenges too. There are limitations and complexities such as cultural and religious beliefs, and potential medical complications for donors. On top of that, public education and awareness about organ donation is needed to increase organ donation rates too. Therefore, I disagree to a large extent that encouraging living donations is the key to improving organ donation rates.

Critics of my argument may posit that living donations can be key to improving organ donation rates as there is improved organ matching rate and hence shorter waiting times, saving more lives. This is because living donations typically occur between family members where DNA Inheritance increase chances of organ matching, or sometimes even between friends and unrelated individuals. Living donation is faster as compared to deceased donation as there is no need to wait for a deceased donor and allows for more precise matching between donors and recipients as compatibility tests can be performed in advance so as to reduce the risk of organ rejection or other health complications after the surgery. The number of individuals on the waiting list dying while waiting for a compatible donor will also be reduced greatly.

While I acknowledge the benefits of living donation, it is important to consider the many risks and challenges it poses too, something which my critics failed to see. One of which is the fact that living donations aren't suitable for all organs and circumstances, such as the heart and pancreas. In these cases, deceased donation remains the primary option as it is suitable for the donation of all organs. This brings me to my point that living donation is not the key to achieving higher organ donation rates as there are several other factors that play a crucial role in doing so which renders the benefits of living donations mentioned by my critics to be useless when it comes to these unsuitable organs, circumstances. Efforts to encourage living donations should instead be part of a comprehensive approach to increase overall organ donation rates.

There are many significant barriers to organ donation, cultural and religious beliefs is one of them. Cultural and religious beliefs surrounding death and organ donation vary widely across different societies and communities. Although organ donation is viewed as a selfless act of charity and compassion by some, some cultures may have taboos or concerns about organ donation, causing organ donation rates to fall within these communities. For example, South Africa reported around only 2.1 organ donors per million population in 2020, which is one of the lowest in the world. This is due to the decrease in willingness to donate heart, liver and corneas by the black African population which is consistent with cultural beliefs that emphasise the role of the ancestors after death, and the notion that the body should remain intact for spiritual reasons. In many African societies, ancestors are revered as intermediaries between the human realm and the spirit world, who continue a non-physical life after death and provide guidance and protection for their descendants, so long as the descendants venerate them. Offerings of food, water, and other goods are presented to ancestors at designated shrines or burial sites to seek their guidance, protection, and blessings. As such, no one in African societies, living or deceased should be donating their organs.

Another issue when it comes to living organ donations is concerns over potential medical complications for the donor in the future. This refers to potential living donors being concerned about the health risks associated with surgery such as bleeding, infection and adverse reactions to anaesthesia. Donors may worry about the impact of donation on their own health and well-being in the short-term right after the surgery, pain and recovery time or the inability of the body to perform its bodily functions effectively and efficiently. In the long-run, the impact on their daily lives. With doubts and concerns about the process growing among people, the stigma surrounding organ donation, misconceptions about the process or outcomes of transplantation, and fear of medical procedures can deter potential donors from signing up for organ donation.

As Arthur C. Clarke once said, “Any sufficiently advanced technology is indistinguishable from magic.” In the past few decades, technology has brought about many opportunities for innovation in many fields, such as healthcare leading to technological advancements that have greatly improved our quality of life. Social media is the largest community connecting over 4.76 billion people across the globe. The power of technology just like magic can be used to accomplish incredible things. In this case, technology advances healthcare facilities, equipment, strengthens transplant infrastructure which optimises the process of organ donation and transplantation, ultimately improving donation rates.

That is not all! Technological advancements have brought about the rise of social media that can be used for a good cause, to increase awareness and promote organ donation. With access to a large audience, features that help us decorate our posts, I consider social media to be an interactive platform where like-minded people can work together to spread awareness. All it takes is a few swipes, and clicking the “send” button on your phone. For example, the National Health Service (NHS) in the UK has set-up a Facebook account which has enabled their NHS Organ Donation Team to interact with over 400 thousand people online. This is a much bigger audience compared to a crowd gathering at an organ donation campaign event. This also has enabled easy communication and more direct messages between the NHS Team as well as potential organ donors, patients. All you need is your handphone which you carry around with you wherever you go, as well as to click on the Facebook app to be kept updated, learn more about organ donation. The same 400 thousand followers will also help raise awareness by sharing posts which they feel are important to their family and friends, allowing the word to spread easily. The John Hopkins researchers who are situated in the US found that a social media push for organ donation on Facebook multiplied the number of people who registered themselves as organ donors by twenty-one times per day. The John Hopkins researchers called this 'The Facebook Effect'. This shows us that social media is indeed an effective tool as more people become willing to step forward and volunteer themselves as organ donors. Promoting living donation requires comprehensive public awareness and efforts to educate the public about the organ donation process, risks, benefits and ethical considerations. Without adequate education and support, potential donors lack sufficient information and hence less confidence in the donation process, deterring people from considering living donation as an option.

In conclusion, while living donations do help improve organ donation rates, I think that it is not the key to improving organ donation rates as there are challenges and risks to it. Instead, a comprehensive, multifaceted approach is necessary if we are to make significant strides in organ donation rates in the future. This includes raising awareness about the importance of organ donation, improving infrastructure for organ transplantation surgical procedures, and addressing issues such as lack of education or misconceptions about organ donation. We can do this through outreach platforms such as social media. I’m sure, in the long run, with enough time and dedication, this multifaceted campaign and hard work will pay off, and organ donation rates will improve sufficiently for all patients to get the help they need.

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