Nguyen Hoang Long, 19

School: Victoria Junior College

Topic: Importance of organ donation awareness and engagement efforts for every age group

Award: First Place, Open Category, 2025

A shared humanity beyond numbers: Saving lives by bridging generations fairly

Introduction 

In Singapore, a liver-failure patient waits about 23 months for a transplant on average^[1]. A kidney-failure patient waits for 8 to 9 years^[2]. The long waiting period makes them vulnerable to worsening medical conditions, which may end up fatal if they do not receive a new organ. For liver-transplant patients, they may develop acute liver failure with mortality rates reaching 50 to 75%^[3]. The thin line between life and death hinges precariously upon an act of kindness from a donor. 

Unfortunately, the organ shortage crisis persists, and may even worsen, due to increasing demand from a population with longer life expectancy, coupled with a limited existing donor pool. Singapore currently has over 500 recipients waitlisted^[4]. The key to this pressing global issue lies with organ donors’ willingness to donate. Thus, substantial efforts to raise awareness and encourage donations are necessary, and every age group must be included. Theoretically, such efforts should reach all ages equally, with the same amount of resources and information provided. However, that may not be the most strategic due to varying impacts, needs and responsiveness of each group. Instead, efforts must be equitable – tailored to the role, preference, and influence of each group to achieve collective societal impact. 

The key problem to address with engagement and awareness programmes 

The need for awareness and engagement efforts to all ages mainly stems from the general lack of knowledge on the topic of organ donation. For many individuals, little information is known about organ donation, which may result in misconceptions. Consequently, potential donors or their families might have erroneous assumptions or beliefs about donating organs that hinders their willingness to approve of this act. One commonly misunderstood notion is brain death. The body signs of the afflicted may lead loved ones to believe in the reversibility of the situation and cling on to a hopeful outcome, causing them to object to the removal of organs from a deceased family member. Moreover, families who are unaware of the donation system, specifically opt-out ones such as the Human Organ Transplant Act (HOTA), may strongly refuse further operation on their loved ones without explicit knowledge of their consent (which is assumed in HOTA). Many of these families’ members have a wide range of ages, all of which require adequate outreach and persuasion to effectively tackle the barriers to improving donation rates. 

Should the efforts reach all ages equally? 

Admittedly, to directly improve donation rates, it is likely that engagement towards age groups with higher decision-making over important decisions, including healthcare-related matters such as organ donation, is the most effective. A lot of engagement efforts such as public education campaigns tend to target those in their early twenties to the middle-age more. This extra attention can be attributed to Singapore’s HOTA opt-out system, where citizens or permanent residents are seen as potential donors once they turn 21 unless they opt out. In this age range, the majority are often able to make decisions with little influence from other family members, and they have the highest suitability to be organ donors in terms of health. Thus, convincing more individuals in this bracket to donate would theoretically bring about an immediate increase in the availability of organs. Additionally, this group often has the most say in decision-making for many households, especially if they are the main providers for their families. Combined with the Asian culture of respecting those with higher seniority, their perceived authority allowed them to assume greater control over family discussions and decision-making for others, including organ donation in the event of a loved one’s death. For example, parents typically serve as primary decision-makers in medical matters for young children, so educating the older adults not only informs their own choices but also shapes the environment in which their young grow up. More efforts and resources might be dedicated to this target group as a result, since their direct contribution and significant influence on the attitudes of other members seem to be the quickest solution to the organ shortage. 

Nevertheless, an overemphasis on one specific demographic over another would mean neglecting the equally important involvement of others. Certainly, kindness, empathy, and altruism are qualities found across all ages. As societies around the world become increasingly progressive, many are more open to discuss organ donation, regardless of age. Yet, their desire to help others may be restricted without enough knowledge. Under the Medical (Therapy, Education and Research) Act (MTERA), individuals aged 18 or above can opt-in to donate their parts, meaning that young adults and adolescents approaching this age may consider their decision. Insufficient engagement with this group may exclude many potential donors from making an informed choice that may directly save lives. In addition, retired seniors might also ignore the possibility of being involved as donors because of their inadequately unaddressed misconception about being too old to donate. 

Limited efforts to inform and initiate actions for some age groups can prevent a culture open to donation and clear communication which can exacerbate the knowledge gap issue. In societies influenced by Asian cultural norms, where death-related topics are often considered taboo, the lack of intergenerational dialogue deepens discomfort and avoidance surrounding organ donation. Differences in mindset across generations, coupled with the absence of transparent communication about intentions, can lead to confusion or even conflict when critical decisions must be made, particularly during moments of emotional distress. In this context, awareness campaigns that fail to inclusively engage all demographics are unlikely to foster open communication or improve donation rates in the long term. Conversely, significant engagement across all age groups can collectively normalise the topic of organ donation, making it more acceptable and easier to discuss. Inclusive awareness efforts help integrate donation conversations into family life, reducing uncertainty and anguish during critical moments. According to the UK’s NHS Blood and Transplant service, family consent is significantly more likely when the deceased had previously expressed their wishes^[7]. On top of that, certain groups such as youth may further promote the topic of organ donation on a wider scale through the use of social media. Their strong drive to fight for their cause, challenge social norms and grow their autonomy can bring about impactful outcomes by influencing family conversations, and maybe community-wide or global discussion. Thus, efforts that target every age group increase the likelihood of organ donation being understood and embraced as a shared family value. 

Barriers to receptiveness of campaigns 

How effective the message is conveyed depends on the medium used in delivering them as different demographics have distinct preferences. The tendencies and characteristics of one age group may influence their media consumption choices, making them favour a means to receive information over another. A message might be unintentionally overlooked by age groups that do not habitually use the medium it was featured in, thereby limiting the scope of the engagement. For youths, digital natives with generally shorter attention spans, quick videos and posts on social media are the prime methods of capturing views and relaying important information. In contrast, many seniors are not tech-savvy enough in using their online resources and may listen more to community workshops, engagement booths and traditional media such as television broadcasts. A one-size-fits-all approach to reach everyone equally undermines the importance of the platforms used to raise awareness, posing challenges for organ donation campaigns to spark conversations or call for action. 

Furthermore, the extent to which different groups resonate with organ donation messages affects how well they respond and internalise their new-found knowledge. Similar to tactics used in marketing campaigns, people are more likely to take action or become a donor if they feel their goals and values align with the engagement. Having common interests can stir strong emotions within the human mind, which can in turn develop deeper personal connections between potential donors, advocates and their cause. Take the elderly, whose dislike of death-related topics tend to deter them from becoming engaged, framing organ donation as a way to leave a legacy for others might better match their values of heritage and forward-paying contribution. Certain themes emerge for other demographics: working adults resonate with ideas of caring for one’s family; youths desire to generate widespread societal impact and assert their identity; young children’s imaginative minds grasp visuals better than words… Without a customised message for every group, it is difficult to effectively nudge them to act. 

Conclusion 

It may not be necessary to engage and provide information to all ages equally, but reaching to each group fairly is pivotal in addressing organ donor scarcity. In doing so, donation rates may substantially rise as a result of short-term increase in awareness and the long-term formation of a culture of open discussions about organ donation. Crafting demographic-tailored messages plays a significant role in achieving this positive mindset shift towards organ donation, potentially on community and global level.

References

1. National University Hospital. (n.d.). Liver Transplant. Retrieved from https://www.nuh.com.sg/health-resources/diseases-and-conditions/liver-transplant  

2. National University Hospital. (n.d.). New organ preservation method to cut transplant waiting times. Retrieved from https://www.nuh.com.sg/health-resources/newsletter/envisioninghealth---changing-lives-one-idea-at-a-time/new-organ-preservation-method-to-cut-transplant-waiting-times  

3. Panackel, C., Raja, K., Fawas, M., & Jacob, M. (2024). Prognostic models in Acute Liver Failure-historic evolution and newer updates. Best Practice & Research Clinical Gastroenterology, 101957.

4. Savulescu, J., & Menon, S. (2024, July 24). Organ Donation. National University of Singapore. Retrieved from https://medicine.nus.edu.sg/cbme/wp-content/uploads/sites/14/2024/08/2024-Jul_Julian-Sumy_Organ-Donation-1.pdf 

5. Live On. (n.d.). About Organ Donation. Retrieved from https://www.liveon.gov.sg/about-organ-donation/  

6. The Guardian. (2016, January 15). Families veto hundreds of organ donations in five years, figures show. Retrieved

7. NHS Blood and Transplant. (n.d.). Consent/authorisation – Communication. Retrieved May 30, 2025, from https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/consent-authorisation-communication/

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2025 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