Lee Xue Ying, 15

School: Naval Base School (Secondary)

Topic: An email to a classmate on your thoughts on pledging under MTERA and how to respectfully discuss organ donation with his parents.

Dear Henry,

How are you? It’s me, Xue Ying, and it has been a while since we last talked. I remember last week, after the insightful talk on organ donation, you came up to me to ask for my opinion on whether your parents should pledge under the Medical (Therapy, Education and Research) Act (MTERA) or remain under the Human Organ Transplant Act (HOTA). I was really touched when you told me about this. While I understand that talking about this matter with your parents can feel uncomfortable and sensitive, I really want to applaud you for being bold enough. On top of that, trusting me must have taken a lot of courage, so thank you for choosing me. Funnily enough, I did not expect this topic to have lingered in my mind for so long, which fortunately allowed me to better understand the differences between HOTA and MTERA as well as other important considerations. That is why I am quite excited to share with you my thoughts so that you and your parents can make a better decision that reflects your needs.

Before making a decision, I think it helps for everyone to understand the differences between HOTA and MTERA so that we know what exactly each system involves. As many of us know, HOTA is a national organ donation legislation. However, it focuses solely on organ transplantation that covers specific organs which are the cornea, liver, heart and kidneys. Well, thanks to HOTA, more lives are being saved with more organs available for transplantation. MTERA on the other hand is also a similar legislation but more extensive and voluntary. Organs and tissues such as lungs and other tissues can be donated, even your entire body. Not only may they be used for transplantation, but also scientific research and medical education. Overall, MTERA is more of a personal choice to contribute more broadly.

If you hear concerns and doubts from your parents as well as friends, do not worry. These are normal and I will share with you some ways to tackle them. For some families, bringing up the topic of organ donation after death can feel uncomfortable for them. Personally, my mother resented the idea of discussing things about death, scolding me each time I brought it up. Gradually, discussions about this became frequent and acceptable as we understood and learned more about each other’s opinions. Looking back, I realised that patience matters a lot because these conversations cannot be rushed.

Apart from emotional discomfort, some people may also have religious or cultural beliefs. If your loved ones are religious, they may worry that it conflicts with their spiritual practices. However, we should not dismiss their feelings because their beliefs may be deeply personal to them. Instead, we can accept and value their choices. After all, MTERA is voluntary, meaning they can decide whether to participate based on their beliefs and comfort.

While I was digging deeper into the topic, I came across multiple pages mentioning that doctors do not try as hard to save your life if you are a donor. My stomach twisted when I first saw it because it seemed so believable, as doctors are in need of organs to save the lives of their patients. So, here I am assuring you that it is not true. After reading more, I found out that doctors prioritise your life first, which means every patient is treated with the best care. In addition, I am confident that this would not happen in Singapore.

Also, did you know that your suitability for organ donation is based on the condition of your organs rather than age alone? Even if you have medical conditions, you might have other viable organs such as your cornea and skin. Besides that, I was surprised to find out that Singapore’s oldest living kidney donor is Mr. Wong Siak Wan. It was really brave of him to donate his kidney at the age of 79 to his son with kidney failure. Till today, I still admire how he showed that compassion and courage is not limited to age, and I hope this inspiring story warmed your heart like it did to mine.

I remember that you also mentioned that you think MTERA is the right choice for your parents, and I can tell how much this decision means to you. I just wanted to say that sometimes, we might unintentionally hurt our parents because we were not careful with our words. I said this because such a thing happened to my mother and me before, and it really was not nice having such a moment weighing my heart down constantly. So, let me share with you some things to keep in mind in order to avoid such a situation. Usually, I would ask myself, am I respecting their feelings, or correcting them? I am sure that you would not like people being pushy towards you and judging your decision, so let us be mindful about this.

Additionally, we can be more thoughtful in the way we speak. A sincere and gentle tone is more respectful than an authoritative tone. It can be just like how I am speaking to you now!

Henry, it has been amazing writing to you. I must say, your willingness to support others in need has inspired me to do more. Even if your parents do not agree with you, I know you will respect and understand their choice. Do not be upset though, there are just other ways for you to contribute meaningfully to Singapore’s healthcare, such as by volunteering to support kidney dialysis patients. “Make the best use of what is in your power and take the rest as it happens” – Epictetus. We may not always get what we wish for, but we can use what we have to make a positive difference.

If you need more support, feel free to approach me. I would love to share my thoughts with you again! Well then, I wish you all the best in the days ahead.

Best regards,
Xue Ying

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2026 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 ↗ (opens in new tab)