Kyla Yoong, 15

School: Anglican High School

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

Dear Atilya,

I hope that you are doing well! Thank you for taking the time to share what’s been on your mind. You have no idea how much it means to me that you’re willing to confide in me about something so personal. Choosing to pledge under MTERA instead of just sticking with the presumed choice is a big deal. Rest assured, I am in full support of your decision to register under it. I understand that initiating conversations about organ donation may feel uncomfortable at home; however, postponing these discussions can lead to confusion and uncertainty – family members may unknowingly make decisions that do not reflect your wishes, just because this conversation didn’t happen sooner. Organ donation is sadly a bridge to a second chance that most overlook. Believe me when I say that you’re such a brave, prudent individual for speaking up! I’ll share my thoughts about it and what I feel is the best way for you to bring it up.

You’re probably well aware of the difference between the MTERA, Medical (Therapy, Education and Research) Act and HOTA (Human Organ Transplant Act). However, I thought it would be helpful to lay things out more clearly, since most use these terms synonymously. Under HOTA, Singapore Citizens and Permanent Residents aged 21 and above are automatically included in an opt-out system. This means consent is the default position unless explicitly stated, and it applies to specific organs like the kidneys, liver, heart, and corneas, solely for transplantation purposes. On the other hand, MTERA is a voluntary opt-in scheme open to individuals aged 18 and above. It encompasses a much more diverse gift, reaching beyond the basics to include things such as lungs, bones, etc. to be donated. These are not just used for transplantation but also for medical education and research. In a way, stepping forward to pledge under MTERA is more than just a choice; it’s about clarity. By making your wishes clear, it removes uncertainty for your family during an already difficult time. It spares them the heartache of second-guessing, replacing a heavy, impossible decision with the peace of mind that they are simply honouring your wishes.

I understand why this decision isn’t easy for you as much as it is for your parents to hear. At such a young age, it may be difficult or confusing to make this irreversible choice that entails this much weight, especially if you’re unsure whether to do what you may feel is right, or follow your parents’ wishes. I know that you’ve mentioned that you feel pledging under MTERA is the right way but allow me to enlighten you on your parents’ hesitations. For most parents – including yours I’m sure, the conversation may be too uncomfortable or distressing. Discussing death may be considered taboo in many families since it’s an unimaginable and touchy topic. Factors such as religious values or limited understanding of organ donation laws further complicate the issue, resulting in families struggling to make timely decisions under the stress of a sudden death.

If you, or your parents are feeling nervous, it’s perfectly normal. I’m sure this topic may have been unexpected for your parents to hear, and they may have been shocked at first, as they needed time to process your decision. Confronting mortality earlier than expected is a huge commitment, so it’s only human to feel worried about it. The important part is what you’re doing now – speaking up and making sure that your loved ones are on the same page as you. Believe me, you being able to express your wishes so distinctly on this vital, yet overlooked topic speaks volumes to me and clearly highlights your maturity and courage at such a young age.

People often worry that saying 'yes' to MTERA means doctors won't try as hard to save them, but I’m here to tell you that this isn’t so. Registered donor or not, saving the patient’s life is always the top priority, and organ donation only even becomes a conversation after every single effort to save you has been made.

Even if your parents’ concerns are based on such misconceptions, I’d like to gently remind you that it’s crucial not to be so dismissive immediately, to really show that you’re taking their opinions in consideration, and this is not just a rash decision you’ve made. Perhaps you could guide them through their misconceptions, approaching it with a gentler, more empathetic tone can really make a difference. For example, being mindful of the tone you take with them, or asking “What do you think about this?” after stating your opinion. When both sides become more willing to listen, reaching a genuine consensus just feels more natural. However, I do hope you know that their hesitation comes from a place of deep love. Just like anyone else, they care for you, which is exactly why it’s so important to clarify their doubts, allowing them to feel as secure about choosing MTERA as you do. I’m certain that with enough patience and understanding, they’ll be able to understand your point of view too. Talking to them as their child first, donor second, shows that you value their feelings as much as the cause itself. So, I think it’s worth leading with sincerity and giving them the space they need to really process everything without feeling rushed, helping them to fully accept and trust you with this heavy decision.

Atilya, you’re truly doing so well. Discussing organ donation, especially with your parents, is a big step, and it's one that truly makes a difference. I wanted to remind you that ultimately, what you choose should be what you think is best for you, and you only. External opinions, even your closest friends and family, shouldn’t drown out your voice. Standing by your choice is truly admirable, so I hope you’ll never forget that we are with you no matter what, every step of the way.

Always a call away,
Kyla

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)