Keanu Tan Ding Sheng, 15

School: Fuhua 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 Jeremiah,

I am really glad that you have decided to learn about organ donation and are even engaging with your parents about it! Organ donation is a very meaningful and personal decision. Thus, I have decided to do some research for you to tell you about the many differences between MTERA and HOTA, common misconceptions about organ donation, as well as how you should talk to your parents about this to avoid misunderstandings.

First, it might help you to understand the importance of organ donation and transplantation and what it is about. Individually, organ transplantation is often the only life-saving treatment for organ failure. Knowing that they may still survive gives them hope and a will to keep fighting. When they finally receive one, it can provide them with a second chance at life, increasing their life expectancy and improving their quality of life. Organ donation also creates a sense of purpose for donors and their families, as donors can feel accomplished for saving a life and families can feel pride knowing that someone related to them saved a life. In terms of society, organ donation is essential for creating developed and mature health care systems. It creates a community where people help each other in times of need and makes a fairer system for those on the waiting list. Donating your organs also helps to advance medical science research and education in MTERA, boosting the development and research of new medicines and treatments for organ failure. In general, organ donation and transplantation provide a myriad of benefits. It saves lives, improves quality of life for others, reduces the toll on healthcare systems and provides comfort and hope for people on the waitlist and their families.

Now, let me help you clearly understand the key differences between HOTA and MTERA. Under HOTA, you are automatically included unless you opt out. This means that certain organs may be taken for transplantation after death, primarily for medical need, and it operates on a presumed consent basis. In contrast, MTERA is a voluntary pledge in system. Choosing MTERA requires an active and purposeful decision to donate your organs or body for a wide range of purposes, including education and research, not just for transplantation. MTERA reflects personal altruism, while staying under HOTA is more of a civil responsibility which prioritises social benefit, so the key difference lies in intent: HOTA is passive unless you opt out, while MTERA is a conscious, proactive commitment. 

That being said, it is understandable that you and your parents might have mixed feelings and reservations about organ donation. Many people react differently when the topic of organ donation is mentioned. Some may feel that it is deeply emotional and meaningful. Donor families can feel a sense of achievement and pride knowing that their family member saved many lives. Recipients can feel overwhelmingly grateful or relieved. However, some may feel that it is distressful. Donor families may feel strange knowing that a piece of their family member lives on in someone else. Some also believe that you cannot pass on properly without your entire body intact, or would like to opt out but do not want to be at the bottom of the transplantation waitlist. Some families may fear that the organs may not be ethically used and may be sold without their consent, or have cultural or religious beliefs that lead them to not want to donate their organs after death.

There are also a few myths and misconceptions that you may want to clarify. One common myth is, “Doctors may not work as hard to save my life if I have registered as an organ donor.” When you go to the hospital for treatment, the healthcare team tries to save your life, not someone else's. In the hospital, you are getting the best care you can get. Another myth is, “Organ donation is against my religion or faith”. Most major faiths accept organ donation. These include Catholicism, Islam, Buddhism, most branches of Judaism and most Protestant faiths. Some religions believe organ donation to be an act of charity. If you don't know where your faith stands on organ donation, I recommend asking a member of your religion. Another misconception is, “I'm too old to donate. Nobody wants my organs.” There's no standard cutoff age for donating organs. The decision to use your organs is based on the health of your organs, not age. You should let the healthcare team decide whether your organs and tissues can be transplanted. Finally, there is a myth that states, “My family will be charged if I donate my organs.” An organ donor's family never pays for donation. The donor family pays for all the medical care given to save your life before your organs are donated. Sometimes families think those costs are for the organ donation. But the person who gets the organs for transplant pays the costs for removing the organs. These are all the myths that I hope I have clarified.

When you discuss this with your parents, it is important to approach the conversation sensibly. Avoid sounding forceful or implying that your view is the only “right” one, as this could make them defensive. Instead, listen carefully to their concerns and show that you respect their perspective, even if you don’t fully agree. You might find it helpful to mention your shared values, such as helping others or making a positive impact, rather than focusing solely on the technical differences between MTERA and HOTA.

Ultimately, whether to remain under HOTA or pledge under MTERA is a personal and family decision. What matters most is that the choice is informed and made with mutual understanding. If you speak calmly and respectfully, you will more likely have a meaningful discussion rather than a disagreement. I hope this helps in your discussion with your parents and gives you a better understanding of organ donation and transplantation.

Best regards,
Keanu

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)