Tai Xin Yu, Diane, 15

School: Mayflower 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.

Pledging with Purpose : Why opting matters in organ donation

Hi Joseph,

How are you doing? How are things going on at home? I hope your family is doing fine. Thanks for letting me have the opportunity to be part of your circle to help you and your family decide the pledge under Medical (Therapy, Education and Research) Act (MTERA) or remain under the Human Organ Transplant Act (HOTA). So, I am writing this email, to advise you on this situation.

First of all, it might help to clearly understand and articulate the difference in intent between pledging under MTERA and remaining under HOTA. HOTA is based on the principle of presumed consent. Its intent is for societal benefit – to increase the organs available for transplantations to save more lives. This act assumes that you have opted in unless you yourself actively opt out from it. This does not mean HOTA is unethical or negligent, instead it reflects a public-health approach where others’ lives are considered.

MTERA, on the other hand, is based on more explicit and deliberate consent. Its purpose is more individual in nature. A pledge under MTERA is an active statement of one’s personal values and willingness to donate for transplantation, education, or education. The difference in intent is important, being under MTERA does not mean rejecting HOTA’s goals. Instead, it reflects that donations should be an intentional act that is clearly chosen and recorded. When you talk to your parents, portray the pledging under MTERA as a matter of clarity, intention, and responsibility, rather than superior to HOTA, which could help them better understand your perspective.

Secondly, it is important to consider the reservations and considerations your parents and family might have. These reservations are often more emotional rather than logical, but this does not make them unreasonable. Some parents might feel hesitant or even uncomfortable discussing death, seeing it as a sensitive topic. Others may worry about what happens to their body, whether it would be treated with dignity, and whether donation would interfere with funeral rites and traditions.

There might also be deeper concerns about trust in the healthcare system. Even though safeguards exist, some families fear that being an organ donor might affect how doctors try to save a patient. Additionally, if your parents are not really comfortable with the idea of brain death, they might struggle to accept organ donation. All these reservations and conservations are common and should not be dismissed as ignorance or fear. Acknowledging these worries is crucial if you wish for the conversation to be constructive.

Thirdly, there are several myths and misconceptions that might need clarification. One common myth would be that doctors would prioritise organ retrieval instead of saving a patient’s life. Whereas in reality, the medical team involved in treatment and those involved in transplantation are separate, and death must be confirmed before any type of donation is considered. Another misconception would be that the deceased would feel pain during the removal of organs, which would not be possible once death has been declared.

Some families also believe that organ donation would significantly delay funerals or make open-casket wakes impossible. While the procedure takes time, hospitals work fast to minimise delays and to respect cultural practices where possible. There is also belief that donation leads to disrespectful handling of one’s body, when in fact strict standards govern how donors are treated. When addressing these myths and misconceptions, it is important not to sound corrective or condescending. Share information as something new that you learned, rather than something your parents thought “wrongly” about.

Finally, it’s important to be aware of the pitfalls to avoid so that the conversation would not unintentionally harm your relationship with your parents. One major pitfall would be framing the discussion as a moral judgement. For example, implying that pledging under MTERA would be the “right” thing to do, and that those who do not do so would be in the “wrong”. This could make your parents feel offended or defensive. Another pitfall to look out for would be rushing the conversation or expecting an immediate response or decision from your parents. Your parents might need some time to process their thoughts, consult their beliefs, or just sit with the discomfort of the topic. Pressuring them could shut down future dialogue. It’s also important to not position yourself as trying to “convince” them. Instead, position yourself as sharing your own perspective and seeking their mutual understanding. Respecting your parents’ opinions is essential, especially since you are asking them to make a personal choice.

In conclusion, the goal of your conversation with your parents does not have to be getting them to pledge under MTERA immediately. A more realistic and respectful goal would be to establish an open space for honest discussion, clarifying the intentions and misconceptions, and also allowing everyone to reflect. If you approach this topic with patience, compassion, and modesty, even disagreements could coexist with mutual respect.

Well, regardless of the outcome, the fact that you’re engaging thoughtfully about these issues already shows that you have a strong sense of responsibility and care, both for your family and for society.

Thanks again for this opportunity. It has been good to write to you again, and I look forward to hearing about your conversation with your parents.

With love,
Keegan Tay

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)