Ahmed Dzafirshah Bin Mohamed Zamry, 16

School: Pei Hwa School (Secondary)

Topic: Are conversations about death necessary to encourage organ donation?

One. Eight. Seventy-five.

One. Eight. Seventy-five. One donor has the power to both save and improve the lives of many. Eight lives can be saved through organ donation, while tissue donation enhances the quality of life for 75 others. Organ donation has given people the power to continue helping others even after death. As such, one might expect it to be a common final act of generosity. However, statistics say otherwise. According to studies conducted by Channel News Asia (CNA), Singapore has only a meagre 4 to 5 donors per million population (pmp). This falls below the global average of 7.6 and 9.2 donors pmp. The contrast becomes even more striking when compared to Spain, which records more than ten times the number of donors at 53.9 pmp. One possible solution to this worrying issue are conversations about death. However, death remains taboo in many societies. Thus, many people avoid topics closely associated with death, including organ donation. However, conversations about death are not the sole factor in influencing the normalisation of organ donation. A more open-minded understanding of religion and culture, as well as education about local organ donation procedures significantly shapes people’s views and opinions towards organ donation.

First and foremost, conversations about death are a key factor in encouraging organ donation. However, as stated, the topic of death is considered taboo, especially in Singapore’s conservative society. In Asian superstition, the discussions about death are frowned upon as they are believed to invite death into one’s home. In Singapore, these superstitions are formed as unspoken rules in households that discourage discussions about mortality. This silence has caused disarray in many families as they struggle with critical decisions regarding the deceased. Consequently, from not discussing the topic of death prior, families lack knowledge of the wills and wishes of the deceased concerning their body and organs. In an article from CNA, Dr Will Low, a consultant in the Intensive Care Unit at National University Hospital, said that families would understandably be surprised at and reject the prospect of organ donation due to uncertainty of the wishes of the deceased. Additionally, there is also the innate fear of accidentally going against the wishes of the deceased. Consequently, surviving family members, especially older relatives, may prioritise traditional familial values over the deceased’s personal wishes. With a grieving family after the bereavement of a loved one, emotions may overpower their ability to make rational decisions. As a result of these factors, families may request for more time to process and come to an eventual consensus regarding the situation. This hinders the process of Singapore’s Human Organ Transplant Act (HOTA) as precious hours are wasted in a race against time. Medical studies have shown that there is a 24- to 48-hour window before the organs become inviable to be used in organ donation. As such, conversations about death are an essential part to promoting the cause of organ donation. When families are armed with sufficient knowledge about the deceased’s wishes, it is more plausible for families to agree to organ donation. Ultimately, it results in the normalisation and the encouragement of organ donation.

Secondly, a more open-minded understanding of religion and culture greatly aids in encouraging organ donation. With reference to a study conducted by the Lee Kuan Yew School of Public Policy in February 2021, a total of 70 percent of male and 69.6 percent of female respondents felt that religion was either of great or slight importance to them. This shows that the practice of religion, regarding in its adherence to the principle rules and values followed, holds significant influence over one’s viewpoint towards sensitive and controversial topics like organ donation. Ironically, the mainstream religions followed by the citizens of Singapore view organ donation as a final and profound act of generosity. The main reason why organ donation rates are so low, despite the support of widely followed religions in Singapore is because of misunderstandings of religious teachings. One such instance is Hinduism where the difference between common misconceptions and actual belief hold polarising views. Some Hindus interpret that the soul’s journey through the afterlife would be impacted. Organ donation is thought to potentially cause deformities in the next life of the soul as the body is incomplete. With the fear of such a possibility, some Hindus abstain or avoid organ donation. However, in Hindu scriptures, specifically the Bhagavad Gita, views the body as merely a worn-out garment that the atman, or known as the eternal soul, discards at death. Studies conducted by the Oxford Centre for Hindu Studies reiterated that the atman remains unaffected by physical trauma. Thus, clearing religious misconceptions are essential to promoting organ donation.

In the context of culture, Singapore is rather conservative in its beliefs. A survey conducted by the Institute of Policy Studies suggests that Singaporeans hold traditional views towards marriage and family structures. Thus, a more open mind to new values and concepts plays a huge role in encouraging organ donation. Asian superstition vehemently avoids the topic of death. However, such traditional attitudes towards death can be challenged through the lens of different philosophical perspectives. One such example is a well-known Stoic concept known as ‘memento mori’, meaning “remember that you must die” instead encourages one to be reminded of their mortality in a meaningful way. When one recognises death as an inevitability, it removes the invisible weight about discussions closely related to death.  As a result, more Singaporeans reflect about the legacy they wish to leave behind. Thus, it encourages the normalisation and acceptance of organ donation in many.

Lastly, education about Singapore’s local organ donation procedures is equally important in encouraging organ donation. While conversations about death normalises discussions about organ donation, a lack of understanding about organ donation would render such conversations ineffective. In Singapore, misconceptions about HOTA creates fear and uncertainty among the public. Some individuals believe that doctors would consider recovering organs before trying all forms of treatment to save a patient, especially during brain death. Others feel that HOTA is imposed on Singaporeans with no way out. There are also misconceptions revolving around brain death, especially of its certification and implications. To many families, brain death can be difficult to accept because the patient may still appear alive through artificial support despite being medically declared dead. A study conducted in Singapore interviewing 799 participants showed that only 38.3% of participants knew that HOTA operates on an opt-out basis. Additionally, 80% of participants were unaware of the stringent process in certifying brain death and 50% did not know brain death was irreversible. With reference to the study, one can conclude that the lack of knowledge among Singaporeans had caused unnecessary fear and discord over systems that have already taken steps to reduce fear and uncertainty surrounding organ donation.

In conclusion, it is more than conversations about death that cultivates a greater culture of organ donation. While it does play a pivotal role, it must be compounded by other factors to encourage and sustain the idea of organ donation. An open mind in understanding religion and culture is what builds one’s moral viewpoints to support organ donation. Education about local organ donation procedures is what allows one to make a more educated choice on what they deem as right in their refined moral compass. One. Eight. Seventy-five. These numbers are not merely statistics, but representations of lives that can be both saved and improved. All because of one selfless donor.

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)