Chia Ying Syuan Mavis, 15

School: Raffles Girls' School (Secondary)

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

The Effectiveness of Conversations about Death in Encouraging Organ Donation

Death is an inevitable final destination for every human. In contrast, in Singapore’s society dominated by Asian culture and superstition, death is perceived as inauspicious and morbid. Following such perceptions, conversations about death, which pertain to discussing end-of-life care, mortality and memorials are typically avoided to prevent discomfort. Yet, what if conversations about death may lead to a life being saved? Globally, thousands die while waiting for suitable organ transplants. Conversations about death carry great significance in reducing taboo surrounding death in society, honouring each deceased’s wishes and emotionally preparing loved ones for death, ultimately providing the security and awareness required to encourage organ donation.

Firstly, conversations about death reduce fear and taboo surrounding death in society, improving societal attitudes towards organ donation. When people harbour negative perceptions about death, they often form misconceptions based on cultural beliefs and superstitions. Closely related subjects, such as organ donation, are mistakenly associated with suffering, grief and emotional burdens. Led by trusted healthcare professionals, either through public dialogue or private counselling sessions, conversations about death can dispel misconceptions surrounding organ donation, such as allowing people to recognise that organ donation is carried out voluntarily without personal expense. In doing so, people acquire a higher competency distinguishing between misinformation and the truth to understand the real purpose of organ donation. Additionally, when people have a direct means of communication with healthcare professionals, trust in the accountability and transparency of organ donation processes in healthcare systems can also be established between potential donors and the healthcare sector. Furthermore, by focusing on the legacy left behind and the lives saved through organ donation instead of mortality, social acceptance towards organ donation and death can be increased. When these discussions become consistent dialogue, people’s awareness about organ donation is extended beyond its significance to tangible methods to support organ donation. Therefore, conversations about death are a crucial driver to overcome fear regarding organ donation so that ultimately, organ donation becomes normalised and encouraged in society.

Moving on, conversations about death ensure that each individual’s final wishes are honoured, allowing loved ones to handle deceased organ donation with clarity and the deceased’s consent. When the deceased did not directly convey their end-of-life plans or final wishes to their loved ones, their family is often left in the dark, uncertain about how to fulfil their final wishes. In contrast, when the deceased had an introspective and honest conversation about death with their loved ones before death, their loved ones are able to understand and empathise with their decisions, as well as discuss their decisions together to ensure that there are no ambiguities or disagreements. Organ donation is generally considered a controversial topic. Conversations about death can prevent resistance by family and close friends towards decisions made on organ donation by the deceased, thereby preventing emotional distress and conflict. As greater understanding is established, loved ones show acceptance towards the deceased’s final wishes and are more willing to cooperate in the organ donation processes, such as supporting medical practitioners in the provision of information necessary for organ transplantation. Individuals feel more secure making significant decisions about organ donation when their personal autonomy is preserved and supported even beyond death. Therefore, conversations about death enable people to engage with organ donation under the awareness and understanding of loved ones, while also reinforcing their loved ones’ abilities to make practical decisions for the deceased.

Finally, conversations about death can emotionally and psychologically prepare loved ones for death, preventing them from being overwhelmed by unexpected decisions regarding organ donation. With each passing, loved ones experience grief, shock and numbness, feelings which they often struggle to process. Conversations about death are pre-emptive measures that reduce psychological shock and despair caused by a sudden death, giving them time for emotional preparation. These intimate conversations are especially important for seniors in their final stages of life and patients under palliative care, whose loved ones may face emotionally overwhelming decisions regarding end-of-life care and organ donation. In the context of organ donation, conversations about death allow family and relatives to be reassured that deceased organ donation reflects the deceased’s wishes. This can reduce the emotional burden of loved ones to face the deceased’s decisions under unstable psychological states, ensuring that they already have an understanding of the deceased’s final wishes. Disoriented by grief, loved ones may perceive organ donation under the Human Organ Transplant Act (HOTA), where there is presumed consent that the deceased is willing to donate organs unless opted out, as losing another part of the deceased. Through consistent conversations about organ donation to build awareness and emotional preparation, loved ones are less likely to reject the deceased’s decisions impulsively, or become overwhelmed by guilt and uncertainty about whether the deceased had truly agreed to organ donation. Therefore, conversations about death ensure loved ones have no doubt that organ donation is being carried out willingly, reassuring loved ones that organ donation reflects a deliberate and respected personal choice.

Despite the benefits of conversations about death, conversations about death alone are insufficient in encouraging organ donation, as willingness to donate organs does not always translate into concrete action. One of the other factors contributing to limited action taken to support organ donation is distrust towards healthcare systems, while another factor is when people support organ donation in principle, but procrastinate in making official arrangements. Recognising these limitations, the Ministry of Health had introduced HOTA which was referenced earlier. HOTA is an opt-out system where Singapore citizens and permanent residents are presumed to consent to organ donation unless they formally withdraw from participation. This measure reduces the dependence on voluntary registration, compensating for societal reluctance to actively engage in conversations about death. Through legal frameworks like HOTA, Singapore’s government is able to increase organ availability more effectively rather than relying solely on conversations about death, which are carried out more intimately on a smaller scale, to enable organ donation. While conversations about death remain valuable in shaping attitudes towards organ donation and have a greater emotional impact on people, existing measures such as HOTA demonstrate that institutional intervention is equally necessary in encouraging organ donation.

Beyond institutional policies, public education and awareness programmes can strengthen societal understanding of organ donation. Both conversations about death and HOTA require a level of awareness and knowledge of organ donation, which do not address the knowledge gaps that persist in society. Educational initiatives spreading awareness on fundamental knowledge about organ donation, such as its purpose and basic processes, can be carried out in schools and community settings to develop accurate understandings of organ donation. This ensures that their decisions are made based on informed awareness rather than misinformation. In particular, introducing organ donation at a young age in schools allow people to normalise concepts of mortality and medical contribution to society, inculcating values of compassion and empathy that support donating organs to save lives. Furthermore, for public campaigns led by healthcare authorities, the processes of organ donation, such as medical safeguards and ethical allocations, can be further clarified to bridge the gap between the healthcare sector and public, building a system of trust. Thus, public education and awareness programmes can increase long-term acceptance by establishing the basis of understanding about organ donation in society.

Additionally, media representation of personal accounts and real stories can encourage organ donation by humanising organ donation to appeal to public empathy. While conversations about death are usually confined to family settings, media platforms such as news channels and social media can publicise real testimonies of donors and recipients in the form of poignant documentaries, stories and articles to a wider audience. These media productions have sufficient influence to shift the narrative away from fear caused by death, to highlighting the lives saved by organ donation and the donor’s legacy of compassion. This can encourage the public to form a more positive perception of organ donation. Furthermore, through real-life stories of recipients whose lives were transformed through organ donation, media campaigns can foster an emotional connection between people and recipients. Real stories featured in media campaigns crucially shed light on the real, positive and life-changing impact of organ donation, spurring potential donors to consider organ donation as a meaningful act that they could viably carry out as opposed to a distant medical procedure. Thus, media representation presents organ donation as an act of compassion and social contribution, encouraging people to do their part for society.

In conclusion, conversations about death are significant in encouraging organ donation as they reduce taboos surrounding death, ensure clarity of the deceased’s wishes and emotionally prepare families to make informed decisions. Beyond conversations about death, legal frameworks, educational initiatives and media representation are able to address complex barriers that influence organ donation rates. Ultimately, encouraging organ donation requires public awareness of its purpose and public understanding of methods to take action. Organ donation is more than a medical procedure; it is a collective responsibility to be compassionate to others in our society.

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)