Jaden Lu Zhenwei, 16

School: Chung Cheng High School

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

“Conversations about death are necessary to encourage organ donation.” How far would you agree?

The USA then-President, Barack Obama, once encouraged people to discuss organ donation with their families and friends in his President Proclamation in 2015. This reflects the growing need to raise awareness about organ donation and its importance in saving lives. Organ donation is the surgical process of removing healthy organs or tissues from a living or deceased person and transplanting them into another to replace failing organs. In Singapore, organ donation remains a pressing issue, where thousands of patients wait for years to receive a healthy, compatible organ, with some even dying before receiving one. Although there are policies put in place like the Human Organ Transplant Act (HOTA), donation rates still remain low. A possible reason is that organ donation rates are often limited by fear, lack of awareness, and cultural taboos around death. Thus, more has to be done by the society and most importantly, within a family. An effective way is to start having conversations about death. However, although having such open conversations about death can help to normalise such a topic and clarify peoples’ wishes, their effectiveness still essentially lies in how they are conducted and whether they are supported by our modern society.

First and foremost, such conversations can help to raise awareness and correct misconceptions that one might have about organ donation. In modern society, people often avoid discussing “death” as a topic, because it can be quite uncomfortable to talk about and many may be misinformed or lack sufficient knowledge about organ donation. According to a PubMed survey conducted on about 950 Singaporean adults, close to 80% of them, who are eligible organ donors, had never discussed death and organ donation with their family and relatives before. This is quite alarming and thus, more effort must be put in place to improve organ donor registration. Without open discussions and unaddressed myths, the mindset that doctors will not take good care of the donor’s body may persist, making people more reluctant to donate their healthy organs. Furthermore, in our Asian society, people may be unwilling to partake in organ donation, due to many stereotypes passed down through generations or due to religious concerns about body disfigurement in the afterlife. However, if conversations about death were normalised, it can help provide education to many and enable them to understand that organ donation is not a fearful process, but instead a compassionate act. They would also understand that doctors are professionally bound to treat and save all patients equally, regardless of race, gender, or organ donor status. Thus, conversations regarding death would be able to encourage organ donation.

Secondly, it helps families honour wishes. In many cases, even in countries with opt-out systems like Singapore, family members are still consulted before organs are retrieved. Without any information or prior knowledge about the deceased’s preferences, family members may be unwilling to consent to donate their organs due to uncertainty and emotional distress. For instance, in the same survey conducted in Singapore, it found that although around 68% of adults were willing to donate their own organs, only 52% were willing to actually donate a relative's organs. This significant discrepancy of 16% reflects how difficult it is for families to make such decisions without any clear guidance and information. This is not only unique to Singapore, as studies also show similar trends globally, where family refusal accounts for around 25% of missed donation opportunities. In some contexts, this number only rises higher. This is seen in another study showing that the rate of family refusal to organ donation was 51.2% and because of religious concerns and uncertainty of the deceased’s wishes on organ donation. Hence, having clear conversations about death with our loved ones, can allow individuals to reflect on their inevitable mortality and share their own preferences explicitly on whether they want to donate their organs upon death. In some cases, such discussions can inspire individuals to register as organ donors as a final act of kindness. This can reduce the burden and the grief of their family members. Moreover, it can enable them to make more informed decisions based on the deceased family member’s final wishes. Families are then more likely to respect them and carry out these wishes, leading to an increase in organ donation. Therefore, by having these conversations, it is not only beneficial but helps to bridge one’s intentions with their actions.

However, some naysayers might argue that conversations about death are not always effective due to cultural and emotional discomfort. In many places, especially Asian communities, including Singapore, discussing death is often perceived as disrespectful or inauspicious. As a result, people avoid this “taboo” topic entirely, in order not to cause distress for others, especially their elders. In our modern society, it is not uncommon for the elderly to dismiss the younger generation when they bring up this topic, despite its great importance. Hence, this cultural barrier limits the extent to which open conversations about death are effective to improve organ donation rates, as people feel uneasy in doing so. Furthermore, one can argue that after a loved one passes away, relatives may be unable to carry out the deceased’s decision to donate their organs due to emotional distress and other considerations.

Nonetheless, while this perspective is valid, it seems to overlook the importance of having these conversations about death. Having discussions about one’s demise is never meant to be enjoyable or something easy to talk about, but it definitely does serve a significant purpose in ensuring that individuals’ wishes are clearly understood and respected after their death. To add on, the persistence of such low organ donation rates, despite strong structural systems like the opt-out system in Singapore and Spain’s highly regarded organ donation model, highlights the immense need for measures on a more personal level. Moreover, as societal attitudes evolve, the effectiveness of these conversations is likely to gradually increase. Efforts such as open conversations between family members and media campaigns can gradually reduce the stigma surrounding death and organ donation. Furthermore, local authorities such as the Ministry of Health (MOH) can conduct educational talks in schools to raise awareness about the importance of organ donation. Such efforts can also encourage students to engage in more open discussions on the issue. This can ultimately encourage more participation in organ donation. Thus, although conversations about death alone are insufficient, they are still necessary and fundamental in driving efforts for organ donation.

In conclusion, conversations about death are not a panacea, but they remain a necessary component that should not be overlooked by society. This is because they are still crucial in encouraging organ donation, by raising awareness, correcting misconceptions and helping families honour wishes. Although these conversations about death might raise cultural barriers and cause emotional discomfort, they are essential in addressing the deeper societal factors that are hindering organ donation by people. Thus, when these conversations about death are conducted properly and handled with sensitivity, they can foster greater understanding, reduce fear and turn one’s intention into action. Therefore, greater societal efforts should be made to encourage open and respectful discussions regarding death and organ donation.

References

1.    2025 National Survey of Organ Donation Attitudes and Practices: Report of Findings https://www.organdonor.gov/sites/default/files/organ-donor/professional/grants-research/nsodap-organ-donation-survey-2025.pdf ↗ (opens in new tab) U.S. Department of Health and Human Services Health Resources and Services Administration Health Systems Bureau Division of Transplantation

2.    Comparing organ donation decisions for next-of-kin versus the self: results of a national survey https://pubmed.ncbi.nlm.nih.gov/34785552/ ↗ (opens in new tab) Christopher Weiyang Liu 1 2 3, Lynn N Chen 4, Amalina Anwar 5, Boyu Lu Zhao 5, Clin K Y Lai 5, Wei Heng Ng 5, Thangavelautham Suhitharan 2 3 6, Vui Kian Ho 2 3 6, Jean C J Liu 7 8

3.    Family refusal rates for organ donation after brain death and after circulatory death: a single-center 6-year experience https://pubmed.ncbi.nlm.nih.gov/41272788/ ↗ (opens in new tab) Federica De Min 1 2, Maria Assunta Donato 1 2, Elisa Raimondo 1 2, Alessandro Ivan De Martino 1 2, Alessia Bresil 1 2, Alessandra Agnese Grossi 3 4, Martina Baiardo Redaelli 5 6, Paolo Severgnini 7 8, Luca Cabrini 1 7

4.    Presidential Proclamation -- National Donate Life Month, 2015 https://obamawhitehouse.archives.gov/the-press-office/2015/04/01/presidential-proclamation-national-donate-life-month-2015/ ↗ (opens in new tab)

5.    Prevalence and Potential Correlates of Family Refusal to Organ Donation for Brain-Dead Declared Patients: A 12-Year Retrospective Screening Study https://pubmed.ncbi.nlm.nih.gov/32943213/ ↗ (opens in new tab) Metin Leblebici 1

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)