Tan Lok Wun, Sarah, 16

School: Nan Chiau High School

Topic: An email to a classmate on your thoughts on pledging under MTERA and how to respectfully discuss organ donation with his parents.

Hi Ahmad!

Congratulations on smashing your long-distance cycling record yesterday! Completing a metric century is absolutely no joke and must have been mentally and physically draining. Imagine my utter amazement and bafflement when I received the email you sent – you must be operating on Energizers. I’m so glad you asked about organ donation – frankly, I knew nothing about it until my grandmother needed an organ transplant this year, whereupon I made it my onus to find out more about organ donation!

There are clear distinctions in intent between pledging under the Medical (Therapy, Education and Research) Act (MTERA) or remaining under the Human Organ Transplant Act (HOTA)! Those pledging under MTERA can donate the whole body, tissues and organs other than those listed under HOTA, such as the lungs, pancreas, heart valves, iliac vessels and skin instead of just the liver, cornea, kidneys, and heart. If you and your parents wish to pass on the gift of life to more people, such as the many who require organs not under HOTA, I would recommend pledging under MTERA! My grandmother, who had resigned herself to using mechanical valves and being on life-long blood thinners after being diagnosed with severe heart valve disease, was on the receiving end of the selfless act from the donor who pledged under MTERA. She was so touched and grateful as she never expected a donor, given that most remained under HOTA, which did not include heart valves. Moreover, if your parents are interested in furthering medical education and supporting research and advancement of medical science, MTERA would allow them to do so! By donating the body or organs under MTERA, your parents can have a hand in shaping tomorrow’s doctors and medical professionals. They can also contribute towards medical R&D, bringing our researchers one step closer to medical breakthroughs by enhancing their understanding about how the human body systems work. The intent when pledging under MTERA is to support any and all organ and tissue transplantation, education, and research and development. Remaining under HOTA supports only selective organ transplantation involving the liver, kidneys, heart and corneas.

Some considerations and reservations which you and your family might have could be how organ donation might conflict with your faith. You can be at ease, as all major religions including Christianity, Islam, Buddhism, Hinduism and Judaism support organ and tissue donation as an act of compassion, love for humanity, and generosity. If needed, donation specialists can also help your family to support your religious and cultural requirements! Moreover, upon successful organ transplantation, your family and you will receive a card from the National Organ Transplant Unit (NOTU), providing basic information about the recipients that your loved one has saved. This prevents your loved one from donating to a completely anonymous recipient, providing your family and you with some closure knowing the organ is not misused nor trafficked, and is instead with a grateful organ recipient. Lastly, an open-casket funeral is still an option for organ or tissue donors, hence your parents still have the flexibility to choose how they wish to be presented to their loved ones when deceased. Their body will always be cared for with the utmost dignity and respect, and the same surgical standards such as surgical incisions with sutures covered in a dressing applied to any living person undergoing surgery will also be applied to organ donors during organ retrieval. For example, in skin donation, since the layer of skin recovered is less than 0.5mm thin, 85% of your skin depth will still be present after the procedure. The skin tone at the donor sites will just appear as a paler shade compared to the outer layer of your skin.

Many people worry that if they are registered donors, doctors would not try as hard to save their lives, which is an erroneous assumption! What is true, though, is that a doctor’s first priority is always to save your life, and no doctor would sacrifice one life to save another. Every patient is given full medical care and every chance at survival, with organ donation only considered after efforts to save the patient are futile. Your parents can opt for MTERA knowing that their medical treatment will not be compromised. Another common myth is that one has to be in perfect health in order to donate their organs or tissues. However, even if someone smokes, drinks or has an unhealthy diet, they can still be considered for organ donation. The medical team will assess accordingly at the time of death whether someone can donate their organs. Only a few medical conditions such as metastatic cancer, infectious diseases like Hepatitis B/C, Tuberculosis and Human immunodeficiency virus (HIV), may prevent you from becoming a donor. Even so, they may still donate their bodies for education and research!

Some pitfalls you should look out for when discussing with your parents about organ donation are their differing views from your own and how to manage it. I think it’s definitely important to hear what they personally feel and think about their issue, while simultaneously sharing your own views and perspectives. This can definitely help them consider the situation with a different pair of lenses and urge them to choose the option which aligns with their morals and values instead of cancelling out the option due to misconceptions. Ultimately, however, you should respect their decisions and not push them to pledge under MTERA, as it is their choice as to what they wish to do with their own organs – even if your view differs from theirs.

While I believe that organ donation is an extremely meaningful cause, I would also strongly urge your parents and you to consult an expert or visit NOTU’s website to find out more in order to make an informed decision. I hope the email helped to give you a broader understanding about HOTA and MTERA. Anyway, I need to catch some Z’s before I collapse from exhaustion tomorrow in school! I look forward to hearing more about the next cycling trip you have planned! 

Cheers,
Johnathan

References

1.    Keng Siang. Human Organ Transplant Act (HOTA). www.surgicalassociates.sg/dist/media/understanding-hota.pdf ↗ (opens in new tab). Accessed Feb 7, 2026.

2.    “Organ Donation.” Ministry of Health, www.moh.gov.sg/seeking-healthcare/organ-donation ↗ (opens in new tab). Accessed Feb 7, 2026.

3.    “Who Is Eligible to Be a Donor.” Live On, www.liveon.gov.sg/about-organ-donation/who-is-eligible-to-be-a-donor ↗ (opens in new tab). Accessed Feb 7, 2026.

4.    “Deceased Donor Organ Transplants.” Live On, www.liveon.gov.sg/about-organ-donation/when-does-organ-donation-happen/deceased-donor-organ-transplants ↗ (opens in new tab). Accessed Feb 7, 2026.

5.    Australian Government [Organ and Tissue Authority]. “Myths About Donation.” DonateLife, www.donatelife.gov.au/all-about-donation/myths-about-donation ↗ (opens in new tab). Accessed Feb 7, 2026.

6.    “FAQ.” Live On, www.liveon.gov.sg/faq ↗ (opens in new tab). Accessed Feb 7, 2026.

7.    Myths and Facts About Skin Donation | Singapore General Hospital. www.sgh.com.sg/our-specialties/skin-bank/myths-and-facts-about-skin-donation ↗ (opens in new tab). Accessed Feb 7, 2026.

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)