Gretel Chng Woon Suang, 20

School: National University of Singapore

Topic: Society’s attitude towards organ donation reveals more about its fears than its hopes.

Society's Evolving Attitudes about Organ Donation.

In Singapore, organ donation comprises medical, education and research. The Human Organ Transplant Act (HOTA) is a law that includes all Singapore Citizens and Permanent Residents, above the age of 21 and of sound mind in organ donation, unless they opt out of it (Ministry of Health, 2025). The Medical (Therapy, Education and Research) Act (MTERA), on the other hand, follows an opt-in system, where donations are used for a wider range of purposes such as research (Ministry of Health, 2025). Organ donation in Singapore is not frequently talked about, despite consent being presumed unless one opts out. This can come across as surprising, as organ donation is quite a big deal in many other countries. I believe that for now, society’s attitudes show more fear than hope towards organ donation, due to taboos surrounding death and the practical consequences that individuals face if they opt out of HOTA. However, I foresee that the future generations will recognise organ donations as bringing life and reciprocity.

At times, attitudes about organ donation do reveal more about society’s fears than hopes. Many families tend to avoid discussions about death and what to do to their loved one’s body due to the taboo surrounding death in Singapore (Teo, 2024). Many families do prepare for the inevitable, but the effort is more so ensuring the future generations are financially covered. For instance, many families actively get insurance and draft up wills to cover their families monetarily after their deaths - this is the new norm. However, fewer actually plan for funeral services, interment and organ donation. This is likely due to the idea that one is “setting a date for their death”, which can be seen as a bad omen. When the time does come for the tough talks, it is likely when the loved one is already unfit to make decisions, when they are bedridden or gone. Hence, many families do not know exactly what their family members want after death (Jalelah Abu Baker, 2015; Teo, 2024). Furthermore, the lack of open discussions also suggests a lack of understanding of laws surrounding deaths in Singapore. Many do not realise that organ donations are on an opt-out basis in Singapore, and it may be too late to refuse it as family members cannot opt out of HOTA on behalf of a deceased person or one who becomes incapacitated (due to dementia, brain damage, etc.); the decision must be made by the individual while they are mentally competent. However, in practice, doctors generally do not proceed if the family is in extreme distress or vehemently opposed. Despite that, families still have to deal with uncertainty and regret (Teo, 2024). Organ donation hence becomes an additional hassle on an already emotionally taxing day. Instead of bringing hope for another family, and hope for the deceased to be able to rest knowing that they helped someone else, it could bring unnecessary turmoil for families who keep discussions closed till the last minute. In truth, death is often perceived to be messy, sudden and scary, which is perhaps why families are inclined to leave things as they are instead of inviting those worries into their everyday lives.

However, as Singapore slowly moves away from the traditional view that talking about death is taboo, attitudes about organ donations can become positive. Newer generations are not only openly confronting death, but are encouraging others too (Lok, 2026; Auto, 2020). Open discussions also allow individuals to make informed choices rather than acting out of fear or misinformation. Educational initiatives like the Live On Festival, which uses art and essay competitions, empower youths to lead these conversations with peers and family. As more information and awareness are spread and discussions are encouraged, families in Singapore do begin to talk about organ donation (Voo, 2019). Families are hence more likely to understand what their loved one’s wishes are when it comes to organ donation. In essence, being able to understand what happens to one’s body after death could bring peace to both the family and the deceased, in contrast to the uncertainty-ridden surrender to fate.

However, there are religious and practical aspects of organ donations that also showcase individuals’ fear. According to most Islamic scholars and major fatwa councils (an Islamic legal ruling for specific questions), organ transplant and donation by the deceased is permissible in Islam, provided it is voluntary, non-commercial and does not bring harm to the donor (Awad, 2025). Despite this, there are still many interpretations of Islamic law that deter Muslims from donating organs due to their faith (Kidney Donation Amongst Malay/Muslims in Singapore, 1993). Other religions also hold beliefs that donating organs could hinder reincarnation. In Buddhism, there is a fear that one may be born incomplete (Tan, 2025). When one opts out of HOTA, they are placed as a lower priority on the organ transplant waiting list should they need a transplant in the future (Ministry of Health, 2025). Although this promotes the principle of reciprocity, it also reveals the internal struggles faced by residents of different religions. It is clear that faith can make individuals unsure of whether to donate, and this uncertainty can translate into very tangible consequences that can impact one’s health. The idea of organ donation in Singapore can be daunting and become less of donating out of goodwill and more of a calculated move to secure a greater chance at living.

However, I believe society is becoming more hopeful about organ donation, driven by evolving religious and scientific perspectives. For the Muslim community, MUIS has been encouraging Muslims to stay opted in to HOTA. MUIS reframed donation as an act of Amal Jariah (continuous charity), fostering a sense of responsibility beyond the implications of opting out of HOTA (Human Organ Transplant Act (HOTA) 2007 (English), 2025). By highlighting the rising rates of kidney disease within their own community (Ministry of Health Singapore, 2008), many now view the process less as a violation of the body and more as a fulfilment of their religious duty to save lives. Today, the fatwas are explained through medical science and compassion, which has helped move the Muslim community from blind compliance and pressure of the law to active participation. This shift is mirrored among the youth, who are increasingly reconciling faith with science (Tan, 2025). Rather than straying from tradition, newer generations are evolving their beliefs to include the practical benefits of medical science. More youths view their contribution not as a compulsory sacrifice but as a return to society, to further one’s life after their own. In addition, recipients of transplants have gone on to live significantly longer as compared to those in other countries (Yap, 2026). This tangible success serves as powerful evidence that donation is a viable, life-sustaining medical miracle. Ultimately, the societal narrative is shifting from a fear of loss to a collective hope about the power of the gift of life.

In conclusion, Singapore’s current attitudes showcase the long held cultural standpoint of death and organ donations. However, as discussions and younger generations bridge the gap between religious tradition and scientific pragmatism, the conversation is no longer dominated by the fear of death, but by the hope of life. Ultimately, society’s attitude towards organ donation is proving to be a reflection of its progress.

References

1.    Auto, J. (2020, January 10). Let’s talk about death over dinner: Social campaign ‘Dying to Talk’ tackles taboo topic. The Straits Times. https://www.straitstimes.com/singapore/lets-talk-about-death-over-dinner-social-campaign-dying-to-talk-tackles-taboo-topic ↗ (opens in new tab)

2.    Awad, S. S. (2025). What is the ruling on organ donation in Islam? SeekersGuidance. https://seekersguidance.org/answers/shafii-fiqh/what-is-the-ruling-on-organ-donation-in-islam/ ↗ (opens in new tab)

3.    Human Organ Transplant Act (HOTA) 2007 (English). (2025). Majlis Ugama Islam Singapura (MUIS). https://www.muis.gov.sg/resources/khutbah-and-religious-advice/fatwa/human-organ-transplant-act--hota--2007--english/ ↗ (opens in new tab)

4.    Jalelah Abu Baker. (2015, June 1). Human Organ Transplant Act: Doctors, families and understanding. Channel NewsAsia. https://www.channelnewsasia.com/singapore/human-organ-transplant-act-doctors-families-understanding-887136 ↗ (opens in new tab)

5.    Kidney Donation Amongst Malay/Muslims in Singapore. (1993). National University of Singapore (ScholarBank). https://scholarbank.nus.edu.sg/entities/publication/916b23e9-8485-4d77-a179-040f5e704e28 ↗ (opens in new tab)

6.    Lok, J. (2026, February 15). He took a 90% pay cut to become an afterlife agent: Why young Singaporeans are talking about death. The Straits Times. https://www.straitstimes.com/life/he-took-a-90-pay-cut-to-become-an-afterlife-agent-why-young-singaporeans-are-talking-about-death ↗ (opens in new tab)

7.    Ministry of Health. (2025). Organ donation. Seeking Healthcare. https://www.moh.gov.sg/seeking-healthcare/organ-donation/ ↗ (opens in new tab)

8.    Ministry of Health Singapore. (2008, January 21). Second Reading of the HOTA Amendment Bill. MOH Newsroom. http://moh.gov.sg/newsroom/parliament-speech-21-jan-second-reading-of-the-hota-amendment-bill/ ↗ (opens in new tab)

9.    Tan, L. (2025). Shortage of organ donors in S’pore: Potential pool could be those who died of cardiac arrest. Singapore General Hospital. https://www.sgh.com.sg/news/patient-care/shortage-of-organ-donors-in-spore-potential-pool-could-be-those-who-died-of-cardiac-arrest ↗ (opens in new tab)

10. Voo, T. (2024, May 12). Dealing with the difficult issue of organ donation when a loved one passes. CNA Lifestyle. https://cnalifestyle.channelnewsasia.com/commentary/commentary-dealing-difficult-issue-organ-donation-when-loved-one-passes-426791 ↗ (opens in new tab)

11. Yap, T. (2026, March 2). NUH living-donor kidney transplant patients survive an average of 31 years, beating global norms. The Straits Times. https://www.straitstimes.com/singapore/health/nuh-living-donor-kidney-transplant-patients-survive-an-average-of-31-years-beating-global-norms ↗ (opens in new tab)

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)