Chua Tian Tong Mickey, 18

School: Ngee Ann Polytechnic

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

Reform & Redefine for Life

Introduction

Singapore is known to be ‘kia-su’. But how do we stand amongst other countries in terms of organ donation? As of 2023, Spain had the highest deceased donor population, at 49.38 per million. And Singapore is way lower on the list, with a deceased donor population of 4.67 per million (Irodat, 2026). Despite the surging waiting list for organ transplants, Singapore faces a unique paradox where the number of deceased donor organ transplants does not increase; 40 in 2016, 36 in 2025 (LiveOn, 2026). Looking back to a personal discussion with my parents, it seems like most hesitation & doubt about organ donation comes from the lack of trust and selfish stigmatism about body preservation. As I quote, “Why should I care? I’ll just do my part when I’m alive.”

Historical Context

How did we get here? The times before the 1880s was defined with the fear of inevitable death than by hope of intervention. It was said that “it was not uncommon for doctors to have to stand by and watch a patient be asphyxiated by his goitre.” Theodor Kocher introduced and developed the surgical techniques necessary for the first recorded organ transplant performed by Theodor Kocher himself, in the 1880s (Cambridge, 2023). But organ transplant has advanced tons since then. By 23 December 1954, the first successful organ transplant in the world was accomplished by Joseph E. Murray, who received a Nobel Prize in Physiology or Medicine in 1990 (Havard Medicine, 2011). This improvement symbolised the shift from experimental uncertainty to life-saving reality. As ‘kia-su’ Singaporeans, we weren’t that far behind our American counterparts for on 8 July 1970 the first organ transplant in Singapore was led by Professor Chan Kong Thoe (NUH, 2026). Despite conservative cultural hesitations and societal fears, Singapore followed closely behind global footsteps.

Societal Fears

Lying in a hospital bed, the white ceiling fan rotates lazily above you. The peeling white paint of the roof doesn’t give you quite the peace of mind you would imagine it to. Stuck alone with your own thoughts about the certain death, the news broken to you only a few hours ago yet drags like years. Helplessness shatters even the strongest of wills: There often isn’t a single positive thought. In such moments, positivity evaporates. If one cannot even care for themselves, how could they imagine offering life to another? Why would they think their decision would be of any influence? In such confrontational, negative, vulnerable context, for many if not most, the thought of organ donation is simply a reminder of their own mortality. Religious beliefs offer comfort: They grab onto any hope they can grasp. The religious symbol they have carried around since birth. The lucky coin they kiss before a life-altering choice. What would this deity do in the face of this situation? Do the scriptures mention anything about the passage from the plane of life to the final destination of death? How should I prepare my soul and body for this lasting journey? For such spiritual beliefs, the choice is not theirs to make. Sacred consequences overshadow compassion, and spiritual duty outweighs altruism. Stigmatism, the collective opinion: Humans are social beings, shaped by the collective opinions of their communities. The aggregated public opinions shape the belief of people (Nature, 2025). As soft of an impact it could have, we draw upon the philosophies of those around us to make decisions, to dish out judgement, to act. Myths, community attitudes, and generational views. These social perspectives reinforce silence and reluctance, closing the door before organ donation can even enter the conversation. Mutilation and dignity: Those who are not bounded by such prerequisite biases, those who have long made peace with the notion of death, would they still be able to afford their final decision to lead to their own desecration? The body they have carried for their fruitful years, broken into, stolen from. “Would my body be treated with dignity, or discarded like refuse?” Organ donation is an uphill battle, inhibited by self, religious, environmental, and negative emotions. If it were such an impossibility, what pushes people to give anyway?

Societal Hopes

Looking around the hospital room, you see the evidence of those who have long given up. On the bed opposite you, a greying man, kidney failure. Next to you, a young bright woman, end-stage liver cirrhosis. There are situations that make it seem that life lacks the ray of sunshine it once had. Everyone wishes for a guardian angel to swoop them up and ward off the grasp of death. Yet they often forget how regular angels look like, the ones laying opposite of you. ‘Gift of life’: Countless fantasies, movies, and wishes have been made where one’s grand finale is turning their death into continuity. The ending where their sacrifice is meaningful and unforgettable. Saving the tears that would be shed by families, softening the impact on their loved ones, despite a loss of your own. The best gift never comes cheap and always comes from the heart. The selflessness reframes their untimely mortality into a meaningful opportunity for others. Sense of purpose & fulfilment: In countries like Spain, donation is a sign of national unity, a duty all must collectively serve. Why not us? People move on easier knowing they were a part of one’s crazy survival story. One must give up their spark of hope in order to provide another with a burning flame. One must find peace knowing their death brought life to others. Is that not the most purposeful use of your body after death? Legacy: In 2015, SOMA, a sci-fi horror game, posed this ethical dilemma to the gaming adolescent population. The Greek word for “body”, specifically distinguishing the body from the soul. It explores and challenges consciousness and the body. But the ending is what left a lasting impression. Simon, the protagonist, successfully sends a copy of humanity’s consciousness to space, only to rot at the bottom of the ocean. The ugliest outcome for such a heroic act. The most beautiful outcome for those who live on. For Simon and his digital consciousness, it would be a problem of identity. But for organ donors, it is a problem of whether you wish to live on as part of someone. Does your need for legacy outweigh the death of your physical self? Many would find hope in remembrance; more would find peace that their existence is carried forward.

Comparative Perspectives

How did this narrative come to be? Geographical location and their culture affect the perspectives of people in drastic ways. Expanding on the Spain example, trust and collectivism is the name of the game. A nation’s gift to itself. Even while grieving, families see hope that their loved ones’ passing can equate to the life of another. Their trust, coupled by a culture of transparency and collectivism, allows hope to overshadow fear. On the flip side, due to an abhorrent cocktail of a structurally failing healthcare system, mazes of legal paperwork, and conservative religious beliefs (Buddhism and Shintoism), Japan has among the lowest organ donation rate. With only 4% of patients on the transplant waiting list receiving organs annually, it is evident that culture and institutional systems play an ever-important role in increased organ donation (American Journal of Transplantation, 2025).

Youth & Future Outlook

Will this be the status quo for long? I argue not; there must be a healthy equilibrium between organ donation for chronic societal benefit. Younger generations are much more open to organ donation than their previous generation, since it is less about taboo religious beliefs or stigmatism. Instead, it is about social responsibility, altruism, celebrating the legacy that one paves. When younger voices are more open, more courageous to confront death, louder than the whispers of fear, the selfless act ensures one’s life echoes way beyond the body’s final breath. The rise of social media has also shown to shine light on the shadows of traditional fears, eliminating lots of misconceptions that were passed down.

Conclusion

To embrace organ donation fully, society must first reform its notion of death; only then can hope take root. One must think: will my life end when the skin and bones buried beneath the soil begin to give life to the grass or trees above? Or will my life end when the last whispers of my altruism fade amongst the generation of the one I saved? Perhaps we need not choose the extreme of these endings but recognise that organ donation can achieve both. Where the body returns to nature, while providing the ‘gift of life’ to the ones that need it. Hand in hand, they create a legacy greater than fear. Passage rather than rupture. Renewal instead of despair. Organ donation is no medical act, but a choice to hope, a choice to redefine living, a choice to leave behind a better societal attitude than when we found it.

References

1.    Cambridge University Press. (2023). Invention of organ transplantation. In Origins of organ transplantation. Retrieved from https://www.cambridge.org/core/books/abs/origins-of-organ-transplantation/invention-of-organ-transplantation/A8D2FC9F6334F2DF100CC730C87D7EF6 ↗ (opens in new tab)  

2.    Harvard Medicine. (2011). A fight for life. Harvard Medicine Magazine. Retrieved from https://magazine.hms.harvard.edu/articles/fight-life ↗ (opens in new tab)

3.    International Registry in Organ Donation and Transplantation (IRODaT). (n.d.). Database. Retrieved from https://www.irodat.org/?p=database ↗ (opens in new tab)

4.    LiveOn. (2025). Statistics on organ donation in Singapore. Retrieved from https://isomer-user-content.by.gov.sg/65/f632fa35-5659-427c-8297-a9580e9ee29f/LiveOn_Stats.pdf ↗ (opens in new tab)  

5.    Nature. (2024). Organ donation and societal attitudes. Nature Reviews. https://www.nature.com/articles/s44159-024-00398-7 ↗ (opens in new tab)  

6.    National University Hospital (NUH). (2026). Organ transplantation services. Retrieved from https://www.nuh.com.sg/care-at-nuh/services/organ-transplantation ↗ (opens in new tab)  

7.    American Journal of Transplantation. (2025). Organ donation and transplantation research. Retrieved from https://www.amjtransplant.org/article/S1600-6135(25)02846-1/fulltext ↗ (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)