Something to ponder upon: Organ donation

Organ donation. How much do you know about it in Singapore? Remember a few months back I was musing to some friend when Mr. Khaw said that we shouldn’t exclude compensation for organ donation. I remembered telling them this will be like the case of the casino. It’ll be legalised anyway, it’s only a matter of time.

I think in times like this, we ought to give the recent change in Human Organ Transplant Act or HOTA a good think through, what are the changes and what implication can it have on us?

There are a few changes like upping the limit of cadaveric organ donation to 65 and donor swapping. But what really unnerved me was the inclusion of compensation for kidney transplant. I’m not sure if this was done in response to a recent higher mortal(read: rich man) attempt to buy a kidney, but the timing and similarity is too much of an coincidence.

Anyway, from an article from the MSM, kidney law to change. The Health Minister actually touch on the issue to compensation or rather, defraying the cost of expenses. In it, it was noted:

He hinted that the sum will be at least five figures, and possibly six. The actual amount of just compensation will be left to a committee, which will be set up to look into this.

In the recent organ trading case involving former retail magnate Tang Wee sung, the Indonesian donor was to have received $23,700 for his kidney, from the $300,000 Mr Tang paid the agent.

That case sparked a debate on whether it is ethical to pay someone for an organ. Yesterday, Mr Khaw repeated that it is not ethical to do so.

But he added, 'The ethical community, including the World Health Organisation, has clarified that it is ethical to compensate, so long as the compensation amount is not so big as to induce.'

My first thoughts that comes to my mind is sum of compensation is at least 5 figures and possibly six, so in theory, it can range from $10,000 to $999,999. Let us all assume a middle class person earn $3,000/month, so his annual wages would be around $36,000. Using the lower limit, it would cost him a third of his annual wages and if we were to apply the upper limit, he wouldn’t even be able to afford a transplant.

My question is what is really the purpose of compensation? To weed out poor people who cannot afford the compensation or to encourage more people to donate their organs? Frankly speaking, this is how I see it. because if the donation is done through blood ties, meaning if you decided to donate an organ to a relative in need, the issue of financial compensation is not important anymore. So by the inclusion of monetary compensation into the picture, it have purely become a tool of inducement.

My next question is how much compensation should the committee set to prevent inducement and at the same time provide for adequate financial care for donor? Should we just set a low base line amount of say $5,000 for a kidney? It will not work, because it will have no effect on the kidney waiting list as the price is too low for defray anything. What if we set it higher so as to cover all expense incurred by the donor. Say let us all set it to $50,000? Readers, for $50,000, will it induce you to donate your organs? All this is achieved by arbitrarily setting an amount, if we follow the norm in Singapore where everything from subsidised housing to minister pay is pegged to the market forces. This will only cause the compensation amount to shoot up, not down, remember the highest bidder wins.

So in the end, the poor who cannot afford compensation loses and have to consigned himself or herself to a never ending waiting list. While the rich who can afford any amount of compensation will just get to cut the queue. And who would want to donate an organ for free when there is like money to be earned? Let say, you can donate to 2 person, one poor chap who cannot offer you any compensation and one rich man who can offer you any amount you ask for, which would you choose? With this I rest my case…

In conclusion, have we as a society have become so pragmatic that we now view our body as a marketable commodity? Monetary compensation is not a feasible solution at all. Why am I paying so much money for such so called highly talented minister to come up with such short sighted solution?

To the 79 MPs that voted for the change in HOTA, I hope your conscience do not eat you alive.

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