Organ Trading - A Commentary

An issue which has been recently brought up in the news would be that of organ trading, and its place in Singapore. Apparently, Mr. Tang Wee Sung, a prominent Singaporean businessman, was arrested and charged for illegal organ trading. This refers to the outlawed practice of ‘buying’ and ‘selling’ a person’s organs, in the guise of organ donation. There is a multitude of varying opinions on the issue at hand, ranging from strong approval to calls for it to remain illegal.

According to a recent survey, most young Singaporeans actually disapprove of this practice. They claim that it was “just not right” to buy and sell parts of the human body, even though this may lead to a greater number of lives saved. Out of the two hundred or so people surveyed, seven in ten expressed this opinion.

Personally, I feel that this reaction is unjustified. We must do what we can to spare our fellow human beings from prolonged pain, and even death, even if they are as squeamish as organ trading. There are many times when conducting an organ trade would be beneficial for both the parties, the donor and the recipient. Not only does the recipient have his condition alleviated, but the donor often receives a handsome payment. In fact, I have once come across an article which showed how many men in an Indonesian village have turned to selling their organs in order to escape the poverty cycle. By selling their unneeded organs, such as a part of their liver or a kidney, they have enough money to use as capital in a business and are able to benefit financially, thus bringing about a higher standard of living.

Additionally, another criticism of the majority’s viewpoint would be that it is far too idealistic and sentimental. To quote someone speaking on this topic, “most people who oppose organ trading have probably not have any experience” of the plight of the sufferers of organ failure. They are willing to let patients suffer unnecessary pain, just because they have no relatives who can donate an organ. On an emotional level, I urge everyone who opposes organ trading to empathize with the patients who truly need it. It is naïve to think that it is more important what is “just right”, rather than the practical solution offered by the selling of organs. We must not allow these so-called “ethical issues” to cloud our judgment and deter us from saving more lives.

Of course, organ selling might have some drawbacks. In such a system, the poor patients may be marginalized because the organs go to the highest bidder. Those who cannot afford to pay the costly price of an organ could be left behind, unable to find a replacement organ. Additionally, there may be health risks which allow diseases or conditions to be passed from donor to recipient, especially if there are unscrupulous sellers out there.

However, these arguments are precisely why we should legalize organ trading. These arguments are applicable only because organ trading is illegal. Currently, because organ trading is illegal, it is done unregulated and dangerously, with shady deals between donors and recipients. This is precisely what allows the unscrupulous sellers to cheat patients, and also the reason behind the high prices. If organ selling is legalized, the government could act as an effective third party to make sure everything goes smoothly and is above board. Also, it could help to regulate and subsidize the price of the organs, in order to ensure that the poorer patients would not lose out. With an effective system of checks and balances to prevent any form of abuse, organ trading would be able to proceed smoothly and we would be able to reap the benefits. We can clearly see how organ trading would benefit us practically, through a greater amount of human lives saved, and economically, with organ trading being a viable source of income for those with lower income. It also benefits socially as well, for those without family or friends are still able to relieve their conditions through the buying of organs.

I urge all Singaporeans who oppose organ trading to get off your ethical high horses. Insisting that we outlaw organ trading because it is “just not right” would be to deprive many people of their health and comfort, for the sake of your naïve view of the world. We can all see how it would bring about greater benefit than harm, so it should be legalized. As I have stated, we must not allow a childish view of ethics to overrule our better sense and stop us from being practical. Legalizing organ trading is in fact the best step forward for all of us.

7 in 10 surveyed say 'no' to lifting ban; those who want it legalised call for government controls

Section:	News
By:	MELISSA SIM, VINCENT LEOW, JOCELYN LEE, CHERYL TAN
Publication:	The Straits Times 04/02/2007
Page:	4
No. of words:	700

SINGAPOREANS are against changing the law to allow organs to be bought and sold here.

In a Sunday Times poll of 200 people aged 17 to 72, about seven in 10 said "no" when asked if the country should lift its ban on organ trading.

The No. 1 reason: It's just not right to allow parts of the human body to be transacted like any other commodity.

The minority who were for such a change felt, understandably, that it would help save more lives.

But even within this group, the bulk or 81 per cent, felt that checks and balances in the form of government regulation would be necessary. This will forestall a free-for-all situation where organs go to the highest bidder, leaving the poor with nothing.

The survey reflects the ground sentiment on a debate which has been raging over the last two weeks.

It was sparked by a Forum letter in The Straits Times written by director of the National Neuroscience Institute Lee Wei Ling.

Dr Lee had argued that there was nothing wrong in incentivising a potential living donor with money, provided a competent doctor has first determined that there were no health risks. The end result, she said, is still another life saved.

Currently, living transplants are mostly between relatives – where money is not likely to have changed hands – though non-relatives can be considered. In both cases, the Transplant Ethics Committee of the hospital gives the go-ahead.

The Human Organ Transplant Act also allows for the removal of the kidney, liver, heart and cornea from non-Muslim Singaporeans and permanent residents (PRs) who have died.

Those who want the law on organ trading changed feel that it would mean a bigger supply of organs to better meet the needs of patients.

There were a total of 85 kidney transplants – from dead and living donors – performed on Singaporeans and PRs last year.

As at Jan 26 this year, there were 543 end-stage renal patients on the waiting list for kidneys, though this was down from a peak of 673 in 2003.

But for Singaporeans like trainee teacher Karen Thiang, organs are "sacred" and not meant to be traded, good intentions notwithstanding. "You can't put a price on them," said the 33-year-old.

Others who don't buy the argument are equally wary about a situation where organs go to the highest bidder, leading to escalating prices which would preclude the poor.

So even if organ trading is legalised, the state should preferably be the sole buyer, while giving a helping hand to the poor, they said.

"A system of subsidies and incentives would be an effective way to increase supply and ensure that patients who can't afford it are not deprived of the opportunity of a transplant," said undergraduate Chew Yun Zhi.

Dr Lam Pin Min, an ophthalmologist and a member of the Government Parliamentary Committee (GPC) for Health, said the relevant government agencies can set strict rules and regulations to determine the priority of organ recipients.

They can also decide the amount of "compensation" for donors because of "extra pain and discomfort" they undergo and "downtime" post-surgery.

Commenting on the survey results, MP Halimah Yacob, who heads the Health GPC, said it showed the dilemma faced by Singaporeans who recognise that organ sales could save lives but feel a natural revulsion towards the idea.

"This means that Singaporeans are not yet ready to deal with the issues that arise from organ trading, particularly the ethical considerations," she said.

"It is difficult for the Government to move ahead of people's values and norms and allow organ trading."

The Health Ministry added that it was not surprised by the survey results.

"Ethically, it is indeed very hard to accept organs as a commodity that can be bought and sold, as the possibilities of abuse and profiteering are tremendous.

"While ethical boundaries do change with time and public sentiments, we would need to study the implications of organ trading carefully. More importantly, society as a whole needs to discuss the issue openly. We welcome the debate."

Additional reporting by Jocelyn Lee & Cheryl Tan

simlinoi@sph.com.sg

leowmc@sph.com.sg



'You can't attach a value to how much an organ is worth. If I smoke, it's worth $5,000; if I don't, it's worth $10,000? I don't think that's right.'

– JUNIOR COLLEGE STUDENT TAN GUANG LING, 18