Human Organ Transplant Act

With the Human Organ Transplant Act, or HOTA, Singapore now has a working system for saving lives by transplanting organs from the deceased into the patients. However, this system is not and will never be infallible, as there are many loopholes and these have led to many heated arguments in the past decade.

With HOTA, how far is it viable to forego consent in harvesting organs? I say that while being used to save another’s life is a noble cause, simply taking an organ from someone who has passed away without any kind of permission is in fact very immoral and wrong. Therefore, consent must be given before the deceased’s organs are removed and transplanted.

However, this has led to the government adapting an opt-out system, which is effective, but considered by many people as unethical, mainly due to the fact that most of the perfectly healthy people are simply not aware of the HOTA and therefore will not think of opting-out of the system. This has led to many conflicts between those that have a need to carry out the HOTA, and the family of the deceased. Another reason why so many conflicts such as the SGH incident occurs is because of the fact that a next-of-kin is not allowed to make decisions themselves on behalf of their dying relatives. However, the point here is that people in a coma cannot talk, and even if they could, they would be asking for their loved ones instead of saying “I want to opt out.” There are many cases like this where individuals cannot opt-out themselves and their family are also helpless to opt-out on behalf of the individual, and all they can do is watch their loved one’s organs get cut out and transplanted.

Another point of the HOTA that I would consider immoral is that those who opt-out of the system, being unwilling to donate their own organs should something happen to them, are given lower priorities on the waiting list should they ever need a transplant. What this basically means is that just because one wishes to keep his organs after death, he has to watch helplessly as people leapfrog him in the queue for an organ transplant. Does this really coincide with the ideals of democracy, where all of the citizens have equal liberty and rights?

The situation desperately needs improvement and to tackle the first issue of people being unaware of the opt-out system, we need to enforce education to the mass public so that they know about this system before they are critically ill. This can be done through campaigns in HDB zones that are mostly inhabited by the elderly, as well as through other forms of advertisement such as pamphlets and posters. Another way to tackle both the first and the second problem is to have an opt-in system instead of an opt-out system. While we do know that the main worry of the government is that not enough people opt-in and therefore lives will be wasted because there were no available organs. However, I believe that if the government makes the incentives of opting-in attractive, there will be enough volunteers, and the problem of ethics can then be solved.