Scuffle for organs sparks donor debate in Singapore

Scuffle for organs sparks donor debate in Singapore

"Japan Times", Mar.5, 2007, (Reuters)

As members of Sim Tee Hua's family sat at his bedside to pray for his recovery, they were horrified to learn that the hospital staff were about to turn off his life-support machine and use his organs for transplant.
The scenes that followed have shocked and upset not just Sim's family but many other Singaporeans, sparking a debate over the country's organ donor policy, which assumes that all citizens are willing donors unless they have registered with the government that they wish to opt out.
Doctors at Singapore General Hospital had declared Sim brain-dead and said they could not delay switching off life-support any longer because of the risk of damage to Sim's organs.
Sim's family had no objection to his organs being used for transplants but wanted doctors to wait one more day before turning off the life-support machine.
But as Sim's 68-year-old mother and about 20 other relatives knelt weeping before the doctors, begging them to wait, nine police officers entered the ward and restrained the distraught family while Sim's body was quickly whisked away.
"The hospital staff were running as they wheeled him out of the back door of the room. They were behaving like robbers," said Sim Chew Hiah, one of Sim's elder sisters.
The Sim family's experience has prompted a wave of letters to the local media, with some people saying they would opt out in protest, and added fire to a debate about organ trading. Lee Wei Ling- a prominent doctor who is the daughter of Lee Kwan Yew, the first Prime Minister of modern Singapore- last month urged the government to legalize organ trading, or the buying and selling of human organs for cash.
"Organ trading is frowned upon and usually not allowed in countries where political correctness reigns," said lee in a letter to the Straits Times.
"If monetary incentive makes a potential living donor more willing to save another life, what's wrong in allowing that?"
Her views have some support from the public.
"If I can sell my organs, give my children a better life, and save someone else's life too, why not? Not everyone drives a Mercedes," said Khalid, 32, who gave only his first name.
Currently, anyone caught buying or selling human organs in Singapore may be jailed up to a year or fined up to $6,500.
Those who oppose the trading in human organs say it promotes greater social injustice.
"To trade it and sell it for $190, $380, or to the highest bidder, that is to prostitute your organ," Dr. Choi Kin, president of the Hong Kong Medical Association, said.
Such donors are likely to be poor and uneducated people from countries such as Brazil and India, who can sell a kidney for as little as $1,000, the World Health Organization said.
And they are usually exploited by organ traffickers, who can charge wealthy clients up to $100,000 and $200,000 for a new organ, according to the WHO.
The chronic shortage of organs for transplant is a global problem. In the U.S. alone, more than 6,200 patients die each year while waiting for an organ, according to the United Network for Organ Sharing, a U.S.-based nonprofit medical group.
The shortage has forced doctors and governments to look for alternatives, such as the use of pig's kidneys, hearts and lungs, or the purchase of human organs.
Patients have also traveled abroad for transplants, notably to China, which has been accused by rights groups of harvesting organs from executed prisoners.
Since 1995, more than 270 Singaporeans have gone abroad, mostly to China, for organ transplants, the Health Ministry said.
To ease the organ shortage, Singapore ammended its Human Organs Transplant Act in 2004 to expand the pool of organ donors and the type of organs that could be donated.
Hospitals can remove the kidneys, liver, heart and corneas of all non-Muslim Singaporean citizens or permanent residents when they die, unless they have objected.
Muslims can choose to donate their organs, as in Iran and Malaysia, although many believe that the dead should be buried with all their organs intact.
Doctors say a system that assumes all citizens are organ donors is necessary because even though many people are in favor of donating their organs, few actually come foreward.
While many European countries, including Belgium, Denmark, Norway, Switzerland and Spain, have laws similar to Singapore's Transplant Act, it can still be a sensitive issue.
Critics say that laws that assume all citizens are organ donors are inadequate because the definition of death is debatable. Others are concerned that life-support may be turned off prematurely or that people may be unaware of the opt-out option.
"It should be up to the citizen to decide," Choi said.
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