Tuesday, March 27, 2007

Human Organ Transplant Act

Human Organs Transplant Act

Just for Info, if you want to opt out from HOTA, please visit this website or get this form.

The recent uproar over how a “declared brain dead” but breathing patient's organs being forcefully removed from his body under the Human Organs Transplant Act (HOTA) has significant impact on various areas. One of my friends rang me up to express his unhappiness over the methods used in enforcing this law. Although he is not totally against HOTA but he feels that there is a total lack of tact and empathy from the hospital in enforcing it.

I have been pondering over this issue for the past few weeks, not only on the way the patient's immediate family members are being treated in the whole process but also on the merits and the philosophical MORAL grounds of HOTA.

I guess nobody could argue with the fundamental aim of HOTA in saving lives by providing the framework whereby organ transplants could be done legally. However, it is important to examine on how the law is being drafted.

While human organs trading is prohibited in Singapore, HOTA allows the state (government's proxies such as hospitals etc) to harvest human organs from certain dead persons which includes persons who died in accidents or those declared brain dead. The most important clause in HOTA is that it allows the state to harvest these organs if the dead did not sign any documents that indicates his objections while he was alive.

There are a few issues which I would like to highlight:

1)When HOTA allows the state to harvest organs from persons who are declared brain dead, then it would mean that those doctors must be 100% sure that the patient is indeed brain dead. But as far as we know, there are instances whereby persons who were declared brain dead “revived” themselves after a certain period of time. Thus, it is impossible for anyone to be 100% sure that a person lying in coma is indeed brain dead.

2)It is the state's responsibilities to educate the public on the necessity of supporting Human Organ transplants by means of donating their organs when they are dead. The clause in HOTA allows the state to harvest human organs without the need of direct consent from the dead or his immediate family members. This will naturally mean that the state no longer need to carry out the necessary educational program to cultivate the people in believing in the merits of human organs transplant.

3)Silence means consent? This is a moral issue. Many people are ignorant of HOTA and the requirement of their documented dissent before they could “opt out” from such scheme. I think in many instances, PAP government has taken things for granted. It has chosen to take the easier way out by using “opt out” schemes for various things. But when it comes to HOTA, it does not merely involve money but human organs, emotions and personal religious beliefs as well. Could the state come up with a law that says if the one did not “opt out”, the state could use his body for drug experiments when he is admitted into hospital! The state could further come up with laws that dictates that if one did not “opt out”, the state could forcefully take blood from people if the needs arise (especially so for those with rare blood groups)!

4)The most fundamental question is this, do your dead body belong to the state after you are dead? If not, then why does the state empowers itself the right to do whatever they want to your body after you are dead? If so, then why the state did not take up the responsibility in conducting the necessary funerals and cremation of the dead bodies? Instead, it just takes whatever it wants from the body and then dump it back to the immediate family members!

5)If saving lives is the primary concern of the state in enforcing HOTA, then my question is this: citizens have already done their part in “donating” their organs to save lives, will the state provide the necessary organ transplant surgery for those who need these organs FREE OF CHARGE? This would mean that whether you are rich or poor, you will have the equal chance of receiving organ transplant without the need to pay the hefty fees for such transplant to take place.

6)If the state is not going to sponsor FREE organ transplant surgery, then it would mean that only those rich individuals who could afford the expensive surgery will get the organs. The problem is, rich or poor, if you did not “opt out” of the scheme, your organs are “liable” for harvesting when you are dead. Is this a “FAIR” system?

7)Who will benefit from the “donation” of the organs if the surgery is not free? Those who need the organ transplant as well as the hospital and doctors that are doing the transplants. The ultimate question is this, if we do not allow people to trade their organs for money, but in the end, this law conveniently allows some other people to benefits indirectly from such “donation”!

8)Those who drafted this law really lack empathy. They have made various assumptions about death and take those family members for granted. This is especially so when there is a asymmetric of knowledge between doctors and layman on what constitutes “brain dead”. For the patient's immediate members, it would be difficult to convince them that a breathing patient is indeed “dead”. Thus, the conflicts arise from the recent case is within really expectation. It is really unimaginable that a self proclaimed world class government could draft a law that lacks simple empathy and sensitivity to the citizens.

9)On the other hand, I really wonder how could those hospital staff and policemen could enforce such law right in front of those grieving relatives! How could the law makers expect hospital staff and policemen to enforce such a law on breathing brain dead patients?

My reflection on HOTA is that this government lacks empathy in governance. We should always remind ourselves that we are dealing with human beings, not just mere digits. You could use cold logic to deal with digits but we should use empathy to deal with human beings.

Most of the time, it would be too simplistic to think in such “cold rationale”:

Brain dead= dead = alright to harvest human organs.

The truth is, there are numerous “miracle revival” of supposedly, scientifically “brain dead” individuals in this world. Thus “brain dead” is actually not “definite death” but just a “probable”
death. i.e. High probability that the patient is dead.

Besides, it is just not about whether the patient is truly dead or not, but rather, whether the family members could accept the death in view of a breathing body. We are after all, dealing with human beings, not some robots.

HOTA is merely one of the many examples whereby this self proclaimed “World Class Government” uses “cold logic” to deal with human beings..i.e. Citizens. Everything could be “digitized” and “explain away” without the need of using human empathy. This also explains why many Singaporeans are unhappy of what PAP does (including minister pay rise, GST rise etc) but they are unable to “logically” rebuke PAP's policies. It is just a matter of empathy.

Goh Meng Seng


Anonymous said...

So if national and international bodies agree that brain death is irreversible (please do not confuse this with coma), should the relatives' wishes override the deceased's?

You are very quick to stand up for the right of families to let their cultural beliefs override other people's right to life.

Are you going to stand up for the right of kidney patients to live?

Anonymous said...

Hope tht when GMS died they giv him a wold heat and dog lung (lang xin gou fei) hahhahha

Anonymous said...

I don't know about this HOTA stuff but GMS, you can held your debate in YPAP blog instead.


Admin said...

Dear kidney patient,

Who will stand for the rights of the dead and their family members? If you want to talk about "right", then on what moral ground do you claim to have a right over a dead body's organs?

The truth is, we need people to "donate" or DIRECT consent to donate their organs to you; else, if not, then it will mean that modern days "Robin Hood" will be legally accepted as he robs the rich to help the poor! There is a vast difference between "Robin Hood" vs Charities.

If you read my post carefully, it is not about "scientific death" that matters, it is about human acceptance of death that matters.

Goh Meng Seng

Ned Stark said...

Mr Goh,
What is ur opinion on the increase in minsterial pay?

Anonymous said...

Oppositon is full of political opportunists, GMS is 1 fine such example, any opportunity presented itself to whack the PAP he would br glad to do so, y not hence I presume the next thing he going to attack is ministerial salaries. the ultimate aim of HOTA is to save lives even GMS admits but he chose bits and pices here and there to criticise without offering real concrete solutuins. Since we all agree HOTA is gd but need some refinements y not propose some ideas? Of cos GMS as usual woul say not my job to spoonfeed those miliion dollars miniters. One actually wonder if he cant outperform PAP ministers y is he in this game and by joinging NSP hope to learn more abt taking nude pics than offering concrtee solutions ahahhahhaahh

Btw GMS conveniebntly leave out the fact tht the hospital did accede to the patient relative request to wait another 24 hrs. Whats his motive for doing so not difficult to guess hahahhah

Admin said...

Dear ned stark,

I am coming to this ministers' pay issue very soon. ;)

Goh Meng Seng

Anonymous said...

thanks for your insightful sharing of information and opinions, despite all the opposing voices. keep up your good work.

btw i'm opting out from the HOTA scheme - not because i don't want to save lifes. i'd rather do it voluntarily than being forced to. i wonder how such legislation can be in place in a developed country like singapore? aren't human rights protected here? aren't people aware of their own rights and stand up for it? i can't agree less with your point that if we are to give out our organs, it should be on a voluntary basis which can be cultivated through education. can somebody tell me where else on earth does such legislation exist?

Anonymous said...

sorry ... it shd be "can't agree more" ...

Anonymous said...

Goh Meng Seng wrote:
'If you read my post carefully, it is not about "scientific death" that matters, it is about human acceptance of death that matters.'

So you feel the definition of death, as defined by scientists and doctors around the world, not just in Singapore, is wrong.

It is a balance of rights. On the one hand, it is a family's claim to a dead man's organs. On the other hand, it is an organ failure's right to life.

Your statement has shown where you stand on this.

The dead man has no need for his organs.

The dying kidney patient will die without a transplant.

At least have the guts to say that you would rather protect the organs of dead men, instead of safeguarding the life of kidney patients.

Anonymous said...

Lets hope none of GMS loved ones need a transplant one fo these days if not he will be crying on the floor no wonder someone says he deserve lang xin gou hei lol

Anonymous said...

kidney patient talks as if receiving organs is an entitlement, probably been (and still is) a very pampered child. fact is, nobody has any right to anybody's organs, opt out scheme or no.

Anonymous said...

GMS is just a political opportunist who won't miss wacking the PAP for his own political gain when he has no real ideas or ability of his own. Look at how he was disgraced by an anonymous forumer in public!!

Anonymous said...

My organs are mine. They belong to me. My assests. My belongings. Mine!. Period!

Just like any of my other assests or belongings like money, property, jewelries,etc. They are mine. When I die these things will be "left" to my love ones. Whether it be money, property, expensive work of arts and by the same token my body as well.

Even if I do not have any will when I die, my possessions will be left to my love ones...my immediate relations. That is the natural, moral and legal course to be expected and undertaken. No legislation should over ride such a basic, natural, moral human right. No legislation should have the take away such right over our immediate relations.

If this unhealthy practices goes further. Who knows the government of the day may one day declare that all possessions of the dead are to by be taken by the state under the rational that they be given to the dire needy poor in the Singapore.

And yes if ever I were to die from some organ failure to lack of available donors so be it. It's my fate, it's my time, it's God's will, etc.

Anonymous said...

So all you opposition supporters have shown your true colours. A kidney patient comes to this blog, posts his views, and you attack him and call him names, just because he disagrees with you.

Do you condone this, Mr Goh Meng Seng?

Anonymous said...

stop being naive michael. prove that kidney patient is a real kidney patient, then get on your high horse.

Anonymous said...

Actually, it's not all opposition supporters, but WP dogs only. WP does not belong to the opposition at all, since when did it ever oppose the PAP? I am a SDA member and I'm utterly ashamed of Goh Meng Seng's views. But I'm surprised by the behavior of WP dogs here as they are well-known for mud-slinging and name-callings, just look at how Petty Tong fix a poor forumer for posting using his BIG NAME on SBF. WP sucks big time!

Anonymous said...

That's strange?!? I'm a SDA member and I feel that that WP and GMS in their OWN way are doing a good job to provide an alternative view/voice for SINGAPOREANS.

Only PAP and their slave dogs cannot tolerate aternative parties and views.

Anonymous said...

PAP has been vilified so many times on internet forums and yet they remain tolerant and embracing. Try rebuking a WP doggie and the entire pack will come barking at you.

The most disgraceful thing about WP shit is that they only know how to bark at ordinary forumers, but not at the PAP. Shame on the WP whores!

Anonymous said...

Anon 7:56

Stop evading the issue!

Why does a family have to BEG the authorities (hospital authorities and policemen) to have one more day on life support. It's the family's preogative whether life support system is to be taken off or not! Not the policemen! NOt even the doctors!

The decision belongs to the family concern!!!

Anonymous said...

All will be revealed when the recipient of his organs are made known.

Anonymous said...

I see your concern about this topic. My peers and i have discussed this before too. However, i feel you have your point as in "awareness to the public" because some of my friends does not even know that they fall under this act.

There are some mis-handle of this issue. They should ensure that the public understand that they can currently under this act.

For the this acts, i feel that it is beneficial because organs are something you cannot bought with money. It is used to help the needy and eventually save people's life. Government structured the act because in singapore the most precious thing is HUMAN RESOURCE.

I believe that you (representing the WP) posting such comments on the blogs will be seen as trying to jeopardising the relationship between the citizens and government. More-ever, i feel that your points are not strong enough.

I was thinking of voting WP but now, i have second thoughts about it. I hope to see there are people who are tactful in WP. And of course, more actions than words.

Anonymous said...

The least the PAP should do is to educate all the public about HOTA.

The least that PAP should do is to educate their officers executing the Act to act with empathy.

The least that PAP should do is to ensure that the State-own paper reports facts.

As far I can see of the reports, some of these views posted on this blog, and letters from the deceased family, the PAP has not fulfil these important tasks.

I am all for volunteering my organs but I do not want it to be taken away by force. If I am waiting for an organ, I want it to be given to be volunteerily.

Is it too much to ask from our money-minded PAP? They have been given great powers and I believe they owe it to us to respect our individual dignity that we deserves.

Anonymous said...

"PAP has been vilified so many times on internet forums and yet they remain tolerant and embracing. Try rebuking a WP doggie and the entire pack will come barking at you.

The most disgraceful thing about WP shit is that they only know how to bark at ordinary forumers, but not at the PAP. Shame on the WP whores!"

That's because PAP hires doggies like you to do the barking?

The most disgraceful thing about these elite doggies is that they only know how to bark at WP members, but not at the PAP's policies. Shame on the PAP doggies!


Anonymous said...

Sadly, i do not agree that human acceptance of death that matters that much.

Someone's life is at stake.

Brain death is death and the only difference is when the family members will accept that death.


Not to blame Singapore's doctors, but there is always a chance that brain death is misdiagnosed.

My uncle is doctor and he says that doctors are under great pressure when it comes to this topic. As such, they tend to rush the tests and there is always a possibility of misdiagnosis.

Please forgive if I am wrong.

You may think the possibilty is small, but 0.01% is large enough when it comes to your loved one.

That is why my family and I have decided to opt out. If it comes to a situation where there is a possibility of brain damage, we will get the doctors to check and check again before we donate the organs.

Am I wrong in thinking so?

Anonymous said...

HOTA is totally wrong. Gov can not default using body parts by grant.

Everyone has the right to his/her body and it is up to he/she to donate it or not.

In my country (Vietnam), only if you sign an agreement when you alive that you are willing to give your body parts after dead then gov will take it, otherwise they can not take it.

HOTA must change to opt-in instead of opt-out.

Anonymous said...

Just to clarify some medical issues. Brain dead is absolute. Brain dead patient requires machines in order for their lungs to breath and heart to beat. Those 'revival' cases are merely patients in coma, not brain dead.

muebles coslada said...

The dude is completely just, and there is no suspicion.