HOTA – Family Trying to Prevent Organ Transplantation

Note: This is a very long entry.

In Singapore, the Human Organ Transplant Act (HOTA) 1987 was amended on 6 Jan 2004 to broaden the scope of the act to allow more Singaporeans to receive cadaveric organs.

Currently, it is an opt-out scheme, meaning that all Singaporeans are automatically enrolled in the scheme. The only exceptions are the Muslims (basically the Malays) because of their religion. For them, it is an opt-in scheme.

For more information on this scheme, please visit the Ministry of Health (MOH) FAQ on the HOTA.

Points to note:
1. It is possible to opt out and to withdraw the “opting-out” at any time.
2. People who opt out donating any selective organs on the HOTA will receive lower priority on the organ transplant list for that particular organ than others.

Now that the background information has been covered, let’s move on to the attention-grabbing, front-page newspaper article in The Straits Times 08 February 2007 – Brain-dead man’s kin in scuffle over op to remove organs.

The Straits Times had taken a more moderate tone. A Chinese newspaper’s article title: Together With 5 Family Members, Elderly Mother On Knees Protecting Body.

Apparently, according to J.’s sources, there has already been an sizable increase in the number of people opting out of the scheme today. This is both astonishing, yet perfectly understandable.

In no circumstance can we blame the family for holding out for a miracle, because
(a) it was a sudden, unexpected death
(b) they are not medically trained
(c) A brain-dead person can outwardly appear to be alive in that the hearts and lungs are still functioning on support.

J. is not sure of what were the measures taken to assure brain death (possible wants include cranial angiography) but assumes that they were all adequate.

What gets J. is how the overall feel of some articles portrayed the organ transplant act in such a bad light, by using descriptions that were emotionally charged. One cannot help but feel for the hapless family as the doctors, against the family’s will, forcibly removed the poor 43-year-old man’s organs. J. knows that is not true. However, the public who are not medically trained will not understand it as such.

Granted, the rest of the Straits Times article not quoting Lianhe Wanbao was fairly reasonable and gave the facts as well as the Ministry of Health’s explanation.

J. believes that this piece of news should not have been given a sensationalist spin to sell newspapers. It is irresponsible and will have an effect on lives. Organ transplants save people. By casting the HOTA is a bad light, it will reduce the number of available cadaveric organs for transplantation (hopefully not by too much) and it will cause the people who had opted out to have a longer wait for their organs (rather fairly, actually).

To even the odds, J. now provides a link to a Channel Newsasia article:
Organ donation gives recipients a second shot at life.
Of the three cases listed, only one was a cadaveric transplant (Heart). The other two were from living donors (preferably to cadaveric).

J. would try to justify why the doctors went ahead with the organ transplant, but it was already explained in the news article: after waiting 24-hours, the transplant team could not wait any longer because it had to balance the family’s wishes against saving the lives of patients requiring organ transplants.

And most importantly, in J’s understanding, in properly certified brain dead patients, the chances of recovery are zilch. Zero. Nada. Legality aside (the HOTA allowed the organs to be removed from Mr Sim), there is little justification to deny other patients lives for a hopeless wish. J. is all for respecting family’s wishes… until lives are at stake.

Also, there is more at stake than a feeling of repulsion at the thought of organs being removed from the body. Which is better, for an organ to carry on functioning past the death of a person, saving the life of another, to rot in the ground while feeding bacteria to be converted to ash in the incinerator?

J. hopes that few people will choose to opt out of the HOTA. If they already have, to think about it and opt back in.

Oh, and Be A Blood Donor, while you’re at it.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: