Making an organ donation in Singapore: Difference between revisions

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In 2015, Singapore’s combined (both deceased and living) organ transplant rate was 20 per million population (pmp).<ref>“Facts About Organ Donation”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/facts.html</ref> In 2019, it was reported that Singapore still faced a severe shortage of organs.<ref>Liu, Jean. “Commentary: Timely to review our opt-out organ donation policy”. ''Channel News Asia''. October 18, 2017. Accessed on 16 April 2019. Retrieved from: https://www.channelnewsasia.com/news/singapore/commentary-timely-to-review-our-opt-out-organ-donation-policy-9317580</ref> In order to mitigate the issue, the Human Organ Transplant Act (HOTA) and Medical (Therapy, Education and Research) Act (MTERA) were established earlier on to encourage Singapore citizens and Permanent Residents (PRs) to donate their organs when they die.  
In Singapore, the Human Organ Transplant Act (HOTA) and Medical (Therapy, Education and Research) Act (MTERA) were established to allow better medical access for Singapore citizens and Permanent Residents (PRs) who require organ transplants. However, it was reported in 2019 that Singapore still faced a severe shortage of organs.<ref>Liu, Jean. “Commentary: Timely to review our opt-out organ donation policy”. ''Channel News Asia''. October 18, 2017. Accessed on 16 April 2019. Retrieved from: https://www.channelnewsasia.com/news/singapore/commentary-timely-to-review-our-opt-out-organ-donation-policy-9317580</ref> In 2015, Singapore’s combined (both deceased and living) organ transplant rate was 20 per million population (pmp).<ref>“Facts About Organ Donation”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/facts.html</ref> 


Prior to 2004, the law in Singapore states that unrelated individuals cannot make living organ transplants. However, in 2002, Mediacorp actress Andrea De Cruz was an exception to the law when she suffered from liver failure due to the [[Slim 10 saga (2002)|Slim 10 saga]].  
Before 2004, the law in Singapore states that unrelated individuals cannot make living organ transplants. However, in 2002, Mediacorp actress Andrea De Cruz was an exception to the law when she suffered from liver failure due to the [[Slim 10 saga (2002)|Slim 10 saga]].  
==Deceased donor transplant==
==Deceased donor transplant==
[[File:HOTA infographic.jpg|thumb|''In 2004, the HOTA was amended to include donations of the liver, heart and cornea. Infographic from Visual.ly, credits to Simon Ang.'']]
[[File:HOTA infographic.jpg|thumb|''In 2004, the HOTA was amended to include donations of the liver, heart and cornea. Infographic from Visual.ly, credits to Simon Ang.'']]
Deceased donor transplant refers to the transplantation of organs retrieved from a donor whose death has been medically certified. Harvesting of organs can only be made if the donor meets the internationally accepted clinical criteria for the certification of death, including brain death. The donated organs will be matched to the blood group, weight and urgency of the common pool of patients on the respective organ transplant waiting lists.<ref>“What My Family Should Know”. ''Live On.'' Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/what-my-family-should-know.html</ref> The cost of any organ donation procedures and tests will not be charged to the donor’s family.<ref>“Understanding HOTA”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf</ref>  
Deceased donor transplant refers to the transplantation of organs retrieved from a donor whose death has been medically certified. The donated organs will be matched to the blood group, weight and urgency of the common pool of patients on the respective organ transplant waiting lists.<ref>“What My Family Should Know”. ''Live On.'' Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/what-my-family-should-know.html</ref> The cost of any organ donation procedures and tests will not be charged to the donor’s family.<ref>“Understanding HOTA”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf</ref>  




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===Human Organ Transplant Act (HOTA)===
===Human Organ Transplant Act (HOTA)===
Introduced in 1987, HOTA is a compulsory organ donation system which allows for the kidneys, liver, heart and corneas to be harvested in the event of death from any cause for the purpose of transplantation.<ref>“What is HOTA all about?”. ''Ministry of Communications and Information''. August 21, 2013. Accessed on 16 April 2019. Retrieved from: https://www.gov.sg/factually/content/what-is-hota-all-about</ref> All Singaporeans and PRs who are above the age of 21 and not suffering from mental disorders will be automatically covered under the Act unless they have opted out. It should be noted that HOTA only applies to deaths that occur in hospitals.
Introduced in 1987, HOTA is a compulsory organ donation system which allows for the kidneys, liver, heart and corneas to be harvested in the event of death from any cause for transplantation.<ref>“What is HOTA all about?”. ''Ministry of Communications and Information''. August 21, 2013. Accessed on 16 April 2019. Retrieved from: https://www.gov.sg/factually/content/what-is-hota-all-about</ref> All Singaporeans and PRs who are above the age of 21 and not suffering from mental disorders will be automatically covered under the Act unless they have opted out. It should be noted that HOTA only applies to deaths that occur in hospitals.




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Anyone regardless of nationality and who is at least 18 years old can pledge to donate their organs and/or tissues.<ref>“Understanding HOTA”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf</ref> In the event where a person had not pledged his organs under MTERA before passing away, the family members are allowed to make a decision on behalf of him upon his death if they wish to do so. Interested individuals can submit the completed Organ Donation Pledge form ([http://www.liveon.sg/docs/forms/Form_02.pdf PDF form]) to the National Organ Transplant Unit via post.
Anyone regardless of nationality and who is at least 18 years old can pledge to donate their organs and/or tissues.<ref>“Understanding HOTA”. ''Live On''. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf</ref> In the event where a person had not pledged his organs under MTERA before passing away, the family members are allowed to decide on behalf of him upon his death if they wish to do so. Interested individuals can submit the completed Organ Donation Pledge form ([http://www.liveon.sg/docs/forms/Form_02.pdf PDF form]) to the National Organ Transplant Unit via post.


==Living donor transplant==
==Living donor transplant==
[[File:Peter Lim Kok Seng.jpg|thumb|''Mr Peter Lim Kok Seng (above) was the first Singaporean to donate part of his liver to a complete stranger. Photo from The Straits Times.'']]
[[File:Peter Lim Kok Seng.jpg|thumb|''Mr Peter Lim Kok Seng (above) was the first Singaporean to donate part of his liver to a complete stranger. Photo from The Straits Times.'']]
Living donor organ transplant refers to a situation in which a living person donates one kidney or part of the liver to another person. It is proven that living organ transplants yield better results compared to cadaveric transplants.<ref>“Living Organ Donation”. ''Live On.'' Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/living-organ-donation.html</ref> Only the kidney and liver are suitable for live organ donation as the human body can function just as well with one kidney and that the liver is able to rebuild itself to its normal size within two months.<ref>“Organ Transplantation”. ''National University Hospital''. Accessed on 16 April 2019. Retrieved from: https://www.nuh.com.sg/our-services/Specialties/Organ-Transplantation/Pages/default.aspx</ref>
It is proven that living organ transplants yield better results compared to cadaveric transplants.<ref>“Living Organ Donation”. ''Live On.'' Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/living-organ-donation.html</ref> However, only the kidney and liver are suitable for live organ donation as the human body can function just as well with one kidney and that the liver can rebuild itself to its normal size within two months.<ref>“Organ Transplantation”. ''National University Hospital''. Accessed on 16 April 2019. Retrieved from: https://www.nuh.com.sg/our-services/Specialties/Organ-Transplantation/Pages/default.aspx</ref>


===Organ matching===
===Organ matching===
Most living donations occur between direct family members due to the lower rate of organ rejection. However, there have also been living organ donations from unrelated persons and strangers. Hence in such cases, the identity of the donor and recipient will be made known.  
Most living donations occur between direct family members due to the lower rate of organ rejection. However, there have also been living organ donations from unrelated persons and strangers in Singapore. In such cases, the identity of the donor and recipient will be made known. In 2016, Mr Lim Kok Seng became the first person in Singapore to donate part of his liver to a stranger.<ref>“Organ Donation in Singapore (Under HOTA, or For Science)”. ''Singapore Legal Advice.'' October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/</ref>




On 6 January 2004, laws on living donor transplants were amended in order to allow more Singaporeans to benefit from organ donations.<ref>Shum, Eugene & Chern, Arthur. “Amendment of the Human Organ Transplant Act”. ''Annals, Academy of Medicine, Singapore.'' June, 2006. Accessed on 16 April 2019. Retrieved from: http://www.annals.edu.sg/pdf/35volno6200607/v35n6p428.pdf</ref> Before that, Singapore law did not allow living organ donation from a living unrelated person.<ref>Khalik, Salma. “Doctors attempt 2-step liver transplant”. ''The Straits Times''. May 31, 2002. Accessed on 16 April 2019. Retrieved from: https://eresources.nlb.gov.sg/newspapers/Digitised/Search?ST=1&AT=search&k=doctors%20attempt%202-step%20liver%20transplant# </ref> An exception was made in May 2002, as Mediacorp actor Pierre Png donated part of his liver to his girlfriend, former TV celebrity Andrea De Cruz, who was a victim of the Slim 10 Pills scandal suffering from liver failure. This was the first living liver transplant between two unrelated people in Singapore.<ref>Yip, Wai Yee. “Pierre Png Destined To Be An Actor”. ''Her World.'' May 7, 2014. Accessed on 16 April 2019. Retrieved from: https://www.herworld.com/celebs-men-sex/pierre-png-destined-be-actor</ref> In 2016, Mr Lim Kok Seng became the first person in Singapore to donate part of his liver to a complete stranger.<ref>“Organ Donation in Singapore (Under HOTA, or For Science)”. ''Singapore Legal Advice.'' October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/</ref>
On 6 January 2004, laws on living donor transplants were amended to allow more Singaporeans to benefit from organ donations.<ref>Shum, Eugene & Chern, Arthur. “Amendment of the Human Organ Transplant Act”. ''Annals, Academy of Medicine, Singapore.'' June, 2006. Accessed on 16 April 2019. Retrieved from: http://www.annals.edu.sg/pdf/35volno6200607/v35n6p428.pdf</ref> Before that, Singapore law did not allow living organ donation from a living unrelated person.<ref>Khalik, Salma. “Doctors attempt 2-step liver transplant”. ''The Straits Times''. May 31, 2002. Accessed on 16 April 2019. Retrieved from: https://eresources.nlb.gov.sg/newspapers/Digitised/Search?ST=1&AT=search&k=doctors%20attempt%202-step%20liver%20transplant# </ref> An exception was made in May 2002, as Mediacorp actor Pierre Png donated part of his liver to his girlfriend, former TV celebrity Andrea De Cruz, who was a victim of the Slim 10 Pills scandal suffering from liver failure. This was the first living liver transplant between two unrelated people in Singapore.<ref>Yip, Wai Yee. “Pierre Png Destined To Be An Actor”. ''Her World.'' May 7, 2014. Accessed on 16 April 2019. Retrieved from: https://www.herworld.com/celebs-men-sex/pierre-png-destined-be-actor</ref>  


===Financial and legal concerns===
===Financial and legal concerns===
Organ donations are purely altruistic and there should not be any monetary incentives or forced compliance. However, the HOTA allows for reimbursement of all medical expenses and loss of earnings incurred as a result of organ donation for altruistic donors.
Organ donations are purely altruistic and there should not be any monetary incentives or forced compliance. However, the HOTA allows for reimbursement of all medical expenses and loss of earnings incurred as a result of organ donation for altruistic donors. Organ trading is also illegal in Singapore and any person guilty of this offence is liable to a fine not exceeding S$100,000 or to imprisonment for a term not exceeding 10 years or both.<ref>“Organ Donation in Singapore (Under HOTA, or For Science)”. ''Singapore Legal Advice.'' October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/</ref>
 
Organ trading is illegal in Singapore and any person guilty of this offence is liable to a fine not exceeding S$100,000 or to imprisonment for a term not exceeding 10 years or both.<ref>“Organ Donation in Singapore (Under HOTA, or For Science)”. ''Singapore Legal Advice.'' October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/</ref>


==References / Citations==
==References / Citations==
[[Category:Adulting Guides]]
[[Category:Adulting Guides]]
<references />
<references />

Latest revision as of 16:59, 17 July 2019

In Singapore, the Human Organ Transplant Act (HOTA) and Medical (Therapy, Education and Research) Act (MTERA) were established to allow better medical access for Singapore citizens and Permanent Residents (PRs) who require organ transplants. However, it was reported in 2019 that Singapore still faced a severe shortage of organs.[1] In 2015, Singapore’s combined (both deceased and living) organ transplant rate was 20 per million population (pmp).[2]

Before 2004, the law in Singapore states that unrelated individuals cannot make living organ transplants. However, in 2002, Mediacorp actress Andrea De Cruz was an exception to the law when she suffered from liver failure due to the Slim 10 saga.

Deceased donor transplant

In 2004, the HOTA was amended to include donations of the liver, heart and cornea. Infographic from Visual.ly, credits to Simon Ang.

Deceased donor transplant refers to the transplantation of organs retrieved from a donor whose death has been medically certified. The donated organs will be matched to the blood group, weight and urgency of the common pool of patients on the respective organ transplant waiting lists.[3] The cost of any organ donation procedures and tests will not be charged to the donor’s family.[4]


The donor’s body will be treated with the same surgical standards applied to any living person undergoing surgery. However, organ donations from a person contacted with an infectious disease such as Tuberculosis, Hepatitis B, Hepatitis C or HIV are not allowed.[5]  

Human Organ Transplant Act (HOTA)

Introduced in 1987, HOTA is a compulsory organ donation system which allows for the kidneys, liver, heart and corneas to be harvested in the event of death from any cause for transplantation.[6] All Singaporeans and PRs who are above the age of 21 and not suffering from mental disorders will be automatically covered under the Act unless they have opted out. It should be noted that HOTA only applies to deaths that occur in hospitals.


Individuals who wish to opt out of any or all 4 organs under HOTA may do so by submitting the completed Objection To Organ Removal form (PDF form) to the National Organ Transplant Unit via post. It should be reminded that anyone who opts out of HOTA would receive lower priority for receiving an organ on the national waiting list should an organ transplant be required in the future.[7]


Individuals who have opted out of HOTA and wish to withdraw the earlier objection may do so by submitting the completed Withdrawal Of Objection To Organ Removal form (PDF form) to the National Organ Transplant Unit via post.[8]

Medical (Therapy, Education and Research) Act (MTERA)

Enacted in 1974, MTERA is an opt-in scheme where people can choose to donate organs that are not covered under HOTA.[9] Examples of organs that can be donated include bone, skin or even the entire body. Besides serving as a gift of life, these donations will also help to support research and advancement of medical science.


Anyone regardless of nationality and who is at least 18 years old can pledge to donate their organs and/or tissues.[10] In the event where a person had not pledged his organs under MTERA before passing away, the family members are allowed to decide on behalf of him upon his death if they wish to do so. Interested individuals can submit the completed Organ Donation Pledge form (PDF form) to the National Organ Transplant Unit via post.

Living donor transplant

Mr Peter Lim Kok Seng (above) was the first Singaporean to donate part of his liver to a complete stranger. Photo from The Straits Times.

It is proven that living organ transplants yield better results compared to cadaveric transplants.[11] However, only the kidney and liver are suitable for live organ donation as the human body can function just as well with one kidney and that the liver can rebuild itself to its normal size within two months.[12]

Organ matching

Most living donations occur between direct family members due to the lower rate of organ rejection. However, there have also been living organ donations from unrelated persons and strangers in Singapore. In such cases, the identity of the donor and recipient will be made known. In 2016, Mr Lim Kok Seng became the first person in Singapore to donate part of his liver to a stranger.[13]


On 6 January 2004, laws on living donor transplants were amended to allow more Singaporeans to benefit from organ donations.[14] Before that, Singapore law did not allow living organ donation from a living unrelated person.[15] An exception was made in May 2002, as Mediacorp actor Pierre Png donated part of his liver to his girlfriend, former TV celebrity Andrea De Cruz, who was a victim of the Slim 10 Pills scandal suffering from liver failure. This was the first living liver transplant between two unrelated people in Singapore.[16]

Financial and legal concerns

Organ donations are purely altruistic and there should not be any monetary incentives or forced compliance. However, the HOTA allows for reimbursement of all medical expenses and loss of earnings incurred as a result of organ donation for altruistic donors. Organ trading is also illegal in Singapore and any person guilty of this offence is liable to a fine not exceeding S$100,000 or to imprisonment for a term not exceeding 10 years or both.[17]

References / Citations

  1. Liu, Jean. “Commentary: Timely to review our opt-out organ donation policy”. Channel News Asia. October 18, 2017. Accessed on 16 April 2019. Retrieved from: https://www.channelnewsasia.com/news/singapore/commentary-timely-to-review-our-opt-out-organ-donation-policy-9317580
  2. “Facts About Organ Donation”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/facts.html
  3. “What My Family Should Know”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/what-my-family-should-know.html
  4. “Understanding HOTA”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf
  5. “Understanding HOTA”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf
  6. “What is HOTA all about?”. Ministry of Communications and Information. August 21, 2013. Accessed on 16 April 2019. Retrieved from: https://www.gov.sg/factually/content/what-is-hota-all-about
  7. “What is HOTA all about?”. Ministry of Communications and Information. August 21, 2013. Accessed on 16 April 2019. Retrieved from: https://www.gov.sg/factually/content/what-is-hota-all-about
  8. “Yes, I Support Organ Donation”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/organ-supporter.html
  9. Lim, Min. “Living Organ Donation in Singapore”. Asia Law Network. December 5, 2018. Accessed on 16 April 2019. Retrieved from: http://learn.asialawnetwork.com/2018/12/05/living-organ-donation-in-singapore/
  10. “Understanding HOTA”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/docs/info_booklets/SO20870_Hota_english2013.pdf
  11. “Living Organ Donation”. Live On. Accessed on 16 April 2019. Retrieved from: http://www.liveon.sg/living-organ-donation.html
  12. “Organ Transplantation”. National University Hospital. Accessed on 16 April 2019. Retrieved from: https://www.nuh.com.sg/our-services/Specialties/Organ-Transplantation/Pages/default.aspx
  13. “Organ Donation in Singapore (Under HOTA, or For Science)”. Singapore Legal Advice. October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/
  14. Shum, Eugene & Chern, Arthur. “Amendment of the Human Organ Transplant Act”. Annals, Academy of Medicine, Singapore. June, 2006. Accessed on 16 April 2019. Retrieved from: http://www.annals.edu.sg/pdf/35volno6200607/v35n6p428.pdf
  15. Khalik, Salma. “Doctors attempt 2-step liver transplant”. The Straits Times. May 31, 2002. Accessed on 16 April 2019. Retrieved from: https://eresources.nlb.gov.sg/newspapers/Digitised/Search?ST=1&AT=search&k=doctors%20attempt%202-step%20liver%20transplant#
  16. Yip, Wai Yee. “Pierre Png Destined To Be An Actor”. Her World. May 7, 2014. Accessed on 16 April 2019. Retrieved from: https://www.herworld.com/celebs-men-sex/pierre-png-destined-be-actor
  17. “Organ Donation in Singapore (Under HOTA, or For Science)”. Singapore Legal Advice. October 26. 2018. Accessed on 16 April 2019. Retrieved from: https://singaporelegaladvice.com/law-articles/organ-donation-in-singapore/