Singapore: Should government legalize organ trade?

An important debate is raging in Singapore: Should government legalize organ trade? The debate began last month when two young Indonesians were arrested and jailed for trying to sell their kidneys to a wealthy businessman in Singapore. The Human Organ Transplant Act “bans the supply of any organ or blood for valuable consideration” in Singapore.

mr wang says so articulates the key ethical issue in the debate:

“The key ethical objection is that human organ trading may lead to the exploitation of the poor and of socially disadvantaged donors who are unable to make an informed choice.”

Singapore is fifth highest in the world in terms of incidence of kidney failure. According to a news report, at least 3,500 people in Singapore have kidney failure; 600 are on the transplant list. But they have to wait up to nine years for a cadaveric donation.

Blinkymummy supports the legalization of organ trade:

“I personally believe that there is no good reason to prevent organ trading, provided the transaction is carried out within a well-defined framework. Why should anyone die on the waiting list because his family and friends are not equipped with a compatible kidney?

“On top of willing buyer and seller, these two parties ought to be fully informed of the risks involved. And the best party to be playing referee is the state. Because it is highly efficient and good at rationalising the necessary.”

But a reader has a different opinion:

“Is the state truly a good party to be a referee? In an ideal country, yes. Since no country is ideal, I do not think letting the state act as referee is safe.

“In a trade of organs, the poor will never have the chance for himself to enjoy a better life, only a chance to redeem his family from poverty. I do not think the state has the moral capacity to play this referee of fate.”

Singapore Law Watch uploads an article by Jennifer Yeo & Madan Mohan. The authors believe organ trade is beneficial:

“Organ donation, even if it involves valuable consideration, may make life better for both parties who find no way out of problems of health or poverty. If the state – and the altruists – cannot help the poor in overcoming their problems, it ought not to raise more barriers for them.

“Singapore can take the lead and set a good precedent for the international community by legalizing organ trade. The Republic has the infrastructure to facilitate such transactions.

“One idea is to set up a kidney registry for registering and screening donors and recipients to find matches and ensure that there has been no coercion, duress or exploitation. A charitable foundation or independent administrative body could take care of this and related matters such as informed consent, protection of identities of donors and donees, requirements, medical bills, insurance, compensation and benefits for donors, their families and other post-transplant issues.”

The authors’ proposals were echoed by government ministers who recently hinted that a certain procedure allowing organ trade will be implemented in the future. Carpe Diem – Seize the day also believes that:

“Singapore can take the lead in studying and implementing a system which permits the sale of organs that would strike a balance between individual needs and societal principal.”

But the Singapore Medical Association is opposing organ trade. Angry Doctor criticizes this position:

“Angry Doc feels that while doctors are individually entitled to their own moral viewpoints, and as a profession our ethics allow us to choose whether to participate or refrain from participation in a certain type of treatment, as advocates for our patients our role when it comes to a medical issue should be one of active participation through education and provision of information. We must not try to abdicate our responsibility while using the morality of a portion of doctors as an excuse.”

Catholic bloggers are opposing organ trade. A quiet moment shares a sample of the Catholic perspective:

“A donated organ can save a life but at whose expense? Somebody could be duped, coerced, pressured, offered incentives or even killed to have their organs extracted for the recipient.

“Has the patient been given adequate information, and made to understand what life will be after post-transplant surgery rather than living a life of regret from depression and ailments common to post-transplant surgery.”

Sze Zeng lambasts the commercialization of all aspects of life:

“In the organ trade, the term ‘organ donor’ is an oxymoron for in a trade there is no compensation but payment, and there is no donor but simply owner. The relationship does not bear any altruistic meaning but pure commercial transaction. The attraction in legalizing organ trade is the extension of widespread commercialization over all sphere of reality.”

Javert's World warns that organ trade will mean the “survival of the rich and extinction of the poor.” Another blogger points out that legalizing organ trade will not eliminate the underground market for kidney sales:

“Should the government decide to legalize organ trade and establish an organized system complete with standard operating procedures, there is no assurance that the black market will be totally eradicated. It is just like how loan sharks can still exist even with banks around, or how underground bets still thrive alongside the legal betting.”

But CTW explains that:

“Having some form of control over organ trading would prevent the middleman from exploiting the would-be donor. I am not suggesting things are simple but the Singapore authorities are good at plugging the loopholes.”

Anders Brink cautions against passing a law that would exploit the poor countries near Singapore:

“What kind of legal position is this, where Singapore can have a law that legalizes exploitation of the neighboring countries’ poor people? What kind of message are we sending to our neighbors? Basically, Singapore is in this position because she is rich, while her neighbors are poor. If when you are rich, you demonstrate to others that you are willing to pass an exploitative law, how do you want to be treated when you are poor?”

Iran is often mentioned in the debates because it is the only country in the world which allows the selling of kidneys (Iranians call it ‘organ sharing’).

A comment written by a reader in the blog of mr wang says so highlights a very significant point:

“I think that a larger issue that has been overlooked is the holistic care of our citizens with chronic illnesses, which includes renal (kidney) failure patients.

“Renal failure patients with poor health are largely from a disadvantaged socioeconomic background. They usually have high blood pressure or diabetes, but could not afford the intensive medical care required to delay the onset of complications. As a result, they progress to renal failure much earlier, which needs to be treated with dialysis.

“How then do we avoid this whole mess? Prevention is really better than ‘cure’, as in this case, kidney transplants are so limited, and essentially priceless. But the prevention is also expensive.

“The question really then, is how much is the government willing to step in to provide cheap healthcare to the people who need it, but are not able to afford it. Based on our national healthcare budget, it doesn't seem to be a lot, compared to other areas such as defence.”

For a more detailed study on organ trade (or transplant tourism) in the world, the WHO has good reference materials.


  • prof Saad ALSHOHAIB

    this issue is very sensitive but i think we should have a firm position as experts in this field wheather we call it organ sharing donation aor helping it is realy organ trading and i think this should not be allowed because of hte following reasons
    organ trading take benefet from the poor to hte rich and it is not a apropriate to give money for an organ which is valuless
    2 these people (donors)would have alow self esteem
    3 poverty can not changed by organ selling poverty can be changed when we change people
    4 reciepents in this kind of organ selling hav a feeling of guilt and can be depressed
    5human rights organization would not favour this kind of organ trading
    6 the human organs ar so precious that what ever monety is given it is nothing
    7 kidney donation may still have some hazards pariculrly if the donr developes diabetes or hypertension later in his life
    8some physician are pro organ trading looking for more numbers and studies to be published

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  • Anni Nominous

    The law in every country today forbids selling organs, whether from living or dead people. (There are a few isolated exceptions, including blood and blood plasma.) The bizarre principle seems to be that everybody is allowed to benefit from the donation except the person who makes the sacrifice. The patient benefits, the doctor benefits, the hospital benefits. But if the donor benefits, that is somehow considered unethical.

    In my opinion this is both bad ethics and bad policy. Ethically, someone who donates an organ, or agrees to make one available after his death, certainly deserves recompense. From a policy point of view, there is generally a shortage of organ donors, and providing recompense would increase the supply and save innumerable lives.

    I don’t agree with the ban, I feel it only creates underground channels. People will do what is most important to them…if proper channels aren’t available they will be made in some form or another.You cant stop necessity. There are also monetary forms of compensation that don’t break any laws, you just have to be smarter than Uncle Sam. I’m a healthy, athletic 35 yr old white male willing to give for compensation. I exercise, don’t drink or smoke and have no family history of any illness or disease. I’m type O-. I live in Denver. 05/03/2010 scojennn@gmail. com

  • Prof Saad. Alshohaib

    We are all pro patients and like to help them
    At the same time we should strict to our ethics.
    Getting money as reward for living donations is not ethical and had bad consequences on the community
    However I believe that a family or children of a brain dead donor can be compensated by a third party
    This would help some poor families that lose a parent in an accident

  • Rachel Page

    Given the fact that virtually all organ owners trade their organ out of
    poverty, organ buyers should not be like an opportunist who takes
    advantage of the owners by harvesting their body parts through financial
    means in their crisis. Unfortunately they are. And often they did it
    under the cover of ‘selflessness’ in a way that seems as though they are
    doing the poor a favor. Bankruptcy Attorney San Antonio

  • Cornell

    I’m Dr Rex Kelvin by name one of Irrua Specialist Hospital doctor, I have be given the opportunity by the hospital management to advertised on the internet how we work and that we have started again for the year for buying and selling of human organs e.g kidney, If you are out there interested in this offer, Please do not hesitate to contact the hospital at the below email: The irrua specialist hospital are specialist in organs Surgery and as a donor there is no risk in it,And we are located in Nigeria, USA and in Malaysia, but our head office is in Nigeria.
    And this is our email:

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