Sunday, March 29, 2009

Organ donation and compensation in Singapore: new legislation

A new law was passed on March 24 in Singapore, allowing compensation for live organ donation. It's not yet clear what this will mean in practice: I excerpt below from a number of stories.

Singapore allows payment for living organ donors
"After a heated two-day debate, in which some legislators raised concerns that the new law might lead to open organ trading, four of the 84 members of parliament abstained the final vote and one voted against, the Straits Times newspaper reported.
...
"Not all legislators were convinced, although Health Minister Khaw Boon Wan had assured parliament that the new law "is not to legalise organ trading."
"We are correcting our current extreme position of criminalising all kinds of payment to the donor," Khaw said.
Singapore already had a legal system to prevent organ trading, he said. "And we will be strengthening it," Khaw added.
The new law, which also contained some other changes, allows living organ donors to be reimbursed the costs for items like travel, accommodation, costs of domestic care and child care, loss of income and long-term medical care.
..
"Another dissenter, Halimah Yacob, said that many foreign workers in Singapore, who are hit hard by the recession, could become "a ready and vulnerable pool of organ donors to be exploited and abused.""To a desperate foreign worker, even a reimbursement of S$10,000 would be attractive compared to going home empty-handed with a huge debt waiting for him," the report quoted her as saying.
The Singapore government proposed to change the law after ailing retail magnate Tang Wee Sung was jailed for a day and fined S$17,000 in June last year for trying to buy a kidney from an Indonesian donor.Tang finally received a kidney from former organised crime boss Tan Chor Jin, who was hanged in a Singapore prison in December for the killing of a nightclub owner."

A tough moral choice : Slew of safeguards promised as MPs approve recompense for organ donors, though five remain unconvinced.
"IT WAS a moral dilemma Health Minister Khaw Boon Wan apologised for imposing on Members of Parliament, after two days of intense debate.
Their tough choice: Should they correct the unfairness against: altruistic organ donors by allowing them reimbursement for their financial losses, but at the risk of opening a backdoor for abuse? "

Singapore allows financial payment to organ donors
"Previously, it was illegal for a living donor to be financially compensated but the issue came to a head last year when a local tycoon was jailed for one day for attempting to pay off a prospective Indonesian kidney donor.
"This is a bill about fairness, being fair to donors who do suffer financial consequences as a result of their act of donation," Health Minister Khaw Boon Wan told parliament Tuesday during the final debate on the issue.
"I know the controversial nature of paying donors," Khaw said. "But we also realise that it is unfair to allow genuine donors to bear all the financial consequences of their altruistic acts."
Khaw said he disagreed with the suggestion made by some lawmakers that foreign donors be barred from accepting financial compensation to prevent exploitation of nationals from poor countries.
"How can we discriminate against the foreign donors in this fashion?" Khaw said.
"Once we decide that some payments can be ethically made, our law cannot unfairly discriminate against organ donors based on their nationalities," he said."

Singapore's Human Organ Transplant Act dates from 1986, when it instituted an opt-out system for all of the country's non-Muslim citizens. Under the law, citizens could opt out of becoming organ donors, but all those who did not would be considered as organ donors upon their death, and would in turn receive priority (over those who opted out) for receiving deceased organs. Unusually among countries with opt out policies, organ donation has been enforced even over the objections of next of kin.
As amended in January 2008, the Human Organ Transplant Act (HOTA) now includes Muslim citizens of Singapore.

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