Market for kidneys: Singapore

The Straits Times reports on proposed new kidney legislation in Singapore.

The new legislation would raise penalties for third party brokers, allow compensation for donors (from a single payer, state fund I think), and allow kidney exchange.

"ORGAN trading syndicates and middlemen will be punished more severely if the proposed changes to the Human Organ Transplant Act (Hota) are approved by Parliament.
They will be fined up to $100,000 or jailed up to 10 years or both - 10 times the current penalties.
In Singapore's first-ever organ trading conviction in September this year, Wang Chin Sing, 44, who was fingered as the middleman was jailed a year and two months. "
...
"Two other changes include removing the age limit for cadaveric donation, now set at 60 years, and allowing paired donations. This is where a donor, whose kidney is not a match for a relative, gives it to someone else who also has a relative willing to give up a kidney [kidney exchange]. "

"Earlier this month, an 18-member national committee on medical ethics had supported reimbursing donors so long as the sum is not so large as to become 'an undue inducement, nor amounting to organ trading'.
The draft Bill spells out measures to protect donors' welfare. These include providing them with long-term follow-up care and short-term life insurance coverage for risks linked to surgery. They will also get priority for receiving an organ in case of any organ failure.
On the issue of compensation, it says that this should be for expenses incurred as a result of the donation, and indirect losses such as lost earnings.
Reactions to the proposed changes have been mixed. Religious bodies like the National Council of Churches of Singapore support 'the provision of reasonable compensation' that helps donors allay fears of incurring high medical costs before, during and after the donation.
'These compensations should not provide incentives for donors out to make a financial gain from their donation,' said the council which represents 193 churches and Christian organisations.
Dr Lam Pin Min, deputy chairman of the Government Parliamentary Committee for Health, said that while changes to the upper age limit and allowing paired matching are 'straightforward and non-controversial', he felt the amendment to allow reimbursement remains contentious for several reasons.
'How are we going to determine what is a fair amount to compensate donors and how do we draw a clear line between compensation and inducement?' he asked.
A spokesman for the ministry told The Straits Times that a committee comprising medical professionals and lay persons will be formed once the amended law is passed 'to look into what is considered fair value in terms of compensation and what should or should not be reimbursed'.
Mr Khaw had hinted at a five- or six-figure sum. "

HT to Marginal Revolution, who focus on the latter.