Personal Commentary - Organ Trading

This commentary is in response to the article: “Why not allow organ trading?" posted below. Summarising briefly, the article primarily examines the objections and criticism of the people against organ trading.

If Bill Gates were to suffer from kidney failure, he would be able to hire the best doctors, buy the most effective equipment, but he would not be able to buy a kidney for kidney transplant, not legally at least. Even with all the money he has, he would still have to undergo dialysis. Yet, if an ordinary person in Iran suffers from kidney failure, if he has the money, he would be able to buy a kidney, and spare himself of the pain of dialysis. Now, why does Bill Gates, one of the richest men in the world, lose out to an ordinary person from Iran, if they were to suffer from kidney failure? The reason is that organ trading is illegal in the US, but legal in Iran.

In almost all countries around the world, the buying and selling of organs, also known as organ trading, is banned.

Currently, with organ trading being banned, the only way of obtaining organs for patients who need them is through altruistic donations and donation of organs from deceased people, and perhaps even underground transactions of buying and selling of organs. However, in many countries, including Singapore, the supply of organs is simply unable to satisfy the demand, and many patients die because they are unable to carry out receive a transplant in time. But if organ trading were to be allowed, would the situation improve?

Yes it would! With the permitting of organ trading, people would be able to offer monetary incentives to potential donors, motivating them to donate their organs, thus increasing the amount of supply of organs. In the article, it is stated that there is a considerable amount of risk when carrying out organ transplants using bought organs. Indeed, the chance of success for a perfect tissue match, and hence easier acceptance of the organ and fewer complications is much greater for that of donations from relatives compared to that of donations from non-relatives. But hey, if patients are completely unable to receive a transplant, their chance of success would be zero. If relatives are unable to, or even unwilling to, then patients have no choice but to turn to donations from non-relatives, despite the lower rate of success.

The scenario examined in the article, stating that six out of eight experienced complications, was that of underground surgeries being carried out, as they had to avoid being caught by relevant authorities. The standard of surgery in those situations is much lower than if transplants were to be carried out in a regular hospital. If organ trading were to be legalised, the operation need not be kept secret, and the quality of the surgery would be better, coupled with proper checking and matching of donor and patient, the rate of success would be greater and more patients would be able to avoid the fate of death, for a longer time at least.

Well, if organ trading is able to improve the situation, then why is it still being banned around the world?

One criticism is that organ trading is merely exploitation of the poor by the rich and middle class. After all, the rich and the middle class, who are not in desperate need of money, would probably never sell their organs. Permitting organ trading only serves to allow the richer people a means to obtain the organs they need from the poorer in exchange for money, and hence they are exploiting the poor people’s situation to obtain the organs they need.

However, is it not a win-win scenario for both parties? The poor receive financial aid, and the rich are able to receive the organs needed for the transplant. The poor may be exploited, but it does not necessarily harm them. In fact, this provides them an outlet to get financial aid. Moreover, the rich and middle class are not the ones who directly cause the impoverished situation of the poor, and they do not force the sale upon the poor. The poor still hold the power to decide if they wish to sell their organs.

Another weakness is that it would be harder for the poor to receive organ donations, since are less able to afford buying organs, and altruistic organ donations from non-relatives would be greatly reduced since selling their organs would be more profitable than donating them. The poor would be disadvantaged, but this applies for other situations as well. In healthcare, being unable to afford certain medication or operations, the poor would also be disadvantaged. Shall we change the way other facets of healthcare work as well? I think not. The poor being disadvantaged is stems from the capitalist beliefs embedded deep in society, and it is hard to change. Nonetheless though, introducing organ trading is what causes the matter of organ donation to be ‘capitalist’, and it would not be beneficial to the poor.

The greatest objection to organ trading is that the act of buying of selling of organs is equivalent to treating the human body like goods, defying the sanctity of humanity, and is hence something immoral and should be disallowed. Yet, to respect this sanctity of humanity, we potentially sacrifice the life of a patient who could survive if given the organ. Does the respect for the human body take priority over the life of a human? As stated in the article by Janet Radcliffe Richards, Reader in Bioethics at University College London, we are protecting our own squeamish sensibilities, namely the notion of not allowing the human body to be commodified, while other people die. Does human life not take precedence over the respect for the human body? Are we to let patients, suffering from organ failure, waiting in pain and agony for an organ transplant, to continue suffering and even die, just to maintain the sacredness of the human body? Is that what is moral?

In conclusion, I feel that organ trading, despite having its flaws, is still ultimately beneficial towards patients waiting for an organ transplant, and hence should be allowed. It provides patients a new ray of hope, allowing them to take action to find a suitable donor and offer them incentives to motivate them to donate their organs, instead of passively waiting for a suitable donor to appear, or rather, die, so that his organs can be used.

Why not allow organ trading?
Friday, 30 August, 2002, 09:10 GMT 10:10 UK
by Chris Hogg
BBC Health correspondent

Is it wrong to buy a kidney to save a life, or to sell one to help yourself out of poverty?

In Britain and much of the rest of the world it is illegal.

On Friday, a retired GP accused of trading in human organs was found guilty of the charges made against him by the General Medical Council.

The GMC heard that Doctor Bhagat Makkar had promised undercover journalists that, for a fee, he could obtain a kidney from a living donor - charges he denied.

Now it has emerged that a second doctor, from Coventry, will appear before the GMC on similar charges in October.

So why not legitimise the practice and allow free trading of human body parts?

The idea of a market for human organs is grotesque to many. But doctors in Britain say because it is banned in this country some people take desperate measures.

Risks 'considerable'

Geoff Koffman, a transplant surgeon at Guy's Hospital, believes patients who were on his waiting list have paid for new kidneys donated by strangers - a practice he finds unacceptable.

"A number of my patients who are on dialysis treatment in London have sought a transplant from an unrelated donor out of this country - strongly against our advice.

"If they were going back to India or Pakistan and having a transplant from a relative, then that would be understandable and reasonably acceptable.

"But if they go over to have a transplant from an unknown donor then I think there's an issue there that we're very unhappy with."

The risks are considerable. Research carried out by doctors in Coventry shows that of eight of their patients who travelled to India or Pakistan for treatment, six returned suffering from serious complications.

Indian market

In Delhi, however, Dr P C Bhatnagar from the Voluntary Health Association of India says odds like that do not seem to have harmed the business.

"Presently it's a flourishing market. On average, around 2,000 sales of kidneys are taking place in this country, and this figure doesn't include all the donations and operations which are taking place under the proper procedures."

The demand is driven by shortages. The British government has responded with recruitment drives for donors, especially from among the Asian community where there is a particular problem. But with little effect.

And so some now believe it is time for us to abandon our reluctance to trade organs for cash.

Janet Radcliffe Richards, Reader in Bioethics at University College London, accepts this is not an attractive option.

But she rejects the argument that it is corrupt to sell or to buy the means to save a life.

"The question is not whether you find this repugnant, it's a question of what the cost of going along with this feeling of repugnance is.

"And my fear about this is we're protecting our own squeamish sensibilities while other people die or have their best options taken from them - and this strikes me as morally outrageous."

Altruistic donation

Others go so far as to suggest how the practicalities might work.

Robert Elms, a transplant surgeon at the Royal Liverpool Hospital, believes the principle of compensation would be more acceptable to many than payment.

He said it was very odd that the act of giving someone a kidney is considered "wonderful, a noble act" - yet as soon as an exchange of money is involved it becomes "so outrageous as to be intolerable".

He points to the examples of injuries compensation in the courts, "where thousands of pounds may be given to the individual who is damaged by an accident".

This, he said, provides a legal and a moral precedent for considering the "extra pain and discomfort and trouble to which someone is willing to go in order to give a kidney to someone they like or they love."

The government is currently considering whether to relax the rules and extend the principle of altruistic donation, allowing people to donate organs to strangers in need.

But the issue of payment is still taboo and is not mentioned anywhere in the proposals. That, it seems, is a step too far.

Source: http://news.bbc.co.uk/2/hi/health/2224554.stm

Democracy Creates Stability in a Society

On the news there are great commotions about the elections in China and USA. These elections are a part of the practice of democracy, in which people vote to decide on who represents them. Democracy is the most common form of government used in countries around the world. However, does democracy create stability in a society?

But first, what is democracy?

Democracy is a system of government by which political sovereignty lies with the people, being exercised directly or through elected representatives in the Parliament.

Inherently, democracy would create stability in a society. Democracy leaves the power to decide in the hands of the people. Through voting, the people are able to effect change in society, allowing their needs to be fulfilled. This would create social stability in the society. But will this always be true?

I first came across democracy when I was in primary 2, when I questioned my mother if we needed to vote after seeing an advertisement about voting. She explained democracy briefly and that people under the age of 21 are not eligible to vote, and since our constituency was not being contested, so we did not need to vote.

Looking back, I ponder on these aspects about democracy in Singapore. Firstly, even now, I do not have the power to vote. While it may be because I am young and ignorant, it means that my interests, as well as that of the entire population of students and teenagers ineligible to vote, are not being directly represented in the elections. This means that our needs may be neglected, since we cannot vote and change who is in power. However, our interests are still being represented by our parents, as well as others in society, and our needs have not been neglected. Yet, if there were a group of people, who did not have power to vote and effect change, would their interests be cared for by the government? What about the minority, whose interests are overridden by the majority? Are their needs cared for? If the needs of these people are neglected, they may retaliate by staging uprisings, resulting in social and political instability.

Secondly, our constituency was not being contested. I believe that many would have experienced similar situations. This leads to us being unable to effect change, even if the government was not doing a good job in our constituency. One of the fundamentals of democracy is that the people may opt for change through voting to improve society and hence prevent social instability caused by protests and uprisings. Yet if the opposition is not strong enough, there would not be alternatives for the people to opt for, and they may choose to cause change through less orderly methods such as riots, causing social and political instability. Hence, there should be a fairly strong opposition, such that there is an alternative to the current situation, should it become unfavourable. Moreover, such opposition creates competition to motivate the ruling party to improve, leading to less social dissatisfaction and instability.

In conclusion, for democracy to create stability in society, there are certain pre-conditions that need to be fulfilled, such as just representation of the people’s interests and a suitably strong opposition and others. Fulfilling these conditions would allow democracy to create stability in society.

Personal Commentary - Teenage and Social Issues

This commentary is in response to the article: “Going Skin Deep" posted below.
The article is about many teenage girls who are too obsessive about their looks and become too fixated on flaws in their appearance.

This occurrence arises due to several reasons.

Firstly, the media gives a very wrong impression about the over-importance of looks, as many popular and successful celebrities and idols are good-looking. This would lead to many teenagers trying to lose weight and doll themselves up to look better as they think that looks will bring them success and popularity. Moreover, they compare themselves to the celebrities, and use the celebrities as a standard for their looks, and thus naturally feel inferior, and start to focus too much on their flaws.

Secondly, peer influence is another factor. Many teenagers make fun of others who are ugly or fat, calling them names and ostracizing them. This would make teenagers want to avoid being fat or ugly, as no one would like to be called names such as ‘fatso’, and sometimes, may lead to certain disorders such as Anorexia nervosa, an eating disorder of a person who has a severe fear of gaining weight.

I completely agree with Miss Celeste Phua, Chairman of the Youth Advolution for Health, who said that "What is most important is taking good care of your body, not feeling bad about how you look." A person’s health is much more important than her looks. Living a healthy and long life as an ugly person, able to go out often and take part in many activities is much better than being a sickly person who is often stricken with illness in bed and dies young, yet looks pretty. Thus, teenagers should not put too much emphasis on their appearances to an extent that they would sacrifice their health to look good.

Moreover, looks are not all that matter. Looks do not last forever, age will soon catch up with a person and they will no longer look as pretty as they used to. A person’s character and upbringing is what truly matters. A person with good character and upbringing would still be more popular than a mean and selfish person, regardless of how much better-looking the latter is than the former. Would you rather have a good-looking friend that treats you like dirt or a friend whose looks are not so pretty but treats you with respect? I believe that the answer is obvious.

To conclude, I hope that teenagers will learn not to be too self-conscious about their looks, and learn to appreciate what truly matters most.

Personal Commentary Article

GOING SKIN DEEP
Section: In
By: TESSA WONG, ALFRED CHUA, RAJESH MISIR, MARK LIM, ERMA DZALIN
Publication: The Straits Times 05/03/2007
Page: 8,9
No. of words: 586

INDEPTH

THE BIG STORY THIS WEEK

TEENAGE GIRLS FACE PRESSURE MEETING IMPOSSIBLY HIGH STANDARDS IN LOOKS. TESSA WONG FINDS OUT WHY BEING FIXATED ON PHYSICAL FLAWS IS ANYTHING BUT HEALTHY

Nor Hidayah Zainudin, 15, is planning to have plastic surgery when she is older.

"I don't like my nose, it's too big. I wish it was as sharp as that of Hollywood stars," said the Secondary 4 student at Jurong West Secondary School, who has hated her nose since she was a lot younger.

She is not the only one. Too tall, too fat, too big-haired, too flat-nosed – all are worries of teenagers unhappy with their appearance.

The girls, that is.

A recent survey by skincare and toiletries company Dove found that up to 60 per cent of Singapore's teenage girls are unhappy with the way they look and their weight.

The study also revealed that one in five young Singaporean women would consider getting plastic surgery to alter their appearance.

Before she goes under the knife, Hidayah pinches her nose often to make it sharper, a habit she developed when she was 13 after gradually realising that "sharper noses look more beautiful".

While social worker Carol Balhetchet points out that it is natural for teenagers to feel self-conscious, being fixated on flaws is not.

"It becomes dangerous when girls get obsessive and start having false ideas of how they're supposed to look," said Dr Balhetchet, who is the director of the Youth Development Centre at the Singapore Children's Society.

It may be down to the fact that teens are constantly under pressure to conform to an impossibly high standard in looks.

"Nowadays the media advertises perfection in looks and fashion, and this does impact on a young person's vulnerable self-esteem and confidence," Dr Balhetchet said.

She added: "Many get their benchmark for looks from well-known celebrities and personalities and like to compare themselves to them."

But the very celebrity icons featured feel just as insecure.

The rail-thin star of TV's The Simple Life, Nicole Richie, has become the dubious poster child for eating disorders, while pop princess Britney Spears recently shaved her head and got tattoos in response to the pressures of constant fame.

The fashion industry, often blamed for glorifying feather-weight models, is beginning to wake up.

Still, it took a tragedy to make that happen.

Last December, Italy and Spain banned too-thin models from fashion catwalks after several models died from eating disorders.

Models now must have a healthy body-mass index and must be certified healthy by a doctor before taking to the catwalks.

Here in Singapore, the prevalence of girls with low self-esteem about their bodies has led to the launch of at least two new campaigns in the past two years to combat the problem.

Last month, Dove launched its Dove Self-Esteem Fund, whose main programme BodyTalk teaches girls to deal with negative feelings about their appearance.

Professional trainers tour secondary schools islandwide, including many girls' schools, to teach realistic standards of beauty through slideshows, videos and talks.

Meanwhile, Youth Advolution for Health (YAH), a group started in 2005 by the Health Promotion Board, is a student-run organisation that promotes a healthy lifestyle, by encouraging anti-smoking and loving one's body through various events.

Said the chairman of YAH, Miss Celeste Phua: "It's important that avenues exist for teenagers to share their worries about their bodies, and learn more about doing the right things to stay healthy.

"What is most important is taking good care of your body, not feeling bad about how you look."



Additional reporting by Erma Dzalin, Alfred Chua, Rajesh Misir and Mark Lim