Thursday, August 9, 2012

Singapore - Most do not believe they d donate

SINGAPORE - The story about why he donated one of his kidneys to a stranger has inspired, touched and moved readers.

But many are still hesitant when asked if they would do the same thing and donate a kidney to a stranger.

This despite the long wait by those in desperate need of a kidney transplant.

As of March, there are 448 patients on the national waiting list for a kidney transplant, said a Ministry of Health (MOH) spokesman.

And as of Dec 31 last year, it took a median waiting time of nine years for a patient to get a kidney from a deceased donor, the spokesman said.

Some died while waiting for a kidney.

This highlights the scarcity of donors, said Dr Chia Shi-Lu, a member of the Governmental Parliamentary Committee (GPC) for Health.

He said: "It's a great story and one we hope to hear more of.

"The problem, as you're aware with transplants, is the scarcity of donors and also still some lack of knowledge (among) the general public of what organ transplantation entails and also an appreciation of the demands and risks."

Dr Akira Wu, 62, a renal physician at Mount Elizabeth Medical Centre, noted the urgent need for more kidney donors.

He said: "We are seeing a shrinking pool of deceased organ donors and are relying more on living donors."

Dr Lam Pin Min, chairman of the (GPC) for Health, said that many transplant centres overseas rely on living donors as an important kidney source.

But such unconventional altruistic donation has not become widely accepted because of the difficult ethical issues raised by this practice.

He said: "This is especially when the donor happens to be a stranger, and there is always a lingering doubt on the underlying motivation for the donation."

The concerns are:

The safety and welfare of the donor, particularly since the donor has a less favourable risk-benefit profile;

The procedure to remove a kidney is relatively safe but is not risk-free. A donor could potentially die if there are any rare complications.

The donor's motivation. The establishment of using strangers as donors would set transplant medicine on a slippery slope towards potential commercialisation of vital organs.

But Dr Lam added that there are counter-arguments.

The desire to donate an organ to a stranger is not necessarily a pathological obsession or something sinister, he said.

He said: "In fact, if the offer to donate is made altruistically, there is a greater likelihood that the patient is truly acting autonomously after much careful consideration.

"These altruistic donors are the only living donors that can truly give informed consent, since there are no overlying emotional concerns or sense of obligation that would invalidate voluntary consent."

He also said that some people do believe in the psychological benefit of such donations.

He said: "It had been suggested that unrelated donors may experience an even more enhanced sense of self-esteem compared to related donors since no sense of obligation exists, making the act of donation truly extraordinary."

"This one guy, Mr Lin Dilun, has made me change my opinion and the way I look at people. No one would donate a kidney to become famous among peers and countrymen. I feel that his desire to help the kid and a fellow countryman comes straight from his heart. It is time to look at ourselves in the mirror and say, Have we done enough?"

- Chef-instructor Vanukuri Kalyan Chakravarthi, 31

"He has not only shown the world what it means to 'put ourselves in other people's shoes' but also in turning words or thoughts into meaningful actions. Although I can't give you a concrete yes regarding donating to a stranger, what Dilun has done has opened my heart towards such issues."

- Undergraduate Elroy Lim, 25

"He has done an extraordinary act... His courage and bravery are a new source of inspiration for many of us. I'm very proud to have him as a friend."

- Undergraduate Priscilla Nui Zhao Qi, 23, on Mr Lin, her secondary schoolmate

"It is quite novel. I can't imagine doing it. I'm quite shocked, actually, when I read about it. I don't think I would give my kidney to a random person if I've not met the person and he has not made an impact in my life."

- Secondary school student Melissa Jane Heybourn, 16

Chai Hung Yin
The New Paper
AsiaOne

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