Tuesday, July 22, 2008

Changes to organ transplant law to meet demand for transplants

July 21, 2008

SINGAPORE is considering legalising kidney trading to help meet demand for kidney transplants, the city-state's health minister said on Monday.

The Health Ministry will examine the feasibility of providing payments to unrelated donors to augment the supply of kidneys, Mr Khaw Boon Wan said in Parliament, acknowledging that the suggestion has stirred controversy.

'We should not reject any idea just because it is radical or controversial,' Mr Khaw said. 'We may be able to find an acceptable way to allow a meaningful compensation for some living, unrelated kidney donors, without breaching ethical principles or hurting the sensitivities of others.'

Mr Khaw said the ministry would review possible changes to current legislation to allow payments for donations from third parties such as those from the charity and religious sectors. Under the proposal, which would need to be approved by Parliament to become law, patients would also get help in finding donors.

'There are desperate patients out there wishing to live and desperately poor people willing to exchange a kidney for a hopefully improved life,' he said. 'Criminalising organ trading does not eliminate it ... it merely breeds a black market.'

Mr Khaw also said the Health Ministry would push to amend existing laws on organ transplants to remove an age limit on deceased donors, currently set at 60 years, because 'the suitability of the organ depends on its condition rather than the age of the donor'.

The two initiatives should enable Singapore to carry out 70 per cent of the kidney transplants needed every year - up from 50 per cent currently, the minister said.

The two initiatives should raise Singapore's sufficiency in kidney transplants from 50 per cent to 70 per cent, the minister said.

He said about 1,000 new cases of kidney failure are diagnosed every year, with nearly 40 per cent unable to survive the first year.

Mr Khaw's comments follow the cases of two Indonesian men who were jailed and fined by a Singapore court earlier this month after being convicted of agreeing to sell their kidneys to two patients in Singapore.

Selling or buying organs or blood is illegal in Singapore, as in many other countries, and carries a penalty of up to 12 months' jail, or a fine of up to S$10,000 or both. -- AP

[The cost of dialysis is $130 per session, at 3 sessions a week, or about $20,000 per year. Median survival rate overseas is about 3 years. NKF apparently has a higher survival rate but some have said it is because they give priority to younger patients. But assuming a 5 to 7 year median for dialysis patients, the total cost would be $100,000 to $140,000 cost. This is what a kidney is worth.

An organ sale market funded by the govt should provide $50,000 to each donor/organ seller (tax-free) and a lifetime of medical care free. And charge the recipient $50,000 to $100,000 (or more) if they can afford it.

For a low income Singaporean, $50,000 is about 2 to 4 years of income. That can give them quite a headstart or boost in their life. With 1000 new kidney failures a year, and so 1000 kidneys required, the budget required is $50m, less some cost recovery from the high income recipients.

Any recipient with annual income of $50k and above should pay for their kidneys either in lump sum or instalments. The cost of the kidney will be one year's salary. The payment should go back to the Organ Purchase Fund.]

No comments: