Monday, September 29, 2008

Compensate donors? Not all favour the idea

Sep 29, 2008

By Salma Khalik & Lee Hui Chieh

HEALTH Minister Khaw Boon Wan's suggestion yesterday that kidney donors be reimbursed has met with mixed reactions.

Madam Halimah Yacob, head of the Government Parliamentary Committee for Health, felt it was too similar to organ trading for comfort.

'The line between reimbursement and sale of a kidney is very thin,' she said, arguing that the moral hazard remains.

While Mr Khaw's suggestion was 'very practical', it did not address the issues of exploitation that had been raised previously.

'Donors will still be the poor. And you won't be able to completely eradicate under- the-table transactions.'

Madam Halimah urged that more time be spent studying the idea. Trying to get such a scheme in place by next year is 'in my view, very fast', she said.

The Singapore Medical Association is also against organ trading, which is when an organ is priced by market forces, said its president, Dr Wong Chiang Yin.

It wants more details on the proposed reimbursement system before deciding if it was acceptable, he said.

'Whatever the case, the Ministry of Health will have to play a central and active role because only the Government has the mandate of the people to decide on such matters,' he added.

In contrast, eye specialist Arthur Lim, who is staunchly in the other camp, asked if reimbursement was attractive enough for donors for whom money might be vital.

He sees the problem of kidney failure increasing over the years as the population ages and diabetes becomes more common.

Professor Lim said: 'We should not be too rigid in the details. Telling them their medical needs will be looked after is not what they want.'

However, giving them money to support themselves over, say, 10 years, might work better, he said.

Associate Professor Goh Lee Gan, president of the College of Family Physicians, who has stood with Madam Halimah against organ trading, sees it as a possible 'win-win' situation for patient, donor and society.

He said it is for society to decide what road it wants to take and it is good that the subject has been widely, if sometimes heatedly, debated.

One good thing that has resulted from the recent debate on the subject is the increased awareness that donors' health should be managed.

He added: 'So long as it is fair to the donor, it is OK.'

But it should be secondary to voluntary donation from relatives, he said.

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