Transplant Ethics Committee

14 February 2012

Question No. 246

Name of person: Ms Ellen Lee

Question

To ask the Minister for Health (a) how many applications have been received by the Transplant Ethics Committee (TEC) since the last amendment to the Human Organ Transplant Act took effect two years ago; (b) what is the breakdown of these applications in terms of (i) Singaporeans, permanent residents and foreigners; (ii) the number of approved and rejected applications in each category; (iii) the reasons for the rejected cases; (iv) the income profile of the donors and donees in each of the categories in (i); and (c) whether the applications cause concern among TEC members that only more affluent patients could afford the necessary transplants.

Answer

1 Since the last amendment to the Human Organ Transplant Act on 1st November 2009, Transplant Ethics Committees (TECs) have received 325 applications for living donor organ transplants. 26% of the applications were made by Singaporeans and Permanent Residents (PRs), with the remaining applications by foreigners.

2 The TEC gives written authorisation for the living donation when it is satisfied that the donor has given his consent freely, without inducement or duress, and that the donation is ethical. All TEC members in each case must unanimously agree to approve the organ donation before authorisation is given. Each member will exercise his or her judgement in each case, taking into consideration many factors. As such, the TECs are not required to provide the reasons for their decisions. 4% of the applications by Singaporeans and PRs and 9% of the applications by foreigners were not approved.

3 The donors and recipients are from a diverse group ranging from high income professionals to those with no income such as housewives and retired persons. For cases involving unrelated locals where they have declared an income, the median monthly income for donor and recipient is $1,900 and $2,250 respectively. For foreigners, as donors and recipients may come from different countries, income comparison may not be meaningful. They range from $0 to $300,000.

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4 We have not received any feedback from the TEC members on affordability concerns. However, my Ministry will continue to ensure access to healthcare services, including transplants for Singaporeans. Singaporeans and PRs are also eligible for government subsidies for the surgery, hospitalisation and immunosuppressant medications.

5 Needy Singaporean recipients who cannot afford to pay for their donors’ surgical bills and long-term follow-up can receive further assistance from special programmes set up by Voluntary Welfare Organisations (VWOs), such as the ‘Share a Life’ programme, jointly launched in 2005 by the Kidney Dialysis Foundation (KDF) and the Khoo Foundation, and the ‘Live Donor Support Fund’ established in 2009 by the National Kidney Foundation (NKF). These various schemes and our Government subsidies continue to ensure that no Singaporean would be denied medical treatment due to financial difficulties.