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Singapore: Human Organ Transplant Act Amended

(Apr. 15, 2009) On March 24, 2009, Singapore's Parliament adopted a controversial amendment to the Human Organ Transplant Law that will permit reimbursement for altruistic living organ donations. The United States and the United Kingdom, among other countries, already have in place schemes for reimbursement. (Pearl Forss, S'pore to Allow Reimbursement for Altruistic Living Organ Donations, CHANNEL NEWSASIA, Mar. 24, 2009, available at
.) Some legislators expressed concern that adoption of the amendment would lead to open organ trading, even though Health Minister Khaw Boon Wan had assured them that the purpose of the amended Law “is not to legalise organ trading,” but to correct “our current extreme position of criminalising all kinds of payment to the donor.” (Singapore Allows Payment to Living Organ Donors, THE SUN DAILY, Mar. 25, 2009,

The fact that details of the compensation aspects of the process were left unspecified in the amendment was a particular source of contention among the legislators. MP Christopher De Souza stated, “[details pertaining to the administration and payment of costs and expenses are central to this entire Bill. Yet, the Bill is devoid of these details.” In MP Sylvia Lim's view, “[w]e do not believe it is wise … [to] leave the compensation framework details to be worked out later, administratively.” On the other hand, the Health Minister pointed out the difficulty of placing a quantitative formula for the sum in the primary legislation and added, “[o]ther countries have also not done so. But the ministry and the ethics committees will come up with guidelines on the sum, in future.” However, the Health Ministry did make the clarification that “a different and much lower reimbursement cap” will apply to foreigners from poorer countries, “because the sum is calculated based on the cost of living. To ensure foreigners are not exploited, the transplant ethics committees are well briefed to be mindful of the potential for exploitation.” (CHANNEL NEWSASIA, supra.)

As spelled out in the legislation by the Health Ministry for the first time, transplant centers must adhere to guidelines on the selection of healthy donors, and before their consent is obtained, potential donors must be fully informed of the possible risks of donation, the need for long-term follow-up care, and the cost implications. An ethics committee will also review every transplant to ensure that donors are not subjected to “any financial inducement or coercion.” (Id.) Hospitals must submit relevant post-operative data on the transplants, and the Health Ministry is to regularly conduct audits to ensure that the ethics committees fulfill the legal requirements in their evaluation of transplant applications. (Id.; see also Alicia Wong & Neo Chai Chin, A Tough Moral Choice, TODAYONLINE, Mar. 25, 2009, available at