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4D/Toto/Score
 

SINGAPORE    High & Low Tides

 

    FrontPage Edition: Sat 11 Apr 2009

 

 

HOTA Bill - working out safeguards

 

Source: www.moh.gov.sg

Speech by Dr Khaw Boon Wan on 7 April 2009

An Excerpt

Working out safeguards
Now that the Bill has been passed, we can move to the next stage of formulating the operational details and the safeguards that need to be put in. We will do this, in consultation with the transplant centres, the transplant ethics committees and interested members of the public. We will do this carefully and thoroughly and will not rush to implement the changes, until we have the appropriate guidelines and regulatory mechanisms in place.
Several good ideas were surfaced in Parliament and in the public forum. They include the following:
First, we will institute an effective system of selecting and informing potential donors. If donors are well selected through a comprehensive and thorough medical and psychological assessment, we can better ensure that their post-surgery complications are minimized and they are unlikely to be victims of exploitation.
Such a comprehensive system of medical check-ups and counseling will cost the donors. With the amendment of HOTA, these expenses can now be properly charged to the prospective recipients. Any patient with a potential living donor will be required to make this payment directly to the hospital or clinic charged with the responsibility of ensuring a thorough medical and psychological evaluation of the donor. This is the concept of payment through a third party that several MPs mentioned in Parliament.
Second, we will impose a cooling off period for the potential donors to have time to reflect on their decisions. This will prevent any future regrets. With availability of dialysis, kidney transplant is not instantly needed. A cooling off period of 2 -3 weeks should not unduly impact the health of the patient.
Third, I like MP Mdm Halimah Yaacob’s suggestion that some of the payment should go towards topping up the donors’ Medisave Accounts. We will encourage this payment mode. But it will have to satisfy CPF rules on voluntary contribution of this nature. The payment will therefore have to be capped.
Fourth, we will implement the scheme in stages, starting with patient-donor pairs involving Singaporeans. As suggested by MP Dr Lim Wee Kiak, we will extend the payment scheme to patient-donor pairs who are both foreigners last, after we have gained confidence in the scheme.
These are some of the ideas that we intend to incorporate. The purpose is to ensure that kidney transplants are carried out with a high level of ethics that Singaporeans can be proud of.
The debate in Parliament over the HOTA bill was intense and robust. This is as it should be as we are dealing with difficult ethical issues. In ethics, two completely rational and reasonable persons can disagree. That is why ethical rules are hard to codify and are often best left to committees of wise persons to assess and judge, within prescribed principles. That is how our HOTA rules on payment will be applied.

Source: www.moh.gov.sg News 7 Apr 2009 (Excerpt)

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