Human Organ Sale, 12 November 2008

National Council of Churches of Singapore
Official Statement


Human Organ Sale

A Statement Prepared by the National Council of Churches of Singapore

12 November 2008

The current shortage of transplantable human organs in Singapore has led the Health Ministry to explore if the legalisation of the human organ market will increase the supply of organs. While the National Council of Churches is cognizant of the current shortage of human organs for transplantation and the plight of those who are in need of them, it maintains that the sale of human organs should not be permitted.  The National Council of Churches is therefore opposed to the legalisation of the human organ market even if this legislation would increase the supply of transplantable organs. It maintains that the pragmatic and even humanitarian rationale for organ sale must be critiqued on the basis of more fundamental theological, philosophical and ethical principles.

The National Council of Churches maintains that the human body and its parts must not be viewed merely as properties at the disposal of their ‘owner’. This is a prominent paradigm in modern medicine according to which the body and its organs are seen merely as possessing instrumental value, and therefore as a resource from which others – patients, physicians and researchers – may benefit. This view of the human body and its organs, which is informed either by Cartesian dualism or materialism, treats them merely as commodities that can be bought and sold. This view, however, fails to fully recognise and appreciate the moral status of the human body. Against the dualistic and materialistic view of the human body and its organs, the National Council of Churches maintains that the human being is an embodied being, a psychophysical unity. As such, the human body cannot be separated from the so-called essential self. This view of the human body is firmly grounded in the Christian Scriptures and the Christian tradition. But it can also be defended on philosophical, cultural and sociological grounds.

The integrity of the person as psychophysical being is such that we cannot alienate the whole or some of its parts, that is, we cannot dis-organ-ise the body without doing the same to the person.

   1 The position of the National Council of Churches is in concert with that of most major professional organisations, including the World Health Organisation, the Transplantation Society, the Nuffield Council on Bioethics, the U.S. Task Force on Organ Transplantation, and the Comité Consultatif National d’Êthique.

In similar vein, we cannot offer some parts of our bodies for sale without changing the way in which we, and our society, understand the value and moral status of human beings.

Not everything in this world is for sale. Conventional wisdom warns us that we cannot commercialise public offices, criminal justice and human beings themselves without incurring enormous moral and social costs, and without bringing incalculable harm to society. The National Council of Churches maintains that by allowing the human body and its organs to be bought and sold we reduce persons to objects, and this will not only threaten personhood, but will also bring about untold damage to human society.

While the NCCS is opposed to the trading of human organs, it supports the provision of reasonable compensation to living donors. Compensation should be conceived in such a way that it does not become an incentive for people to donate their organs. In other words, donors must not make any financial profit through the compensation or reimbursement schemes. Compensation could come either in the form of monetary reimbursement for expenses incurred in the transplantation surgery and post-transplantation medical care, or in the form of free or subsidised provision of certain services (e.g., transplant surgery and medical expenses). This would exclude any lump sum payment at the point of organ donation, as such payments can easily become a form of organ trading in disguise. Because of the numerous ethical problems associated with financial compensation, the NCCS recommends that reasonable compensation for living organ donors be restricted to the provision of services in government funded hospitals. These may include:

“Pre-transplant medical screening for all potential living donors;

“Hospitalisation, tests, treatments and all medical procedures related to the transplant, including the surgery;

“Post-transplant medical consultation, tests and treatment for life;

“Advantage in the organ allocation process, if donors later need a transplant;

“Special medical insurance.

These services can either be fully or partially subsidised by the government. In the situation of partial government subsidy, the government should set up a Fund that comprises a combination of government subsidies and public donations. Organ donors may also contribute to this Fund, if they are able to. The Fund should be managed by the government to ensure equity and transparency. Appropriate government authorities should monitor these services to ensure compliance and prevent abuses.

These compensations do not provide incentives for donors out to make a financial gain from their donation. But they help willing donors allay fears of incurring high medical costs before, during and after the donation

Euthanasia, 6 November 2008

National Council of Churches of Singapore
Official Statement



A Statement Prepared by the National Council of Churches of Singapore

6 November 2008

According to the American Medical Association’s Council on Ethical and Judicial Affairs, ‘Euthanasia is commonly defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy’.  Active euthanasia is doing something positive (such as the administration of a lethal injection) in order to bring about the death of the suffering patient. Passive euthanasia is intentionally causing death by not providing necessary and ordinary (usual and customary) care (treatment) or food and water. Involuntary euthanasia is ending the life of a person without his or her explicit consent. Voluntary euthanasia is euthanasia that is provided for a competent person with his or her consent or on his or her request. Non-voluntary euthanasia is ending the life of the person who lacks the capacity to know or express his or her wishes (e.g., an infant or a person with severe brain damage or dementia).

While the NCCS supports and promotes compassionate responses to human suffering, it categorically opposes all forms of euthanasia on the basis of the following principles:

1.Sanctity of Human Life. The NCCS maintains that human life is a gift from God the Creator. God alone, from whom all life derives, has the authority in matters of life and death. The human being, created in the image of God, must be accorded with dignity and value. Human life is precious, and therefore should always be protected. This principle also maintains that human life has an inherent value, not just a conditional one. The life of a patient suffering from a chronic or terminal illness is as valuable as that of a healthy individual.

2.Respect for Human Life. The sixth commandment of the Decalogue, which prohibits murder, maintains that human life is sacred and must therefore be respected. As such the commandment also forbids suicide. This principle is enshrined in law in the form of the absolute prohibition on the intentional killing of innocent human beings. This commandment therefore applies to euthanasia because it prohibits the termination of the life of a human being either by an act of commission or omission, even if it is done within the context of terminal illness. The NCCS therefore maintains that human beings do not have the right to die. Although human beings are free agents, their exercise of freedom does not extend to ending their own lives.

3.The Ethos of Medical Practice. Euthanasia or ‘mercy killing’ is against the very ethos of medical practice because the duty of the physician is always to care and never to kill. Euthanasia occurs when a doctor, not an illness, kills a patient. Such an act violates both the Hippocratic tradition and Judeo-Christian teaching. The duty of the physician is not merely to ‘minimise suffering’ but always to ‘maximise care’. The ethic of euthanasia presents intentional killing as an acceptable means of ‘treating’ the patient who is suffering from a distressing illness. This approach must be categorically rejected.

4.Euthanasia and Society. The legalisation and acceptance of euthanasia would result in the ‘euthanasia mentality’ that sees death as the only solution when faced with terminal illness and which does not consider other alternatives. This will have serious and adverse consequences on society. Death becomes the ‘solution’ to many social ills. Just as abortion is seen as the answer to ‘problem or unwanted pregnancies’, so euthanasia becomes the solution to pain and suffering. Such a society, which very subtly impresses upon suffering, aged and vulnerable persons that it is their ‘duty to die’, will diminish the value of human life itself.

We shape our society, and society in turn will shape us. A society which accepts or sanctions euthanasia will be vulnerable to serious and far-reaching consequences. We are mistaken if we think that euthanasia has to do only with the decisions made by the patient and his or her family members, and carried out by a physician. Euthanasia is more than one-on-one killing. It is societal killing, and it will have grave implications on the way we think of ourselves and about matters of life and open the door to serious abuses that would threaten the rights and dignity of persons and society.

Society should care for those who are suffering and those who are dying. The NCCS maintains that the community should provide the best possible palliative care to people who are chronically and terminally ill. Pain control is a main issue in the quality of life. There is strong evidence to suggest that patients whose symptom and pain control has been inadequate often request for euthanasia. Such requests often cease after adequate pain and symptom control is administered. More funds should therefore be directed at the establishment of hospices, the training of physicians and nurses, and research in palliative medicine and symptom relief techniques.

True compassion does not have to do with terminating the lives of people who are suffering (or those whose suffering we find unbearable). Rather it has to do with sharing another’s suffering and pain. The NCCS therefore maintains that euthanasia is neither an ethical nor compassionate way of dealing with people with chronic and terminal illnesses. It maintains that the fundamental goal of physicians and health-care professionals is to exercise compassion towards and care for the sick, the disabled and the dying. They are to encourage the relief of symptoms and pain so as to improve the quality of life of their patients. Euthanasia must always be rejected as a means of achieving these goals. The introduction of death should never be seen as a treatment option.