Singapore is to allow compensation for kidney transplants and for eggs. A government proposal has been approved by a bioethics committee and legislation will be introduced early next year. The committee declared that reimbursement for kidney donation was acceptable as long as it is not "an undue inducement, nor amounting to organ trading".
What exactly this means for kidneys is difficult to fathom. According to the BMJ, a sum of S$10,000 was mentioned. According to the Straits Times, the health minister, Mr Khaw Boon Wan, mentioned "at least a five-figure sum, possibly even six-figure" as appropriate reimbursement. This would include expenses, such as transport and medical costs, as well as loss of earnings. Also, the donor should be covered for follow-up medical costs and higher insurance premiums as a result of losing a kidney.
Although Singapore is eager to become a hub for medical tourism, the government does not want to become tainted by a black market in organ trading. Back in July a retail magnate was convicted for trying to buy a kidney for S$23,700. He spent a day in jail and was fined S$17,000. The donors – poor Indonesian labourers -- were given two weeks' jail and a $1,000 fine and 14 weeks' jail and a S$2,000 fine.
The committee has recommended that the reimbursement scheme begin with donors who are Singapore citizens and permanent residents. About 600 patients in Singapore are awaiting kidney transplants. The minister claims that his scheme is ethical according to the standards of the World Health Organisation.
The government also plans to authorise payment for eggs in order to facilitate embryo research and therapeutic cloning. According to the Straits Times, its bioethics advisory committee believes that “fair compensation would encourage women to come forward to donate their eggs - among the most highly prized items for biomedical research. So far, no woman here has ever voluntarily donated her eggs purely for research.”
Compensation will be authorised only for loss of time and earnings. The government does not want to create a market in human eggs because of the danger of exploitation.
Other changes to Singapore’s legislation are contemplated: lifting the age of dead donors, which is now capped at 60 and allowing paired donation, in which a donor whose kidney is not a match for a relative, gives it to someone else, who also has a relative willing to give up a kidney. ~ BMJ, Nov 7; Straits Times, Nov 1;