Dr Lee Wei Ling's bemused ranting about living kidney donors

Dr Lee Wei Ling is back in the news with a letter to the Forum page essentially attacking doctors who are uncomfortable with the organ trade. She accused wary doctors of being afraid of being labelled professional pariahs in the international community. "....groan"

Not a very fair attack I must say. Somewhat childish, I might add. I mean, to resort to name calling just to make your point. Tsk Tsk, she should know better.

The resistance to the organ trade isn't about providing reimbursements. It is about designing and implementing a system whereby there can be appropriate and just compensations without allowing the system to degenerate into a crass free for all, cash for organ trade where the rich sick can exploit the poor and defenseless. Because that would be a system where wealth justifies any manner of abuse.

Think again, Dr Lee.

Lee Wei Ling's lack of empathy

Notwithstanding Lee Wei Ling's privileged position to comment on just about anything, her forthrightness has earned her a weekly column in the Sunday Times. But unfortunately, except for the occasional pearls that fall out, most of her comments fall short of being wise in any way.

Her comments today on empathy was somewhat scary and unreal in its coldness and lack of logic.

Looking out for oneself and one's own is a reality of life which probably applies to most animal species. This is how packs, herds and tribes survive. Without this empathy, it becomes everyone for his/her own and everything unravels. She seemed somewhat surprised by her own empathy for people around her that she could identify with. But what really surprised and scared me was her confession of an obvious lack of empathy beyond what she could identify as family, friends or fellow tribesman. Did she not consider that a fellow human being in Darfur or further, was worthy of consideration or assistance? Was that distant being not a fellow citizen of our race, and a fellow passenger here on planet earth?

She excused herself in the end by the almost flippant remark that this lack of empathy beyond our shores kinda indicates that we have a "Singapore identify that transcends race and religion". And that somehow seems noble to her.

I would have been ashamed to discover that my compatriots cared little for people and suffering beyond our tiny prosperous little island where poverty was represented by not owning an HDB flat.

Medicine a calling and not just a career? Really??

Dr Lee Wei Ling is back n the news with a letter addressing the above issue. But she is right this time.

Medicine is a calling. Sadly for many doctors, and medical students, it has become nothing more than a career. Many doctor friends counsel their children never to take up medicine, believing that this is no longer a satisfying and fulfilling career option.

This shift in our value system has been due largely to the national push for commercialized medicine. This strategy, articulated in the late 70's at the very highest level of our government, steered us smack down this road...at full speed. Medicine was to be one of the major pillars of our economic growth. But we can't really deny the economic sense this strategy made. It is just that the philosophy was totally wrong. It was another nudge that increasing turns us into little more than mere economic digits.

Can our lives...can doctoring be denominated just in terms of a dollar value?

But there are broader implications, and associations of this very materialistic philosophy that we need to be aware of, and concerned about. This has far wider implications.

a] The commercialization of medicine, and the strategy of establishing us as a medical hub, is in itself not necessarily wrong, but it has caused every doctor to begin to evaluate his/herself in terms of the dollar value of their contributions. There are few who are strong enough, and clear enough about their personal value system to withstand this constant and very public pressure to excel in dollar terms.

b] Medical education, is increasing being subverted by this intense pressure for our students, not to become good caring doctors, but famous award winning clinician researchers. Nobel prize anyone? I mean...do you really want your family physician to be a Nobel prize laureate? Yet the medical school is increasingly diverting must needed teaching resources into research laboratories, and losing valuable educator positions to scientists with long credentials but cannot teach.

Good teachers are increasingly belittled as dinosaurs, and new staff who care little for students clamour for attention and public acclaim. *sigh*

Who are their role models? No more the humble GP who gives his life to serve the community, but the attention grabbing stem cell clinical researcher.

c] The gradual corruption of the medical ethos will be seen in the the increasing pressures to 'bend' morality and ethics to serve mammon. Observe the increasing pressure to push the medical profession into serving the organ trade, ....and euthanasia perhaps...?

What can we do to stem the slide? Precious little, I am afraid. Another example of the slippery road to self destruction? Perhaps.

Dr Lee Wei Ling, will you be our flag bearer to reclaim the noble values in doctoring?

Human organ trade - Lee Wei Ling's rant

Dr Lee Wei Ling has jumped back into the fray once again with respect to the kidney trade issue. Today's Straits Times carried carried half a page of her rants about this much debated issue.

I have great respect for Dr Lee. At other times she has given voice to segments of society that have been marginalized, and otherwise voiceless. But on this issue, I believe she is way off course. There is no doubting her passion in wanting to save the lives of patients who are dying of kidney failure. But her passion is misplaced, when she chooses to dismiss the exploitation problem. In doing so, she has chosen to take the side of the wealthy sick against the poor. Is the life of a wealthy Singaporean worth so much more than the welfare of the poor that she should so readily brush off any suggestion that they may be exploited in this transaction?

She makes the point that "If the seller makes an autonomous decision and, in return, receives a substantial payment that may improve his and his family's quality of life, why should that constitute exploitation?" I would find nothing objectionable in that statement, other than the fact that in a dependent and vulnerable position, the donor is not likely to be able to make a fully autonomous decision. Yes, he/she remains lucid, and rational. Yet we know that given a real choice in the matter he/she would rather not have to sell his/her kidney, whatever the price. She herself acknowledges: "Let's get real: Who would willingly donate his kidney to a stranger without profiting from that act?" She herself would not. She should therefore ask herself why a poor man/woman would go under a knife and 'donate' his kidney to a stranger unless the financial reasons were so compelling. This is the very nature of an 'inducement'. A fully autonomous decision needs to be free of inducements. It is true however, that in life, our decisions are always compounded by some element of inducement, but taken to the extreme, inducements compromise our autonomy. And in the situation of reimbursing kidney donors, the greater the payout, the greater the financial need of the donor, the greater the inducement will be, and the greater the likelihood that the decision was not made with full autonomy.

Much as we may be motivated to save the life of a dying patient, this must not be at the expense of another individual. Therein lies the dilemma in regulating organ trade. Our wealth must not be an instrument of exploitation of the poor.

But perhaps I am too idealistic. (See my other comments on this and related issues...)

I take further offense with respect to her comment : "Why the rigid insistence that the remuneration for the seller should not be so high as to be an inducement to part with a kidey? To be blunt, the main reason is because there is not enough independent thinking here."

Errmmm... 'not enough independent thinking'? Does she imagine that the only independent thinkers are those who agree with her? Legitimizing the organ trade is really a no brainer...and the far easier path to trod. Afterall, who doesn't want to save lives? Standing the moral high ground is a far more difficult choice to make. Wealth empowers. But it takes a stronger (and a more independent minded) person to exercise wisdom and forego that power in defense of the weak and poor.

C'mon Wei Ling....who is more deserving of your support?