BY: Salma Khalik, Health Correspondent

SHOULD society condemn a man to death purely to uphold a principle?

That is what the law prohibiting the sale of organs is doing to many people.

A human body or its parts should not be bought and sold, defenders of the existing law say. Allowing organ trading will only advantage the rich and exploit the poor.

Yes, there are many good arguments in favour of the law. But against those arguments are stark facts: The lives that could have been saved but weren't because of this law.

Every day, three people in Singapore lose the use of their kidneys. But just one cadaveric kidney becomes available each week.

A couple of dozen patients each year are fortunate to have close relatives who are both able and willing to give up a kidney for them.

The risk to the donor is small. In all the years of live-donor transplants here, there has been only one death of a donor - a woman who died within days of giving a kidney to her husband.

Other patients may have relatives who are willing to donate, but whose kidneys are not suitable. These patients have no choice but to go on dialysis and hope they can get a cadaveric kidney before their time runs out.

That, or go overseas to try to get a kidney on the black market. More than 300 Singaporeans have done just that. Yes, they have broken the law. But they are alive.

It is well established that both the quality of life and the survival rate are far superior for people who receive transplants than for those on dialysis. Wouldn't it be better to provide a system where organ trade occurs in a way that best protects the donor?

Such a system should do away with unscrupulous middle-men and ignorant donors conned into parting with a kidney.

Today, Iran is the only country that allows the legal sale of organs. It has had more than 1,500 purchased kidney transplants since 1988 - or more than three in four of all transplants in the country.

To prevent 'transplant tourism', foreigners aren't allowed to buy a kidney. The government brokers the sale, paying for both the kidney and the operation.

Singapore can improve on Iran's system. It could institute a monopsony, with the government as the sole purchaser. That way the government could ensure that sellers are not taken advantage of.

It is likely that the poor will be the sellers. But a proper system could even the playing field by providing a means for the poor to also benefit. Cash-rich philanthropic organisations - or even the state - could buy organs for the poor.

The bottom line is this: The sale of organs would increase the total number of life-saving organs available for transplant. The rich who buy an organ can automatically be taken off the waiting list for a cadaveric organ. A shorter waiting list would translate into a better survival rate for all who need transplants.

Sellers would benefit financially. For many, the sale might lead to a better life for his or her family. A small minority might want the money for less than noble reasons - to settle gambling debts, say. Their desire for money may not be laudable, but the sale would save a life nevertheless.

Should society stop them? Or should the decision be left to individual sellers? Those who speak out against organ sales tend not to be in need of an organ themselves or are relatively well-off.

Instead of deploring an act that they say reduces the human body to a tradable item, shouldn't they deplore an unequal world that can drive people to sell their organs?

The World Health Organisation estimates that a good 10 per cent of transplants now involve organ trafficking - worse than trading, as trafficking can involve coercion and perhaps even outright kidnap. Better a regulated market.

Admittedly, that would not be easy to institute. Iran has legalised organ sales, but it also has a black market for organs.

But that should not be the reason for rejecting the idea outright. Just because one country is not able to do it well is no reason to assume that it cannot be done. We should, at the very least, re-visit the topic - and with open minds.

It would certainly not be an easy task to change the law here, for to do so would go against international norms. But few things that are truly worth doing come easy.

Let the people of Singapore give this issue some serious thought, for many lives hang in the balance.

And not just in Singapore. If a system could be set up to protect donors and yet benefiting patients, it could well be adopted by other countries, where the need for organs is growing every year.

Such has happened with smoking. When Singapore pioneered the ban on smoking in public places, it was condemned for infringing on the rights of people.

Now, the world has seen the light and adopted this practice. Perhaps Singapore can lead the way with organ sales too.

This article was first published in The Straits Times on July 8, 2008.