SINGAPORE is not ruling out legalising organ trading.

The surprise comment from Health Minister Khaw Boon Wan yesterday is bound to re-ignite the fiery debate on the benefits and dangers of allowing the buying and selling of human kidneys, lungs and other organs.

The Government has stood firm so far on enforcing the present laws, which prohibit organ trade.

But yesterday Mr Khaw said that organ shortages and a black market in the region made legalising trading an option.

'I think we should not write off or reject the idea of selling organs. But I think we need to study it carefully,' he said.

There are no immediate plans to change the law, as there are practical reasons why overturning the ban could backfire - like shrinking the current donor pool, he added.

'By legalising trading, you could actually lose the family members who currently donate. Instead, you could get organs from outside the family, through payment, and the result would not be as good,' he explained.

Siblings are the best bet for a perfect tissue match if a transplant is needed - with a one in four chance of success. This figure shrinks to one in 2,000 for non-relatives.

Last year, 86 Singaporeans received kidneys from living donors, including 53 who got the organ from a relative.

Hundreds of others were not so lucky, most of them languishing on waiting lists and dying within five years without a transplant.

The minister's remarks at a community event yesterday came in the wake of a highly publicised organ trading case here, in which two Indonesians were jailed earlier this month for selling their kidneys. It also involved CK Tang executive chairman Tang Wee Sung, who was charged with attempting to buy a kidney.

In an e-mail response to The Straits Times, Mr Khaw said his stance yesterday was not a turnaround from his earlier comments that the trade, motivated by financial transactions, is 'definitely wrong, morally and legally'.

He said yesterday: 'I remain of the view that organ trading is not the way to go, but we should not reject any idea given the reality.'

Meanwhile, the Singapore Medical Association (SMA) has come out steadfastly against legalising the organ trade, following an emergency meeting on Saturday.

Its spokesman, Dr Tan Sze Wee, said organ sellers face an array of short- and long-term medical risks. The sellers, almost always desperately poor, could also be abused and exploited.

'We see tremendous resources needed to enforce organ trade regulations in a transparent and equitable way.

'These make it inappropriate for SMA to support any move towards legalising the trade,' he said.

Mr Khaw said the best approach is still one of prevention, such as better control of diseases like diabetes.

Singapore should promote altruistic donations through the Human Organ Transplant Act (Hota), and live transplants among relatives.

When Hota is extended to Muslims next month, the pool of organs would increase, he said.

Singapore could also learn from Norway and Spain, where organ supply almost matched demand - a figure higher even than Iran, the only country that has legalised organ trading.

In Spain, for example, specially trained doctors and an efficient donor detection programme have contributed to its success.

Mr Khaw added that he hoped to find a solution that protects the interests of the donor and the patient.

'How? I don't know. But if we do not force ourselves to think out of the box, then we will never be able to find a better solution,' he said.

juditht@sph.com.sg

tansle@sph.com.sg