Both these cases slipped by Mount Elizabeth Hospital's ethics committee, which comprises doctors and lay people.

The panel has rejected many applications in the past, including those from two Indian nationals sent in shortly after the two Indonesians were prosecuted.

There are several valid reasons for barring the donation of an organ from a living person. But the bulk of rejections stems from the panel's belief that there may be 'fraud, duress or undue influence' on an individual to make him part with his organ, or that the donation is a financial transaction.

If it is a crime to buy or sell an organ for transplant here, then it begs the question: Is a simple rejection by a hospital committee enough? Or should hospitals refer rejected cases to the Ministry of Health (MOH) for possible prosecution?

The buyers and sellers in these cases escaped justice simply because the ethics committee they faced was suspicious and turned them down. One could say that the two kidney sellers from Medan, Toni and Sulaiman Damanik, were just unlucky because they succeeded in convincing the panel that they were kosher - and not because they were any more guilty than those who were unsuccessful.

For the law to be fair, both successful and unsuccessful applicants should be prosecuted if organ trading is involved.

In some of those cases, the suspected buyers are Singaporeans. Shouldn't action be taken against them as well?

Sending rejection cases to MOH for further investigation would serve a double purpose: If the committees were wrong and the offer of the organ was truly altruistic, the patient would have a second shot at a transplant. If, on the other hand, there was a financial transaction between donor and recipient, then they could be prosecuted for committing a crime.

To extend the net further, the law against organ trading should apply to Singaporeans both at home and abroad.

Several hundred Singaporeans have undergone transplants overseas, using organs that they paid for. Some are quite open about the deal. They have fought for a better quality of life and do not see their action as a crime.

On their return, they openly tell their doctors, as well as the National Organ Transplant Unit, that they have had a transplant abroad and can be taken off the wait list for a cadaveric organ. Since 2002, they have been entitled to subsidised medication, which they need to stave off rejection of the organ, regardless of where or how they obtained their new organ.

Should Singapore close an eye on these transactions simply because they happened beyond our borders?

If the country truly wants to send a message that it does not tolerate organ trade, then prosecution should be par for the course in all these cases as well.