The compensation for the donors is to come from a third party, like a charity or religious group, and not directly from organ recipients.

Health Minister Khaw Boon Wan indicated the prospect of such an outcome yesterday when he highlighted three ways the Government is considering for augmenting the supply of kidneys.

But he foresees the other two measures doing better in raising the supply.

They are: removing altogether the 60-year age limit when getting organs from a person who had died; and setting up a registry that will find a match among donors who are unrelated to the patient.

These two measures could raise the transplant rate within 10 years to 70 per cent of the demand from eligible kidney patients, said Mr Khaw. Currently, only half the demand is met.

The Health Ministry hopes to implement these changes over the next one year.

Organ trading has been the subject of heated debate in Singapore this month, since well-known retailer Tang Wee Sung was named for allegedly trying to buy a kidney. He has been charged.

The controversy led MPs like Madam Halimah Yacob (Jurong GRC) and Dr Lam Pin Min (Ang Mo Kio GRC) to ask about safeguards against illegal organ trading and legalising such trading. Madam Halimah chairs the Government Parliamentary Committee on Health and Dr Lam is the deputy.

Mr Khaw's suggestion yesterday to allow compensation for some donors stems from requests made by charities and religious groups.

They had asked him if they could provide compensation - in cash or kind - to organ donors and their families to acknowledge the altruistic act of the donation.

The move is likely to stir controversy. However, Mr Khaw believes the solution lies in distancing the donor from the patient.

'The more you can break the direct relationship between the donor and the recipient, (the more) the unethical considerations can be minimised.

'So I think this is a possible option that we should explore, and certainly I'm studying this carefully, with a view to doing so.'

Exploitation of the poor, Mr Khaw has previously said, is his biggest worry. He believes that if a way can be found to minimise such exploitation, paying for organs may be acceptable to people.

He urged Singaporeans yesterday to 'not reject any idea just because it is radical or controversial'.

'The reality is...there are many desperate patients out there wishing to live, and desperately poor people willing to exchange a kidney for a hopefully improved life.

'This is the stark reality and the dilemma confronted by many in such desperate situations.

'We must therefore take a practical approach. Criminalising organ trading does not eliminate it...it merely breeds a black market.'

Most countries are short of kidneys, except for two: Norway and Spain, which are almost self-sufficient.

But what is perhaps most striking to Mr Khaw is that they rely on altruistic organ donations.

'In Singapore, we have not yet maximised the yield through altruistic organ donations. Let us emulate them and push altruistic organ donations to their maximum potential,' he said.

Attitudes towards compensating kidney donors have also been gradually changing, Mr Khaw pointed out.

He cited the views of Singapore Medical Association past president Arthur Lim and Nobel laureate Gary Becker.

Prof Becker, an American professor in economics and sociology, had argued that markets in organs are the best available way for a patient to get organ transplants more quickly than under the present system.

But this may be arguable in the light of the situation in Iran.

It is the only country in the world where organ trading is legal. Yet its transplant rate remains low.

huichieh@sph.com.sg