A class difference?

I had a discussion with a friend the other day on how privileged kids who grow up in comfort surrounded by material wealth and "elite experiences" may lack a certain empathy towards others or humility, unless the parents take care to inculcate proper values in them. My friend was playing, quite gleefully, the devil's advocate, but I think we agreed on the issue. Academic ability, wanton wealth, position and power do not a better man make.

If only many more of the "upper socio-economic class" people are like Lee Wei Ling.

The article below by Lee Wei Ling appeared today in The Straits Times.
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Doing what's right without fear or favour

I was born and bred in Singapore. This is my home, to which I am tied by family and friends. Yet many Singaporeans find me eccentric, though most are too polite to verbalise it. I only realised how eccentric I am when one friend pointed out to me why I could not use my own yardstick to judge others.

I dislike intensely the elitist attitude of some in our upper socio-economic class. I have been accused of reverse snobbery because I tend to avoid the wealthy who flaunt their wealth ostentatiously or do not help the less fortunate members of our society.

I treat all people I meet as equals, be it a truck driver friend or a patient and friend who belongs to the richest family in Singapore.

I appraise people not by their usefulness to me but by their character. I favour those with integrity, compassion and courage. I feel too many among us place inordinate emphasis on academic performance, job status, appearance and presentation.

I am a doctor and director of the smallest public sector hospital in Singapore, the National Neuroscience Institute (NNI). I have 300 staff, of whom 100 are doctors. I emphasise to my doctors that they must do their best for every patient regardless of paying status. I also appraise my doctors on how well they care for our patients, not by how much money they bring in for NNI.

My doctors know I have friends who are likely to come in as subsidised patients. I warn them that if I find them not treating any subsidised patient well, their appraisal - and hence bonus and annual salary increments - would be negatively affected. My doctors know I will do as I say.

I remind them that the purpose of our existence and the measure of our success is how well we care for all our patients - and that this is the morally correct way to behave and should be the reason why we are doctors. In NNI, almost all patients are given the best possible treatment regardless of their paying status.

My preference for egalitarianism extends to how I interact with my staff. I am director because the organisation needs a reporting structure. But my staff are encouraged to speak out when they disagree with me. This tends to be a rarity in several institutions in Singapore. The fear that one's career path may be negatively affected is what prevents many people from speaking out.

This reflects poorly on leadership. In many organisations, superiors do not like to be contradicted by those who work under them. Intellectual arrogance is a deplorable attitude.

'Listen to others, even the dull and ignorant; they too have their story,' the Desiderata tells us. It is advice we should all heed - especially leaders, especially doctors.

I speak out when I see something wrong that no one appears to be trying to correct. Not infrequently, I try to right the wrong. In doing so, I have stepped on the sensitive toes of quite a few members of the establishment. As a result, I have been labelled 'anti-establishment'. Less kind comments include: 'She dares to do so because she has a godfather'.

I am indifferent to these untrue criticisms; I report to my conscience; and I would not be able to face myself if I knew that there was a wrong that I could have righted but failed to do so.

I have no protective godfather. My father, Minister Mentor Lee Kuan Yew, would not interfere with any disciplinary measures that might be meted out to me.

And I am not anti-establishment. I am proud of what Singapore has achieved. But I am not a mouthpiece of the government. I am capable of independent thought and I can view problems or issues from a perspective that others may have overlooked.

A few months ago, I gave a talk on medical ethics to students of our Graduate Medical School. They sent me a thank-you card with a message written by each student. One wrote: 'You are a maverick, yet you are certainly not anti-establishment. You obey the moral law.' Another wrote: 'Thank you for sharing your perspective with us and being the voice that not many dare to take.'

It would be better for Singapore's medical fraternity if the young can feel this way about all of us in positions of authority.

After the Sars epidemic in 2003, the Government began to transform Singapore into a vibrant city with arts and cultural festivals, and soon, integrated resorts and night F1. But can we claim to be a civilised first world country if we do not treat all members of our society with equal care and dignity?

There are other first world countries where the disparity between the different socio- economic classes is much more extreme and social snobbery is even worse than in Singapore. But that is no excuse for Singaporeans not to try harder to treat each other with dignity and care.

After all, both the Bible and Confucius tell us not to treat others in a way that we ourselves would not want to be treated. That is a moral precept that many societies accept in theory, but do not carry out in practice.

I wish Singapore could be an exception in this as it has been in many other areas where we have surprised others with our success.



The writer is director of the National Neuroscience Institute. Think-Tank is a weekly column rotated among eight heads of research and tertiary institutions.

What about the donor?

The debate that has been raging in our nation's main newspaper, or the "newspaper of record", focuses mainly on ethical considerations, the need of the organ recipient and the rich versus poor controversy. Surprisingly, nothing much has been said about the impact on the donor and his health, apart of a line or two in some articles.

It should not be so. The impact on donor health, both short- and long-term, costs of medical expenses in the long run, insurance, ability to work, quality of life... have not been sufficiently discussed and understood for a truly meaningful public consensus or opinion to be reached.

The info below was taken from organdonor.gov, "the official U.S. Government web site for organ and tissue donation and transplantation". A para in there says:
"Because all of the effects, especially the long term effects, to the donor are not known at this time, the Federal government does not actively encourage anyone to be a living donor. The Federal government does recognize the wonderful benefit that this gift of life provides to the patient awaiting a transplant and has several ongoing programs to study, support, and protect the living donors who do choose to provide this gift."

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http://www.organdonor.gov/donation/typesofdonation.htm

Suitability to Donate

Each potential living donor is evaluated to determine his or her suitability to donate. The evaluation includes both the possible psychological response and physical response to the donation process. This is done to ensure that no adverse outcome, either physically, psychologically, or emotionally, will occur before, during, or following the donation. Generally, living donors should be physically fit, in good health, between the ages of 18 and 60, and not currently have or have had diabetes, cancer, high blood pressure, kidney disease, or heart disease.

The decision to be a living donor must be weighed carefully as to the benefits versus the risks for both the donor and the recipient. Often, the recipient has very little risk because the transplant will be life saving. However, the healthy donor, does face the risk of an unnecessary major surgical procedure and recovery. Living donors may also face other risks. For example, a small percentage of patients have had problems with maintaining life, disability, or medical insurance coverage at the same level and rate. And, there can be financial concerns due to possible delays in returning to work because of unforeseen medical problems.

Follow-up for Living Donors

The National Institutes of Health is in the process of conducting a study to collect information on the outcomes of living donors over time. At present, follow-up reviews of living donors by some transplant centers show that living donors, on average, have done very well over the long term. However, there are some scientific questions regarding the effects of stress on the remaining organ. There could be subtle medical problems that do not develop until decades after the living donation that are not known at this time because living donation is a relatively new medical procedure. To ensure the safety of all living donors, it is critical that the long term results of the effects of living donation are studied further.

The Decision to Donate

The decision to be a living donor is a very personal one and the potential donor must consider the possibility of health effects that could continue following donation. In most cases, that decision must also take into consideration the life-saving potential for a loved one—the transplant recipient.

Because all of the effects, especially the long term effects, to the donor are not known at this time, the Federal government does not actively encourage anyone to be a living donor. The Federal government does recognize the wonderful benefit that this gift of life provides to the patient awaiting a transplant and has several ongoing programs to study, support, and protect the living donors who do choose to provide this gift.

The decision to say yes to both organ donation after death and/or as a living donor is the focus of many very active and successful research projects that are being conducted across the nation, and these efforts are supported by the Division of Transplantation, Health Resources Services Administration, U.S. Department of Health and Human Services.

Federal Assistance for Living Organ Donors

In September 2006, HRSA awarded a cooperative agreement to the University of Michigan to establish a national program to provide reimbursement of travel and subsistence expenses to living organ donors who cannot afford these expenses. In October 2007, the University of Michigan in partnership with the American Society of Transplant Surgeons launched the National Living Donor Assistance Center to help donors with travel, lodging, and meal expenses associated with the organ donation process.

They sure come in all shapes and sizes

This house reminds me of a ship -- narrow, long and tiered. Truly individualistic though I wonder why it was built this way.