INTERPRETATION (AMENDMENT) BILL (As reported from Select Committee)

Order for Third Reading read.

The Minister for Health (Mr Yeo Cheow Tong): Mr Deputy Speaker, Sir, I beg to move, "That the Bill be now read a Third time."

Sir, the Select Committee on the Interpretation (Amendment) Bill received nine written submissions. After considering the submissions, the Committee decided that it was not necessary to hear oral representation as almost all the submissions were in support of the Bill, and none had specifically opposed it. The Committee's Report has been presented to Members of the House.

The Committee deliberated on the key points raised in the submissions and agreed that they are already catered for in the Bill. These include safeguards to ensure that before brain death is certified, having two doctors to determine that irreversible cessation of all brain functions has indeed occurred, the inclusion of an independent medical practitioner to certify brain death and that the statutory definition of death be kept separate and distinct from provisions governing organ transplant.

Sir, the Select Committee has, after deliberating on the issues raised in the submissions, recommended that there be no amendment to the Interpretation (Amendment) Bill.

Let me take this opportunity now to reiterate five important points concerning the Interpretation (Amendment) Bill. First, the objective of the Bill is to provide a legal definition of death for all purposes and formalise what is the currently accepted medical practice. The traditional concept of death, referred to by doctors as "cardiac death", occurs when there is permanent cessation of the circulation of blood and respiration in the body of a person. This concept, however, can no longer be applied in every case because of advances in medical treatment and technology, in particular, resuscitative and life support technology. The law must allow doctors to certify death when a person's brain has ceased functioning totally and irreversibly, even though his heart is kept beating or can be kept beating through artificial means for a limited period of time. This is because such a person is in effect dead and there is no possibility at all that he will ever become alive again. The legal definition of death proposed in the Bill will allow doctors to use either the cardiac or brain death criteria to determine when death occurs. The doctor determines which set of criteria should be used according to the clinical circumstances of the case.

Second, the determination of brain death will be in accordance with clinical criteria that will be prescribed in the regulations under the new section 2A of the Act. These criteria will be the same as those currently prescribed in the Human Organ Transplant Act (HOTA) Regulations for determining brain death in the case of HOTA donors. The brain death criteria in HOTA are a refinement of the criteria that were unanimously adopted by the Medical Royal Colleges and Faculties of the United Kingdom in 1976. . Third, HOTA was implemented in January 1988. The definition of brain death and the criteria for determining brain death under HOTA have therefore been tried and tested for the last 10 years and have gained public acceptance.

Fourth, there is a need in certain circumstances to define precisely the time of death. For example, the family of a brain dead person who is being maintained on a ventilator can be spared unnecessary mental anguish and financial burden if brain death can be promptly determined and certified. Also, if the deceased or his family had consented to organ donation, accurate and timely determination of death is necessary so that his organs would still be viable when harvested. Any delay in certifying death may result in the donated organs being unsuitable for transplantation to save the lives of others.

Fifth, there are additional provisions in the Bill governing the certification of death in situations where organs will be lawfully removed for transplant purposes. This is to assure the family of the deceased and the community that adequate safeguards are in place to prevent untimely removal of the donor's organs.

Sir, I beg to move.

Question put, and agreed to.

Bill accordingly read a Third time and passed.