Ethics in Organ Donation

Ethics in Organ Donation

Table of Contents

Introduction

Human body consists of organs which work in tandem in order for the body to exist. It’s like a machine which needs constant mechanism of its parts to keep it going. So imagine if any one part undergoes failure. Would the machine continue working? No! So goes for the human body as well. All its parts, organs, need to be working in order for the body to sustain. But just like a machine parts, organs too give up on certain occasions and become dysfunctional. Organs, being indispensable, cannot be just discarded and removed from the body. If a person’s heart were to undergo failure, would it mean to remove the heart? Off course not! And hence the medical need of organ transplant arose.

An organ transplant is a surgical operation where a dysfunctional organ of the human body is removed and replaced with a new functional organ. The person who receives the organ is the recipient while the one who gives away his organ is called the donor. The organ donor can be a deceased or an alive person.

Not all organs can be transplanted. Organ transplant typically refers to transplants of the solid organs which are heart, lungs, kidneys, liver, pancreas and intestines. Even animal and artificial organs may also serve as transplantable organs. There are other types of transplants as well, which are less invasive or may require specialized procedures include:

• Skin transplants or grafting technique
• Corneal transplants in eyes (corneas are the outer layer of the eye)
• Bone marrow transplant

Organ transplantation is considered a boon to the medical industry as it is instrumental in saving lives of people who would otherwise die because of their dysfunctional organ. It gives new lease of life to an individual who is on threshold of death. Though medical science has advanced to this stage of organ transplantation not every life is saved. Not every patient has access to such treatment. Of all the patients who have access to such treatment, not each one of them gets a compatible organ to replace their dysfunctional organ. And above all there are certain Governmental rules and policies which have to be followed. Certain legal formalities and documentation to be done before a patient undergoes transplant. These rules vary based on situations but often precious time is lost in completing these formalities.

Indian Scenario

As the organ transplantation started gathering impetus, malpractices and illegal trafficking emerged. To control these activities government the Government of India came up with a law in 1994 that made organ sale a crime. The Human Organs Transplant Act, 1994 was implemented which laid down certain rules and regulations that had to be followed while conducting organ transplant.

According to Organ Transplant Laws:

• No money exchange was allowed between the donor and the recipient
• Close relatives of the recipient like siblings, parents, children and spouse could donate the organ without the need for clearance from the government
• The unrelated donor need to file an affidavit in the court of a magistrate stating that out of affection the organ is being donated. Later, the donor had to undergo a few tests before the transplant.

In the end the approval and clearance would happen after the Authorization Committee has checked all the supplied documents. As per the Law, sale of organs was banned. Thus legally no foreigner could get a local donor. In case there was a money exchange then the offender had to pay heavy penalty.

The aim of Transplantation of human organs act, 1994, was to rationalize organ donations and transplants in the country. The main aims of the act were:

• To regulate removal, storage and transplantation of human organs for therapeutic purposes
• To accept brain death and make it possible to use these patients as potential organ donors
• To preventing commercial dealings of organs.

After this law, the concept of brain death was legalized for the first time in India.

Though it aimed to prevent commercial dealings of organs ad stop organ trafficking, the illegal trade continued unabashed in certain areas of India until they were busted by Indian Police. These areas were dominated by the poor and impoverished of the society who would readily give away their organ for some amount of money. After the Indian Ocean tsunami, post 2007, the fishermen near the southern cost lost their livelihood and fell prey to traffickers. They sold their kidneys to meagre amount of money to support their family and I some instances get rid of debt. Hence a new bill was laid down in 2009.

The Transplantation of Human Organs (Amendment) Bill, 2009

This Amendment Bill offered regulation to the transplantation of human tissue along with organ transplant. It made necessary for the medical staff which looked after the patient to put forward a request to the relatives of the brain dead person for donation of organs. It was made necessary for every organ donation case to go to the Authorisation Committee first. Some of the key highlights of the Bill are as follows:

• The act permits donations from living relatives who are near relatives. It added grandparents and grandchildren to the list of “near relative”.
• The doctor has to inform the patient or his relatives about the possibility of organ donation and make sure for their consent to it.
• If there is a medical mismatch in organ of the donor and the recipient, the bill permits to swap organs with another pair of such a person.
• It increased in the penalty for illegal removal of human organs as well as payment for a human organ inexchange of its receipt

The latest amendment was made in 2013 to this bill, according to which there will be a Verification Committee in addition to the authorization committee for the verification of the details of the donor and the recipient as well as the other legalities of the matter of organ transplant.