Introduction
Over 10 lakh individuals are waiting for corneal transplants, 50,000 are waiting for heart transplants, and 20,000 are in need of lung transplants in India, where the state of organ donation is deplorable. This is particularly regrettable given that an organ donor can, on average, save up to nine lives and provide 25 different organs to those in need. The transplant waiting lists in India are getting longer every day, while the list of organ donors is not currently growing at the same rate.
By surgically replacing a patient's faulty organ with a healthy one, organ donation can prolong a patient's life by many years. Sometimes the only treatment for long-term illnesses like leukaemia or kidney failure is organ donation. That being said, the concept of organ donation also involves a number of legal aspects which will be discussed further in this article.
Organ Donation working
When an individual's organs start failing or deteriorating and they need a transplant to survive, that marks the initiation of the process. If a person is a fine fit for a transplant, a transplant centre will undertake a comprehensive evaluation and add them to the National Transplant Waiting List. The clock starts to run and the wait for an organ begins once the person is added to the list. It is a mechanism that matches donors with patients on waiting lists. Blood type, body size, the severity of the patient, proximity to the donor, tissue type, and length of the waiting list are used to categorise donors. The following criteria is never used to match organs:
There is no way to predict how long the wait would be; in fact, some people's organ transplants are delayed because the waiting list is so long and there aren't enough donors. Because of this, a good number of people on the waiting list die on average every day.
Indian Legal Provisions Administering Organ Donation And Transplantation
The primary legislation, The Transplantation of The Human Organs Act, of 1944, covers organ donation and transplantation (THAO). It sought to uphold appropriate regulations for the removal, preservation, and transplantation of organs for medical purposes. The primary responsibility of the law is to stop transplant commercialism.
Key aspects of the 1994 bill
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The authorisation Committee must be organised at the State and Center levels and consist of a unique collection of experts. The committee would be in charge of keeping track of the organs that are available and approving requests for transplants.
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Only the medical professional who has registered with the authority will be given the responsibility of executing the procedure for removing the organs from the deceased's body.
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An institution where the transplant would be performed must have authorization from the State authorities in order to be recognised as an approved centre.
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Without the consent of a trained neurosurgeon, a person cannot be pronounced brain dead right before the transplantation is about to begin.
Amendments of 2014
After twenty years, neither has the number of organ donors has increased nor have the authorities been able to stop unlawful organ transplants and the use of human trafficking unlawful transplants. These changes were made with the intention of simplifying the organ donation process and streamlining the entire process. The modifications are as follows:
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Every hospital that could offer suitable care for donors and ventilators to collect the organs was given the authority to do organ transplants in order to increase accessibility and scope.
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In order to confirm that a neurosurgeon was required to be present when a person was declared dead, a relaxation of the earlier mandatory rule was approved.
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It was mandated that medical professionals approach the relatives of the deceased, inform them of the transplantation process and encourage them to move forward because it would be good for society.
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The recipient, his family, the government, or non-governmental organisations would be responsible for covering the cost of transportation, medical care, the donor's maintenance, and the recovery of organs or tissues.
THAO, 1994: A Critical Analysis
The Act outlines the procedure for obtaining organs from the deceased, a related person, or someone who is not related in order to prevent the unlawful trade in human organs. The law establishes that the primary motivation for organ donation stems from the need to help a close relative, such as a parent, sibling, child, or spouse. The relationship between these individuals must be confirmed through genetic testing or legal documentation. The Authorization Committee (AC) has been established by the government to ensure that organ donations for unrelated donors are made exclusively out of "Affection and Attachment" with the patient and that there is no unreported financial benefit being given to the donor.
The Authorization Committee's goal is to ascertain whether or not there is a business relationship between the donor and the patient, as well as whether there is even a remote chance that the donation may be illegal. Authorization Committee and Others v. Balbir Singh, it was mentioned that "Near Relative" was used in this case.
The Act was passed with the intention of prohibiting the trade of human organs. The law stipulates punishment for anyone who performs the unlawful and barbaric crime of selling organs for profit, including a sentence of two to seven years in prison and a fine of between Rs. 10,000 and Rs. 20,000. Despite the 2011 Amendment, this Act hasn't been able to stop the unlawful trade of organs.
Requirements and Permissions
The age requirement for organ donation is zero. It can begin as early as six weeks. Your organs' state of health and condition are the only things that matter. All of your organs and tissues, including your heart, kidneys, lungs, corneas, and pancreas, can be donated. Even living organ transplants are possible, particularly in the case of the kidneys since a person can survive in good condition with just one kidney.
The procedure of Organ donation
The Method of Living Donation
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To ensure that the living donor is medically compatible with the recipient, the donor must go through a number of tests and examinations.
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A physician certifies the medical suitability of the living donor. The transplant cannot take place until every test has conclusively shown that the donor and the recipient are compatible.
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Medical professionals perform surgery to remove the living donor's organs. Before being transplanted into the recipient, they will be momentarily kept in specialised chemical solutions.
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The living donor must remain under medical supervision for a few days or weeks following organ donation in order to be healthy enough to return home.
The Donation Method for the Deceased
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A deceased donor is frequently someone who experienced a fatal head injury or brain haemorrhage. A group of medical professionals in a hospital declares she/he to be brain dead.
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Before the organ retrieval process may be started, the donor's family must approve the donation. Until the organ retrieval process can begin, the donor is kept on life support with doctors taking care of all of her or his needs.
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From a waiting list, suitable recipients are chosen for each organ. They receive a call and are instructed to go to their respective hospitals.
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The donor's body is respectfully returned to the family after retrieval.
Requirement of Forms
The Transplantation of The Human Organs and Tissue rules, 2014 prescribe the following forms:
Form 1: Consent for organ or tissue donation from a near-relative
Form 2: Consent for organ or tissue donation from the spouse
Form 3: Consent for organ or tissue donation from other than a near-relative donor
Form 4: Certificate of Donor’s Psychiatrist evaluation
Form 5: Certificate of genetic relationship of living donor with the recipient (HLA DNA profiling report)
Form 6: Consent spousal living donor
Form 7: Self-consent for deceased donation
Form 8: Consent for organ donation from family (also applicable for minors)
Form 9: Consent for organ donation from unclaimed bodies
Form 10: Brain death declaration form
Form 11: Joint transplant application by donor/recipient
Form 12: Registration of hospital for organ transplantation
Form 13: Registration of hospital for organ retrieval
Form 16: Grant of registration
Form 17: Renewal of registration
Form 18: Decision by hospital authorisation committee
Form 19: Decision by district authorisation committee
Form 20: Verification of Domicile for non-near-relative
Form 21: Certificate of the relationship between donor and recipient in case of foreigners (Letter from Embassy)
Website for Organ Donation
Link: https://notto.gov.in/index.htm
The National Organ and Tissue Transplant Organization (NOTTO) is a national-level organisation housed in the Institute of Pathology (ICMR) Building at Safdarjung Hospital in New Delhi. It was established under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. It has the two divisions listed below:
"National Biomaterial Centre" and "National Human Organ and Tissue Removal and Storage Network".
Link: https://www.mohanfoundation.org/
The MOHAN Foundation is a non-profit, non-governmental organisation that was established in 1997 in Chennai by benefactors and medical experts under the direction of Dr. Sunil Shroff to promote organ donation. It is a recognised non-profit organisation with offices in Chennai, Hyderabad, Delhi-NCR, Chandigarh, Nagpur, Jaipur, Mumbai, and the United States. It is also free from income tax under Sections 80G and 35AC. A group of like-minded and concerned medical and non-medical professionals founded the MOHAN Foundation with the goal of extending the application of the Transplantation of Human Organs Act. This law was passed in 1994 by the Indian government to promote organ donation and end the trade in organs, particularly kidneys. Now, in addition to donating eyeballs, one can also donate their heart, lungs, liver, kidneys and pancreas.
Link: https://www.organindia.org/
The Parashar Foundation, a Delhi-based NGO, started The Organ Receiving & Giving Awareness Network (ORGAN) India in March 2013 to address the appalling status of deceased organ donation in India. In order to address this organ donor shortage, we are working to develop the necessary infrastructure in India.
The late Ashok Parashar founded the Parashar Foundation in 2000 with the goal of assisting the underprivileged by funding numerous hospitals, schools, and other organisations. While the majority of our prior efforts consisted of financial contributions to various charities, our current focus is to raise public awareness about organ donation in Delhi, which will help all people, regardless of religion, age, sex, caste, or gender.
Conclusion
The number of organ donors is still incredibly low despite the steady increase in demand. The illegal trade in organs has dramatically increased as a result of the strong demand for organs, and the worst-affected nations are those in developing regions with high rates of poverty and lax law enforcement. It is a sad fact that despite being in effect for 15 years, the THO Act has not been able to prevent the commercial trade in organs or to promote organ donation.
The best course of action in India is to spend money raising awareness about the deceased’s contribution and passing legislation requiring the donation unless someone opts out. The conservative mindset of society needs to shift, together with strict legislative requirements and their successful implementation, in order to close the enormous gap between the supply and demand of critical organs.
