Background Normally the family that donates a deceased relative's kidneys after death, gives it to a registered "organ procuring agency"operating within the hospital. This agency (eg.,the Zonal Transplant Coordination Centre or ZTCC in Mumbai) allots it according to a common waiting list of patients , subject to medical compatibility. If the the donor kidney is incompatible with the blood group of the 1st patient on the list, it is matched with the 2nd or the 3rd and so on. Nobody is allowed to "jump" the queue.
The crime:The mischief starts when a LIVING donor for reasons of "special affection" names a patient for the donated kidney. This loophole in the law is exploited by organ touts and rich patients to "buy" a kidney. Invariably it is a poor donor that donates to a rich patient: like a driver or a cook donating to a member of the family for whom he or she works. This affection or love is difficult to prove. In the other method, the driver or cook is given false papers and a false identity to show an actual relationship with the donor, complete with photographs and forged documentary evidence. These tricks get past the officials whose duty is to check illegal donations officials.
The solution suggested: In all suspicious cases an official advertisement with names and addresses and photographs of such organ donors and the specified organ recipient be placed in popular newspapers with stated reason for agreeing to the organ donation. A mandatory one month's delay should also be stipulated before scheduling surgery. This allows transparency and allows anyone in the public to raise an objection or identify a falsehood. The method is exactly as used to discourage malpractices before (1) a civil wedding at the marriage registrar to solemnize an inter-caste marriage and (b) registering a change of name.
The objection from doctors Doctors all over India have refused to debate this issue publicly stating that disclosing the name of organ donor to a recipient is a BREACH of MEDICAL ETHICS under the RIGHT OF PRIVACY FOR ORGAN RECIPIENTS AND DONORS. They seem to believe that this solution is worse than organ scandals.
The debate that is necessary
Organ donation is a HUMAN ISSUE needing generosity when the donor is grieving from a relative's death. Social activists like me are convinced through trials and hard evidence that this is possible and that there are enough good-hearted individuals in our country to significantly improve legitimate organ supply to save patients'lives. SHOULDN'T IT BE these ANONYMOUS CITIZENS (both donors and patients) and THE PUBLIC who should rule on "ethics" of organ donation AND NOT JUST THE DOCTORS?
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Since I posted the orginal blog,two important developments have occurred.
(Development No.1) There were several meetings held in Delhi and Mumbai in 1st quarter of 2007. Doctors and social workers and govt.agencies attended. The consenus that appeared was (1)The Transplantation of Human Organs Act 1994 need not be changed and that it needed too long a process to attempt change.(2) Public disclosure in newspapers of names of unrelated organ donors and the recipients to whom they wished to donate a kidney for reasons of "affection" would be a breach of medical "ethics" - though it could discourage illegal kidney donations.
Both these arguments were raised and carried through mainly by doctors. It seems obvious that if breakthroughs are to be expected,they HAVE to come - not from doctors but from civil society in general and specially from patients needing organs and generous organ donors.
(Development No.2) Some concerned indviduals and agencies have got together to form a NATIONAL BODY to represent interests of organ donation, retrieval, and equitable sharing in India.This organization is expected to be "registered" and functional by October 2007.
Some of us are now trying to get legal help to check whether this objection of "medical ethics" to prevent public disclosure of unrelated kidney donors and recipients, is really valid. We are also trying to get assistance from a Law Univerity to redraft a new version of the Human Organ Transplantation Act.
This new version would then be put up for public debate.
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