Mains Article

Organ Donation: Does India need an organ donor policy? [Mains Articles]

Organ donation is one of the greatest medical marvels of the twentieth century which has saved the lives of several patients. However, the disparity between the huge demands for the organs and their poor supply still remains the main contentious issue.
By IT's Mains Articles Team
December 07, 2019

Content

  • What is Organ Donation?
  • Which Organs can be donated?
  • Who can be a donor?
  • What is the difference between Required Request, Presumed Consent and Informed Consent?
  • Types of Living Donor Related Transplant
  • Why Organ Donation is essential in India?
  • Comparison with other Countries
  • What are the hindrances?
  • What are the steps taken by the Government?
  • Possible Solutions
  • Conclusion

Organ Donation: Does India need an organ donor policy?

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Context

  • Every year, the Indian Organ Donation Day is observed by the Government of India on November 30.

Indian-Organ-Donation-Day

What is Organ Donation?

  • Organ donation is the harvesting of an individual’s organs after he or she dies for the purpose of transplanting them into another person.

Which Organs can be donated?

  • Vital Organs like the heart, liver, kidneys, intestines, lungs, and pancreas can be donated only in case of ‘brain death’. However other tissues like corneas, heart valves, skin, bones etc can be donated only in case of natural death.

 Organs-can-be-donated

Who can be a donor?

  • Anyone can be an organ donor irrespective of age, caste, religion, community, current or past medical condition. Children can also be organ donors after taking consent for organ donation from their parents.
  • However active cancer, active HIV, active infection or Intravenous (IV) drug use are some of the contra-indications (situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person).
  • Patients who have Hepatitis C can still donate organs to a patient who also has Hepatitis C. The same is true for Hepatitis B. Most cancer patients can donate corneas.

 

What is the difference between Required Request, Presumed Consent and Informed Consent?

Required Request

Presumed Consent

Informed Consent

Any person, who wishes to donate his/her organ and tissue after his death, has to affirmatively make a pledge that his/her organs after death can be used for transplantation and saving lives of another person.

In the presumed consent, every person is supposed to be agreeing for organ donation at the time of death, unless the person has decided during his/her life that he/she is not willing for organ and tissue donation after death. 

Informed consent is a process, which is not specific to organ and tissue donation. This is a process of reaching an agreement based on a full understanding of what will take place, in the form of medical treatment. Informed consent involves information sharing as well as the ability to understand and freely make a choice in relation to medical treatment.

 

Types of Living Donor Related Transplant

  • Living Near Related Donors: Only immediate blood relations are accepted usually as donors viz., parents, siblings, children, spouse etc.
  • Living Non- near relative Donors: are other than near relative of recipient or patient. They can donate only for the reason of affection and attachment towards the recipient or for any other special reason.
  • SWAP Donors: In those cases where the living near-relative donor is incompatible with the recipient, provision for swapping of donors between two such pairs exists, when donor of first pair matches with the second recipient and donor of second pair matches with the first recipient This is permissible only for near relatives as donors.

Why Organ Donation is essential in India?

Organ donation is probably the noblest way of living beyond one’s death and giving another person, a new lease of life. The organs from an individual can save up to 8 lives.

In India, more than half of all people on the transplant waiting list are from a racial or ethnic minority group. That is because some diseases that cause end-stage organ failure are more common in these populations than in the general population.

The following data summarizes the acute shortage of organs for transplantation:

·         Every single day, at least 15 patients die waiting for an organ and every 10 minutes, a new patient requires an organ.

·         Every year, 500,000 people die because of non-availability of organs. 200,000 people die of liver disease and 50,000 people die from heart disease.

·         150,000 people await a kidney transplant every year but only 5,000 get one.

·         1,000,000 lakh people suffer from corneal blindness and await a transplant.

 

Organ Donation is essential in India

Organ Donation is essential in India 1

Comparison with other Countries

  • The rate of organ donation in India used to be 0.5 per million populations, but in 2018 it has climbed up to 8.
  • Despite this, India is still far away from other countries like Spain, USA, China, Germany, Australia and Brazil who are way ahead when it comes to organ donation. While Spain is leading the cause of organ donation with the highest rate of organ donation (per million population) at 46.9, USA has 31.96 rates, followed by Australia (20.70) and Brazil (16.60).

Comparison with other Countries

What are the hindrances?

the-hindrances

What are the steps taken by the Government?

Enactment of The Transplantation of Human Organs Act, 1994

The Transplantation of Human Organs Act, 1994 was enacted by the Parliament, in Goa, Himachal Pradesh, Maharashtra and in all the Union Territories. Thereafter, it was adopted by all States except the Jammu & Kashmir and Andhra Pradesh, which have their own legislation to regulate transplantation of Human Organs.

Purpose of the Act

Purpose of the Act

  • It allows organ donation, and legalized the concept of ‘brain death’. Brain death is the irreversible and permanent cessation of all brain functions.
  • The main purpose of the Act is to regulate the removal, storage and transplantation of human organs for therapeutic purposes and to prevent commercial dealings in human organs.
  • In 2011, the Government of India enacted the Transplantation of Human Organs (Amendment) Act, 2011 that allows swapping of organs and widens the donor pool by including grandparents and grandchildren in the list.

Some of the important amendments under this Act to promote organ donation are as follows.

1. Provision of ‘Retrieval Centres’ for retrieval of organs from deceased donors and their registration under the amended Act.

2. Definition of near relative expanded to include grandparents and grandchildren.

3. Brain death certification Board has been simplified and more experts have been permitted for this certification.

4. ‘Mandatory’ inquiry and informing option to donate in case of unfortunate event of brain stem death or ICU patient for the purpose of organ donation.

 

5. Mandatory ‘Transplant Coordinator’ for coordinating all matters relating to removal or transplantation of human organs.

6. National Human Organs and Tissues Removal and Storage Network at one or more places and regional network.

7. National Registry of Donors and Recipients.

8. Removal of the eye has been permitted by a trained technician to facilitate eye donation.

 

 

National Organ Transplant Programme (NOTP)

  • Directorate General of Health Services is implementing National Organ Transplant Programme for carrying out the activities as per Transplantation of Human Organs (Amendment) Act 2011.
  • Under NOTP, patients below poverty line are supported bu government of India for the cost of transplant as well as cost of immunosuppressant after transplant for one year.

Objectives:

  • To organize a system of organ and tissue procurement & distribution for transplantation.
  • To promote deceased organ and Tissue donation.
  • To train required manpower.
  • To protect the vulnerable poor from organ trafficking.
  • To monitor organ and tissue transplant services and bring about policy and programme corrections/ changes whenever needed.

Establishment of National Organ and Tissue Transplant Organization (NOTTO)

National Organ and Tissue Transplant Organization (NOTTO) is a National level organization set up under Directorate General of Health Services, Ministry of Health and Family Welfare.

Establishment-of-National-Organ-and-Tissue-Transplant-Organization-(NOTTO)

Tamil Nadu Government`s initiatives

Tamil Nadu Government`s initiatives

Citizens, traffic police and government bodies come together in a concerted manner to create ‘Green corridors’, which are special routes created to enable harvested organs to reach the intended hospital waiting for it, as quickly as possible.

Possible Solutions

Possible Solutions

Conclusion

In a study done by Prof Harold J. Morowitz at the Yale University, he estimated that to create the human body, it would cost more than six thousand trillion dollars – that’s 77 times the GDP of the world and this is without the intuitive intelligence that we are all blessed with.

 

It is therefore important that people realise the enormity of the situation, its impact and many more people must step up for the cause of organ donation. India must create an enabling environment for organ donation and also acknowledge those who pledge their organs, as it will motivate others to follow.

 

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