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Trending: Call for Papers Volume 3 | Issue 2: International Journal of Advanced Legal Research [ISSN: 2582-7340]

Ethical and Legal Issues of Organ Donation and Transplantation.

“Organ transplantation is an issue that must be dealt with sensitivity. Orienting society to accepting the ‘value of life after death’ will go a long way in strengthening transplantation as medical treatment. – Usha Raman 

 

INTRODUCTION 

In India, Kidney transplants was first started in the year of 1970s and since that time , India has become a foremost country in this field on Asia. Organ transplantation is not an experiment of some sort of science. For many diseases, organ transplant has become the quality method of treatment.

The major cause for necessitous performance of Organ Transplant program is absence of cognizance among public in which there is lack of organ donation , but also lack of cognizance, positive view and incentive amongst medical practitioners.

The Organ Transplantation is a blessing to medical field that has helped in saving millions of life’s. The legislation that regulates organ transplantation is The Transplantation of Human Organs Act, 1994 but still many problems arises due to lack of execution of policies and incomprehension of government in this field. 

WHAT IS ORGAN DONATION AND TRANSPLANTATION? 

• Organ Donation is a process of granting an organ who is in need for transplant. This donation of organ will definitely saves the life of person who receives the organ. Organ donation is an magnanimous act which save millions of lives in the UK every year.[1]

• Organ transplantation is a medical course of action in which an organ is removed from one body and replaced in the another body who has a damaged or missing organ.[2]

NEED FOR ORGAN DONATION AND TRANSPLANTATION 

• There are more organ transplant patients waiting all over the world. Regrettably there are only fewer donor organs available. Some people may die awaiting for an organ transplant. Some may wait in the hospitals for weeks or months, while others may visit the hospital for treatment every week.[3]

• More than 112,000 patients are in the National Transplant waiting list as of March 2020. Over 39,718 transplants were performed for patients in the year 2019.

• Over 20 people die each day waiting for an organ transplant. It is a need for Organ Donation and Transplantation in recent times.

• There is an amazing fact that one person can donate upto 8 lifesaving organs. [4]

ETHICAL ISSUES

The ethics for organ transplantation involves three conditions:
1. Medical Probity: Patients must be able to have some faith on doctors not to sacrifice the interest of one to another. Only individuals make sacrifices but not doctors.
2. Scientific Reasonableness: In each and every case the primary biology and technology must be adequately assured to offer a chance of favourable outcome.
3. Consent: The consent that donors give must be unforced and their willingness should be concerned.
Some of the Ethical issues that are involved in organ transplantation are beyond the boundaries of ethics. Some of the circumstances are causing ethical issues in organ transplantation are

§ When a donor is donating an organ or tissue it should not affect the health or body functions of the donor. 
§ The donation must be made unselfishness and the donation must be given without any pressure or coercion. 
§ The consent of spouse or children must be considered while donating an organ. 
§ Exploitation of organs must not happen in the case of donation. 
§ The next issue is ethical predicament of the physicians while deciding. Perhaps, Autonomy is the most common ethical predicament experienced during organ donation.[5]
• In relation to WHO Guiding Principles 9 and 11 three cases involve in ethical dilemmas. 
§ The first case involves in breach of deceased donor’s information and media reports. The media reported a donor’s information who was suffering in financial difficulty.[6] 
§ The second case deals with a request for directed but unqualified donation. In the second case the local authority allowed the directed donation to take place even if the donor’s name was not on the hospital’s transplant list. 

§ The third case deals with conditional donation. This case was repudiated by the local authority and the case went on appeal. In the third case the family of the deceased accepted to donate organ of the deceased but on the condition that if an organ was given to the deceased’s brother. In this case it requires the intervention of the national authority.[7]

LEGAL ISSUES IN ORGAN DONATION AND TRANSPLANTATION

• Organ trade has been a global phenomenon in both developed and developing countries. The major two central issues associated with organ trade are

1. the efficacy in executing current law and
2. financial needs that makes people to donate their organs.
• Organ trafficking is on the rise worldwide. Numerous brokers, doctors and hospitals engaged in this illegal trade have been featured in high-profile media.[8]
• Organ trade means trading of human organs for transplantation illegally in red market for profit.
• LEGAL RULES GOVERNING ORGAN DONATION AND TRANSPLANTATION:
§ The Transplantation of Human Organs and Tissues Act, 1994 was the first legislation enacted for transplantation and donation of human organs of a living donor or deceased person.[9]
§ OBJECTIVES OF THIS ACT:
• The basic objectives of this act is to avert trading and illegal donation or give any promotions to human organs.[10]
• According to Sec.18 (1) of this act any person who renders his services to or to at any hospital and who, for purposes of transplantation, conducts, associates with or helps in any matter in, the removal of any human organ without authority shall be punishable with imprisonment for a term which may extend to ten years and with fine which may extend upto twenty lakh rupees.[11]

• Before transplantation of human organs and tissues for purpose of removal or storage of such organs or tissues or both, as may be prescribed it shall be the authority and obligation of hospital to consult the entitled person.[12]

RECENT ISSUES REGARDING ORGAN DONATION AND TRANSPLANTATION

• There has been a sharp decline in the city for organ donations due to Covid – 19. According to Zonal Transplant Coordination Committee (ZTCC) data there has been 70% decline in organ donation between March and July.[13]

• In Asia the first bilateral lung transplant is performed on a patient of Covid- 19 at Chennai. This was the first transplant on Covid patient according to the MGM Healthcare facility in Chennai where the procedure was performed.[14]
• “ As the hospitals were busy in taking care of Covid-19 patients they didn’t have the capacity to be taking care of potential organ donors”, Givertz said.
• A Malaysian is ostensibly involved on organ trafficking by decoying poverty- stricken victims from around the world to sell their organs, according to report. A man had boasted to the UK paper that he had masterminded 45 illicit kidney sales the SUN reported.[15]
• Since organ transplantation surgeries have come to an almost halt during this Covid-19 , organ trafficking have temporarily declined. Due to ban in travels organ recipients are unable to travel abroad and access organs. As there is large number of unemployment many people are lured into selling of organ.[16]
• A man in west Bengal has been arrested for selling of kidney of his wife without knowing her. He has been charged for trading human organs and detaining a woman with criminal intention. Police reported that the man had sold the kidney to a businessman in Chhattisgarh.[17]
• Four people have been arrested in Lucknow for human organ trafficking. During the interrogation, the accused alleged that the used to lure people with money and alcohol and after their kidney has been removed they sell them at high prices outside the state.[18] 

CONCLUSION

• The major cause for encouragement of illegal trading in organ is unproductive implementation of laws. In recent years technological development in organ donation and transplantation has grown better. But unfortunately there are only less number of organ donations.

• Organ donation depends on decision of individuals if anyone wants to be an organ donor they can register to be an organ donor and must inform this decision to their family and health care agents.
• Medical tourism which has been cheap in India also a major cause for organ trading. The gap between the organ donors and organ recipients is widening globally. Only the rich people are able to afford organ transplantation but poor’s are lured only for organ sale.

• The ethics of organ donation has chief comportment on the society as this would form the fundamental aspect to solve conflicts in this regenerative society. 
This blog is authored by- Gowrav Hari Krishnan. P

[1]https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/faq/organ-donation-and-transplantation/
[2] https://www.britannica.com/science/transplant-surgery
[3]https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/organ-and-tissue-donation
[4]https://www.organdonor.gov/statistics-stories/statistics.html
[5]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779960/
[6]https://pdfs.journals.lww.com/transplantjournal/2018/07001/ethical_dilemmas_in_deceased_organ_donation_and.352.pdf
[7]https://pdfs.journals.lww.com/transplantjournal/2018/07001/ethical_dilemmas_in_deceased_organ_donation_and.352.pdf
[8]https://www.ajkd.org/article/S0272-6386%2809%2901177-9/abstract
[9]https://www.indiacode.nic.in/handle/123456789/1962?sam_handle=123456789/1362
[10]http://www.nhp.gov.in/donation-and-transplantation-of-human-organs-and-tissues_pg
[11]https://www.indiacode.nic.in/show-data?actid=AC_CEN_12_13_00014_199442_1517807323753&sectionId=6534&sectionno=18&orderno=23
[12]https://indiacode.nic.in/show-data?actid=AC_CEN_12_13_00014_199442_1517807323753&sectionId=6514&sectionno=3&orderno=3
[13]https://www.hindustantimes.com/mumbai-news/70-decline-in-organ-donations-in-mumbai-since-march-due-to-covid-19/story-JmE812Pw0dugJpnhyodNOM.html
[14]https://in.news.yahoo.com/chennai-doctors-perform-asias-first-113135786.html
[15]https://www.thestar.com.my/news/nation/2020/08/09/malaysian-allegedly-involved-in-organ-trafficking-says-report
[16]https://www.cfr.org/blog/evolution-human-trafficking-during-covid-19-pandemic
[17]https://www.ndtv.com/kolkata-news/bengal-man-arrested-for-selling-wifes-kidney-she-didnt-even-know-it-was-gone-1810546

[18]https://www.ndtv.com/lucknow-news/four-arrested-for-organ-trafficking-in-lucknow-572345 

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