The southern Indian state of Tamil Nadu has put in place rules that could facilitate transplantation of human organs and check exploitation of the poor.
Orders issued in January make it mandatory to declare brain deaths in all government medical college hospitals in the state capital of Chennai.
Transplantation of Human Organs Act, 1994 does not elaborate on the format for declaration of brain deaths or specify who all are authorized to declare brain deaths.
The recent orders say a duty doctor treating a patient can certify brain deaths. Besides, any registered medical practitioner can refer brain deaths to the head of the institution, resident medical officer, assistant resident medical officer or duty resident medical officer. A panel of doctors, and neurologist or neuro-surgeon nominated by the Director of Medical Services can also certify brain deaths.
A brain death is an irreversible condition in which all activities of the brain stem is stopped and the organs function with life-support system.
"Several brain dead have been kept on life-support systems ... that could have been utilised by other patients who are not in similar state and have a better chance of recovery," it has been pointed out.
By another set of orders, passed in May last, criminal cases may be filed against anyone submitting false records to the Authorisation Committee that clears live, unrelated organ donation.
All donors and recipients are now required to appear before the Authorisation Committee, even if they receive organs from relatives.
The Authorisation Committee is required to recommend to the Appropriate Authority to file criminal cases against the donors/recipients when false records are submitted.
In the case of minor recipients, the parents or guardians signing the fudged documents will be proceeded against.
The Authorisation Committee is also permitted to refer doubtful cases to the police or Revenue Department for further enquiry. The Revenue Department will check the bona fides of the individuals and the police will be asked to verify if doubts arise about the particulars furnished by the proposed donors.
The orders also prohibit a donor, rejected once by the Committee, from applying again.
The state health department has been forced to act after organised organ rackets were busted by various agencies time and again. Even tsunami victims were not spared by vested interests.
A senior city-based nephrologist was arrested by the Mumbai police in 2007. The department then realised that most documents, including those giving addresses and names of donors submitted to the authorisation committee were fake.
"Our aim to plug all lacunae and loopholes in the Act," said special secretary P W C Davidar. The meetings will also be videographed, the order said.
The Committee has also been authorised to give recognition (certification) to counselling institutions in the State to provide additional counselling support to live donors. Thus the need for such counselling is now acknowledged by the state government.