Finally, after many a debate and discussion, the proposed amendments to the Transplantation of Human Organs Act will be presented in the Lok Sabha today, 5th August 2011.
This we hope will be a red letter day for the deceased organ donation programme in India provided the recommendations of the Parliamentary Standing Committee on Health and Family Welfare have been incorporated into the amendments. It would have a far-reaching impact on the status of lakhs of patients with chronic organ failure waiting for a transplant.
The proposed amendments presented to the Parliamentary committee last year covered both live organ donation as well as deceased organ donation. The key amendments are listed below:
1. To expand the definition of "near relative" in order to include the grandfather, grandmother, grandson and granddaughter as near relative.
2. To make it mandatory for the Intensive Care Unit or Treating Medical Staff to request relatives of brain dead patients for organ donation.
3. To enable a surgeon or a physician and an anesthetist or intensivist to be included in the medical board and expand the number of doctors besides neurosurgeon or neurologist for certification of brain death.
4. To regulate the transplantation of organs for foreign nationals, to prevent the exploitation of minors, to provide for Swap Donations of organs.
5. To constitute Advisory Committees to advise the Appropriate Authorities.
6. To establish a National Human Organs and Tissues Removal and Storage Network.
7. To appoint a "transplant coordinator" in all hospitals registered for organ retrieval and transplantation; and to provide for the registration of non-governmental organisations working in the field of organ retrieval, banking and transplantation.
8. To enhance the penalties provided under the Act. While the Parliamentary Committee was in concurrence with most of the amendments, it made some recommendations to make the amendments even more effective.
These include -
1. The appointment of a transplant coordinator would prove to be beneficial for the organ donation and transplantation programme. The task of required request and counselling should be assigned to the transplant coordinator having the required qualifications and professional training for the purpose and not a doctor.
No hospital shall be registered under the Act unless the Appropriate Authority is satisfied that the hospital has appointed a transplant coordinator having the required qualifications. The job of a transplant coordinator would be more of a counselor who is trained in dealing with human emotions and sentiments.
Note: This point has been amply proved by a pilot project in the Government General Hospital, Chennai in collaboration with MOHAN Foundation. Transplant coordinators from MOHAN Foundation have been instrumental in facilitating the retrieval of 213 organs and tissues from 38 deceased donors from February 2010 to July 2011.
2. The establishment of not only a National Human Organs and Tissues Removal and Storage Network but also a state level network. A thorough study of existing networks in Tamil Nadu, Maharashtra and Karnataka needs to be done.
3. The definition of payment to exclude cost of maintenance of brain dead donor, transportation of deceased donors between hospitals and for burial/cremation, costs of any recognition/award/benefit given to family of deceased donor.
4. To work with Ministry for Home Affairs to list priority of relatives who can give consent so that there is no ambiguity or delay.
5. Health Dept. to work with Home Dept. in making legal provisions so that organ retrieval and post-mortem can be done simultaneously.
6. Organ retrieval may be allowed in unregistered hospitals, but the retrieving team has to be from a registered hospital.
7. Mandatory to exercise the option of organ donation in the Biometric National ID card or exercise option of organ donation in driving license.
8. IEC campaign (Information, Education, Communication) on organ donation by Health Dept - pamphlets, ads, documentaries on TV channels, radio.
9. Compulsory in curriculum of schools and universities (HRD Ministry).
10. State governments to felicitate families of deceased organ donors).
11. National Organ Donor Day.
12. National toll-free helpline.