There are two
aspects to the cultural acceptance of organ donation in India: public
acceptance and professional acceptance. Both are current impediments to
widespread knowledge about organ donation and deceased donor transplantation in
India today, but these impediments are surmountable.
many advantages of organ donation
Organs that can be donated include the heart, lungs, liver, kidneys, pancreas
and small bowel. Tissues that can be donated include corneas, heart valves,
blood vessels, bone, tendon and skin. A single deceased donor can save or
vastly improve the lives of more than 50 people. Hundreds of thousands of
Indians suffer from end stage organ failure of the heart, liver or kidneys due
to chronic diseases such as hypertension, diabetes and fatty liver disease. The
potential benefit to the transplant recipients is obvious. Perhaps less obvious
is the benefit to the deceased donor and the donor's family. The miraculous act
of organ and tissue donation brings profound meaning to the memory of the
donor's life and gives great comfort and closure to the family members in an
otherwise tragic situation. The donor lives on in others. This is reincarnation
in it's most literal sense, isn't it?
what really are the barriers to cultural acceptance of organ donation in India?
that religious beliefs constitute the toughest barrier to overcome for cultural
acceptance of organ donation in India, but there is much evidence to the
contrary and all major religious traditions (Hindu, Muslim, Jain, Sikh,
Christian, Zoroastrian and Buddhist) support an individual's decision to pledge
and/or become an organ donor. There remain, however, various levels of
acceptance based on one's religious affiliation. Most Muslims, Orthodox Jews,
and Confucian/Shinto Asians are unlikely to consent to organ donation, whereas
most Christians accept organ donation freely. Hindus, despite their strong
beliefs in reincarnation, often accept the idea of organ donation out of their
belief in Daan, or helping those who suffer. Jains and Sikhs are even more
welcoming of organ donation because of Daan.
objections" to organ donation often have more to do with one's education on the
subject rather than one's personal religious views. For example, organ and
tissue donation and transplantation are allowed according to the Supreme Council of Ulama in Riyadh's resolution (no.99 dated 6 Dhul Qa'dah 1402). A recent review of
70 fatwas by C van den Branden and Broeckaerton all supported organ donation.
Muslim families often consult with their Imams when confronted with a need for
organ donation and the Imams themselves may or may not be familiar with all
fatwas and impart only their personal opinions (which are, of course, duly
followed by the family). This lack of awareness can and does happen in any
religion, so focused and informed educational efforts must be undertaken for
each individual religious tradition.
is medically and legally recognized
in India as constituting actual death, despite the fact that the heart
continues to beat for a period of time even though the brain is dead.
Declaration of brain death can be difficult for lay people to understand and there
even exists widespread misunderstanding of brain death among physicians.
As in the
West, cultural acceptance of organ donation is age dependent in that young
people are far more likely than older people to embrace the idea of organ
donation, especially when presented with accurate education focused on youth.
There is a natural tendency for young people to want to help others and make
the world a better place. Organ donation, when explained properly, resonates
with youth as a just cause. Studies show that even those as young as 16 years
respond positively to organ donation efforts. If youth-focused education
campaigns are properly and systematically implemented, it is quite possible
that organ donation could become culturally accepted in India within one
professional acceptance of organ donation in India, especially among medical
professionals, is at present a more severe barrier to a general cultural
acceptance. Non-transplant medical professionals generally look upon transplant
with suspicion and tempered disdain. This is because transplant is currently an
economically driven affair in which recipients pay entirely for their
transplants and for their donors' surgeries. Because of this suspicion,
neurosurgeons, neurologists and critical care doctors are reluctant to declare
brain death, the absolute prerequisite to considering organ donation.
There is even
a curious reluctance among many transplant professionals in India to embrace
deceased donor transplantation and organ donation. Whether this is due to their
satisfaction with the current economic state of living organ donation
transplant, a reluctance to take on more work or a fear of legal retribution is
unclear and likely unknowable.
What needs to be made clear to everyone are the
benefits of organ donation and the donor transplant program in India
. First, transplant
volumes would greatly increase, allowing more people with end stage organ
failure to be transplanted. Second, transplant in India could become "democratized"
if sufficient deceased donor activity took place in the government hospital
setting. Here, even the poorest of Indians would have access to this life
saving endeavor. Finally, the possibility exists to cease, or at least greatly
temper, the illegal organ trade in India. If enough organs became available
from family consented brain dead individuals, then there would be no need for a
recipient to seek out a donor through illegal means.