The kidney racket that was unearthed last week in Gurgaon and Faridabad, while shocking, will not push up many eyebrows. The police team from Moradabad that busted the case arrested several doctors who were involved in the criminal trade for years. This shows how deep its roots run, as urologist-turned-organ-traders solicit ‘orders’ for kidneys — and other organs — from patients who fly into India and are supplied with ‘matches’ obtained by swindling poor labourers.
For too long has this great Indian kidney bazaar gone on, with the poor induced to sell their body parts to meet the transplant needs of high-paying customers. Ironically, the chief problem in checking this illegal commerce seems to be loopholes in the very legal system that regulates organ transplantation in India: the Transplant of Human Organs Act (THO). While the Act proscribes monetary exchange between donors and recipients, its vague text allows would-be recipients to exploit the absence of any monitoring or enforcement mechanism. Most of the kidney scandals that haunt the country are evidently a result of patients and clinicians misusing this section of the law, which can, by default, be read as legal permission to do live unrelated transplants. No wonder this lets criminals abuse medical ethics and peddle organs at will for financial gain.
It is high time this aspect of the law was tightened, so that genuine cases could be helped. Transplants in the West were originally performed using organs from bodies where all functions had stopped. These often failed, as the organs are viable only for a short while after the heart stops beating. Although the concept of ‘brain death’ (where the brain is irreversibly damaged, but the heart beats) has now been more or less widely accepted, the idea is still frowned upon in India. The government should educate the public on the concepts of brain death and establish an Organ Retrieval Bank Organisation that could network hospitals for organ donations and coordinate transplantations. This is also a good time perhaps to speed up stem cell research that could solve the problems of non-availability of organs and delete forever the unacceptable trade in them.