India to have presumed consent
In an attempt to tide over the massive shortage in organs for transplant, the government is planning to harvest the organs of all brain dead people in government hospitals - starting with the cornea - even without the consent of relatives.
This move, known globally as presumed consent, is aimed to prevent the illegal organ trade and will help thousands of people waiting for corneas to gain sight.
However, in case the brain dead person has earlier specifically stated that he or she is against organ donation, then the cornea will not be removed.
Health Minister Anbumani Ramadoss said the ministry is introducing presumed consent in three months. The concept is one of the amendments proposed in the Transplantation of Human Organs Act, 1994.
"We want people to learn about presumed consent first and that's why we will first start with the cornea. Then we will follow this with other organs," Ramadoss told IANS.
One of the major reasons for the health ministry to adopt presumed consent was the busting of the illegal kidney racket in Gurgaon, on the outskirts of Delhi, Jan 24.
Before deciding to impose the concept of presumed consent, health ministry officials visited countries like Spain, Belgium, France and Singapore to study the organ transplant laws there.
The team, headed by Director General of Health services R.K. Srivastava, suggested that India follow the Spanish model, where the presumed consent has led to increased donor rates.
Ramadoss said concerns were expressed in the US about presumed consent. In the US, 'required request' is followed in which it becomes mandatory for all hospitals when a death occurs to make a request to the next of kin to donate the organs.
The model in Iran was also found very novel. "There the government compensates anyone who voluntarily comes forward to donate their organs. The government also provides free organ transplant facilities whenever necessary," he said.
The health minister said the team found the Spain model the best.
"We are hopeful that presumed consent would lead to a huge increase in organ availability. But before we launch it we would create a lot of awareness among the populace. As we are introducing it first for cornea, people will get to know about the concept," he added.
To harvest organs, the health ministry will also set up 10 Organ Retrieval and Banking Organisations (ORBO), on the lines of the one at the All India Institute of Medical Sciences (AIIMS).
These ORBOs will be in cities like Kolkata, Mumbai, Chennai, Bangalore, Ahmedabad, Guwahati and Lucknow. These centres will coordinate swift retrieval, storage and transplantation of organs across all hospitals approved to do transplantations.
"The ORBOs will be linked up with ICU which will notify these centres about harvesting the organ -- first cornea, then other organs," he added.
The country has 109 eye banks. But of the 14,000 eyes that are collected, 30 percent are those that can't be used because of problems in tissue matching.
But under presumed consent, the organ will be harvested faster making tissue matching easier.
Welcoming the move to introduce presumed consent, Tanuja Joshi, past president of the Eye Bank Association of India, an umbrella body of all the eye banks in the country, said, "Going for presumed consent is a positive step."
"We will now be able to meet the demand for organs and tissues," Joshi, who is managing director of the Venu eye Institute and Research Centre, told IANS.
There is a backlog of 1.1 million corneally blind people in the country and every year 30,000 new cases come up, she added. "The annual collection of eyes in the whole country is about 28,000 eyes. With this concept there will be an increase in eye donations, which will reduce our problems," she said.
Most of those who are in dire need of an eye are children and young adults, she explained.