Can legalisation prevent fleecing of organ donors?

New Delhi: The busting of another huge organ racket involving two employees of the city's Apollo hospital has again brought to light the massive scarcity of organs required for transplant, which experts say can be overcome only by legalising living organ donation in exchange for money, or "commercial donors". Medical experts say the government was "not willing to even discuss the subject" of organ donation in exchange for money because it was apprehensive that poor people could take advantage of it lured by the monetary factor.

"Solution to such illegal organ racket is that the process should be legalised, but at the same time the government needs to ensure that the money to be received by the donor is directly transferred into his or her account, without any broker or middle man coming in between," M C Misra, Director of All India Institute of Medical Sciences (AIIMS), told IANS. Misra felt it was difficult to prevent illegal organ rackets as usually the top authorities of hospitals are involved. He said legalizing the process was the only solution or more such rackets could mushroom in the future.

"Legalising will at least prevent innocent poor people from getting exploited by the middlemen who do not pay them the promised money after they donate their kidneys or any other organ. A legal backing will help in doing away with the middleman factor," said Mishra, who is also chairman of the Renal Transplant Authorization Committee of AIIMS.

Police busted a major organ transplant racket last week with the arrest of five people, including two employees of Apollo Hospital. Police said the gang was involved in at least eight to 10 kidney transplants in the capital since January 2016, with each recipient paying Rs 25-30 lakh. However the poor donor received only 1-2 lakh.

In India, in every 15 minutes, a person is added to the long wait list for organ transplant. Every 10 minutes, a person dies waiting for an organ. Delhi, with a population of 9.8 million, saw only 14 organ donors in 2015, which is probably why families are increasingly turning to purchasing organs from "commercial donors".

Former Director of NOTTO (National Organ & Tissue Transplant Organisation) Saudan Singh, told IANS: "Yes, legalising organ donation in exchange for money is required, but the issue needs to be discussed by Parliament first. Currently doctors can't really do much about it. Today the situation is such that 90 per cent of the organ donation is happening by living donors, even if illegally, while cadaver donation which is legal happens only in around 5-10 per cent cases."

The 1994 Transplantation of Human Organ Act makes cadaver organ donation legal, but in the case of living organ donation it says that only the immediate family members of the recipient -- mother, father, brothers, sisters, son, daughter, and spouse can donate their organs. As per the rules, the immediate relative is required to provide proof of relation by genetic testing or by legal documents.

In case there is no first relative, the recipient and donor are required to seek special permission from the government appointed authorization committee and appear for an interview before the panel to prove that the motive of donation is purely out of altruism or affection for the recipient. While in Western countries around 70-80 per cent of people pledge their organs, in India only about 0.01 per cent do so. According to Voluntary Health Association of India, about 2,000 Indians sell a kidney every year.

D.S. Rana, Chairman Board of Management at Gangaram Hospital, told IANS that he was not in favour of legalising commercial organ donation. He felt that it would increase the exploitation of the poor. Rana, who is past president of the Indian society of Nephrology, said: "Only the poor will be affected. Instead the government should try to make the norms for transplantation more stringent."

By Rupesh Dutta