Stated consent

One of the frustrating realities in Indian healthcare is the gap between demand and supply of organs for transplant. Hundreds of thousands of patients wait for transplant of kidneys,lungs,hearts,liver,pancreas and corneas and their wait is stretched due to a combination of institutional delay and individual prejudice. On one hand,theres still no national registry of willing organ donors; on the other,many people still baulk at the very suggestion of cadaver donation. The governments energies,until now,have been directed at coming down on the booming black market in organ transplant,and regulating who may donate to whom. Belatedly,the government is now proposing steps to increase the availability of organs for transplant.

For instance,theres a proposal to widen the scope and definition,as well as regulation,of transplants with the Transplantation of Human Organs Amendment Bill 2009. This will allow for the transplant of tissues,apart from organs,and will include grandparents and grandchildren in the definition of near relatives. The health ministry also plans to have a column in driving licences allocated to reflect a persons willingness to donate vital organs. Given the absence of a registry,this would be a significant step.

However,in and of themselves,these incremental steps may not be enough to address the scarcity. The driving licence reform is based on the US example,and the records show that a large percentage of American drivers have not registered as donors. Many misconceptions surrounding organ donation and transplant are familiar to us in India,and its reported that some worry that doctors will not try hard to save their lives if they are seen to be potential donors. Therefore,greater attention is required to awareness programmes for both voluntary donations and what should be the eventual policy objective of presumed consent.