Inadequate laws for organ donation in India and lack of knowledge about what to do to donate one’s body parts after death, keep even supportive people from making a legally binding commitment.
For instance, few people know that they can mention it in their wills that their body parts such as kidneys, liver and eyes should be donated after death.
Experts say making it mandatory for all people to express a choice in the matter of organ donation, would increase donations and go a long way towards meeting the shortage of organs for transplant.
With the world celebrating the Sixth (India’s first) International Organ Donation Day on November 28, it may be educative to examine what other countries have done to promote organ donation.
Many countries have adopted a ‘presumed consent’ policy and have passed laws for its implementation. Under this policy, the state presumes that a deceased citizen has said yes to organ donation, unless he has opted out by mentioning this in a legally accepted document.
Dr Sunil Shroff, head of the department of urology and renal transplantation at Sri Ramachandra Medical College and Research Institute in Chennai, said that under ‘presumed consent’ law, the consent of family members is not required. In the event of a person’s death, his/her organs can be retrieved without delay.
The ‘presumed consent’ law was first passed in 1989 by Spain which, till then, had one of the lowest organ donation rates in the world. But thanks to the law, it now has the best organ procurement programme in the world.
Today, Spain has 34 per million person donation rate, despite the fact that it has one of the lowest incidence of road mishaps in the European Union. In contrast, India has just 0.1 per million person donation rate.
The ‘presumed consent’ law now exists in Belgium, Austria, Finland, France, Norway, Spain and Singapore and UK, too, may pass the law soon. Dr HL Trivedi of the Institute of Kidney Disease and Research Centre (IKDRC), Ahmedabad, said the law had led to a dramatic increase in donations in these countries.
"The law has, to a large extent, helped these nations overcome their shortage of organs for donation," Trivedi said.
Dr Shroff, however, said that legislation of a 'presumed consent' law is unlikely to be accepted in India "India has not yet reached that level of awareness that makes organ donation from cadavers a routine matter," he said. "Hence such a law would not help us."
Some other countries, however, have made it mandatory for their citizens to make a choice whether or not they wanted their organs to be donated.
The 'mandatory choice' legislation has been in place in Sweden and Denmark since 1996. Because of this law, Sweden's potential national donor registry has swelled by 6 lakh and Denmark's has increased by 1.5 lakh.
Medical experts are of the view that India, too, should make it mandatory for citizens to declare their choice regarding donation of their organs for transplantation. This can be done by registering with a national body or expressing a choice during issue of important documents such as driving license or national identity card or passport, experts said.
They, however, added that even for 'mandatory declaration' to succeed, there is an urgent need to raise the level of awareness of organ donation in this country.