Legal aspects of transplantation in India

Abstract

The shortage of organ donors for patients with end-stage organ diseases requiring transplant is a global problem. This led to organ trafficking with exploitation of poor people who were made to sell their organs. To address the issue of organ trafficking and to ensure fair allocation of organs from cadaver donors, most countries have passed laws to regulate transplants. In India, the law (THE TRANSPLANTATION OF HUMAN ORGANS ACT, 1994) was passed in 1994 and the rules framed in 1995. The most important aspect of the Act was that it legalized brain-stem death as death allowing organs to be retrieved from brain-stem dead patients. Other important aspects of the Act include the following: (1) regulation of removal of organ/s for transplantation from cadaver donors, (2) regulation of removal of organ from living donors, (3) regulation of hospitals, (4) regulation of medical practitioners, and (5) punishment for those flouting the Act. The Act has significantly regulated living and cadaver donor transplant but made the process of obtaining approval for living donor transplant difficult even in genuine-related cases. Swap transplant or paired donation between related pairs is treated as unrelated donor transplant, making the process of obtaining approval very lengthy and tedious. For reasons that cannot be understood, although living unrelated transplant can be performed if there is no commercial dealing, swap transplant between unrelated pairs is not permitted. Punishment is harsh for anyone who contravenes any provision of the Act and unfortunately, transplant team doctors are made liable in most cases.