Organ & Tissue Transplant- Policies, Technologies, etc.

[op-ed snap] Getting organ donation to tick againop-ed snap

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing much

Mains level : Organ Donation


Context

Organ donation day is observed with the primary objective of promoting organ donation and transplantation. This helps a number of persons suffering from organ failures, such as the kidneys and liver, as they can get a new lease of life using organs gifted by others who have lost their lives.

Undermining altruism

  • Certain negative perceptions appear to be growing and undermining the altruistic donation mindset of donor families. 
  • There is a steep drop seen in Kerala — from 76 deceased donors in 2015 to 8 in 2018.
  • This is due to a perceived scandal that private hospitals were declaring a person brain dead when they were not really so, to harvest their organs and profit from them.
  • The reasons are as below:
    • the highly privatized health-care system in India and the growing trust gap between patients and doctors in the tertiary care-seeking second and third opinion on patient treatment is commonplace today
  • Though an organ comes free, transplanting it to another person costs between ₹5 lakh and ₹25 lakh, including profit to the hospital. 
  • There will be an unavoidable suspicion that unethical practices may take place, as seen in a recently published book “Healers or Predators? Healthcare Corruption in India.”
  • A majority of accident victims who become donors are lower middle class and below. A majority of organ recipients are from the small number of persons who can afford transplant surgery and costly lifetime medication thereafter. 
  • The cost factor is the key reason why more than 3/4th of the donated hearts and lungs do not get taken.

Public hospitals cannot help

  • Very few public hospitals in the country do kidney transplants and less than five do liver and heart transplants. 
  • In a country where public spending on healthcare remains an abysmal 1.2% of GDP, priority should be on spending on areas that would benefit the greatest number of persons. 
  • A World Health Organisation Consultative Group in its 2014 report points to a study in Thailand which finds that money spent on dialysis can save 300 times more healthy life years if spent on tuberculosis control. 
  • It considers expansion of low- and medium-priority services before near-universal coverage of high priority services as an “unacceptable trade-off”.
  • It does not include dialysis or organ transplantation even in the low-priority category. 
  • If a given amount is spent on organ failure prevention, it will save many more lives than if spent on organ transplants.

Solutions

  • Regulate hospitals through acts and rules. The Transplantation of Human Organs Act, 1994 should be revisited for its effectiveness.
  • Substitution of bureaucratic procedures for hospital and transplant approval by self-declaration and mandatory sample verification involving civil society.
  • A further amendment is needed to ensure full State autonomy in this area. 
  • Avoiding the Central government’s interference in organ distribution, which is demotivating many hospitals. 
  • State organ distribution agencies need to make their operations fully transparent
  • Making online organ distribution norms and the full details on every organ donation will help build public confidence.
  • To tackle the feeling of “organs from poor to rich” moderation of the inequality in our country is needed. India figures in the top 10% of unequal countries in the world. It is among the top 10% of high proportion population spending more than 1/10th of their income on health.
  • Mandate that every third or fourth transplant done in a private hospital should be done free of cost to a public hospital patient.

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