INDIAN EXPERIENCE WITH SOCIAL, MORAL & ETHICAL ISSUES OF ORGAN DONATION

Case Study 4: Marriage Squabbles (case discussed during brain death symposium held at CMC Vellore by MOHAN foundation)

 55-year-old diabetic hypertensive admitted with intra cerebral bleed. Declared brain dead on day 3. Family requested for eye donation on their own. On making solid organ donation request, family very willingly agreed. All preparation for organ retrieval made. Kidney recipients’ hopes raised with cross match on 3 patients being negative. Suddenly one member of the family claiming to be the first legal wife appears on the scene and flatly refuses for organ donation and creates a nasty scene. Other family members tell the doctors to ignore the wife and go ahead with their request. How will you approach the problem?

Summary of discussion

            Is she really the legal wife? Can she prove it? Can she produce a marriage certificate? These were some of the questions that were raised.    Since the primary person involved, i.e., the potential donor has no ability to give consent; the issue of prime importance is to establish the appropriate surrogate. If on the one hand, the rest of the family agrees, but the legal wife doesn’t and there appears to be a potential messy situation developing, it is better to stay away from such situation. Serious legal consequences may ensue if retrieval proceeds, unless the patient has left behind a written form giving consent and pre-stating that a particular person would be responsible for his\her decisions.

1)      Any donor may, in such manner and subject conditions as may be prescribed, authorize the removal before his death of any human organ of his body for therapeutic purposes.

2)      If any donor had, in writing and in the presence of two or more witnesses, unequivocally authorized at any time before his death the removal any human organ of his body after his death, for therapeutic purposes the person lawfully in possession of the dead body of the donor.

3)      The authority given under sub-section (1) or sub-section (2) or as the case may be sub-section (3) shall be sufficient warrant for the removal, but no such removal shall be made by any person other than the registered medical practitioner.