There is an overwhelming need to make certain amendments in the THO Act to give momentum to the flagging cadaver transplant scene in India. In 1996 the Madras Bar Association had similar ideas. It formed a committee headed by the former Advocate General of Madras High Court and was called  the “Krishnamoorthy Committee” after his name. The committee members included Mr. Venkatapathy, Advocate General Of Tamil Nadu, Mr. M. Ravindran, President  of Madras Bar Association, Senior Standing Counsel for the Central Government, Mr.  V. T  Gopalan, Dr. S. S. Badrinath, Dr. P. C Reddy, Dr. K. M. Cherian and Dr. Sunil Shroff. After deliberations of over  6 months  and many meetings  a comprehensive  report was made out  to be presented to the Law ministry. Unfortunately, due to political upheavals and subsequent general elections this never happened. It is however  worth looking at the main gist of the recommendations: 

1.  Incentives to Organ Donor families by the government, like some rebate on insurance or Income Tax. Honouring organ donors posthumously during Republic or Independence Day celebrations.

2.   To remove corneal grafting from the purview of the Transplantation of Human Organs Act.

3.   Make it obligatory on the part of medical practioners to ask  the relatives for organs in event of diagnosis of “Brain Death”.

4.   A government machinery should be operational to create awareness about organ donation.

5.   Heart valve retrieval should be popularised to save the exchequer Rs 30,000 on imported valves. 

The above recommendation would go some way in helping  to successfully implement the Act. Beside the above recommendations there are two other simple additions  that can be made to the THO Act.  The first is to make organ donation in  “medico legal cases” (especially road traffic accidents) a simpler process by making it possible  for the “Forensic Surgeon” to be present  in the operating room during retrieval of organs. This would, in majority of the cases, do away with he painful process of formal  post mortem for the grieving relatives of the donor. (There is already a precedence of this being done in Scotland). The second is to include the organ donation clause on the Indian Driving License so that it can act as a substitute for the “Donor card”.

Certain other areas in the THO Act need clarifications. For example, who pays for the ‘Maintenance, and surgical  costs' (including Eurocollins or UW solution) of a brain dead donor once “Brain Death “ is diagnosed. Should the prospective recipients bear the costs or should it be borne by the hospitals. The act was formatted on lines of that of the UK where the National Health Service absorbs a lot of such costs, similarly in India too, if organ donation takes place in the Government  Hospitals this question is unlikely  to be an issue. However in India it is the Private Hospitals that have kept this programme alive and they require some guidelines from the THO Act. 

Most of the above mentioned recommendations are not likely to cost the Government any money to implement. The Indian transplant community had worked very hard to make the THO Act possible and it is now  very disappointing to see the cadaver  program flagging. The transplant community  should once again  lobby and push the Government for amendments in the Act . It is only then that the organ failure patients in our country can be benefitted from the THO Act of 1994.