Indian Transplant Newsletter. Vol.1 Issue No.3. June 1999
Urology Conference at Bhubaneswar discusses Cadaver Transplantation Issues
Indian Transplant Newsletter.
Vol.1 Issue No.3. June 1999
Print ISSN 0972 - 1568
A similar symposium on Cadaver Renal Transplants was organised earlier in the month of January at the Annual conference of The Urological Society of India at Bhubaneswar. The following doctors participated in the symposium covering the various issues of cadaver transplant in India: Dr. S. Punekar, Dr. S. Shah, Dr. S. Subramanian, Dr. S. Varadarajan, Dr. S. S. Joshi, Dr. Gopalakrishnan.
Dr. A. P. Pandey, has sent us the following summary of his views on the cadaver issues in India:
“Today, thousands of patients are waiting in line for organs and the number of patients dying while waiting is increasing. Statistics reveal the sad fact that only 31% of the total potential for organ donation is realised. A lot of this is still due to managerial and technical hurdles. However, the next most major reason is refusal to donate. This is the factor that needs to be addressed urgently.
There are several reasons why relatives refuse consent. The concept of brain death is difficult to explain, especially to an illiterate person when they can still see the heart beat and the lungs breathe artificially. There is always a fear that once consent for donation is given, the health team may not do their best to save the life of the potential donor. The inherent mistrust is more in places where the ordinary man regards his health care system with suspicion.
Unless the wish to donate has been made clear during life, the relatives on whom the onus of responsibility rests are always in a dilemma as to whether they are doing what the deceased would have wanted. Besides which, the decision comes at a time when they are already struggling to cope with the grief of losing a loved one.
In India, we still follow a system of “opting in” for organ donations, which means that an individual must voluntarily express his willingness to donate his organs. Many people fail to do this only because they can’t be bothered with the formalities and paper work that this may involve. In western countries a system of ‘opting out’ is followed. After death the relatives have only to confirm the wishes of the deceased. Relatives give their approval when they feel they are just endorsing the wishes of their loved one.
Another movement towards gaining more organ donors comes in the form of financial incentives. In the US, this is being actively considered by several groups. Suggestions include the setting up of a fixed fee for donor’s families, paying of funeral expenses for the donor and a life insurance scheme which contain a reimbursement for families of donors. I am personally against financial incentives because majority of people still feel that “conscience and not cash” should be the incentive for organ donation.
The need of the hour is to spread information about organ donation and how exactly a person may go about pledging his organs after his death. We should harness the strength of celebrities, involving more stars of both films and television, to endorse organ donation. Television is a powerful medium in our country and it could be used to spread the message of organ donation to the masses.
Organisations like scouts and guides can play an active part. The youth can help people fill up forms to pledge organs thereby saving them a lot of the hassle associated with paper work. This is of even more significance in poorer and illiterate areas of the country.
Finally, doctors and health teams involved in organ transplantation should play an active role in the procurement of organs as well as generating and improving public awareness in organ donation.”
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- Keywords: Dr. A. P. Pandey, CMC, Vellore, on Cadaver Renal Transplants