New Delhi|HL
The law was passed two years ago but it was only last week that IMA issued a circular, instructing its 2.5 lakh member-doctors to ensure that families of those dying in a hospital or at home are given the option to donate organs -the corneas, at least.

In what could be a turning point for cadaver organ transplant, the Indian Medical Association (IMA) has asked doctors to mandatorily request every brain-dead patient’s kin to donate organs. And the next step could be putting in place a system where organs from a brain-dead patient are mandatorily harvested unless the family denies this in writing.

This measure, dubbed `required request’, could speed up organ donation -which has been painfully slow in taking off in most parts of the country, particularly Bengal in just a year, the IMA feels.

It has been seen most families don’t know they can donate their dead kin’s organs.

The apex body of doctors could follow up by placing the onus of refusal on the patients’ families, said K K Aggarwal, IMA secretary general. “In the first phase of our drive to popularize organ donation, we are emphasizing on increasing awareness. The second phase could see a more intense effort, where cadaver organs will be extracted unless there’s a formal request against it. But the first phase is more critical because people need to know about organ donation and should be given the choice to go ahead with it.” Considering the number of brain deaths in India, the volume of organs that can be generated is huge. `Required request’ is mandated by law, but rarely happens. Once it is done as a rule, cadaver donation will shoot up dramatically,” said K K Aggarwal, IMA secretary general.

Less than 10% of brain-dead patients’ families are counselled or requested to donate organs, say doctors. Last week, a brain-dead woman’s kidneys and corneas were extracted and transplanted in Kolkata after her relatives spent four days getting past red tape. It was the first ever cadaver donation in Bengal. “This indicates that the time has come to move ahead. The obvious next step is to make more people aware of organ donation and that it can be done easily. Even if the majority refuse, there will obviously be a substantial number who will agree to it. Whatever the number, there will be an increase in the number of organs available for donation,” said Aggarwal.

The medical fraternity in Kolkata hailed the decision. But it should not be a mere formality and families should be counselled properly , said Diptendra Sarkar, HoD, breast cancer department, Institute of Post-Graduate Medical Education and Research. “At least five minutes should be devoted to explaining the importance and necessity of the procedure to kin. More importantly, the infrastructure to extract and transplant organs should be ready,” said Sarkar.

Oncologist Gautam Mukhopadhyay felt ‘required request’ should have been implemented by now. “Since we have a law, it should have been a practice by now. But better late than never. Organ donation can never be mandatory and we can definitely have more donating organs,” he said.

One of the reasons why doctors refrain from counselling patients is the apprehension that organs will be misused.”Other than the social prejudice, many fear that hospitals extract organs to sell them,” said Rajendra Pandey, head of nephrology at SSKM Hospital, who was involved in last week’s organ transplant.

The IMA, said Aggarwal, is not worried about the impact of ‘required request’. “It is an experimental first step and whatever change it makes will be a bonus. Depending on the impact, we will form our subsequent strategy. But in the next phase, we will definitely push harder for it, putting the onus of refusing to donate on the patients’ kin,” he said.
Inputs:TOI

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