THIRUVANANTHAPURAM: Myths, misconceptions and opaque processes are hindering organ donations and transplants in the state, the International Workshop on Transplant Administration organised by Kerala Network for Organ Sharing (KNOS) and Government Medical College, Thiruvananthapuram, has observed. The observations are significant in the backdrop of KNOS, the state government’s nodal agency for organ retrieval and sharing, conceding that organ donation from the deceased is yet to pick up in the state.
Dr Sasikala K, head, Forensic Medicine Department, Government Medical College, Thiruvananthapuram, admitted that some wrongs were happening in organ donation and transplantation processes at private hospitals. “What usually happens in the private sector is that if there is a brain-dead patient and his/her relatives express their wish to donate the organs, the hospital then donates one organ to the government pool and the other they allot as per their wish. This is happening when there are strict guidelines regarding organ donation and transplantation,” said Dr Sasikala.
She added that private hospitals often eschew providing any explanation on why they had allotted a particular organ to a particular person. “These actions will only help generate suspicion among people and turn them against organ donation. Also, the lack of communication between a doctor and relatives of the brain-dead patient creates confusion. Incomplete documentation of the process related to organ donation including brain dead certification is another major concern,” added Dr Sasikala.
The forensic medicine head also said incomplete documentation including the issuance of brain dead certification would invite trouble for the doctors as they could be charged with causing death by negligence (Section 304 A of IPC) along with charges of grave medical negligence. At the same time, Health Minister K K Shailaja said at the workshop, “Conservatism persists in society. Due to that, some false beliefs like ‘life after death’ are also there. People believe that if they donate their loved one’s organs, it will create difficulties for them in their afterlife. Such misconceptions can be addressed only through awareness.” According to her, strategies will have to be put in place to increase organ donation in the state and for the same, a network will have to be established with international organisations in the organ donation and transplant domain. She added that awareness is also needed to address the misconception that there is a mafia of organ traders operating in the state.
Public fears remain, but doctors see good intention
Kochi: The new set of guidelines issued by the state health department towards certification of brain stem death has triggered apprehensions. The apprehensions among the public range from chances of an unsympathetic approach from hospitals to maintain life support to misuse of the guidelines by the organ donation mafia for organ harvesting.
However, many of the doctors said the new guidelines have been issued with good intention. According to Dr Mathew Jacob, transplant surgeon at Aster Medcity, hundreds of people die in road accidents and if the families of these persons agree to organ donation, several lives can be saved. “Of the 200 or 300 transplants that take place in hospitals in the state, the majority of them are live donors. Only a few donor transplantations from the deceased take place in Kerala. Records show that accident cases in the state are high. People should understand that just like cardiac arrest, brain death cases also have no hope of getting back to life,” said Dr Mathew.
However, with the film ‘Joseph’ and writer Benyamin’s book ‘Sarira Sasthram’, a lot of insights into the organ donation scam in Kerala were brought to light, which seriously affected organ donations in the state back in 2017. “Many movies and books to an extent have tried to depict the realities and happenings in society. Therefore, we also have apprehensions regarding the organ donation field. What happens to the brain death declared people is uncertain, especially in case of private hospitals,” said Raju V, a resident of Ernakulam.
“The doctors themselves have created the situation and deliberately attacked the system. There was a time when organ donations were above 200. It is because of the intervention of some doctors, though they are a minority, organ donation got bad publicity,” said a health department official. He also added that this does not mean that the kin’s consent will not be asked during organ donation. “The health department with the new guidelines has linked brain death cases and organ donation. The ultimate decision lies with the family as to what they have to do with their loved one’s body. Organ donations take place only through Kerala Network of Organ Sharing (KNOS),” he said. “In the case of brain deaths, two certifications are required six hours apart from a panel of four doctors. Two of these have to be doctors nominated by the appropriate authority of the government with one of the two being an expert in the field of neurology,” said Dr Mathew.