CHENNAI: If the blood relative of a brain-dead patient is in need of a vital organ, can the family who is willing to sign papers for donation
demand that the organ be given to the relative? Is the doctor or hospital coordinating a cadaver organ donation liable if the organ retrieved loses it vitality? If the organs of a brain-dead person, the result of a road accident, is removed, will it mean tampering with evidence in a medico-legal case?

These and other related questions came up for a detailed discussion on Saturday when doctors from at least 50 hospitals in Tamil Nadu, mostly licensed transplant centres, met officials from the state health department at a workshop on cadaveric transplantation in Tamil Nadu’, organised by the director of medical services and rural health. The workshop was organised to discuss the Transplant of Human Organs Act 1994 and a series of government orders issued by the health department since January 2008 to promote cadaver transplant.

Over the past six months, the state has seen a rapid increase in organ donation. Forty kidneys, 14 livers, six hearts, 26 corneas, 14 heart valves and skin were harvested from 20 cadavers. Health secretary V K Subburaj said that the meeting was called to discuss problems the network faced in the last six months. “We are sure in the next few months we would be able to streamline the system for cadaver organ donation that would possibly reduce the need for any live donors,” he said.

IT secretary PWC Davidar, instrumental in issuing the government orders (GOs) while he was in the health department, discussed the GOs. “These are not just a set of rules written to be filed as orders. We want every hospital to certify brain death,” he said.

One city-based doctor wanted to know if the donor’s relatives had the right to dictate who the recipient should be. “In one case, the donor’s brother was blind and was waiting for a corneal transplant. They were willing to donate all the organs but requested that one eye be used for his brother. It was tricky situation and we did not know how to handle it,” he said.

Most government officials were for hospitals remaining firm. “With the present rules we don’t have provisions for that. We only encourage voluntary donation with no strings attached,” said Dr J Amalorpavanathan, convenor, cadaver transplant programme.

After hearing out narrations of several incidents, Davidar said that the department would look at options such as passing government orders that could deal with such special situations. “Sometimes, when the donor’s blood relative is in need of an organ, we will have to work it out as well,” he said. “We are also working on orders for organ transplant in medico-legal cases,” he said.

Presently, doctors take in only those cases where the cause of death is ascertained as a road accident. “We also take written consent from the investigating officer that the organ donation will not hamper investigations,” said Dr Amalorpavanathan.

Doctors clarified that no doctor or hospital was legally bound for the viability of the organs before or after transplants. Hospitals agreed to pay Rs 10,000 as annual fee for being a part of the organ sharing network. They decided that a website giving limited information about organ donation and organ sharing would help the public and ensure patient confidentiality.