Delhi High Court’s Recommendations on Organ Transplant Timelines

Context:

The Delhi High Court has suggested an optimal timeframe of 6-8 weeks for concluding organ transplant procedures involving living donors. In a directive to the government, the court emphasized the importance of adhering to specific timelines for every stage of organ donation applications, aligning with The Transplantation of Human Organs and Tissues (THOT) Act, 1994, and Transplantation of Human Organs and Tissues Rules, 2014 (THOT Rules).

Relevance:

GS II: Polity and Governance

Dimensions of the Article:

1. Provisions of the THOT Act, 1994
2. Provisions of the THOT Rules, 2014
3. High Court’s Decisions Regarding Organ Transplantation

Provisions of the THOT Act, 1994

• Regulation of Transplantation: The Transplantation of Human Organs and Tissues (THOT) Act, 1994, oversees the transplantation of human organs and tissues in India, encompassing both living and deceased donor scenarios.
• Regulations for Healthcare Providers: The law establishes stringent regulations for healthcare providers and hospitals, prescribing penalties for any violations in the organ transplantation process.
• Living and Deceased Donations: The Act permits organ transplants from deceased donors, facilitated by their relatives. Additionally, it allows living donations, primarily from close relatives, with provisions for altruistic donations from distant relatives or friends.
• Documentation for Living Donations: Living donations from close relatives, whether Indian or foreign, require thorough documentation, including identity proofs, family trees, and photographs establishing the donor-recipient relationship. Interviews of donors and recipients are also conducted.
• Scrutiny for Altruistic Donations: Altruistic donations from distant relatives or friends undergo additional scrutiny to ensure the absence of any financial transactions.
• Prevention of Illegal Dealings: To prevent illegal organ trade, donations from unrelated persons necessitate extensive documentation and photographic evidence, reviewed by an external committee.
• Penalties for Violations: The Act imposes strict penalties, including imprisonment of up to 10 years and fines up to Rs 1 crore, for offenses such as paying for organs, advertising organ transactions, and involvement in fraudulent document preparation.

Formation of NOTTO

National Organ and Tissue Transplant Organization (NOTTO):

• NOTTO is a national-level organization established under the Directorate General of Health Services, Ministry of Health and Family.
• Mandated by the Transplantation of Human Organs (Amendment) Act 2011, NOTTO serves as the apex center for coordinating and networking nationwide activities related to organ and tissue procurement, distribution, and transplantation.
• It also maintains a registry of organ and tissue donation and transplantation across the country.

Provisions of the THOT Rules, 2014

• Constitution of Authorisation Committee: Rule 7 of the 2014 Rules outlines the formation of the Authorisation Committee and delineates the nature of the inquiry and evaluation conducted by it.
• Prevention of Commercial Transactions: Rule 7(3) emphasizes that the Committee must ensure the absence of commercial transactions in cases where the donor and recipient are not near relatives.
• Expedited Evaluation in Critical Conditions: Rule 7(5) permits an expedited evaluation process if the recipient is in a critical condition requiring transplantation within a week. Hospitals can be approached for accelerated assessment in such cases.
• Application Process for Living Donor Transplantations: Rule 10 details the application process for living donor transplantations, requiring joint applications from both the donor and recipient.
• Personal Interview and Eligibility Determination: Rule 21 mandates the Committee to conduct personal interviews with applicants to assess their eligibility for donation, ensuring compliance with ethical standards.

Role and Composition of the Authorisation Committee

• Overview: The Authorisation Committee is responsible for overseeing and approving organ transplant procedures involving donors and recipients who are not near relatives, particularly in cases driven by reasons of affection, attachment, or special circumstances.
• Composition: As per Section 9(4) of the Act,1994, the composition of the Authorisation Committee is prescribed by the Central Government. State governments and Union Territories are mandated to constitute one or more Authorisation Committees with nominated members.
• Powers and Inquiry: Under Section 9(5), the Committee conducts a thorough inquiry during the review of transplant applications. The inquiry verifies the authenticity of the donor and recipient, ensuring that the donation is not motivated by commercial interests.
• Role in Rule Formation: Section 24 of the Act grants the Centre the authority to make rules, subject to parliamentary approval, for various purposes of the Act. This includes rules related to donor authorization, certification of brain-stem death, preservation of removed organs, and other essential aspects of organ transplantation.

High Court’s Decisions Regarding Organ Transplantation

• Formation of Authorisation Committees: The Act mandates state governments and Union Territories to establish one or more authorisation committees, comprising nominated members, ensuring the integrity and effectiveness of organ transplantation protocols.
• Timeline for Processing Applications: The high court stresses the importance of adhering to a timeline for living donor transplantation applications, setting a maximum processing duration of 10 days from the application date.
• Document Verification Period: Within a maximum of 14 days, the court mandates the verification of documents related to the domicile status of the recipient and donor, with any documentation opportunities communicated within the prescribed timeline under the Rules.
• Interview Scheduling: After four to six weeks of application receipt, interviews should be scheduled within two weeks. The committee is responsible for conducting interviews, facilitating family meetings, and communicating decisions within this timeframe.
• Overall Process Duration: The court emphasizes that the entire process, spanning from submission to decision, should ideally not exceed six to eight weeks, ensuring efficiency in the organ donation approval process.
• Submission of Judgment: The high court directs the presentation of the judgment to the Secretary, Ministry of Health and Family Welfare, ensuring the prescription of timelines for all steps in considering organ donation applications after consulting relevant stakeholders.

-Source: Indian Express