It takes lives to save lives.” ― Oscar Auliq-Ice
The ethical and moral issues created by current advances in organ transplantation, the issue of organ supply versus organ demand, and the appropriate allocation of available organs. It discusses the risks and benefits of organ donation from living people, appropriate and acceptable methods to enhance organ donation from deceased individuals through the application of the principle " presumptive consent", appropriate methods for providing acceptable appreciation and compensation to the bereaved family as well as voluntary and selfless donors, and duty and responsibility of medicine and society to help others.
Legislation known as the Human Organ Transplantation Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. In general, the law accepted brain death as a form of death and made organ selling a punishable offence. . In most cases, the implementation of the law is flawed and the provisions of the law are more often abused. On July 30, 2008, the government introduced several new amendments to the Official Gazette to end the organ trade. The ethics of organ donation trade and transplant tourism have been widely criticized by international bodies. With the acceptance of brain death, one can not only proceed with a kidney transplant but also can initiate other solid organ transplants such as liver, heart, lung and pancreas. Despite the THO Act, organ and kidney trafficking scandals are regularly reported in the Indian media. The legal and ethical principles we generally follow regarding organ donation and transplantation are also important for the future because they can be used to resolve our conflicts regarding new science. emerging as cloning, tissue engineering, and cells.
In the 18th century, researchers began to test organ transplants and they failed repeatedly and did not get the desired results. 2006 - The Institute of Medicine releases the report Organ Donation: Opportunities for Action. The report makes 17 recommendations on the ethical and social implications of ways to enhance and improve deceased organ donation. The scientific and technical advances that have led to successful organ transplants began just over a century ago and provide one of the most convincing documents in the history of medicine. This complex, multidisciplinary effort now save the lives of tens of thousands of patients worldwide each year, providing them and countless others who would otherwise be dependent on dialysis, insulin, or dialysis. nutrition with excellent long-term quality of life. This success is based on the efforts of a small number of independent doctors and scientists, who have worked tirelessly and with modest support to overcome what their colleagues see as impossible obstacles. overcome. However, especially between 1950 and 1980, they exploited every opportunity in the complex interplay of technical innovation, laboratory science, and empirical observation to bring their vision forward. their become mainstream. This involves breakthroughs in several key areas: vascularization techniques, efficient preservation of donor organs, laboratory and clinical evaluation of organ function, transient maintenance recipients by hemodialysis or cardiopulmonary bypass and safely suppress primary cell immunity. The advent of mechanical ventilation, the legal acceptance of the concept of brain death, and fundamental changes in social attitudes are also important. In the early 1980s, despite many failures, all of these were achieved and clinical outcomes were variable. Signs of success are the establishment of regulatory bodies, ensuring equitable distribution between agencies, appropriate standards of care, and monitoring and review of outcomes. The era of rapid expansion has begun, driving improvement and innovation that continues to this day.
Ever since the Indian transplant programme acquired the skill in the 1980s there has been exploitation of the donors from the lower-income groups. The usual scenario driving these poverty-stricken people is desperation for monetary payments. Some are under pressure from loan sharks and others to pay off for some major family costs (eg. Marriage). In many instances, once they have donated, these exploited individuals themselves act as middlemen to drive others in their community to kidney donation. Many transplant centres in the country receive letters or have people who walk into their clinics declaring that they wish to donate a kidney for money. Like child labour and prostitution, the ethics of organ donations is much more complex in our country and these are part of the corrupt fabric of our society. The country provides many hamlets of poverty that are fertile areas for any kind of exploitation. Organ commodification is, however, more serious exploitation as there can be an endangerment to health especially in the case of living liver donation. There have been at least two deaths of healthy young donors in the Liver programme and many donors have had long-term complications related to the donation process. The surgery for living kidney donation is safe with minimum morbidity with no long-term problems, however, it has been found in some studies that when the motive of donation has been purely commercial, donors in the postoperative recovery period have been more prone to ill-health. In comparison where the donation motive is pure altruism; there was more positivity in the process and recovery has been much better.
The THO Law, although passed 15 years ago, neither restricts the trade in organs nor helps promote a deceased donor program to address organ shortages. The gap between the number of organs available and the number of patients on the waiting list for a kidney transplant is widening globally. The high demand for the organ has led to its becoming a commodity, especially in countries with a large proportion of the population below the poverty line with weak regulatory agencies. As a result, transplant tourism has caused an uproar from many international organisations. In India, the potential for donations from the deceased is huge due to the high number of fatal road accidents and this reserve is still being exploited. Few committed hospitals and NGOs in the country have shown that donating to the deceased is a viable option. The ethics of kidney donation is important to society as it will serve as the basis for resolving many of the contradictions in the emerging regenerative sciences.
 National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779960/ (last visited Sept 22, 2021).
 OXFORD MEDICINE ONLINE, https://oxfordmedicine.com/view/10.1093/med/9780199651429.001.000 1/med-9780199651429-chapter-1 (last visited Sept 22, 2021)
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