Wednesday, February 21, 2024

Organ donors need to know outcomes of surgery

Organ donors need to be fully informed about all possible outcomes of a transplant which they are likely to experience after surgery, the Delhi High Court has remarked.

Justice Rajiv Shakdher, hearing a case on liver donation, said it would be appropriate if donors were informed about the possible outcomes of such an operation as “in such like cases, lack of informed consent could vitiate the entire process”.

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The court’s observation came on the plea of a 62-year-old woman awaiting a liver transplant. She had challenged a hospital’s decision not to allow the prospective donor to donate the organ.

Urmila Anand from Agra, suffering from chronic liver disease, has been undergoing treatment at the Indraprastha Apollo Hospital here and was advised to undergo immediate transplant. She had even found a willing donor, Gulab Devi, who has been associated with her family for 30 years.

Passing the judgement, the court said the authorisation committee of the hospital where the patient was admitted has to communicate post-operative changes to the donor.

“In matters like this, the donor needs to be fully informed about all possible outcomes of a transplant surgery. It is, therefore, necessary that this aspect of the matter should also be recorded,” Justice Shakdher said.

“In the video recorded by the authorisation committee (Indraprastha Apollo Hospital), I did not find that the authorisation committee had informed the donor as to the possible outcome(s) as also the post-operative changes that she is likely to experience upon such a surgery being performed on her,” the court said in an order passed last week.

The court also interviewed the prospective donor, Gulab Devi, and concluded that her decision to donate a part of her liver was not an informed decision.

It asked the appellate authority — Directorate General of Health Services (DGHS)– to tell her about the outcomes of the operation.

“In these circumstances, it would be appropriate if the appellate authority were to call the donor and inform her about the possible outcomes of such an operation; their assessment as to whether she has understood the possible outcomes of such an operation would be vital to the decision-making process.

In such like cases, lack of informed consent could vitiate the entire process,” said the court. The court also set aside the order of the DGHS and asked it to hear Anand personally in support of her appeal and decide the appeal in 10 days.

According to Anand, Devi had given consent to donate a part of her liver after her blood group matched that of Anand’s.
However, the authorisation committee of the hospital, which examines cases of organ donation by distant relatives, had rejected their request on the ground that the donation involved a commercial transaction.

Challenging the order, the patient’s son filed an appeal before the DGHS which rejected the appeal and backed the decision of the hospital.

Anand then approached the court. Talking to IANS, Anand’s lawyer Jitender Sethi said emergency cases of transplantation had to be done as early as possible, while the appellate authority took a long time in deciding these cases.

“(Union Minister) Vilasrao Deshmukh, who was awaiting liver and kidney transplants, died because he could not get donors on time,” said Sethi.

He said organ donation by Devi would be voluntary and out of love and affection.“We also produced family photos taken 30 years ago to prove the relationship between the donor and the recipient,” said Sethi.

According to the plea, the hospital rejected the donation request, saying there was financial disparity between the women, and ignored their bonding for 30 years and the no objection certificates issued by Uttar Pradesh Organ Transplantation Committee, the District Authorisation Committee of Agra and letters from a member of parliament and a mayor.

The blood groups of Anand’s two daughters and a son did not match with her group while Gulab Devi’s did.
Sethi said the Delhi High Court, in a recent ruling, had held that a request for donation of an organ could be considered on the basis of the love and affection between the donor and recipient, even when they were not related.

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