The Institute of Medicine & Law (IML) conducted a panel discussion as part of its National MedLegal Awareness Campaign on organ donation virtual series on 19th January 2021 in Kochi, Kerala. This was the third such panel discussion, the first and second panel discussions were held in Ahmedabad and Hyderabad respectively. The panel discussion primarily featured doctors and patients from different parts of Kerala. Dr. Sumana Navin, Course Director, MOHAN Foundation was also a panelist. The guest of honour was Hon’ble Justice Ravi Tripathi.
Mr. Ravindra Mangal, Executive Director, IML gave the welcome address. Justice Tripathi in his opening remarks emphasised that in the sphere of public awareness superstitions about organ donation should be addressed, the influence of religious leaders was enormous and their help should be sought in spreading the word about organ donation. He said that doctors should feel protected with regard to their bonafide actions.
The panel discussion was moderated by Mr. Sunder Rajan, CEO, IML. The patient viewpoint on the need to lessen paperwork in living donation and transplantation was put forth forcefully by Mr. Vinu Nair, a liver transplant recipient. Mr. Nair is also a part of an association called the Liver Foundation of Kerala that has made a representation to the government to provide immunosuppressants to poor patients either free or at a reduced cost. Mrs. Manju, wife of a patient Mr. Raju said that he was waiting for a liver transplant due to lack of a donor and lack of information regarding availability of financial aid for poor patients.
Dr. Noble Gracious, Nodal Officer, Kerala Network for Organ Sharing said that the Kerala government was working towards simplifying the living organ donation paperwork within the ambit of the law. He also gave information on the financial aid available through government schemes for patients waiting for a transplant and added that the liver transplant programme would start in the government sector in a couple of months. Dr. Rajeev Jayadevan, Senior Consultant Gastroenterologist and Deputy Medical Director, Sunrise Hospital, Kochi, and President, Indian Medical Association, Kochi elaborated on the enormous harm that films had done to the deceased donation programme in Kerala. A case in point was the Malayalam film ‘Joseph’ that portrayed road traffic accidents being staged to make people brain dead so that their organs could be used for transplantation. He said that negative publicity far outweighed any attempts at positive publicity to contain the damage, and that it was important for key opinion leaders (KOLs) to speak about negative and false portrayal of medical facts.
Dr. Sumana Navin spoke about the need for training neuro and intensive care teams in brain-stem death certification and donor optimisation. Transplant coordinators also needed to be trained in the various aspects of living and deceased donation and transplantation. However, the need of the hour was to work towards a ‘Uniform definition of death’ in the Registration of Births and Death Act, 1969. Doctors needed the freedom to practice medicine without fear especially in the context of certifying brain-stem death and lawmakers could offer that clarity. On the public front, she said that unhealthy lifestyles rendered people unfit to donate organs. Mr. Saju Kurian, Advisor of Lions Club District 318C, concurred with Dr. Sumana and said that education about a healthy lifestyle should start in schools. He added that people should be made aware that only organs of a certain quality are acceptable for donation.
Finally, the legal viewpoint was presented by Mr. Mahendrakumar Bajpai, Advocate, Supreme Court of India Standing Counsel, and Hon. Director, Institute of Medicine & Law. He said that the nation needed a central law on uniform definition of death. Organ donation and brain-stem death should be decoupled and that is what the Kerala and Gujarat Governments had done. With regard to organ donation in medicolegal cases, he explained that it was important for the police to understand that they had the discretion to seek a post-mortem in such cases (e.g., road traffic accidents). Also, while donation from unclaimed bodies was permitted, there was no procedure in place. Specific rules needed to be laid down to enable deceased donation to proceed smoothly in all these circumstances.
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