Wednesday, May 22, 2002
Wednesday, May 22, 2002 |
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Karnataka-Bangalore
By Alladi Jayasri
This rule asks transplant centres to ensure that apart from possessing the wherewithal for performing transplants, related or unrelated, there should be a communication system in place. A social worker, a psychologist, and a neurologist should be at hand to help make the transplantation smooth and stress-free for the donor and the recipient. In a State where, over five years, the authorisation c ommittee that monitors unrelated transplants, actually facilitated over 1,014 such transplants, allowing itself to be swayed by emotional bonding between the donor and the recipient, it can only be expected that none of the five major hospitals where they were conducted seriously considered putting in place an ethics committee as a self-regulatory mechanism to ensure there was no trading in kidneys. The exception is the St. John's Hospital in the City . Two years ago, when "agents" touting kidneys for potential recipients were found conducting business out of PCOs on the hospital premises, St. John's became the first to say no to unrelated kidney transplants as a matter of principle.It also set up a six-member ethics committee to look into each application and scrutinise records of the donor to determine whether altruism was the driving force or any pecuniary benefits were likely to accrue to the donor. The rules are clear, the convenor of the committee told The Hindu on condition of anonymity, f or obvious reasons naming the members could make the committee vulnerable to appeals from patients and donors, as has happened with the a uthorisation c ommittee, which actually has patients appear before it stating their case. None of the six members must be a part of the transplantation team. In fact, the six include two clinical experts (from medical or paediatrics), two social workers, one pastor, a psychiatrist, and a clinical psychologist. When the case is brought before the committee, the six members, who shall remain unnamed, will look at the information provided and assess the donor as well as his close family member. There is a two-week "cooling-off" period, during which the members individually make their assessment. They look for anything that can confirm to them that the donation is indeed altruistic. They inquire to determine how well bond the relationship is. They make sure that everyone has understood the finer points of what is known as "informed consent", and that the donor is psychologically and emotional strong enough to accept that he will have to live with one kidney for the rest of his life. And finally, the six members give in their verdict. Like the Security Council, it is veto power that dictates the final decision. Even if one member says thumbs down, the committee brings in a negative decision, and the transplantation will not take place. The committee has had seven cases before it in two years, and four have been cleared. The committee meets regularly to update itself on developments in medical ethics. While St. John's shows, like a beacon, that ethical medical practices always pay, it doesn't seem to have impressed other hospitals much, where putting a price on human organs comes easier.
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