KARACHI– A two-day conference and workshop on deceased organ donation and curbing the menace of commercial trade of human organs, was heldat Sindh Institute of Urology and Transplantation (SIUT).
The briefing was held by the Coordination Committee, appointed by Supreme Court of Pakistan including, Secretary Law & Justice Commission of Pakistan, Additional Attorney General Pakistan and Prof Adeeb Rizvi, himself.
It was concluded that, the most effective way to curb the commercialization and sale of organs and tissues is to proactively promote the donation of organs to be harvested from persons certified as brain dead, in accordance with certain protocols that are internationally accepted and are credible to the family of the deceased donor.
The National and Provincial Registries were urged to establish at state expense to create a deceased donor data base and bank of potential recipients, prescribed with methods for safe and efficient harvesting of organs. A transparent system for their equitable allocation and transplantation needs to be put in place. The state should support all the public hospitals in providing transplantation, free of cost, to all patients and provide lifelong care to donors and recipients.
The Working Group recommended that the state should institute mechanisms that enable all citizens that are willing to join the deceased donor program, to exercise compassion. Moreover, deceased donors and their families should be publicly recognized and should be honored by medals and certificates.
Recognizing that the state is bound to ameliorate poverty and exploitation that compels a person to agree to sale his or her organs, therefore it is recommended that the victims should come forward as whistle blowers; and the law enforcing agencies and prosecutors must take an action against this awful business.
Law enforcing agencies have expressed their frustration at the provisions of Federal and Provincial laws on transplantation dealing with the cognizance of offences under the respective Federal and Provincial Acts. The Monitoring Authority must ensure that it acts with all deliberate speed while dealing with complaints brought to its knowledge from any source, particularly from the vigilance committees of various law enforcing agencies, and that suitable Rules be framed to prescribe the manner of filing complaints with the Monitoring authority and for their expeditious disposal.
The Working Group recommended that transplant activities conducted at places other than establishments recognized under the Transplantation Acts and Rules, should be punished under the regular penal laws and for that purpose an additional section must be added in the Pakistan Penal Code, by an amendment made by Parliament in exercise of power under Article 142 of the Constitution as follows:
“374A- Punishment for commercial dealings in human organ and tissue / cells -Whoever, -(a) makes or receives any payment for the supply of, or for an offer to supply, any human organs and tissue / cells.
(b) seeks to find a person willing to supply for payment of any human organ;
(c) offers to supply any human organ, tissue / cells for payment;
(d) initiates or negotiates any arrangement involving the making of any payment for the supply of, or for an offer to supply any human organ-
(i) takes part in the management or control of a body of persons, whether a society, firm, or company, whose activities consist of or include the initiation or negotiation of any arrangement referred to in clause (d); or
(ii) publishes or distributes or causes to be published or distributed any advertisement, –
(a) inviting persons to supply for payment of any human organ and tissue / cells;
(b) offering to supply any human organ and tissue / cells for payment; or
(c) indicating that the advertiser is willing to initiate or negotiate any arrangement referred to in clause (d); shall be punished with imprisonment for a term, which may extend to 14 years and fine that may extend to 10 million rupees.
An appropriate amendment be made in Schedule II to the Code of Criminal Procedure making such offence non-compoundable, non-bail-able and cognizable and to the schedule of the FIA act.
The monitoring authority while granting registration or renewal, should reserve the right to review the amount charged by a registered establishment according to prescribed criteria and to audit the transplant data and accounts maintained by the establishment. These authorities must obtain a No-Objection Certificate of the relevant healthcare commission.
In case of brain dead donors, the respective police surgeons should follow guidelines before removing organs, in situations where medico legal cases are pending.
For the effective implementation of the transplant law the law enforcing agencies, hospitals and civil society organizations, a vigilant committee should be established to take immediate action and promptly coordinate with secretary of the monitoring authority, and complaints must be disposed off within 24 hours. Round the clock call centers should be present, so that violation can be reported instantly.
Registration and recognition should be in respect to designated premises where organs and tissue / cells may be removed or transplanted. Fresh registration shall be required where ever a new establishment opens, changes or adds to its place of operation.
All monitoring authorities should ensure that the evaluation committees of the recognized establishments enjoy credibility and periodically audit their decisions.