Facilitating hassle-free body and organ donation

Last month, a 63-year-old woman’s vital organs gave a new lease of life to five different patients in Pune, when her radiologist son permitted harvesting and transplant of his mother’s kidneys, eyes and liver, after she was declared brain-dead in Kolhapur, Maharashtra.

The very fact that we don’t see such news reports frequently indicates how rare these occurrences are. The concept of eye, organ or body donation has been around for several years, yet many bereaved families find it unthinkable to do so with the bodies of near ones, even if it is perceived as a noble cause.

First of all, amidst the grief and shock of death, body or organ donation is hardly the first thought that comes to mind. Secondly, even if it does occur to one particular family member, convincing others is an uphill task, because most people are still conditioned to think that organ harvesting or body donation is a kind of violation of the dead person’s dignity and mortal remains.

Linked to the same conditioning are religious and ritualistic aspects. A huge majority of people believe that unless last rites are properly performed, the deceased soul will never receive atonement and release.

But even assuming family members are progressive enough to get over these considerations, there remains the big practical hurdle of actually being able to organise organ or body donation, in the few hours following death.

Indeed, it is far easier to cremate or bury a loved one than to organise the donation, because family members simply cannot be expected to be in a frame of mind to ferret out requisite information and go through tedious procedures.

Last December, my uncle, award-winning Marathi author, Ravindra Desai passed away due to sudden cardiac arrest. Following in the footsteps of my grandmother, he too had expressed a wish that his body be donated for medical research.

However, he had not signed the requisite form and registered it with any medical institution. The private hospital where he had been rushed, in the late evening hours, had no idea how and where we could arrange for body donation.

One doctor helpfully made a few calls and informed us that we could take the body to Sassoon General Hospital, keep it in the morgue overnight and the next morning, the procedures would be completed.

The idea was not very appetising, since government hospitals suffer from reputation deficit, the perception of bureaucratic hassles, and more importantly, the eyes could not wait for the next morning to be harvested.

Fortunately, having gone through the entire procedure once before in the case of my grandmother, I got in touch with Armed Forces Medical College (AFMC) instead. We were connected to the head of department concerned, who immediately agreed to make necessary arrangements and instructed us to bring my uncle’s body along with the death-pass issued by municipal authorities.

By the time we reached AFMC, it was nearing midnight. A senior medical officer arrived soon after, examined the body and checked the documents. In the absence of a body donation form signed by my uncle, my father, as next of kin, completed the permission formalities, which were processed without hesitation or red-tape.

Since the eye-doctor had still not arrived to harvest the corneas, we had a further wait on hand. The senior medical officer took the opportunity to emphasise just how important body donation was, since medical colleges across India suffer a perennial, acute shortage of cadavers in good condition for the purposes of study and essential demos for medical students.

Indeed, it was sobering to learn that hardly 2–3 body donations were received at the institution every month – a miniscule figure. Eye donation figures were better, but still only a fraction of the requirement.

Black market rackets

The question therefore is, in a country where there are long waitlists for organ transplants leading to black market rackets or avoidable deaths, why is next to nothing being done to educate and encourage people to enlist as eye, organ or body donors?

Why is there no awareness creation and simplification of procedures to enable bereaved families to feel psychologically and emotionally comfortable in considering organ harvesting or body donations of loved ones?

It is a fact that getting the Indian society as a whole to embrace the concept is a long-term project that might require decades. But surely there is at least a tiny minority of progressive people even today, who might respond positively to the noble idea if made aware of its live-saving potential at the right moment and if the procedures are made donor-friendly and convenient.

Often, all it requires is one champion of the cause, like my grandmother Rukmini Desai, was in our family. With her body donation in 2011 when she passed away in her late 90s, she inspired several other family members and even friends and relatives, to consider what would otherwise have been unthinkable.

Sadly, a few exceptions apart, we don’t hear of too many Indian celebrities, sport icons, politicians and statesmen, leading businessmen and industrialists or notables from other walks of life pledge themselves to this cause by becoming registered donors.

Of course, philanthropy and altruism are by their very nature supposed to be deeply personal, voluntary acts and cannot be thrust on anyone, even if there is a crying need for something like organ and body donation.

That said, saving lives and furthering medical education are surely worthy objectives. So is it not possible for the medical fraternity and the state to at least develop a standard protocol, within ethical boundaries, of delicately suggesting and counselling bereaved families to consider organ harvesting or body-donation and making hassle-free arrangements available? Indeed, it just might make all the difference.

(Desai is a Pune-based author and filmmaker)