Following the Karnataka High Court ruling that the government cannot discriminate against adopted sons when it comes to compassionate appointments, some doctors in Karnataka are now asking whether the same yardstick can be applied in terms of organ donation too.
Why cannot an adopted child get an organ from adopted parents and vice versa similar to spousal donation? This is the question being raised by many. As of now, the Transplantation of Human Organs and Tissue Act (THOTA), 1994, does not allow this. Although a few States are learnt to have raised the issue with the National Organ and Tissue Transplant Organisation (NOTTO), Karnataka’s Organ Transplant Authorisation Committee has not come across any case seeking approval wherein an adopted child is involved.
NOTTO Director Krishan Kumar, who admitted that logically adopted children should also be included in the list of “near relatives”, said the organisation will discuss the subject in the Apex Technical Committee and with the Director General of Health Services (DGHS). “Subsequently, we will bring it before the Ministry of Law and if there is concurrence we can consider amending the Act,” he told The Hindu.
Sankaran Sundar, former chairman, Southern Chapter, Indian Society of Nephrology, who also heads the International Transplant Services at Manipal Hospitals, said an adopted child in Karnataka will not be considered a near relative as DNA fingerprinting and tissue typing is required. “The Authorisation Committee may give permission as we can prove affection but the point no one is answering is whether like spousal donation where only marriage certificate is enough and the spouse is considered a ‘near’ relative, can an adopted child also be considered as ‘near’ relative without approval from the Authorisation Committee,” he said.
“Even with spousal donation we are insisting on tissue typing with children to show that the child is common to the couple. This is not a legal requirement but we want to play safe to avoid marriage for donation,” he explained.
K.C. Gurudev, nephrologist and president of Ramaiah Memorial Hospital, argued that once someone is legally adopted, they are considered as first-degree relatives for all other legal procedures. “Hence this should not be an issue at all. I did a girl’s transplant 17 years ago in Mysuru. Surprisingly, the mother’s HLA did not match the daughter’s. The family later disclosed that the girl was adopted. I referred her to the then Authorisation Committee, which gave permission,” he said.
Need for caution
G.K. Venkatesh, former chairperson, State Authorisation Committee, said one should be careful to see when the adoption has happened. “There is a possibility that marriage/adoption may happen just for organ donation. We have seen a few such cases during my tenure. That is why the Act has such stringent rules,” he said.
Stating that the only way out is to legalise unrelated transplants with strict monitoring, the doctor pointed out that the government monitors payment to donors in some countries. “But that may not be possible in India,” he said.
H. Sudarshan Ballal, chairman of Manipal Hospitals, also emphasised that although donation by adopted children seems reasonable, there have to be checks and balances.