This is in response to the article ‘Organ donation-looking beyond tokenism' written by Dr. Sunil Shroff and Dr. Sumana Navin (Open Page, June 10), in response to my earlier article, ‘Organ donation: is tokenism costing lives?' (Open Page, May 27, 2012).

The article, while endorsing many of the points I made (value of grief counsellors, ICU Forms asking for organ donation willingness, etc.), unfortunately distorts some of the key issues I raised. My central theme was that the present donation system in India is not working well enough and is heavily loaded in favour of the rich. The reason for suggesting a state-sponsored, paid programme, where the government pays the donor, is simply that it will make organs available to the poor as well.

Do the authors seriously believe that all non-related transplants, approved by the authorisation committees, are happening purely out of “affection and attachment” that the unrelated donor has for the recipient? Is it the poor or the rich who can afford to get total strangers to develop “affection and attachment” towards them? Does anyone seriously believe that there is no corruption involved or money being paid to these unrelated donors? Has there been a study done in India to find out the satisfaction levels in these unrelated donors years after the surgery?

The authors say that symbols and tokens inspire society. Perhaps they do. Try telling that to thousands of poor patients waiting for years for an organ and facing death every day that there are now organisations which are ready to inspire the youth and that though they cannot be saved some day their grandchildren may or may not have such difficulty in getting an organ for a transplant.

The authors have also not provided any hard facts to justify their claim that the PR exercise is working except to say that their own counsellors felt a change in patient family attitudes towards donation. How many donors carried Donor Cards? (Many is what is claimed-how many?). In any case, the total numbers are so distressingly too small to even draw any conclusions.

The system of “presumed consent” suggested, as in Spain, would be a disaster for patients in India where doctors could well prefer you dead to being alive as it by default makes your organs available for transplant even without your explicit consent. So they would stand to gain more by your death than by your continued existence. It is this hypocrisy that afflicts the organ donation programme. The present programme is not working well enough or fast enough for thousands of desperate patients. To say that things are fine is to condemn these voiceless poor people to a painful death.

By the way, in the U.S. in 2011, 2,242 organ donors were between the ages of 50 and 64 and 595 were over 65. So the issue that organs cannot be harvested from senior citizens is not entirely true though obviously the harvesting rates would be lower.(Source: U.S. Govt. Dept. of Health and Human Services- <http://www.organdonor. gov/about/statistics.html>)

Iran is not the only country that pays organ donors. Singapore and Israel also financially compensate donors. Many other countries plan to follow suit.

(The writer is a consultant in Internal medicine. He can be contacted at sumanthraman@vsnl.com)

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