Centre eyes ‘presumed consent’ for cornea retrieval in hospital deaths
- Going by the new initiative, corneas could be retrieved from all citizens who die in hospitals without the consent of the family. This means that every person dying in a hospital would be presumed to be a cornea donor.
Highlights:
- The Ministry of Health and Family Welfare is considering amendments to the Transplantation of Human Organs and Tissues Act (THOTA), 1994. These amendments would allow the retrieval of corneas from all patients who die in hospitals across India, without requiring consent from the deceased's family.
Background and Need for Change:
- India faces a significant shortage of cornea donations, with only 50% of the demand being met. The proposed changes aim to increase cornea availability by making every hospital death a presumed cornea donation unless the person had opted out while alive.
Key Proposal: Presumed Consent System:
- Automatic Cornea Donation: Under the new system, all hospital deaths would result in automatic cornea donation unless the deceased had registered their unwillingness to donate during their lifetime.
- Opt-Out System: Those who do not wish to donate their corneas must register their opt-out status.
High-Level Meeting and Recommendations:
- A significant step towards this initiative was a meeting convened by Atul Goel, Director-General of Health Services (DGHS), in which various experts discussed the future of cornea donation, retrieval, and distribution. The DGHS suggested implementing a presumed consent system with an opt-out option to enhance cornea donation rates.
Training and Implementation:
- Compulsory Training: It was decided that all postgraduate trainees, resident doctors, and medical officers in eye departments must receive compulsory training in cornea/eye retrieval.
- Technician Training: States and Union Territories will implement training for technicians based on guidelines from the Eye Bank Standards of India, 2020.
- Coordination with National Programmes: The effort will be coordinated with the National Programme for Control of Blindness and the Directorate of Health Services.
Streamlining Procedures:
- Avoiding Delays: Experts recommended that post-mortem examinations should not delay cornea retrieval, especially since cornea removal neither disfigures the face of the deceased nor affects post-mortem findings. Delays in medico-legal cases often result in the loss of valuable time, making cornea retrieval impossible.
Experts Involved in the Discussion:
- Participants included notable experts such as:
- Anil Kumar, Director, National Organ and Tissue Transplant Organisation
- Radhika Tandon, National Eye Bank, AIIMS Delhi
- Sarita Beri, Director of Ophthalmology, Lady Hardinge Medical College, Delhi
- Namrata Sharma, Eye Bank Association of India, AIIMS Delhi
- Manisha Acharya, Director, Dr. Shroff’s Charity Eye Hospital
- Jaswant B. Mehta, Managing Trustee, Eye Bank Coordination and Research Centre.
Prelims Takeaways:
- Transplantation of Human Organs and Tissues Act (THOTA), 1994
- National Programme for Control of Blindness