KARACHI:At the end of two-day conference and workshop on deceased organ donation and curbing menace of commercial trade of human organs, a press briefing was held at Sindh Institute of Urology and Transplantation (SIUT).
The briefing was held by coordination committee appointed by Supreme Court of Pakistan included Secretary Law & justice commission of Pakistan, Additional Attorney General of Pakistan and Prof Adib Rizvi Following recommendations were unanimously adopted by this working group.
That the most effective way to curb the commercialization and the sale of organs and tissues is for the state, civil society, medical practitioners and health care providers to proactively promote the donation of organs to be harvested from persons certified as brain dead in accordance with protocols that are internationally accepted and are credible to the family of the deceased donor and for that purpose urges that National and Provincial Registries be established at state expense to create a deceased donor data base and bank, a data base of potential recipients and to prescribe methods for the safe and efficient harvesting of such organs.
At the same time a transparent system for their equitable allocation and transplantation needs to be put in place. Appropriate Rules can be made under the existing national and provincial legislation on transplantation of organs and tissues. The state should support the public hospitals in providing free of cost transplantation to all patients and provide lifelong care to donors and recipients and the capacity of all monitoring authorities should be exponentially enhanced.
The Working Group recommends that the state should institute mechanisms that enable all citizens desiring to join the deceased donor program to exercise the option of making a lifetime gift of such organs. Deceased donors and their families should be publicly recognized through the award of medals and certificates.
Recognizing that the state is duty bound to ameliorate poverty and exploitation that compels a person to agree to a sale of his or her organs and recommends victims should be encouraged to come forward as whistle blowers and the law enforcing agencies and prosecutors ought to establish guidelines on when to prosecute the donor whistle blower or to make him or her a witness against others charged with partaking in unlawful transplants or aiding, assisting or abetting such activity.
Law enforcing agencies and prosecutors 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 recommends that transplant activities conducted at places other than establishments recognized under the Transplantation Acts and Rules be punished under the regular penal laws and for that purpose an additional section 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 with fine which 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. At the time of grant of registration to an establishment and at the time of renewal thereof the monitoring authority must obtain the No-objection certificate of the relevant healthcare commission.
In case of brain death donors, the respective police surgeons to provide guidelines of the procedures to be followed before removing organs of deceased donors in situations where medico legal cases are pending in such cases police surgeons be part of the procedures for brain death.
For the effective implementation of the transplant law the law enforcing agencies, hospitals and civil society organizations should establish vigilance committee who should take immediate action to promptly coordinate with secretary of the monitoring authority who should be required to dispose of complaints within 24 hours. All monitoring authority should establish round the clock call centers where violation can be reported.
Registration and recognition should be in respect of designated premises where organs and tissue / cells may be removed or transplanted and recognized establishment may only operate from the designated premises. A fresh registration shall be required where 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.