A coordination committee, constituted by the Supreme Court of Pakistan to curb the sale of organs in Pakistan, has urged the government to establish federal and provincial registries at state expense to create a deceased donor database and a bank of potential recipients and to prescribe methods for safe and efficient harvesting of such organs.
The most effective way to curb the commercialisation and sale of organs and tissues is that the state, civil society, medical practitioners and healthcare providers proactively promote the donation of organs to be harvested from persons certified as brain-dead in accordance with protocols that are internationally accepted and credible to the family of the deceased donor, members of the committee said while addressing a news briefing at the Sindh Institute or Urology and Transplantation (SUIT) on Saturday.
The briefing was addressed by coordination committee members, including Law and Justice Commission Secretary Dr Abdur Rahim Awan, SIUT Director Prof Adibul Hasan Rizvi, Anwar Naqvi and Munir A Malik, who presented the recommendations of four working groups at the end of a two-day conference and workshop on deceased organ donations and curbing the menace of commercial trade of human organs.
They said that at the same time, a transparent system for their equitable allocation and transplantation needs should be put in place, suggesting that appropriate rules could be made under the existing national and provincial legislation on the transplantation of organs and tissues. The state should support the public hospitals in providing free transplants to all patients, provide lifelong care to donors and recipients, and exponentially enhance the capacity of all monitoring authorities, they added.
The four working groups further recommended that the state should devise mechanisms that enabled all citizens desiring to join the deceased donor programme to exercise the option of giving a lifetime gift of such organs. Deceased donors and their families should be publicly recognised through the award of medals and certificates, they added.
They said that as the state was duty-bound to end poverty and exploitation that compelled people to sell their organs, it should encourage the victims to come forward as whistleblowers and the law enforcing agencies and prosecutors should also establish guidelines on whether to prosecute the donor whistleblower or to make him or her a witness against others charged with partaking in unlawful transplants or aiding, assisting or abetting such an activity. Coordination committee members deplored that law enforcing agencies and prosecutors had expressed their frustration at the provisions of federal and provincial laws on organ transplants dealing with the cognizance of offences under the respective federal and provincial acts.
They said the working groups had also recommended that transplant activities conducted at places other than the establishments recognised under the Transplantation Acts and Rules be punished under the regular penal laws and for that purpose an additional section be added to the Pakistan Penal Code by an amendment made by parliament in exercise of powers conferred under Article 142 of the constitution.
They said an appropriate amendment should also be made in Schedule II to the Code of Criminal Procedure as well as to the schedule of the FIA act, making such offences non-compoundable, non-bailable and cognizable.
The coordination committee maintained that in case of brain- death donors, respective police surgeons should provide guidelines on the procedures to be followed before removing organs of deceased donors, and in situations where medico-legal cases were pending, police surgeons should be consulted.
For the effective implementation of the transplant law, law enforcing agencies, hospitals and civil society organisations should establish a vigilance committee which should take immediate action to promptly coordinate with the secretary of the monitoring authority who should be required to dispose of complaints within 24 hours.
The committee further recommended that registration and recognition should be in respect of designated premises where organs and tissues/cells may be removed or transplanted, and recognised establishments should only operate from the designated premises. The monitoring authorities should ensure that the evaluation committees of the recognised establishments enjoyed credibility and periodically audited their decisions, it added.