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1. ISSUES RELATED TO ORGAN TRANSPLANTATION

2. Issue Related to Doctor Doctor should ensure that the organs removed, should be the one for which consent has been given Doctor should not be involved in any money transaction. The doctor should not do the transplant if the donor is related to him. Concerned specialist should not encourage organ transplant for want of money. Failure to screen disease may lead to negligent act.

3. Issue Related to Donor Voluntary refusal of life prolonging treatment by a competent adult must be respected In untested body organ transplantation, doctor must take every precaution to ensure to rule out the risk of acquiring disease. Doing/taking organ without the consent(>18 years) and that of relative-Unethical

4. Unethical to go ahead with organ transplant-if the donor is mentally unsound. Marriage done for organs (kidney Marriage)- unethical Mutilating the foetus for benefit of others - unethical

5. Issue Related to Recipient Xeno -transplant Potential recipient and their relative can be tempted or pressured. Blackmail or bribe of living donor to donate. Unethical to go ahead with the transplantation when the deceased had not consented but after death the relatives does. Surrogate mother: A possibility of that the fertilized egg is reared as a foetus and infant for the purpose of organ transplantation.

6. CAUSES OF SHORTAGE OF ORGANS Lack of awareness and will among most practicing physician has result in high inadequate cadaver donation. Failure to convert potential donors into actual donor Evolvement of better trauma management facilities.

7. Issue Related to Organ Procurement Commercial trading of organ is an offence -kidney buyers -kidney marriage -human organ shop -surrogate mother

8. Means to Correct Organ Shortage More awareness for both the Govt. and health sector , doctors and NGO. General public should be told about organ transplantation and should be given right to choose before hand. Presumed consent should be followed in every country ( eg : Spain, Australia, Belgium, Denmark, Finland)

9. There is considerable global disparity and diversity in the level and extent of government regulation and oversight of both donation and transplantation of organs and tissues. A national transplantation agency constitutes a possible model for effective integrated development of donation and transplantation.

10. There is an agreed need to have global safety and quality principles for the regulation of organs and tissues. Regulation of health tourism is a relevant strategy to inhibit illegal organ trafficking.

11. The Transplantation of Human Organs Act (THOA) 2011 Amendments Tissues have been included under the definition of organ transplant ii. SWAP organ transplant has been included iii. Mandatory requirement of transplant coordinator in the centre iv. Mandatory information to a dead in ICU telling about options for organ donation v. Penalty has been increased to 20 thousand.

12. vi. Diagnosis of Brain death made easy by including anaesthetist and intensivist in the category of neurologist. vii. No organ donation from mentally challenged person viii. Minors cannot donate ix. Indian cannot donate to foreigners unless near relatives. x. Eye enucleation can be done by trained technicians .

13. Significant changes related to deceased organ donation in THOR 2014 as compared to THOA 1994 THOA 1994 THOT Rules 2014 Declaration of brain death Restricted to hospital registered for transplantation Allowed in any hospital with ICU Requirement of neuro-physician / neuro-surgeon Mandatory for declaration of brain death No mandatory , if not available Counseling for organ donation Not mandatory Mandatory Donor maintenance & organ retrieval charges Not clear To be borne by the recipient or institution or Govt. or NGO Transplant coordinator in hospitals Optional Mandatory : qualification specified