What to Read in The Hindu Editorial( Topic and Syllabus wise)

Editorial 1: ​​​Justice and equality

Context

No one in urgent need of an organ transplant should be deprived of the opportunity to receive it.

Introduction

The NOTTO advisory is a progressive measure rooted in natural justice, aiming to correct a persistent gender disparity in organ transplant access. By acknowledging that women are more often donors than recipients, it challenges entrenched patriarchal norms. This step not only addresses statistical inequities but also redefines fairness in life-saving medical allocations across India’s healthcare system.

Principle and Purpose of the Decision

• Natural Justice at Core– Decisions rooted in natural justice aim to address social inequities or correct specific wrongs.
• NOTTO’s Recent Advisory– The National Organ and Tissue Transplant Organization (NOTTO) has advised giving priority to women patients and relatives of deceased donors awaiting transplants.
• Rewriting Gender Narratives– The move seeks to address gender disparities in organ transplant recipients.

Evidence of Gender Imbalance

• Decadal Data (2013–2023)– NOTTO’s records reveal a gender skew:
  • Living Donor Transplants (2023)– Women formed 63% of donors, but far fewer were beneficiaries.
  • Beneficiary Share (2023):
    • Heart: 24%women
    • Lung: 47%women
    • Kidney: 37%women
    • Liver: 30%women
    • Pancreas: 26%women
  • BMJ Analysis (Past 5 Years)– Out of 56,509 living organ donations, women contributed 36,038 donations but benefited in only 17,041
  • Aim of the Advisory– Address gender imbalance by granting extra allocation points to women patients on the waiting list.

Implementation Challenges

• Current Protocols– Organ allotment prioritises only on health grounds, with no provision for gender-based preference or benefits to relatives of donors.
• Unclear Definitions– Ambiguity over the scope of “near relatives” and whether donor families from as far back as 1995 will be included.
• Risk of Misuse– Fears of out-of-turn allotments or exploitation, especially with ongoing organ racket busts in India.
• Need for Inclusivity– Despite risks, the policy should not be discarded, given its intent to counter patriarchal bias.

Way Forward

• • Make the policy participatorywith inputs from all implementation agencies.
  • Ensure compliance with the Transplantation of Human Organs Act.
  • Expand organ access without undermining health-based priorityfor those in greatest need.

Conclusion

While the advisory’s intent is commendable, its success depends on clear definitions, transparent protocols, and safeguarding against misuse. Inclusive consultations with stakeholders can ensure equitable access without compromising health-based prioritisation. If implemented with integrity and accountability, the initiative can widen organ access, protect donor families’ rights, and set a precedent for socially just healthcare policies in India.

 

Editorial 2: Clear the myths, recognise organ donation as a lifeline

Context

Ongoing awareness campaigns can ensure no one dies for lack of a donor organ.

Introduction

Organ transplantation is among modern medicine’s greatest triumphs, offering the gold standard treatment for terminal organ failure. Yet in India, over 500,000 lives are lost annually due to the absence of a suitable donor organ. Despite transplants rising from 4,990 in 2013 to 18,378 in 2023, only 1,099 came from deceased donors. With a donation rate of just 0.8 per million, far below Spain and the US at over 45 per million, each such preventable fatalityis one we must never accept.Helping families to overcome their fears

• Reason for Demand–Supply Gap:Deep-rooted myths and misconceptions discourage families from consentingto organ donation after a patient’s death.
• Need for Change:Requires sustained education and awareness campaigns to counter misinformation.
• Myth – Body Disfigurement:Many believe organ donation disfigures the body, affecting funeral rites or violating religious traditions.
  • Reality:Organ retrieval is conducted with respect and care to preserve the donor’s appearance for final ceremonies.
  • Cultural Sensitivity:Health-care teams work within cultural frameworks; leaders across faiths affirm organ donation as an act of compassion aligned with spiritual values.
• Myth – Premature Declaration of Brain Death:Some fear hospital staff might declare brain death early to harvest organs.
  • Reality:Brain death is declared only after following the legal and clinical framework under the Transplantation of Human Organs and Tissues Act, 1994.
  • Safeguards Include:
    • Strict medical criteria
    • A multidisciplinary boardof experts
    • Defined clinical assessmentsrepeated after a set interval
    • Complete documentationon prescribed forms
  • Outcome:Ensures a robust, transparent, and ethically sound process that confirms irreversible neurological death and enables timely organ retrieval.

The issue of age and health

• Myth about Young Donors:Age and health often cause the misconception that only young accident victims can donate organs. While younger donors may provide optimal organ performance, many organs and tissues—kidneys, liver segments, lungs, and corneas—can come from older donors or those who die of natural causes.
• Value of All Contributions:Even donations of bone, skin, and heart valves can save or significantly improve lives.
• Addressing Myths:Requires sustained focus through awareness campaigns and direct engagement.
• Mass Media Campaigns:Audio-visual content on TV and social media can target younger audiences effectively.
• Real Stories:Using real donor families and transplant recipients in campaigns shows the tangible impact of organ donation.
• Community Workshops:Led by trained counsellors, these provide safe spaces for questions on funeral rites, medical protocols, and donor eligibility.
• Early Education:Integrating organ donation education into life sciences and ethics curricula in schools and colleges builds a culture of giving from a young age.
• Peer-to-Peer Learning:Empowers students to take ownership, foster empathy, and debunk myths through relatable storytelling.
• Role of Health-Care Professionals:Must become champions of organ donation through regular training to initiate compassionate conversations with donor families.
• Example – Apollo Hospitals:Dedicated transplant coordination teams guide families through complex decisions with sensitivity and clarity.

Steps to ensure public confidence

• Need for Collective Will:India must build a national commitment to close the huge gap between organ supply and demand.
• Sustained Efforts Beyond the Day:Awareness and action on World Organ Donation Day should continue year-round through policy reforms and grassroots engagement.
• Promising Policy – Presumed Consent:
  • Successful in Spain, Croatia, and other European nations.
  • Every adultis considered a donor unless they formally opt out.
• Supporting Measures:Establish robust family support systems and grievance redress mechanisms to maintain public trust and ensure ethical oversight.
• Moral Dimension:Organ donation is a profound act of charity and the noblest legacy one can leave, allowing others to live through one’s gift.

Conclusion

The moment to act is now. Every eligible adult should register as a donor, and every family must honour that decision. For patients with end-stage disease, where a transplant is the only treatment, organ donation is a lifeline. By dispelling myths and showing unwavering commitment, we can ensure no Indian dies for want of an organ. On World Organ Donation Day (August 13), let us pledge to embrace this cause as a shared responsibility.