Sanjay Nagral

Deceased organ donation in India: where do we go from here?

Transplantation represents one of the best examples of the scientific achievements of medical science. However, its success has also led to some of the fiercest ethical challenges in modern medicine. Partly as a response to the uncovering of a flourishing clandestine kidney trade, the Central government promulgated the Human Organs Transplant Act (HOTA) in 1994. HOTA, along with its amendments, was a step forward in recognising concepts such as brain death. Nevertheless, there are numerous ethical challenges still to be resolved, particularly with regard to consent, incentives to donors and families, and equitable distribution of donated organs.

Ethics, equity and justice: a view from the belly of the beast.

The second reason, which I suspect is more accurate, is that for the last two decades I have worked as a surgeon in the world of curative, specialty medicine in both the public and private sectors in Mumbai, the capital of India’s commerce, and perhaps, of market medicine. In that sense, I have been a part of the beast of modern specialty medicine in its extreme form and, therefore, have had the opportunity to get an insider’s view from the belly of this beast. Hence the title of today’s talk. In the next 20 minutes or so I will attempt to touch upon the following questions:

The kidney trade again.

In our scandal-prone Indian public life, one scandal distinguishes itself by the amazing regularity with which it hits the headlines every few years. The only variation is its shift from one city to another as if in planned rotation. Thanks to the desperation, ingenuity and collusion of the players involved, the Indian kidney bazaar, as it was crudely described at some stage in its history, refuses to die down. The latest exposé comes from Mumbai, where a leading doctor from a reputed hospital was arrested for his involvement in a well-organised racket (1).

Satpal Dang - a personal memoir.

[ 280 ] In the early 1990s when this journal was in its infancy and struggling to establish itself, I used to enthusiastically show it to all those who I thought would be even remotely interested. I always carried copies and passed them on to colleagues, friends and family members. I then requested them to read it, spread the word among their doctor contacts and of course, solicit subscriptions. Many of them would look at the journal and say the usual nice things, and it often ended there.