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2024 Supreme(Mad) 2692

IN THE HIGH COURT OF JUDICATURE AT MADRAS
G.R. SWAMINATHAN, J.
Sudha Mathesan – Appellant
Versus
The Authorisation Committee (Transplantation), Rep. by its Chairman, Coimbatore Medical College of Hospital – Respondent 
W.P. Nos. 13918, 13922, 13967, 13969 of 2024
Decided On : 30-05-2024

Advocates Appeared:
For the Appellant : M. Manivasagam,
For the Respondents: K. Tippu Sulthan, Elizabeth Seshadri, Iyer & Thomas

The court emphasized that kidney transplantation from non-near relatives requires the Authorisation Committee's prior approval to prevent commercial dealings, underscoring altruistic motives in organ donation.

Headnote:(A) The Transplantation of Human Organs and Tissues Act, 1994 - Sections 2(f), 2(i), 2(m), and 9(3) - Writ petitions concerning kidney transplantation from non-near relatives - Approval from Authorisation Committee required - Court directed that application be submitted directly by the parties to avoid unnecessary delays. (Paras 6, 8, 28)

(B) Legal Framework - The Act provides comprehensive regulation for organ transplantation, particularly emphasizing the prohibition of commercial dealings in human organs. (Paras 6, 12)

(C) Approval Process - The Authorisation Committee must evaluate the genuineness of donations from non-near relatives, ensuring that no commercial benefit is involved. (Paras 11, 17)

Facts of the case:
Petitioners undergoing dialysis require kidney transplants from unrelated donors. Hospital hesitancy in forwarding applications due to regulatory concerns prompted these writ petitions. (Paras 1, 2, 8)

Findings of Court:
Petitioners permitted to submit applications directly to the Authorisation Committee; the committee must decide based on statutory norms within four weeks. (Paras 28)

Issues: The primary issue is the need for proper authorization of transplantation from non-near relatives under the governing Act. (Paras 4, 12)

Ratio Decidendi: The court reinforced the necessity of evaluating donor-recipient relationships to ensure compliance with the Act, underscoring that altruistic motives must be prioritized where commercial interests are absent. (Paras 17, 27)

Result: Writ petitions disposed of with directions.

Table of Content
1. consent required for kidney transplantation. (Para 1 , 2)
2. petitioner's arguments regarding hospital procedures. (Para 3 , 4 , 5)
3. overview of the transplantation act and its provisions. (Para 6 , 7 , 8)
4. informed consent requirements for organ donation. (Para 9 , 10 , 11)
5. enquiry procedures by authorisation committee. (Para 12 , 13 , 14 , 15)
6. burden of proof on applicants for non-relative donations. (Para 16 , 17 , 18 , 19)
7. role of evidence in assessing donor's motives. (Para 20 , 21 , 22)
8. compensation for altruistic donors is non-commercial. (Para 23 , 24)
9. insurance coverage and guarantees for donors. (Para 25 , 26)
10. obligations of the authorisation committee for donor care. (Para 27)
11. direction for application process by petitioners. (Para 28)
12. conclusion and order of writ petitions. (Para 29)

ORDER :

1. All these writ petitions are disposed of by a common order since the issues raised therein are identical.

2. The first petitioners in these writ petitions were admitted for renal failure in the second respondent hospital. They are undergoing regular dialysis. Kidney transplantation is the only solution. The second petitioners have come forward to donate their kidneys in favour of the corresponding first petitioners. But the donors who have given consent for transplantation are not “near relatives.” Hence, prior approval from the Authorisation Committee (first respondent) is statutorily required in each case. The hospital is hesitant to forward the papers to the Authorisation Committee for taking appropriate decision. In these circumstances, the present writ petitions came to be filed.

3. The learned counsel appearing for the petitioners reiterated all the contentions set out in the affidavit filed in support of the writ petitions and called upon this Court to grant relief as prayed for. My attention was drawn to the order dated 17.04.2024 made in W.P.No.9306 of 2024. A learned Judge of this Court had directed the hospital concerned to forward the papers/medical summary along with application submitted by the patient to the Authorisation Committee immediately. There was also direction for taking decision within a time frame.

4. When I was inclined to dispose of the present writ petitions on the same lines, the learned counsel for the hospital requested me to take note of the prevailing reality and pass a detailed order. I, thereupon, requested her to circulate a note for my better understanding. The learned counsel was kind enough to comply with my request.

5. The learned Government Advocate for the first respondent submitted that on receipt of the application from the second respondent, the Authorisation Committee will take a call in the matter as per law.

6. I carefully considered the contentions advanced by the learned counsel. The Central Act 42 of 1994 was originally called as “The Transplantation of Human Organs Act, 1994”. It came into force in various States on different dates. The statute underwent substantial amendments vide Act 16 of 2011. The Act now is called as “The TRANSPLANTATION OF HUMAN ORGANS AND TISSUES ACT , 1994”.

7. The need to pass such a legislation was felt because there was no comprehensive legislation to regulate the removal of organs from living as well as deceased persons and transplantation of such organs. The preamble notes that the Act is also intended to prevent commercial dealings in human organs and tissues. The Act has 25 sections and it is divided into seven chapters. The statutory rules were framed in the year 2014. Since the cases on hand involve donation by persons who are not near relatives, let me examine only those provisions that have a direct bearing on the issue. Section 2 (f), (i) and (m) and Section 9(3) of the TRANSPLANTATION OF HUMAN ORGANS AND TISSUES ACT , 1994 are as follows:-

(f) “donor” means any person, not less than eighteen years of age, who voluntarily authorises the removal of any of his human organs for therapeutic purposes under sub-s

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