Uwakwe Abugu is a regulation professor on the College of Abuja’s School of Legislation, specialising in medical regulation and ethics. Abugu is the present Vice-Chancellor of Ave Maria College in Piyanko, Nasarawa State, in addition to the President of the Medical Legislation Skilled Affiliation of Nigeria. The MELPAN President discusses the legal guidelines governing organ donation in Nigeria and different international locations on this interview with LARA ADEJORO
What precisely can we seek advice from as an organ transplant?
An organ transplant is the removing of an individual’s organ with the aim of transplanting it to a dwelling particular person whose organ is both diseased or has turn into dangerous or doesn’t exist. The process is a contemporary growth in medical and healthcare supply methods rising in all places.
In developed international locations, it has turn into a method to save humanity from the scourge of incurable ailments. An organ transplant itself is an excellent and salutary intervention by a human being within the lifetime of one other. An creator described an organ transplant as a method to affirm and share humanity along with your neighbour.
As of 2020, there was a regulation handed by the UK authorities which supplies that any dwelling human being is deemed to have consented to transplanting or harvesting his organs when she or he dies for the aim of donation to save lots of anyone’s life. If you end up dwelling, you’re presumed to have consented that your organ, upon dying, must be donated for the service of humanity. So, you’re given the choice to choose in or out of the regulation. Opting in is when you don’t do something about it, however if you wish to choose out, it’s essential register your identify within the Nationwide Well being Service Register on organ donation. If you don’t register, chances are you’ll inform your relative that whenever you die, your organ shouldn’t be donated.
What’s the implication of turning into an organ donor and what are the precautions one must take earlier than and after donating an organ?
The implication of organ donation must be left to the docs. However what we all know is that an organ that’s able to being donated is one which should you donate it, it is not going to turn into dangerous to your system. As an example, earlier than you donate your kidney, you should be licensed to be able to donating and make sure that your two kidneys are actively practical, and science has confirmed {that a} human being can dwell healthily as much as time period with one kidney.
Is there an age restrict for donating an organ?
Probably not, however the regulation has offered that in case you are beneath 18 years, you would possibly donate an organ, however you may not have the medical and authorized capability to consent, so your consent will now turn into the consent of your dad and mom or your guardian. Additionally, the age restrict for the donation of an organ relies on the scientific investigation of the proposed donor.
The medical personnel could determine that you’re too younger to donate, so in that case, you may not be able to donating. Nonetheless, as soon as the medical personnel confirms that your organ is totally developed and can be utilized for the substitute of one other particular person’s organ, you may donate it.
Which means that in case you are greater than 18 years outdated, you would possibly give your consent to donate, however in case you are lower than 18, you’re presumed by regulation to be incapable of consenting. Even with somebody that’s beneath 18, if he doesn’t need to donate, the dad and mom can not power him to donate, but when he needs to donate, his parental consent turns into a requirement.
Sequel to that, there may be what we name Gillick Competence, which is when anyone is beneath 18 however greater than 16 years outdated and has the psychological capability to grasp the implications of his motion. In that case, even when the dad and mom withhold consent and the courtroom finds out that you simply perceive the implications of what you’re going into, then the courtroom can allow you to consent, overriding the withholding of consent by the dad and mom.
Is there a regulatory physique on organ harvesting and donation in Nigeria?
Sure, there’s a regulatory regulation that governs organ harvesting and donation in Nigeria. It’s within the Nationwide Well being Act of 2014. The Act, between sections 48 and 57, has made a number of provisions governing organ transplants or tissue transplants because the Act makes use of them. It prohibits the supply of organ transplant companies by any hospital, besides a duly authorised hospital, and with the written consent of the medical physician accountable for medical companies of the hospital. If a hospital is authorised to supply organ transplants, the medical officer accountable for medical companies would have given written consent for these companies to be offered by the hospital.
The Act additionally prohibits the commercialisation or commoditisation of human organs to the extent that if an individual is concerned within the sale, procurement, or distribution of human organs, he could run afoul of the Act, and the Act has made penal provisions for phrases of imprisonment or high-quality. For those who commercialise an organ, you’re liable to N1m high-quality or not lower than two years’ imprisonment.
Therefore, the essence of the non-commercialisation of organs is {that a} donor is prohibited by regulation from donating an organ as a industrial transaction. However when you’ve got incurred some bills within the technique of donating, you is perhaps reimbursed for these bills. There are different provisions of the Nigerian regulation within the Nationwide Well being Act referring to organ donation. The Act supplies that there shall be no removing of organs or tissue with out the knowledgeable consent of the organ donor.
Consent is on the coronary heart of organ donation and on the coronary heart of all medical procedures to the extent that beneath no circumstance shall medical personnel contact or deal with a affected person with out his consent, regardless of how useful or innocent the process could also be or how silly the affected person’s choice could also be.
Once you apply this to organ donation, you can see out that the consent should be knowledgeable as you need to have informed the organ donor the character and objective of the process, the danger concerned, and different penalties. The consent should not be beneath duress or promise of a bonus. Any act of organ harvesting or donation with out consent will quantity to assault and battery.
What are the variations between the legal guidelines in Nigeria and different international locations guiding organ harvesting and transplantation?
Underneath Nigerian regulation, there isn’t a presumption of deemed consent to organ donation, in contrast to the supply in UK regulation {that a} dwelling particular person is presumed to have consented to the donation of his organs upon his dying until he opts out.
Nigerian regulation has made copious provisions for organ donation. Within the NHA, sections 48 to 57, numerous provisions are embedded and have lined many of the provisions within the English Human Tissue Act of 2004, which is the authorized framework for organ transplants within the UK. The one distinction now could be that in England in 2015, they enacted an organ donation Act that makes provision that when you’re a dwelling particular person, you’re presumed to have consented that whenever you die, you’re donating your related organ until you decide out of that normal provision of the regulation.
Underneath the English HTA of 2004, the one allowable organ donors and recipients are those that are genetically associated. In case you are not genetically associated, then there may be an exception the place you need to show that it’s not for industrial functions and you need to have consented voluntarily to the donation.
What are the organs within the physique of a wholesome particular person that may be donated?
The primary organ donation developed by scientists was kidney donation, which was within the ‘50s, however within the 1960s, additional development got here to the extent that the lungs and the guts have been donated. Now, we will even donate a part of the liver, a small portion of the bowel, pancreas, and so on. You probably have donated your kidney, the second kidney will probably be working usually, and it’s potential to donate your lung if the opposite lung is working usually.
Does Nigeria have organ banks?
As of now, there aren’t any organ banks in Nigeria. What we’ve got are blood banks. Organ banks in Nigeria are remoted circumstances in several hospitals, however there isn’t a normal laws making a authorized or regulatory framework for organ banks.
Some superior hospitals have organ banking services that they use as the necessity arises, however that doesn’t imply that Nigeria has a system of organ banking. Any organ financial institution you see in Nigeria is a person association by the hospitals.
Is it okay to compensate an organ donor in money or variety, akin to awarding scholarships, as an illustration?
As I stated earlier, organ donation should be altruistic and actuated by the necessity to help humanity and never for industrial functions or because of some inducement. In the meantime, if an organ donor incurs affordable bills in donating, he’s entitled to be refunded.
Is there a penalty for somebody who compensates a donor?
The regulation is stringent {that a} high-quality of N1 million or imprisonment for not lower than two years is prescribed, nevertheless it doesn’t imply that it should be two years. The courtroom has the discretion to present you life imprisonment or provide you with twenty years’ imprisonment, offered the punishment isn’t lower than two years.
What function, if any, do Nigerian hospitals play in procuring organs for needy members of the general public?
Organ donation continues to be at an infancy stage in Nigeria due to our tradition, faith, and different issues and challenges. If the Nigerian hospitals are conscious of the provisions of the NHA, they needn’t enter into organ transplant companies with out the authorisation of the Nationwide Tertiary Establishment Customary Committee for which the supply is made within the NHA. It’s the committee that may authorise a hospital to have interaction in organ transplant companies.
