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This Article is written by Supriya of S.S Khanna Girls’ Degree College, University of Allahabad.

Abstract –

Organ transplantation is defined as giving an organ or part of an organ to be transplanted into another person. Organ transplantation is the only option to save lives in patients affected by terminal organ failures and improve their quality of life. The U.S Congress passed the National Organ Transplant Act, 1984 for improve the organ matching process.

And also, later the potential of organ rejection limited the number of transplants performed. Medical advances in the prevention and treatment of rejection led to more successful transplants and an increase in demand The National Organ Transplant Act of 1984 (NOTA) established the framework for a national organ recovery and allocation system in the private sector. The goal of this system is to help ensure the organ allocation process is carried out in a fair and efficient way, leading to an equitable distribution of donated organs based on medical criteria.

Also in 1984, United Network for Organ Sharing (UNOS) separates from SEOPF and is incorporated as a non-profit member organization. In 1986, UNOS receives the initial federal contract to operate the Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients. In 2001 the total of living organ donors for the year (6,528) exceeds the number of deceased organ donors (6,081).

Introduction-

Organ transplantation is a process in which organ, or a tissue is transferred from one body to another body by the surgical method to save the life of a person. Today, the U.S. system of organ donation or transplantation and recovery is best among the world. In 1954, kidney was the first human organ to be transplanted successfully. As an innovation or alteration and continuous improvement, more patients need of organ transplant then ever have received the gift of life.

https://m.timesofindia.com/city/pune/punes-sassoon-hospital-and-bjmc-pune-perform-first-organ-and-tissue-donation-after-covid-era/articleshow/96198204.cms

Current U.S. law for organ transplantation-

In the U.S. there are two major purposes of organ donation laws at the state and federal level. First is fair contribution or donation of organs to save the life of a person and second is the increase the strength or potential of donors to increase the availability of the number of organs for transplant.

National Organ Transplant Act, 1984.

The U.S. Congress passed the National Organ Transplantation Act (NOTA) in 1984.This Act passed or addressed by congress to improve the shortage of organ matching processes. This Act also established the Organ Procurement and Transplantation Network (OPTN) is used to matching the organ of individuals to maintain a national system. The Act also called for the network to be operated by a private nonprofit.

Under federal contract. The united network for organ sharing currently operates the OPTN for HRSA.

Uniform Anatomical Gift Act (UAGA) –

The 1968 Uniform Anatomical Gift Act (UAGA) provided the legal basis upon which human organs and tissues could be donated for transplantation by implementation of an anatomical gift authorizing document. Since 1972, all 50 states and the District of Columbia have adopted this Act or amended forms of this Act. The Uniform Anatomical Gift Act, the first law (1968) governing organ and tissue donation in the United States. In 2006, the UAGA was again revised to workers compensation laws are created by federal legislation to provide uniformity in every state in state laws regarding organ and tissue donation, strengthen the lifetime decision of a person making an anatomical gift, and clarify the list of people who can make a donation decision on behalf of a person who has died.

Consolidated Omnibus Reconciliation Act ,1986

The Consolidated Omnibus Reconciliation Act (COBRA) was passed by the United States Congress in 1986. It primarily brought amends to the Employee Retirement Income Security Act, 1974 (ERISA), the Internal Revenue Code, 1986, and the Public Health Service Act, 1944, and addressed health benefits and health insurance coverage. The landmark federal law mandates the employers to provide continuing group health insurance coverage for certain eligible employees and their family members in the event of job loss or other qualifying events like work reduction, transition periods, etc. Other qualifying events include employee death, business filing for bankruptcy, Medicare eligibility, divorce/legal separation, covered dependent reaching adulthood. Thus, even after losing a job for some period of time, the employee can access such benefits. 

First Person Consent Laws-

First-Person Consent Laws were passed in the 1990s in order to acknowledge the wishes of the person donating organs. The hospitals and organ cooperative purchasing organizations would have to follow the patient’s organ donation desires as specified on their driver’s license or in a health care directive required by the law.

For places with enacted laws, the hospital and the organ purchasing association are legally entitled to abide by the written wishes of the expired person who made the donation and without approaching the dead person’s family for organ removal permission. However, it has been suggested by some advocacy organizations that as many as 2/3 of people who sign organ donation consent forms do not have their wishes honored when they die. The reason behind this is that they do not get the family’s approval to conduct such removal. Thus, these laws try to resolve the complexities between the expired organ donator’s wishes and their families’ consent by honoring the patient’s wishes. The acknowledgement of autonomy is supported in America and considers self-determination as a fundamental right that comes from exercising autonomy.

Besides these laws, the U.S. Food and Drug Administration (FDA) also supports and regulates research on deceased organ donors that are similar to but not identical with those in the Common Rule.

Moran v. State [1]

IN THE SUPREME COURT OF THE STATE OF KANSAS

No. 80,741

JON F. MORAN, M.D.,

Appellant,

v.

STATE OF KANSAS; THE KANSAS BOARD OF REGENTS.

THE UNIVERSITY OF KANSAS MEDICAL CENTER; DANIEL HOLLANDER, M.D.; GLENN E. POTTER; KIM RUSSEL; A.L. CHAPMAN; and JON JACKSON,

Appellees.

Fact-

Moran was chairman of the Department of Cardiothoracic Surgery at KUMC from June 1985 to April 1994.   He remained on staff at KUMC until he resigned on March 3, 1995.Moran claims the district court erred in (1) finding he did not establish that his reputation was damaged by defendants’ statements, and (2) requiring that he must show injury to his reputation when defendants have acted with actual malice.   In their cross-appeal, defendants claim they are immune from liability under the discretionary function exception of the KTCA, and Moran is required to prove special damages or a quantifiable pecuniary or economic loss or detriment in order to make out a prima facie case for defamation. Plaintiff claims he was damaged because the frequency with which he has been approached about considering positions as division or department chief of an existing CTS (cardiothoracic surgery) program or to start a new CTS or heart transplant program or as a transplant surgeon in an existing transplant program, have decreased dramatically since the subject Statements In his answers to defendants’ interrogatories, plaintiff set forth a number of ways in which defendants’ defamatory statements had harmed his reputation:

‘While I am still able to practice as a cardiothoracic surgeon, my academic advancement has been markedly impaired by defendants’ actions.

Judgement-

In the present case, defendants invoked Supreme Court Rule 118 (1998 Kan. Ct. R. Annot. 161), which requires a plaintiff to provide a written statement of monetary damages sought.   Moran complied, stating that he seeks $250,000 for pain, suffering, and mental anguish; $1,500,000 for loss of time and income; and $1,500,000 for injury to professional reputation.   Defendants would have this court classify all of these claims as special damages and require an economic expert’s evidence that Moran actually suffered quantifiable economic detriment.

Defendants use the term “special damages” as if it signified something extraordinary; they talk about Moran’s proving a “prima facie” case of defamation and “quantifiable” loss.   This court has not squarely decided whether in Kansas any and all defamation plaintiffs must allege and prove actual damages rather than relying on the theory of presumed damages.   Thus, the issue the defendants might be expected to raise is whether Moran, in the circumstances of the present suit, must prove actual damages.   The arguments they make, however, assume that question and push for additional requirements of expert testimony and proof of specific dollar amounts.

With respect to the proof required, defendants take the position that Moran cannot make his case without expert testimony. The deadline for naming expert witnesses has come and gone. The KUMC defendants contend that Moran’s only evidence of damage is his own unsupported speculation. Moran’s case no doubt is weak with regard to evidence of damages and might benefit from testimony about medical salaries and economics, but nothing cited by defendants stands for the proposition that his case is over without it. The authorities cited by defendants for their contention that “special damages” must be “quantifiable monetary loss” are pre-Gobin Kansas cases and cases from other jurisdictions.

 In Gertz v. Robert Welch, Inc., 418 U.S. 323, 94 S.Ct. 2997, 41 L.Ed.2d 789 (1974), the United States Supreme Court ruled: “It is necessary to restrict defamation plaintiffs who do not prove knowledge of falsity or reckless disregard for the truth to compensation for actual injury.”  418 U.S. at 349, 94 S.Ct. 2997.  Gertz changed the law in Kansas.   Damages recoverable for defamation, whether per se or not, could no longer be presumed but must be proven.   The issue raised by defendants in this cross-appeal is best answered by Justice Powell, speaking for the majority in Gertz:

 “We need not define ‘actual injury,’ as trial courts have wide experience in framing appropriate jury instructions in tort actions.   Suffice it to say that actual injury is not limited to out-of-pocket loss.   Indeed, the more customary types of actual harm inflicted by defamatory falsehood include impairment of reputation and standing in the community, personal humiliation, and mental anguish and suffering.   Of course, juries must be limited by appropriate instructions, and all awards must be supported by competent evidence concerning the injury, although there need be no evidence which assigns an actual dollar value to the injury.”  418 U.S. at 349-50, 94 S.Ct. 2997.

We find no merit in the issues raised by the cross-appeal.

The district court’s order of summary judgment is reversed, and the case is remanded for further proceedings consistent with this opinion.

[1]- July 09,1999

Conclusion –

Organ transplantation involves removing organs from a donor and transplanting them into someone who may be very ill or dying from organ failure. It can save the life of the person who receives the organ. Organ donation by living donors clearly saves lives, improves transplantation outcomes under some circumstances, and reduces recipients’ waiting times. It also increases opportunities for patients without living donors to receive organs from deceased donors.

References-

The history of organ donation and transplantation | UNOS

https://unos.org/transplant/history/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086721/

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-022-00791-y

https://www.organdonor.gov/about-us/legislation-policy


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