The organ transplant law has been approved by the Shura Council. The next stop is the People's Assembly, reports Reem Leila Eight years after the Doctors' Syndicate first proposed a draft law to regulate organ transplants, the Shura Council has finally signed off on the controversial law, much to the relief of thousands of desperate patients. Last month the Shura Council approved a draft law on organ donations and transplants following discussions by 84 Shura members, including doctors and legal experts. The discussions highlighted the necessity of ensuring a measure of equity and transplants for low- income patients which will be financed by the government, whereby the Health Ministry will conduct surgeries according to case urgency, with a specialised committee in place to decide on priority cases. A proper organ waiting list will be drafted with provisions that would seriously penalise anyone who tries to cheat his way into the list. The draft law was referred to the Shura Council for deliberations after the People's Assembly (PA) officially approved it earlier last month. The PA's Health Committee and the Constitutional and Legislative Affairs Committee signed off on the law which has been under discussion in parliament for two years. Now, the draft law will be referred back to the PA where members will vote on it next month. The bone of contention in the bill was agreeing on the definition of death. Although clinical death in medical terms is brain death, many Shura members argued that death must involve the total stoppage in the function of both the brain and the heart. Hence, both Shura and PA health committees decided that the legislation would not define death but would refer cases of organ donation from deceased persons to a panel of three experts who must reach consensus on whether or not the donor is dead. The Higher Committee for Organ Transplants would appoint the experts in conjunction with the Ministry of Health. Disagreeing with the medical definition that brain death constitutes final death, Egyptian MPs argued that the complete death of both the brain and the heart are necessary to declare a person dead and hence allow the removal of their organs. Other debates involved tortuous concepts about whether any person has the religious right to give away part of their body, which in itself, is a gift from God, and to whom it shall return. "Strangely, these arguments persisted even after the Grand Sheikh of Al-Azhar Mohamed Sayed Tantawi, issued the fatwa in 1997 which permits organ transplants, and declared his intention to donate his own organs to any needy patient," said Shura member Shawqi El-Sayed, who is also a member of the National Democratic Party (NDP). MP Hisham El-Qadi said that what was agreed upon "was the opinion of the Islamic Research Centre [IRC], which stated that death is the cessation of all bodily functions -- the brain, the heart and everything else. For this law to see the light after all these years we all had to agree on this definition," El-Qadi added. According to the draft law, any decision to remove organs before the panel's approval would be considered first- degree murder and punishable by death. Abdel-Rahman Shahin, official spokesman of the Ministry of Health, said the new law penalises doctors who perform illegal organ transplant procedures, subjecting them to a maximum sentence of 15 years in jail. "Hospitals and medical facilities allowing illegal operations will also be fined up to LE1 million and can be shut down altogether," Shahin warned. According to MP Hamdi El-Sayed, head of the Doctor's Syndicate, organ donations could help many people in Egypt in need of transplants. El-Sayed previously said the government was "very excited about the new law and the ruling party has the majority of seats in the PA so it will pressure its members to approve the legislation." According to the draft law, organ donations from live donors is no longer restricted to family members of the fourth degree. "It will be allowed for anyone as long as his written consent is submitted to the hospital where the operation will take place," El-Sayed said. Last week, El-Sayed pointed to the large number of people killed in road accidents each year who represent about 90 per cent of organ donators. This number comprises mostly young people who could potentially donate to some 42,000 people in Egypt in need of organs. Accordingly, "procedures surrounding establishing consent should not be made too strict," El-Sayed added. Shahin stated that there was still a debatable article in the draft which stipulates that organs of people who are sent to death are to be taken for transplants without their consent. "Since they are sentenced to death, they are incompetent and accordingly are unauthorised to provide any document in this regard," Shahin said. The draft also stipulates that all organ transplants are to be conducted in public hospitals affiliated to the Health Ministry so the ministry can monitor the procedures. "The hospitals have not yet been identified," Shahin said. Currently there are at least four or five hospitals in Egypt where organ transplants can take place. The number could be increased to 10 in order not to create a waiting list for patients. The new draft will penalise doctors who perform illegal organ transplants; they can be subject to a maximum sentence of 25 years in jail, whereas donors and patients could get a maximum of 10 years in jail for violating the law. "The current law's maximum penalty was a three-year jail sentence," Shahin said. Doctors who can prove that either the donor or the patient face health hazards after the donation will be subject to a penalty ranging from a fine to spending several years in jail. Shahin highlighted the importance of the draft law and the role it will play in eliminating organ tourism and regulating organ transplants to benefit those who "need them the most -- not the ones who can pay the most." Illegal organ transplants have consequences linked to "poverty, social and economic problems and the culture of a whole community," he added. In case the draft is passed and approved by the PA, the Health Ministry will allocate one of its four airplanes to transport organs to people who need it across the country. A network will be created to connect the hospitals together with the Health Ministry and the ambulance department "which will report accidents to the ministry and the hospitals so that organs can be taken from them," stated Shahin. "The dead person's consent is not necessarily required unless any of the relatives disagree."
