Why Living Donation Is So Rare in India

The Legal Framework: Protection First

India’s Transplantation of Human Organs and Tissues Act, and its amendments, were created to prevent organ trafficking and exploitation. The law mandates authorization committees to evaluate every living donor, ensuring the donor is not being coerced or paid. For unrelated donors, the scrutiny is especially strict. The intent is admirable: protect vulnerable people from exploitation.

Yet the same framework can feel daunting to well-intentioned donors. Bureaucracy, paperwork, and long wait times for approval can discourage even the most motivated. The system is designed to say “no” to the wrong people; the challenge is not saying “no” to the right ones.

Stigma and Misunderstanding

Cultural and religious beliefs about the body, death, and donation vary widely in India. Some fear that donation—living or deceased—conflicts with spiritual or traditional values. Misinformation about health risks persists. The idea of giving an organ to a stranger can seem strange or suspicious, partly because it is rarely discussed openly.

Awareness campaigns have made progress, but gaps remain. Many people do not know that living with one kidney is medically safe, or that anonymous donation is legal and supported. Education, delivered sensitively, can address these gaps.

The Path Forward

India has the medical infrastructure to perform transplants at scale. What it needs is more awareness, streamlined processes for voluntary donors, and a cultural shift toward seeing donation as a noble act rather than a taboo. Regulation protects; transparency empowers. Both are essential.