Third-Party Organ Donors Cannot Be Viewed With Suspicion, Authorisation Committee Must Only Determine Commercial Interest: Madras High Court
Safiya Malik
The Madras High Court Single Bench of Justice P.T. Asha directed the Authorisation Committee under the Directorate of Medical Education and Research to grant approval within three weeks for a kidney transplant involving a law student as recipient and the brother of his maternal aunt's husband as donor. The court set aside the committee's rejection — premised on the ground that the relationship between the parties was not established — holding that third-party donors need not be viewed with suspicion, and that the committee's role is limited to determining whether the donation was commercially motivated rather than altruistic.
The petitioners approached the High Court seeking to quash the order dated 09.01.2026 passed by the Authorisation Committee rejecting their application for approval of kidney transplantation and to direct grant of permission based on their application dated 22.11.2025 submitted in Form 11 under the Transplantation of Human Organs and Tissues Rules, 2014.
The first petitioner, aged 20, was diagnosed with chronic kidney disease Stage V and was advised to undergo renal transplant surgery at the third respondent hospital. His near relatives were medically tested but were not compatible donors. The second petitioner, who is the brother of the first petitioner’s maternal aunt’s husband, volunteered to donate his kidney. The petitioners jointly submitted the required application along with supporting documents.
The Authorisation Committee called them for an interview on 09.01.2026 and subsequently rejected the application through a one-line order stating “Relationship not established.” The petitioners contended that the donor was a third-party donor and that Section 9(3) of the Transplantation of Human Organs and Tissues Act, along with Rules 7(3) and 19 of the 2014 Rules, governed such cases.
The Madras High Court examined whether the Authorisation Committee had correctly applied the statutory framework governing third-party organ donations, and found that the committee had proceeded on a fundamentally flawed basis by treating the absence of a familial relationship as sufficient ground for rejection.
The court observed that the committee had overlooked the fact that the donor was not a near relative, and that in such cases the applicable standard under Section 9(3) of the Act was not the establishment of relationship but the determination of whether any commercial interest underlay the donation. The court noted that the impugned rejection order confined itself to a single line — "Relationship not established" — without engaging with the material placed before it, and recorded that no evidence had been produced by the respondents to demonstrate that the donor had not acted out of altruism.
On the standard applicable to third-party donors, the court stated: "Every third-party donor does not require to be scrutinised with a needle of suspicion as there are genuine donors who come forward voluntarily to donate their organ and such third-party donors are therefore not ones who have been exploited. It is, however, the duty of the Authorisation Committee to examine, investigate and arrive at the conclusion that the donation is not backed by any commercial interest for which the rules provide certain parameters."
On how such donations ought to be assessed, the court cited with approval the Kerala High Court's observations in Muhmeed Rasheed and Another v. State of Kerala, where it was stated: "It would be unpragmatic to assess every donation between non-relatives on arithmetical scales or view them with scepticism in such summary proceedings. A rigid and inflexible interpretation of Section 9(3) of the Act would undermine the laudable object of the provision and render it otiose and nugatory. Even otherwise, nowadays, it is common knowledge that the number of recipients outnumber the donors."
On the burden placed on applicants, the court drew from the coordinate bench's ruling in Sudha Mathesan and Another v. Authorisation Committee and Another, where it was stated: "They can only assert that there is no commercial dealing. They cannot be called upon to prove the negative." The same judgment was further cited for the proposition that "if the donor states that out of love and affection, he/she is making the donation, in the absence of any credible reason, the averment should not be doubted."
The court also noted a broader concern about the arbitrary exercise of the committee's discretion, quoting: "If the recipient is well placed and connected, the decision of the committee will swing in his favour. If the recipient is not all that influential, by passing a template order, permission can be rejected. One must take note of the fact that parliament never intended to rule out donation by non-near relatives."
On donor welfare, the court cited the directive that "apart from taking medical insurance coverage in favour of the donor, a lump sum deposit shall be directed to be made to the credit of the Authorisation Committee" to ensure the donor's physical and medical needs are adequately met following the procedure.
The Court directed that “the impugned order of the 2nd respondent is set aside and the matter is remitted back to the 2nd respondent. The 2nd respondent is directed to grant permission for transplantation in accordance with law within a period of 3 weeks from the date of receipt of the copy of the order. In case the same is not granted within the stipulated time it shall be deemed to have been granted. Upon grant of approval/ deemed approval the petitioners are entitled to undergo the transplantation.”
“The writ petition is allowed and ordered as above. No costs. Consequently, the connection Miscellaneous Petitions are closed.”
Advocates Representing the Parties
For the Petitioners: Mr. N. Manoharan
For the Respondents: Mr. M. Bindran, AGP; Mrs. T. Vennila.
Case Title: B. Shyam & Anr. v. State of Tamil Nadu & Ors.
Case Number: W.P.No.2127 of 2026
Bench: Justice P.T. Asha
