Organ donation in South Africa: OPT-in, OPT-out or mandated choice

Abstract

Given the enormous gap between supply and demand for donor organs in South Africa, this research report seeks to answer the question ‘which system of organ donation is the most ethically and practically suitable for South Africa?’ I begin with an analysis of the varying aspects of the country that influence organ donation rates. Following this, opt-in, opt-out and mandated choice are all critically evaluated in terms of their suitability as organ procurement systems in the country. The four principles of autonomy, non-maleficence, beneficence and justice (theory of Principlism) are used to assess each system. In conclusion, a hybrid system of opt-in and mandated choice is argued to be the most ethically and practically appropriate system for South Africa to improve organ donation rates. As would be required for any improvement of the system, effort needs to be made to increase awareness on the topic of organ donation throughout South Africa.