High-res version

A recent article published by Bhekisisa discussed an unexpected consequence of promotional activities for the movie “Bypass”, which is ostensibly based on the Netcare ‘KidneyGate’ case (which never actually went to full trial, by the way, so we don’t really know what happened).  In Cape Town, flyers which purportedly advertised a hospital where wealthy people in need of organs could buy them from poorer ‘donors’ were distributed.  In SA, organ sales are illegal and many in the medical community – those on the ground who actually spend their days trying to facilitate transplants – were understandably upset.  But this sentiment wasn’t necessarily shared.  In the week after the hoax, the Organ Donor Foundation (ODF) reported a 30% increase in donor sign-ups.

Now don’t get me wrong, it’s heartening that so many South Africans appear willing to donate their organs after death.  But I have some concerns that when ‘singing-up’, people don’t necessarily understand the process and how it is impacted by SA legislation.  This is evidenced by live, healthy people who have signed-up saying things like:  “I am an organ donor!  Are you?”.  The answer is:  “No, I’m not an organ donor, I am still alive, so I can’t actually be a donor at the moment”.

In a 2016 supplement to the Mail and Guardian Newspaper I discussed some of the pitfalls which people ought to be aware of when signing up as a potential organ donor.  The bottom line is that yes, you can and should sign-up, but doing so is not legally binding in SA and doesn’t actually mean that your organs will be donated upon your death.  Ultimately, the written authorisation of your family is needed.  At the time of your death, your family may feel unwilling or hesitant to provide this authorisation – and there are a number of reasons for this (grief, being uncertain about your wishes or they may have their own beliefs about organ donation which aren’t the same as yours etc.).  Be assured though, that your family are under no obligation to acquiesce to your wishes just because you have signed up.  Because a person’s family is the gatekeeper of the final organ donation decision, I think it’s much more important that you have discussed your preferences with your family and that they know how you feel about organ donation and why you want to be a donor.

Another equal but opposite misconception amongst the SA public seems to be that you can only donate organs if you have signed up.  This is false.  You may have never considered organ donation, never discussed it with your family and never signed up.  But if it gets to the point where you are ‘brain-stem dead’ and the circumstances are conducive, your family may be asked to consider organ donation anyway.  They are legally entitled to authorise it regardless of whether you have signed up or not.

Finally, the public should be aware that although the ODF keeps a list of donor sign-ups, this is not actually available in hospitals where donors are identified – so, if you were under the impression that someone types your name into a computer and can find out whether or not you have signed-up as a donor, think again.  Your family are the ones who eventually decide, it’s most important that they know what you want.

The views published in this blog are entirely my own (informed) opinions.  They are open to debate, discussion and disagreement.