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.