South Africa’s Catholics should to know that the church approves of organ donations
Low organ donor rates are a global concern. In South Africa, only 0.2% to 0.3% of the population are registered donors who have committed to donating organs at death or on being declared medically brain dead.
More than 5 000 people in the country are on the waiting list for organs, many for kidneys, but others for livers, lungs and hearts, as well as skin tissue, corneas and other body parts.
With the ushering in of a new pope, there is concern among Catholics as to whether he will uphold Pope Francis’s support for ethical organ donation as an act of mercy. Francis was known for being liberal but each successive pope has their own set of norms.
For my PhD, for which I graduated in April, I researched the concepts and practices of organ donation in the Catholic Church. In Gqeberha, Eastern Cape, I interviewed a diverse range of practising Catholics from five churches to investigate the socio-cultural, socio-economic and socio-demographic factors that could affect conceptions of, and practices of, organ donation to understand if these factors, in addition to their Catholic beliefs, would affect their willingness to become a donor.
As a medical anthropologist with an interest in public health, and as a Catholic, I established that organ donation has been approved by the Roman Catholic Church since John Paul II who was pope from 1978 until his death in 2005. He said it was a gift of human love but he made it clear that there should be no payment for organs and, if it is a live donation, it cannot bring harm to the person donating the organ and neither can there be harm to the recipient.
Donation is the only option to save someone’s life if they are suffering from end-stage organ failure. The high level of non-communicable diseases in South Africa, such as hypertension and diabetes, often leads to heart disease and failure, and kidney or multiple organ failure, respectively.
The low transplant rates in our country necessitated investigating how knowledge, values and beliefs influence organ donation acceptance or rejection in the Catholic community in South Africa, which comprises approximately 3.8 million people from a wide range of cultures.
My research was also motivated by my personal experience. In 2014, at the age of 19, I had the first of several episodes of chronic kidney stones. It put me in hospital every six months and the situation was distressing but, fortunately, the chronic medication I was put on worked.
During this time, I started questioning my beliefs and values in relation to organ donation and, if it came to it, whether it would be permissible for me, as a Catholic, to receive an organ. I was relieved to know the pope had given his blessing for this, while not mandating organ donation as a must.
Despite the church having approved organ donation — and it being something for which Pope Francis issued encyclicals (papal letters) — my research showed that this is not widely known and donation remains something of a taboo subject.
If we look at the Bible, it speaks about the body being a temple and says that we are created in the image of God, so there is a lot of sacredness about the body. Some of the people I interviewed felt that organ donation is too invasive and ruins the image of holiness.
One Catholic interviewee, who was from a “traditional” African background, said that he could not be a donor because, in his traditional belief system, the body must be whole for the spirit to transition to the ancestral plane. In this instance, the traditional belief system took precedence.
Other interviewees from African, and other “traditional” and “Western” backgrounds, said that, because of the Catholic Church’s approval of organ donation, they supported it. Some said they would be prepared to be donors on death; others said they would also be prepared to be live donors, particularly if a family member needed this.
Several of the interviewees questioned the definition of “brain death”. The official definition is that two medical doctors have to declare a person brain dead, in other words, that there is absolutely no brain activity and the only reason the body looks alive is because the patient is on a ventilator. However, because of the belief in miracles, several interviewees said they were against the brain dead declaration, and questioned whether this really is death.
A few of the interviewees also voiced their concern about organ trafficking, which has become a commercial enterprise in Africa and globally, as highlighted in Mariana van Zeller’s documentary Trafficked.
Ultimately, as my research established, across the socio-cultural, socio-economic and socio-demographic spectrum, people’s religious, traditional and personal beliefs can influence whether they support organ donation. However, it is very important for Catholics to know that the church supports it, should they be considering it. As a Catholic, I support organ donation but I want to see if the new pope supports it too, as the rites of a Catholic burial are very important to us.
For those who would like to find out more about organ donation, South Africa has the Organ Donation Foundation, and becoming a donor is a simple process. You need to be 18 and above and in good health and, usually, below 65. The law also specifies that you have to get familial consent — in writing is best.
I am now pursuing postdoctoral research on organ donation and will be including interviews with medical doctors in the public and private sector who deal with organ transplants and a diverse range of people across the belief and non-belief spectrum.
Contact the Organ Donor Foundation on 0800 22 66 11 or at https://odf.org.za/. For frequently asked questions go to https://odf.org.za/faqs/.
Dr Terry Adams is a medical anthropologist in the Department of Anthropology at Nelson Mandela University.