Organ donation after circulatory death – legal in South Africa and in alignment with Chapter 8 of the National Health Act and Regulations relating to organ and tissue donation

Main Article Content

D Thomson
M Labuschaigne

Abstract





Organ donation after a circulatory determination of death is possible in selected patients where consent is given to support donation and the patient has been legally declared dead by two doctors. The National Health Act (61 of 2003) and regulations provide strict controls for the certification of death and the donation of organs and tissues after death. Although the National Health Act expressly recognises that brain death is death, it does not prescribe the medical standards of testing for the determination of brain death (neurological determination of death), circulatory death (circulatory determination of death) or for determination of death based on somatic criteria. However, in all cases of organ donation, including after circulatory death, the National Health Act mandates that two doctors certify the death, with one doctor possessing more than 5 years of experience. Additionally, both doctors must be independent from the transplant team. The standard for such determination, as for brain death, aligns with accepted medical standards. The Critical Care Society of Southern Africa has published South African (SA) Guidelines on Death Determination that outline rigorous standards for death determination in hospital settings by either a neurological or circulatory method. Legislation and the Health Professions Council of SA’s (HPCSA) professional guidance direct clinicians on obtaining informed consent for donation either from the patient or in cases of incapacity from their surrogate decision maker. Collectively, the legislation, regulations and professional guidelines in SA provide a robust ethical framework that supports organ donation after circulatory death.





Article Details

How to Cite
Organ donation after circulatory death – legal in South Africa and in alignment with Chapter 8 of the National Health Act and Regulations relating to organ and tissue donation. (2024). South African Journal of Bioethics and Law, 17(1), e1561. https://doi.org/10.7196/sajbl.2024.v17i1.1561
Section
Research Articles
Author Biographies

D Thomson, Division of Critical Care, University of Cape Town, Groote Schuur Hospital

Consultant
University of Cape Town
Surgery
SOUTH AFRICA

M Labuschaigne, Department of Jurisprudence, School of Law, College of Law, University of South Africa

Professor Melodie Labuschaigne is Professor in Medical law and Ethics in the Department of Jurisprudence in the School of Law, University of South Africa. Her research focuses on the ethico-legal regulation of stem cell research and human tissue, genomic and genetic research and assisted reproduction. She has been involved with the revision and drafting of health legislation for many years and is the recipient of various research excellence awards, spanning four decades. She serves on various boards in different capacities and was appointed in 2020 on the National Health Research Ethics Council.

How to Cite

Organ donation after circulatory death – legal in South Africa and in alignment with Chapter 8 of the National Health Act and Regulations relating to organ and tissue donation. (2024). South African Journal of Bioethics and Law, 17(1), e1561. https://doi.org/10.7196/sajbl.2024.v17i1.1561

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