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Transplantation is the only therapeutic option for terminal organ failure. The principle that donation should be a routine component of endof-life care is recognised in many countries, but only 38% of them have official deceased-donor programmes, and South Africa (SA) does not have one. Scrutinising the policies in countries such as Spain, the UK and the USA (Pennsylvania), where official referral programmes exist, could help to determine which option will be best suited to SA. It is concluded that the best basic step to start with in SA would be if the Department of Health could implement a routine-referral policy document, compelling physicians to refer every death to be evaluated for the possibility of organ retrieval.

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