Faith and institutional silence: Organ donation and moral ambiguity within Gqeberha’s Roman Catholic Community

This article explored how Catholic parishioners in Gqeberha conceptualised organ donation to understand the moral, theological, and emotional dimensions of donation. Despite South Africa’s critically low organ donor rate and the Church’s official endorsement of organ donation as an act of ‘brotherly love’ or ‘agape love’, there was a significant gap between the doctrine and practice. Drawing on qualitative data from eight focus group discussions, 15 semi-structured interviews, and participant observations across five urban parishes, this study argued that the choice to become an organ donor was not purely biomedical, but a moral practice shaped by individual agency and lived experience within a broader, often unspoken public health crisis. The findings highlighted that the ‘institutional silence’ from the pulpit— often mistaken for irrelevance existed within a theological vacuum filled with ambiguity about doctrine and other social issues, such as distrust in the medical system. Although narratives of living donation among family members were framed as sacred agape love, some parishioners did not readily favour deceased donation. By anthropologically exploring these entanglements, the study offered a lens into how parishioners negotiated biomedical advancements through their faith, lived experiences and their beliefs, suggesting that addressing silences is important for effective advocacy.