Mr. Speaker, I move—

Mr. Speaker, I am profoundly aware of the fact that this is an historic occasion, an occasion which justifies a departure from the normal practice that no speeches are made when a Bill is introduced. However, I believe that you will agree with me that it is important on this occasion that certain basic points of departure in the Government’s approach should be stated.

At the very outset I want to point out that I believe it is imperative that the discussion which will follow upon the introduction of this Bill will take place in an atmosphere which the dignity of this House requires, but also in an atmosphere which will emphasize the urgency of the circumstances in which we are living. The fact of the matter is that we are living in a dynamic society, which has, since the founding of this nation in 1652, always been faced with challenges which we have been able to meet with daring, with faith and with courage. I believe that the human material and the challenge of our country have always interacted in a dynamic way, which made heavy demands on meaningful adjustments.

The most important motives for the adjustments, which run like a golden thread throughout our history, were in the first place, the need for effective government, and in the second place the presence of conflicting interests which were deeply rooted and which called for reconciliation. It is a commonplace to say that the South African society is more complex, and consequently has a higher tension potential owing to its great variety and diversities and the conflicting interests associated with them than is the case in many other similar situations and circumstances. Yet we have a proud record of reconciliation in this country. On the other hand, however, we are also deeply conscious of the extent to which we share a common destiny in this country. As we are assembled here in this House, with whom and what we represent here, there is no one who does not believe that the circumstances of the country require reform. All parties in this House and those outside are agreed that the existing Westminster system of government is not capable of being used to serve a society such as ours effectively; on the contrary, all parties represented in this House are unanimous in their approach that the so-called system of one man, one vote within the present structure will lead to the domination of minorities by majorities, and that this will cause serious conflict between the various population groups, with destructive consequences for everyone. There are differences of opinion as to the methods of reform, but there is unanimity on the need for it.

So it was, then, that successive Governments and Prime Ministers of our country brought about reform. This has been a continuous process, for example Union in 1910, the Statute of Westminster and the Status Acts of the early ’thirties, the abolition of appeals to the Privy Council, becoming a Republic in 1961, the Black States becoming independent since and after 1976, and now the draft constitution of 1983. The line running through all these events is that of greater sovereignty, of the granting and development of self-determination, and of the recognition of the interests of minorities.

The present proposals are the culmination of all these points of departure.

Just like every man-made proposal, these 1983 efforts will also display defects. Human imperfection, however, may never be an excuse for a lack of progress. This Bill must be analysed and interpreted within the context of the general constitutional objective of the Government, namely to bring about a dispensation by means of orderly, evolutionary reform in which every person, separately and in a group context, will acquire an effective say in the decision-making processes as far as they affect each individuals own interect, and without the claim of a single people or group to decide their own way of life, continued existence and values for themselves being impaired.

†Mr. Speaker, the realization of this objective requires adaptation, reform and renewal. Injudicious and ill-considered reform can cause a disruption of our society. Though committed to the process of constitutional development and change the Government is not prepared to take any steps that may in any way jeopardize the order and the stability in this country. Therefore the Government will continue to act in a sensible and responsible manner.

It is equally important to emphasize that judicious reform and stability go hand in hand. Adaptations are necessary in order to ensure the maintenance of stability in the longer term. The demands of our time and our sense of justice require action. The Bill represents progress in the process of reform. Naturally there will be differences of opinion in regard to the details and especially on the extent to which the reform satisfies everybody’s subjective expectations and allays the fears of people. We are, however, at a juncture where the mere discussion of reform must be translated into concrete action. Every South African who subscribes to the concept or the idea of reform now has the opportunity to make a tangible contribution in both his analysis and judgment of this Bill.

*Finally, efforts are being made in every sphere of life to raise the spiritual and material level of welfare of all people. The Bill before us addresses the constitutional sphere. The Bill itself will not give rise to an improvement in the living conditions of groups and individuals, but it provides the political structures within which the groups may effectively participate in the decisions affecting their lives.

It is the sincere belief of the Government that all South Africans can associate themselves with the objectives spelt out in the preamble to this Bill, viz. that we declare our intention to uphold Christian and civilized standards, with recognition and protection of freedom of faith and worship; to safeguard the integrity and freedom of our country; to maintain law and order; to furthere the contentment and the spiritual and material welfare of all in our midst; to respect and protect the human dignity and the rights and liberties of all in our midst; to respect, to further and to protect the self-determination of population groups and peoples; to uphold the independence of our judiciary; and to further private initiative and effective competition.

Mr. Speaker, I rise to express the views of the official Opposition on this motion in the absence of the hon. the Leader of the Opposition who, owing to prior commitments in the Transvaal, is unable to be here this afternoon.

None of us either inside or outside this House should underestimate the importance of the process that has been started by the proposal of the hon. the Minister to introduce the Republic of South Africa Constitution Bill in this House. This debate marks the occasion on which Parliament as the sovereign law-making body formally enters the process of constitutional reform. In that sense it is a day for which some of us have worked long and hard. I want to refer way back to 1959 when the Progressive Party pronounced such heresies as the following—

Therefore, to the extent that this is a milestone in the process of constitutional reform, we welcome the occasion.

The way in which Parliament—and this includes both Government and Opposition—conducts itself during the process is going to have a profound impact on the course of the history of our country and of its people. Clearly this is a process during which the interests of the country should transcend the interests of political parties. It is in this spirit that we in the PFP, mindful of our responsibility to the people of South Africa as a whole, will play our part in the debates and discussions that lie ahead.

The PFP’s approach to constitutional reform is based on two fundamentals. The first is our belief that peaceful coexistence of our people in the future demands that our present constitution with its built-in group domination and its “winner take all” political system must be replaced by one which provides for full participation of all of its citizens without the domination of one group over the other. The second fundamental is our recognition of the fact that while a new constitution should be the product of negotiation between the leaders of all groups of the population, it is this Parliament, the sovereign Parliament of South Africa, which must finally decide upon and give legal authority to any new constitution in our country.

So, in the days and the weeks and possibly the months that he ahead we in the PFP, putting as we see it the interests of our country before all else, will examine the Bill and we will judge the Bill. We will debate the Bill in the House. We will use the procedures of Parliament and of its Select Committees to attempt to ensure that the new constitution as finally enacted by the Parliament will meet the criteria which we regard as essential if we are going to promote unity and peaceful coexistence amongst all individuals and groups in South Africa.

We, from our side, are going to judge the Bill on whether it extends participation in the process of government to all the citizens of South Africa or whether it excludes some from it. We will judge it whether it protects the various groups in our population from domination or whether it entrenches domination of one group over the other; whether it moves South Africa away from apartheid and discrimination or whether it reinforces the structures of racial division; whether it extends the democratic principle and reinforces the freedoms without which democracy cannot exist or whether it creates a new form of authoritarianism; whether the new constitution re-establishes the rule of law and the paramountcy of the judicial process or whether it leaves liberties and the rights of the individual South African at the mercy of politicians; and finally whether amidst the diversity which is South Africa the new constitution provides the prospects of achieving a greater unity or whether, because of the nature of the constitution or the processes which it will set in motion, it is going to lead to further polarization and to conflict. It is against that sombre, serious background that we will participate, deliberate and constructively involve ourselves in the process of constitution-making.

Much is going to depend on how the Government handles the process of constitutional reform in this House. Let me say at the outset that I believe the Government has gone off to a bad start having delayed the publication of the Bill for weeks. Its tabling in Parliment takes place just a few days before a critical round of by-elections in South Africa. [Interjections.]

Order!

The fact is that no opportunity will be given to those who have not been privileged enough to see the Bill to make a real in-depth study of the Bill, its processes and the procedures. It appears to us from the timing of the publication of the Bill that the Government unfortunately is trying to manipulate the process of constitutional change in the interests of its own political party. [Interjections.]

Order!

Let me say immediately that this is a criticism of the past. Let us forget the past for a moment and let us look at the future. Let us say immediately that the Government, if it really is concerned about the interests of South Africa, will be well advised not to bulldoze the Bill through Parliament but rather to give time for all interested parties and experts inside this House and outside this House to make a study in depth and to make representations and suggestions for the improvement of the legislation.

As was stated yesterday by the hon. the Leader of the Opposition, the PFP would not be opposing the introduction of the Bill. The PFP nevertheless has fundamental objections to the constitutional guidelines which have so far been made known by this Government. Let the Government take note that to the extent that it becomes clear, after the tabling of the Bill which we have not seen, that what we have objected to initially in the guidelines has been carried over into legislation, the Government can expect the vigorous opposition of the PFP. [Interjections.] We wish to separate two issues. On the one hand there is our desire to start the process of constitutional reform, and on the other hand there is our fundamental opposition to the guidelines that the Government has so far advanced. Our procedure on this occasion is to adopt the recognized parliamentary procedure of abstaining should a division be called on this. We do not want to be an obstacle to this Bill being introduced as part of the process of constitutional reform … [Interjections.] … but neither do we, in any way, want to be linked or associated with the specific guidelines that the Government has stated for its constitutional proposals.

Mr. Speaker, I apologize for the parliamentary leader of the CP, Dr. Hartzenberg, not being able to be present. He had already accepted obligations from which he could not withdraw. Together with the hon. the Minister of Constitutional Development and Planning I also wish to say that it is essential that changes have to be effected in a dynamic country like South Africa, that methods have to be employed to bring peace and prosperity in this country with its diversity of people. We also agree with him that different political parties have different recipes for achieving this peace. I now wish to quote a passage from a report which appeared this morning in Die Burger—

This brief report in Die Burger brings a very important point into prominence. Reference is made to the “ingrypende” (drastic) new constitutional dispensation for South Africa. Of course we are aware that a political party’s policy and principles are approved at congressses. We also know that the hon. the Prime Minister places a very high premium on this. That is why the hon. the Prime Minister has already indicated that the principle contained in the Bill is the same as that of the constitutional guidelines accepted by the congresses of the NP. The principle in the Bill is therefore political power-sharing and mixed government for South Africa’s Whites, Coloureds and Indians in one Parliament in one fatherland. I should like to quote what the leader of the CP, Dr. Treurnicht, said to indicate that changes should in fact be effected (Hansard, 1983, col. 1257)—

The CP is familiar with the principle contained in this Bill and adopts the strongest possible standpoint against this principle since it is diametrically opposed to the CP’s programme of principles and its constitution. This is a debate on a principle, the principle on which the constitution of the Republic of South Africa is based. There can be no law more important to a people than its constitution. The CP believes firmly that the principle at issue here is whether or not this Parliament will remain the exclusive Parliament for the Whites, whether this Parliament should become a component of a multiracial tricameral parliament. The CP believes that this sovereign Parliament is the exclusive Parliament of the Whites and should remain so. In this connection I should like to quote from Hansard of 4 March 1968, col. 1508—

The speaker made no secret of a matter of principle being involved when it came to the White Parliament. He said that that principle had always been one of the cornerstones on which South Africa was built. That speaker was the hon. the Prime Minister.

Surely what you are saying is a half-truth. [Interjections.] A half-truth is worse than a He.

The NP says the character and the composition of the House of Assembly will be preserved. What is the character of this House of Assembly. This House of Assembly, together with the State President, forms the Parliament, the legislative authority in the Republic of South Africa. This House of Assembly is vested with sovereign power. The hon. the Prime Minister said in Bloemfontein—

This Parliament in which we are sitting today, will, if this plan is implemented, be replaced by a new legislative authority, a new multiracial Parliament which will consist of three chambers, a multiracial President’s Council under the control of the President who is elected by a multiracial electoral college, and a Cabinet which will also be multiracial. This Parliament in which we are sitting today and which is vested with sovereignty, is being degraded into a component of the new Parliament. This Parliament is being divested of its sovereign authority. This Parliament is losing its sole say over the Important matters in our State administration. The principle that this Parliament shall remain the exclusive Parliament of the Whites in South Africa is being thrown overboard.

It is not necessary to reiterate the history of this Parliament and the constitutional development it has brought about. The political integration which was begun in 1910 when Whites and Coloureds were represented in this Parliament, has been systematically eliminated by resolutions of this Parliament, so that this Parliament today is the exclusive sovereign Parliament of the Whites in South Africa.

The Government adopts the standpoint that territorial separation for Black peoples is justified. The Government says that it is the right of each Black people to govern itself in its own territory. The CP says to the Government that we are in full agreement with it that it is the right of these Black peoples to govern themselves. It is also a finding of the President’s Council with which we agree. However, the CP maintains that if it is the right of the Black peoples to govern themselves in their own territories, it is also the right of the Whites to be governed by their own people in their own territory. The CP maintain that when legislation is proposed which in principle is aimed at amending the existing constitutional dispensation in such a way that it impairs the rights of the Whites to govern themselves exclusively, we shall oppose it tooth and nail. The CP maintains that the date with destiny does not lie in a partnership among Whites, Coloureds and Asians, but that it lies in full self-determination for the Whites, Coloureds and Asians in the same way as for the Black peoples.

I should like to quote what the late Dr. Verwoerd said about this—

That is why this party will oppose any legislation which seeks to change this Parliament. This sovereign White Parliament which has already led four Black peoples all the way to self-determination should not be impaired by any legislation. This Parliament should lead the Blacks, Coloureds and Indians towards and help them to obtain full self-determination within their own areas. Any Bill which wishes to change the present parliamentary legislative authority in South Africa according to the guidelines proposed by the Government, terminates the existence of the last White Parliament on the continent of Africa. That is why we shall oppose this Bill. [Time expired.]

Mr. Speaker, the hon. member for Sea Point referred to this occasion as a sombre occasion. However, I want to tell the hon. member for Kuruman that for his party and for him it is a lost opportunity. For us on this side of the House, today is a joyful occasion because we find ourselves experiencing one of the great moments in the constitutional history of South Africa.

After 1910 the first great moment in our country’s history was the date 23 January 1961, when Dr. Verwoerd as Prime Minister moved the introduction of the legislation for the creation of the Republic of South Africa. Today, 5 May 1983, the hon. the Minister of Constitutional Development and Planning has moved the introduction of legislation to make provision for replacing the Westminster system with a system of presidential government. That is why I think this is a good opportunity to contrast these two historic events with one another briefly.

In 1961 Dr. Verwoerd, during the discussion of that legislation, said inter alia the following—

That hope was primarily centred around greater unity between White South Africans. That hope was not in vain. Each one of us sitting here this afternoon can probably testify to that without reservation. In 1983 the hon. the Prime Minister—after all, it is in effect he who is speaking today—stated the case for a new constitutional dispensation as follows—

That courage and faith is not only demanded from the Whites, but from the Coloureds and Asians as well. It is also aimed at better relations, not between two White language groups, but between all the various national groups. In my heart I am convinced that the vast majority of people in South Africa are prepared to accept the challenge of the future in an earnest and responsible way and that our descendants will in future be able to testify that our courage and our faith were richly rewarded.

I want to single out a second contrast. The 1961 constitution was the result of a strong idealistic urge. It was an idealism which has since 1961, over a period of 22 years, extended to the entire White population. The 1983 constitution is the result of a strong realistic urge, the realization of the need for constitutional reform because the present dispensation does not, without adjustment, offer a solution to the constitutional problems of our country. In my mind there is no doubt that this realism will also work its way through to an ever-increasing percentage of all three participating population groups.

There is a third contrast. With the 1961 constitution, the character of our constitutional dispensation was not changed. We did, it is true, change from a monarchy to a republic, but the constitutional structure remained untouched. The constitution which we are now going to consider, however, is going to effect a drastic change to the character and the structure of the constitutional authorities. Consequently we find ourselves at a far more important turning point in our history today than in 1961. We find ourselves at a turning point of very much wider and greater dimensions than in 1961. The judgment of history in regard to the nature of the opportunity facing us today will be that we had arrived at a fateful moment for our country and for the various national groups. The facts of the present and the challenges of the future are going to make heavy demands on all who have to work on the success of the new dispensation, demands of good relations, demands of reasonableness, demands of patience and demands of statesmanship. For that reason the new dispensation is not going to have any room for the vacillators, the objectors, the pessimists and the fearful. There is, however, going to be a lot of room for the courageous, for the fearless believers, for the calmly determined, for those with some backbone and drive.

I want to put forward the following question for discussion: What are the objectives of the new constitution going to be? Briefly stated, I think they will be the creation of a democratic system in which the effective say and decision-making of each participating group over matters affecting their own interests will be assured, while responsibility for matters of common concern will be shared by the groups. The voters of this country can with justification make certain basic demands on us as their representatives, who are assembled here today, when we wish to begin to give statutory shape to the reform process. I think the most important of these demands will be, firstly, that the constitution shall uphold Christian values and civilized standards. In the second place, it has to ensure order and stability in the country in a democratic way. Thirdly, it has to make provision for the right to self-determination of all the participating groups. The NP, this side of the House, believes that with this constitution these are the very things it is going to achieve. We are therefore venturing into the future with a humble faith, but also with great determination, united behind our courageous leader-in-chief, our esteemed Prime Minister. We are venturing into the future with our hearts and with great confidence.

Mr. Speaker, it has been suggested on occasions when the motion for introducing a Bill is opposed by a party in this House that it is the strongest form of opposition or of protest against a Bill. The arguments we have heard so far on this motion are arguments which could have been heard during the Second Reading. In my humble submission opposition to the motion for the introduction of a Bill is an exercise in futility. It is something which we believe really does not achieve anything. The strongest protest against a measure in this House is to move at Second Reading that it be “read this day six months”. If adopted that effectively kills a Bill. This is the only way in which a Bill can be effectively killed. Simply to vote against a Bill, either at First, Second or Third Reading means that, if you are successful, the Government lives to fight another day and to reintroduce the measure once more. So you have not achieved what you have set out to do.

Sir, as I have said, opposing the motion for introducing a Bill is an exercise in futility. I liken it to giving a child a hiding for something which you think he may be going to do tomorrow. All we have before us here this afternoon is a motion of introduction which reads—

Far be it from me to try to play down the importance of this moment. This is indeed an historical moment and could be the turning-point in our history. Personally I am very proud and somewhat humble at being part of this moment. I think all of us in this House this afternoon should pause and reflect on what this moment is going to mean to our country.

The degree of turn, the degree of pace of change is contained in a Bill which we as members of this House have not yet sighted. We hope to have sight of it this afternoon or by the latest tomorrow morning. This is in accordance with the standard practice of this House, a tradition of this House. Only after we have sighted the Bill will we be able to study its details and its principles and will the NRP be able to determine the line we will take on the measure. Mr. Speaker, I would like to give you the assurance that whatever line we take, you may rest assured that this party will contribute to every debate, to every committee appointed to examine the Bill in order that we may play our part in bringing about the constitutional change that we most want to see in the Republic. The destiny of all our peoples at this moment lies in our hands, and we must not fumble. It is our prayer that what we will do will be remembered by generations to come with pride. We want history to praise us; not to condemn us. The members of the NRP in all humility dedicate themselves to achieving what is best for this country.

Mr. Speaker, we will support this motion.

Mr. Speaker, let me hasten to say that I was not surprised at all by the attitude adopted here today by the hon. member for Sea Point. What he did here today is completely characteristic of his party. They have never been able, ever since the establishment of that party, to rise up to the occasion in the constitutional history of this country. [Interjections.] Never! [Interjections.] The truth is that the PFP has not made any substantial contribution to the constitutional development and the constitutional history of South Africa. That party has on all important occasions failed to make its contribution. [Interjections.] Mr. Speaker, I did not interrupt the hon. member for Sea Point when he spoke. I therefore expect hon. members opposite to give me a fair chance to reply now.

Having listened to the hon. member for Sea Point again this afternoon it appeared clearly that the hon. member had to satisfy once more the conflicting views within his own party. [Interjections.]

You are back to party politics again.

No, I am not. [Interjections.] Let us just look at what the attitude of the hon. member is. I must presume that that is also the attitude of his party. They intimate that they will abstain from voting. In other words, once more, at a crucial moment, the contribution of the PFP is to abstain from being part of the decision. [Interjections.]

What you want is a blank cheque. [Interjections.]

With respect, Mr. Speaker, that is the reason why that particular party is destined to be relegated to the past; the reason why it will not be part of the future of this country. [Interjections.]

Order!

In conclusion, Mr. Speaker, I submit that the attitude of the PFP is that there can be no constitutional change in South Africa unless they succeed in finding consensus at a national convention, which in fact implies in practical terms that they want to dominate the scene for ever in this country. Furthermore, let us look at what the hon. member for Sea Point does. He accuses the Government of withholding the introduction of this Bill for political reasons. He also accuses the Government of manipulation in this particular regard. If we wanted to do that, why then would I introduce the Bill before the by-elections on 10 May? What substance is there in that accusation by the hon. member? What reason does the hon. member have for saying this? I submit he has no reason whatsoever. His accusation amounts to an untruth, which warrants no further comment. [Interjections.]

*I now wish to turn to the hon. member for Kuruman. If there is one opposition party in this country which ought to have supported this legislation in principle, it is the CP and its hon. members. [Interjections.] Oh, please, cannot those hon. members keep quiet? Mr. Speaker, what is the record of the hon. members of the CP? It can only be one of two possibilities.

The legislation which I wish to introduce here today, contains in every detail, in every aspect pertaining to its contents, every principle for which those hon. members stood until February 1982. [Interjections.] I hasten to add that I would have had respect for those hon. members if they had been prepared to say that they had re-considered their position. Surely in our politics there is opportunity for people to say that they have changed their standpoint.

Well, I hope you are going to change your standpoint.

But then we must have the moral courage, as members of this House, to act in accordance with our convictions. If I am wrong in my deduction, then there can be only one other explanation and that is that the hon. members of the CP, for reasons of expediency, for reasons which suited their purpose, remained on the NP while they strove to achieve other political objectives. [Interjections.]

You people are reformers by stealth.

We therefore have a situation in our own politics which amounts to the greatest political deception and disloyalty we have ever known. The politics of our country requires …

What an historical occasion!

Yes, Sir, the politics of our country requires on an historic occasion, of which the hon. member for Grey town understands nothing, that we should at least use the truth in conducting our arguments.

The hon. member quoted what the hon. the Prime Minister had supposedly said in 1968, but he omitted one fundamental statement, namely that the legislation which will in a moment be read for the First Time, is the first drastic deviation from the Westminster System, which we were still utilizing at the time.

The hon. member argued further about the sovereignty of the White Parliament. However, the sovereignty of the White Parliament has been impaired on various occasions during recent decades. Its sovereignty was diminished in respect of four peoples that became independent; its sovereignty was impaired when five other peoples received legislative assemblies; its sovereignty would have been impaired in terms of the model for which the hon. member stood when the White Parliament had to relinquish its rights of decision over the Coloureds and Asians. Surely it would have relinquished these rights when it had to share decision-making on matters of common concern with a Coloured and an Asian Parliament. What are we trying to do when we debate in this House?

Finally I want to say that I agree with the hon. member for Umhlanga. If this House passes this legislation, it will bring a specific constitutional era to an end. I would even say that there is no one who is participating in this debate with greater hesitation than I am, because I realize my imperfections and my inability to foresee the future. However, I do want to say one thing and that is that it is not only constitutional models which will ensure peace in this country. It is not constitutional plans alone which will assure orderly development. Whether our plans succeed is going to depend on the people of this country. It is going to depend on the attitude of the people whom this constitution has to serve.

There is one thing this House cannot escape from. If constitutional change in this country is to proceed in an evolutionary and orderly way and if it is to be beneficial to the country, then this House must do so. This House will not be big enough to carry out this task of destiny if group interests are put before national interests. Lying ahead for us during the coming week is one of the most crucial tests any House of Assembly has ever had before it.

Question put,

Upon which the House divided.

As fewer than fifteen members (viz. Messrs. S. P. Barnard, J. H. Hoon, R. F. van Heerden and Dr. F. A. H. van Staden) appeared on one side,

Question declared agreed to.

Republic of South Africa Constitution Bill read a First Time.

Mr. Speaker, when the House adjourned last night, we were discussing the general principles of the Bill and also some of the clauses which we considered important. We discussed the importance of donations of tissue and we also discussed who can donate tissues and bodies. I should like to ask the hon. the Minister whether he thinks this is enough.

There is no doubt that the importance of donations has now become accepted, not only in South Africa but also in many parts of the world. There is no doubt that donations of tissues and bodies play a very important role in medical management. There is also no doubt that there is a great shortage of blood for transfusion, of corneas for transplants and of other organs—bone-marrow and even gametes.

I should like to put it to the hon. the Minister that he should consider making donations of tissues more freely available. We should not really have to obtain consent; we should have the opposite. Any patient who is admitted to a hospital must accept that his organs, tissues or body can be used unless he or his relatives sign a document to disallow this.

Never.

The hon. member for Roodeplaat is, I am sure, a great expert on this very important issue I am raising and he says “never”. [Interjections.] I can assure him that this is very important. I say this because the human body is a valuable asset, and there is so much waste. The bodies of so many people, I feel, could be made use of when this measure is implemented. I am putting that to the hon. the Minister as a thought. I think he understands the importance of the donations. Now that transplantation is becoming more acceptable, that is perhaps something towards which one could lead the public in future. It is not that a persons’s body must be used. A person must just sign a form stating that he will not allow his body to be used.

I do not think that anyone, reading this Bill, will find the word “race” mentioned anywhere. I consequently want to extend a warning to the Government and hon. members of the CP to ensure that what we have achieved in medicine, in transplantation, stays that way. Except for a millimetre or less of pigmentation, the human body is exactly the same in all races. In transplantation—especially since the first heart transplant—attempts have been made by certain people, for various reasons, to bring race or racial discrimination into the whole issue. They did not succeed. I therefore want to extend a very friendly warning. I mentioned two specific aspects last night that I wanted the hon. the Minister to reply to. I do, however, also want to warn the CP again of the fact that we do not bring the concept of race into donations of tissue and organ transplantation. [Interjections.]

You are doing it now.

Thirdly I should like to tell the hon. House that with the help of this legislation we have attained high medical and ethical standards in dealing with human tissue. This is important when it comes to obtaining the trust of the patient. Nowhere must this trust be denied him, not by this hon. House, not by the public or by the medical profession.

We have discussed the Bill in detail, and except for a few problems I raised with the hon. the Minister, I would like to say that we on this side of the House support this Bill. I look forward to hearing the hon. the Minister’s reply.

Mr. Speaker, the hon. member for Parktown began his speech in this House last night. He referred with great compassion and nostalgia to the role played by his colleagues. This afternoon, however, I also wish to refer to the major role he himself has played on exceptional occasions in our medical history in South Africa. Accordingly I wish to pay tribute today to what the medical profession in South Africa has done in the best interests of all our people. As a researcher, the hon. member for Parktown has shown himself to be in the front rank in the field of transplants in South Africa’s history, he as well as his brother, Dr. Chris Barnard. We shall always honour them for that. As a member of this House, too, he has sometimes made good contributions, particularly in respect of his area of expertise. [Interjections.] Here I want to interrupt myself to say that the hon. the Minister and his department must be congratulated on the way in which this piece of legislation has been drafted and for the wide field covered by the legislation, the way in which certain situations have been anticipated in this legislation and the way in which certain instruments have been set in operation in order to deal with them. I want to congratulate the hon. the Minister on that. Then, too, I wish to turn at once to a matter raised by the hon. member for Parktown last night, viz. the dilemma in which the medical profession finds itself concerning the determination of the moment of death. He said that he found it a problem that there was no definition in the legislation of the precise moment of death or when it occurred. I am no doctor, but I had to work for long periods in hospitals in connection with my studies as a pastoral psychologist. I was also a member of the multi-disciplinary team that stood by at death-beds, and had to struggle with exactly the same problem.

If medical science has to struggle with the extremely complex matter of determining exactly when death occurs and what the exact moment of death is, the church, on the other hand, has also struggled with the same problem, which is certainly an ethical and religious problem as well. For us who are on the pastoral psychological side, it is good enough for two medical practitoners to find that a person is clinicaly dead—in other words, that certain organs and functions are no longer functioning. We then accept that in clinical terms, death has occurred. How the church, in its field of operations, has to deal with those who remain behind and assist them, is another matter. I am specifically concerned with what the hon. member for Parktown has to say with regard to the moment of death, to indicate how risky it is to want to define in the legislation what is meant by the moment of death, because we are dealing here with a grey area. I think we are on very thin ice in this regard. I think that the hon. the Minister will also reply to the issue of wanting to define in the legislation at a purely medical level exactly what the moment of death is and when it occurs.

To me there is another clause that is of the utmost importance in this fine piece of legislation. It is right at the other pole. It concerns the precise moment when life begins. I want to refer to the clause relating to artificial insemination or artificial fertilization. In my humble opinion the process of in vitro fertilization is one of the great breakthroughs in medicine, a break-through which followed many years of research. Even though success has been achieved in this field, there are still so many problems involved that it cannot yet be presented as a successful method for conceiving of children. At best it can be regarded as an experiment that has been reasonably successful. Accordingly I want to say here and now with regard to clause 22 that I am content with the specific codes of practice stipulated by the Department of Health and Welfare in regard to the matter of artificial fertilization. I endorse those codes. However, I want to add at once that in order to adopt a balanced view of this extremely contentious matter of artificial fertilization, one must bear in mind that there is more at stake than medical science, the church and theology. We must ask what the law, the legislator, tells us in this regard, so that we can adopt a balanced view concerning an extremely contentious matter. This is an issue which is still in its infancy. If I may venture to turn to the field of jurisprudence, it is because there are no precedents in law. There have been occasional situations, but as yet there have been no clear test cases which the courts could refer to today and in accordance with which they could adopt a specific standpoint. Later in my speech I shall have more to say about this juridical aspect.

I want to ask that we discuss this contentious matter in a sober and balanced way and that we take cognizance of all these standpoints. There are still difficult and unresolved questions that must be answered and have thus far remained unanswered. The final word in regard to all these disciplines I have mentioned—the church, the law, the legislator and medical science—has certainly not been pronounced as yet.

Before stressing the ethical and religious aspect I want to dwell for a moment on the forensic. I do not pretend to be an expert in the medical field but I have ascertained what the situation is with regard to this aspect. On the basis of statistics we can draw certain conclusions and establish certain guidelines. It is said that one out of every eight marriages in South Africa is childless due to some medical problem as regards the man or the woman or a combination of the two. Medical science has been struggling for years with this problem of so-called “infertility” of the man or the woman. The first great breakthrough in this field was the process of in vitro fertilization. I referred to this earlier on. This was the reward for years of patient research in the medical field. I do not wish to deal in detail with the processes that take place but I do just want to put hon. members in the picture. Just recently, in 1978, the first successful fertilization by artificial insemination took place in the United Kingdom and a daughter, Louise Brown, was born. She is still strong and healthy today. In South Africa the first such birth took place last year when a daughter, Dominique Darval, was born.

Such parents are certainly patients of a specialist in this process. This is so because we are concerned with the situation in which absolute specialist knowledge is required. For these parents, and other patients in their group, there is no option as far as fertility is concerned. I want to stress that no other option exists. When the church, the law or the legislator considers the situation in which there is a possibility that parenthood may indeed occur or develop, then this must be done in a very positive way.

There are various reasons why this problem occurs with regard to various patients. However, I do not want to go into the details of that now. The fact of the matter is that we are dealing here with a selected group of patients that may be considered for in vitro fertilization. It is a carefully screened group. As far as the technique of the matter is concerned, it is as well to know that a process is initiated which results in the birth of a baby known as a test-tube baby. Without going into detail, one can state that as far as the technique is concerned it is not a highly complex technique, but that it does not afford instant solutions for childless parents, because there is more at stake than the mere fact of success with regard to this process. There are other matters involved, too, for example the process used—laparoscopy—and the fact that we are told in this regard that when the ovaries of a woman have to be obtained to be paired with the sperm of the man, 85% of the efforts succeed, whereas eventually on by 65% of the embryos develop. When they are replaced in the uterus of the woman, only 9% to 12% will lead to pregnancy. When we refer to pregnancy, we refer to a development of more or less nine weeks or longer. This gives an extremely low figure, namely 4 live births out of that initial percentage. Taking all circumstances into account, we must regard this practice as nothing but a research modality, because only when the success rate is more than 25% can it be presented to humanity by medical science as a functional service.

One can consider the risk run in this process. In the first place, there are the ordinary risks, e.g. those entailed by a general anaesthetic. Then there are risks with regard to the chromosome composition of the embryo and concerning the long-term implications of test-tube babies. As yet this is by no means clear. Then, too, there is the possibility of psychological consequences for the developing individuals.

When we look at all these risks it is also imperative that we consider the persons involved in the matter. Therefore it is not to be wondered at that in that regard, too, we should have an extremely stringent screening process with regard to the man and woman because we would expect to be dealing with emotionally very stable people, people capable of dealing with disappointment. There would have to be a stable marital relationship between those two people who went in for in vitro fertilization. Then, too, these people would have to be extremely highly motivated and very mature in their relationship with one another. Due to the artificiality of the procedure, those who wanted to let themselves in for this would first have to deal with and assimilate this aspect before the technique was applied to them. Therefore counselling, not only by the medical practitioner but by the therapist, the psychologist, the social worker and the clergyman, is of the utmost importance in this process. Therefore, if I could sum up certain conclusions in a nutshell this afternoon, in vitro fertilization is a research activity which brings hope for a specific group of patients who could otherwise never become pregnant. On the other hand, however, I can say this afternoon that as research progresses—and it is progressing by the day—the results ought also to improve to such an extent that eventually it would be sufficiently functional to be presented as a solution for childless couples.

In the second place I should like to dwell briefly on the legal implications of this matter. As far as this Bill is concerned, it is of importance to know that the law has always, particularly as regards matters such as sexual life of people and transplant functions, had a very strong religious basis. Looking at the Roman law, we see that it was the Christian religion which did not manipulate the Roman law in this sphere, but dominated it to such an extent that its orientation, its basis, was of a Christian nature. To us who live in a Christian country, it is important to know with regard to the law regulating this matter that this is the background from which it is to be approached. As far as artificial fertilization is concerned, we have no precedents in our law to refer to if matters were to go awry at the juridical or medical level and the matter had to be considered by the courts. But, despite that, we still have the so-called bona mores to refer to. This means that the social pressure extended by the community in which the law operates will be the guideline for the law and the judge, on the basis of which he will pass certain judgments. In other words, the law allows itself to be guided by good morals. It is a matter of the convictions concerning law that prevail within a community. Whereas we are dealing with the purely medical aspect here this afternoon, the law will know what the social evaluation of an action is, in the full sense of the word. In this regard I may say that South African law adopts a positive attitude towards the issue of test-tube babies in particular, but also in general. It is regarded as admissible. Test-tube babies procreated artificially are not children out of wedlock and all four disciplines to which I referred this afternoon ought to take cognizance of that and scrutinize it carefully from every angle.

There is one problem, a problem which the Church also recognizes, relating to the situation where an external donor is concerned. If one considers marriage as a monogamous and lifelong union between two people, and a third person enters that monogamous relationship as a donor, this creates extreme moral and religious problems, and this is an uncharted field which the Church in particular will have to consider, and it will have to consider the ethics of the matter as such. Tests, even at the veterinarian level, have been so successful as to be implemented on farms throughout South Africa. I have this in my own constituency. The system of the so-called “host mother” is used, where an embryo is implanted in a mother, in this case a cow. Tremendous success has been achieved in this regard in improving the breed or pursuing a bloodline or ensuring that breeding occurs far more rapidly. However, the situation becomes frightening if one bears in mind that such a situation could be applied at the human level, and here I want to express myself very strongly today.

As far as the pastoral perspective in this regard is concerned, it is of importance that we should also consider the other aspect, and that is that 12,5% of all women experience unfulfilled motherhood. I have before me church documents to support this. Their own research has brought this to light. Parenthood in this sense is a normal consequence of marriage; marriage is oriented towards parenthood. Motherhood confirms the feminity of the woman, and fatherhood the masculinity of the man. The man in the street has the impression that it is the women to whom this situation is most traumatic, viz. when she is unable to be a mother. But the latest research shows that the man is far more gravely affected at the psychological level than the woman. Here I want to plead for understanding and ask that the churches with their pastoral services make a specific point of guiding and assisting these people in that situation: The woman with a deep pain in her heart and the man with the pain of longing in his heart. The Church must guide that couple through deep waters. They must be motivated. It is important that the churches must take cognizance of the fact that when a well-motivated couple have a strong desire to make use of these scientific methods, they should not allow themselves to be led by synodal decisions or by whatever church or religious leaders may say to them. They want to become parents, and if medical science is capable of assisting them in this regard, then they should consult a medical practitioner and ask him for assistance. In this regard I recall what Rachel said to Jacob in Genesis 30 when she sobbed out her jealousy of Leah and said to Jacob: “Give me children, or else I die.” This need is very strongly rooted in married couples.

It is so often said that the orphanages are full of children and that childless couples should adopt children. Why then resort to other methods against which there may be ethical objections? “Orphanages are full; make the hearts of children rejoice and fulfil your high calling by adopting children,” is what they say. That is true, I endorse that, but what are the facts? The facts are that at present, there are hardly any children available for adoption in orphanages. 150 000 Whites in South Africa are affected by infertility. This, in turn, is an aspect of the society we live in: The higher the standard of living, the higher the level of infertility. But I do not wish to discuss that this afternoon. I now come to the fact that in 1981 there were only 1 200 adoptions not involving a child’s own parent. If we consider that 150 000 people means 75 000 parent couples, this means that only 1,6% of them may adopt children. Even taking the low success rate of artificial insemination into account, this does appear to be an extra prospect for the thousands of people, one that must be developed to the maximum.

We now have the problem of people locked in an inner conflict between two poles, people who, on the one hand, are determined to become parents, and for whom it is indeed possible to become parents but who, on the other hand, must endure the uncertainty as to what is and is not permissible and all the other negative actions that that entails. I have made a plea for empathy on the part of the Church. I appeal for this once again.

I should like to conclude my argument this afternoon by pointing out that this necessarily brings us to certain ethical perspectives which we have to consider. However, suffice it to say today that one cannot discuss these matters without in the process taking cognizance of the intentions of God, and in the first place His intention that marriage should be a monogamous link and ultimate fulfilment of life based on an enduring relationship accompanied by the begetting of children. Therefore I believe we must concede today that certain criteria that applied in the past with regard to the way in which this can be made possible, medically speaking, has fortunately changed a great deal so that the Church itself, through its scholarly documents, is beginning to tell us that these alternatives will have to be very objectively considered.

I therefore want to support this legislation wholeheartedly, particularly clause 22. Even if it only entails the benefit that cognizance is being taken of a complex problem, certain guidelines may indeed be drawn which are of great importance to us in the medical, the juridical, the psychological and the ethical spheres, which are being very carefully considered. The contents of the clause and its implications cannot, however, be overlooked or explained away, nor can they be summarily ignored. This is an important matter, a matter which deserves attention in all four of these fields of study. I therefore wish to thank the hon. the Minister for having included this specific clause in the legislation.

Mr. Speaker, in the Bill under discussion we have an extremely important measure, legislation of a far-reaching nature. I believe that for that reason we could display considerable understanding for one another’s standpoints and we must not attack one another purely on the basis of certain differences in our standpoints.

Personally I have great appreciation for the speech made here last night by the hon. member for Parktown. For the most part I agree with several of the statements that the hon. member made and also with many of the standpoints he adopted. However, I do differ with him in a certain respect.

I also agree to a large extent with what the hon. member for Brits said. However, I also wish to put it to the hon. member for Brits that there is one particular aspect about which I disagree with him. I want to point out once again that due to the importance of this legislation and also due to its far-reaching nature we should show respect for one another’s standpoints. Accordingly I want to say that we on this side of the House—although we do not agree with certain aspects of this legislation—will not oppose the Second Reading. Indeed, I believe that there are so many important things in this legislation that ought under no circumstances to be opposed but which must be accepted. On that basis I want to say right at the outset that in spite of our disagreeing with the provisions contained in certain clauses we shall support the Second Reading. In this regard we shall also like to support the hon. the Minister so that those important things that are essential and that must be dealt with in terms of this legislation, may, we trust, be effected very successfully.

It is true that tremendous developments have taken place in medical science over the past number of years. These developments have been such that if the legislation did not keep pace with them we could create problem situations in the country. Accordingly it is essential that the legislation should take these developments into account.

It is already the case that for many decades human organs have been donated post mortem and used in the medical world. I listened attentively last night when the hon. member for Parktown waxed somewhat nostalgic while discussing the training of a doctor. Perhaps he was thinking about those cadavers with which they worked and by means of which they became proficient in anatomy.

I thought about the nurses more.

The hon. member says he thought about the nurses more. [Interjections.] The fact of the matter is that the bodies of persons are made available post mortem for use by medical science. Today the situation has developed and changed to such an extent that people themselves, in their lifetime, provide in their testament for donation of their bodies or organs for use by medical science. However, it is also true that there are at present people who, while they are still living, part with their organs. Here I have in mind, for example, certain kidney transplants that are performed, in which people who are still living give up their organs for the sake of medical science.

The situation has now developed to the extent that we must have legislation to provide for these testamentary bequests but also for the people who are still alive and make their organs available for medical science. I believe that this legislation before us goes a long way towards meeting the need that does exist. Bearing in mind what the hon. member for Parktown said last night in connection with heart transplants and the problems they experience in that regard, I believe that this legislation goes a long way towards resolving these problems that are encountered by medical practitioners.

I also wish to associate myself with the two hon. members who discussed the issue of death. Last night the hon. member for Parktown referred to the issue of brain death, and I have before me the South African Medical Journal, Volume 62 of 11 December 1982 in which the question is asked—

They then give the criteria mentioned last night by the hon. member for Parktown, which I do not wish to repeat. After the hon. member had mentioned them last night and raised the possibility that it would perhaps be as well if this were to be included in the legislation so that the medical practitioner would know exactly what the legal position was, I considered the whole situation and was tempted to join the hon. member in making a plea here today for us to do so. However, I just wondered whether the hon. member for Parktown is not taking the matter a little too far. I support the standpoint adopted by the hon. member for Brits, viz. that due to the complex nature of the matter it should rather not be included in the legislation and that we should keep it a non-legislative matter. I believe that we should not try to formulate and define the whole issue of death and time of death, and in that regard set certain demands to be complied with before it may be stated that death has occurred.

The transplantation of an organ, and the heart in particular, has made it necessary to introduce the concept of brain death. The important question here is when that irreversible loss of all brain functions occurs. Who is able to determine that moment with precision? I therefore believe that we should rather leave this whole issue of exactly when death occurs, to the medical practitioners, who are concerned with the matter and have more knowledge of it. They must determine that and they should not have to be bound by a statutory provision. I understand the hon. member for Parktown saying that there are difficulties, but I believe that it would create more difficulties if those prescriptions were to be laid down by statute for them to abide by.

I have no problem as regards making available any tissue or blood as far as the legislation is concerned. I have no problem as regards the donation of the organs or blood to medical practitioners for use in patients to improve or attempt to improve the conditions of patients. I have really major problems with the whole issue of the gamete, the reproductive cells. I want to approach the matter with the utmost seriousness; this is my standpoint on the matter. If in clause 19(c), in which provision is made for the transplantation of gametes from one person into another, the words “within wedlock” were inserted so that the idea of the outside donor was excluded, then I would have no difficulty with that either.

My problem concerns the outside donor, the third person. The three Afrikaans churches have adopted a standpoint in this regard. The S.A. National Council for Child and Family Welfare states in a document I have before me that the council is opposed to artificial insemination by a donor. Therefore it is not only the churches that have difficulties in this regard, but the National Council for Child Welfare, too, which deals every day with children, the adoption of children and childless parents who want to adopt children, and so on. That council, which has first-hand knowledge of the problem, is opposed to provision being made for a third person as donor.

There are a few former clergymen in the House today. As a Reformed theologian I want to say … [Interjections.] No disparaging statement need be made about that; after all, it is so. Did the hon. member perhaps think I was not one? According to my theological view it is in direct conflict with our Christian Calvinist convictions that sex-linkage out of wedlock should be allowed by way of a third person as a donor. The aim of marriage as a monogamous institution between man and woman is for that to take place within the union. I do believe that in spite of what Rachel said to Jacob, and the standpoint of Hannah and others I could mention from the Bible, the situation remains that as far as those Biblical figures are concerned there was no question of artificial insemination by way of a third person as donor. It was an act of Providence in answer to the prayer of the believer, and here I have in mind in particular the case of Hannah. God, who had first shut up her womb, unlocked it in answer to the prayer of the believer. In spite of the urge to have children, the great need for it, to what extent must we as Christians, believing people, also take into account in this regard the Divine Will in this situation? If those specific—even medical—methods that could be applied within wedlock still fail, then in this situation are we not also called upon to guide people to accept the Divine Will rather than to make provision for a third person as an outside donor? I believe that is in conflict with the principle of the seventh commandment. I believe that in the final analysis this amounts to adultery.

In this regard I should like to refer to the fact that recently there was a court verdict relating to a child procreated by donor by way of artificial insemination. The finding of the court was that that child was born out of wedlock. I am also aware of a case where use was made of a host-mother. However, after the child had been born she refused to part with the child and said that it was her child. She was not prepared to relinquish the child to the couple for whom she had acted as host-mother. In spite of all the preparations made, in spite of the demand set—for example, in this code of practice that has been drawn up—that these people be prepared, that it be seen to that the people are mature, that it be ensured that they accept the situation, etc., we must nevertheless be careful in this regard as regards the spiritual and psychological disposition of the person concerned, because at one time or another the outside donor is going to be the cause of friction between the couple in question. Nor is this something I have sucked out of my thumb. I am acquainted with a case where such a thing took place. The couple in question have now parted because in spite of the preparation, it eventually became a factor of decisive importance to the man that the child was not really his child. He felt that it was not his lineage, born of him. He later felt that that child was the child of another man, even though he did not know who it was. However, I think that there is another problem that is also involved here. Hon. members themselves know what problems are encountered even as regards the adoption of a child, how much preparation is necessary so that eventually the child, who is adopted as a very small child, can be told that he is not the true child of his parents. Hon. members are probably also aware of the tremendous shock experienced by children who are not prepared for this from a very early age and who only later discover that they are not the true children of their supposed parents. However, if this is so bad even in the case of an adopted child, at what stage is it going to be brought home to the child at issue here that he is not really the child of the father he has accepted as his father? We must take this into account. These problems that crop up, that are created due to the entry of a third person, the outside donor, are far greater than the problem of a man and woman who have to go through their whole lives without having had a child.

Are you sure of that statement?

I am sure of it.

I have no problem with artificial insemination within wedlock, because I believe that that does not conflict with the Seventh Commandment as I understand it. Within wedlock it does not appear to me to be a form of adultery, and in that case I believe that medical science can be of help and value to the parents.

I am convinced that everywhere in the legislation where reference is made solely to the utilization of a gamete, the words “within wedlock” should also be included. I cannot support or endorse the provisions contained in those clauses if this applies outside wedlock. The whole issue of artificial insemination has assumed major proportions. In the Medical Journal of 8 November 1980 reference is made to 10 000 such people who have already been born in the USA at this stage. Reference is made in the same article to the situation in South Africa. I quote—

Then they discuss the donor, the third person from outside. Surely we can already achieve so much success within wedlock, with what medical science has managed to do, that I believe that we should respect the Christian/scriptural standpoint in this regard as well in our legislation. I call upon the hon. the Minister, since he has to regulate these matters by way of legislation, to give serious consideration to rather inserting a provision to the effect that such a donor would not be permitted in South Africa but that this would only take place within wedlock. Rather than to permit a donor, let us prohibit it by law.

I also have difficulties with clause 21, which concerns the gonads. I believe that that entire clause is not really appropriate. I believe that the hon. the Minister would do well to delete that clause rather than provide that his written permission should be obtained. I foresee that it could cause major problems for the hon. the Minister to determine when this could be authorized and when not. I believe it would be better rather to delete that than to let it stand in the legislation.

Then, too, I have a problem with the question of race as far as this legislation is concerned. I want to ask the hon. the Minister whether this could not be included here in one way or another. I am convinced that if the hon. the Minister is not prepared to keep the provisions contained herein within the marital context only, then he must insert a provision to the effect that the donor must belong to the same race group and not to a different race group. I put this forward as an alternative in case the hon. the Minister is not prepared to allow the issue of the gamete only within wedlock.

I also wish to put a few questions to the hon. the Minister concerning clauses 25 and 26. I do not wish to deal with every clause during the Second Reading as the hon. member for Parktown did last night. In terms of section 25 and 26, provision is made for the import and export of gametes under a permit issued by the Director-General. I want to ask the hon. the Minister whether requests have ever been received for the importation of gametes and if so, what were the population groups of those applicants, at whose request were they and what motivated these people to import gametes.

I want to say to the hon. the Minister that I read the little brochure relating to the code of practice for artificial insemination per donor (AID) with great attention. The standpoints and requirements set out in the brochure may be entirely satisfactory to the medical practitioner, but as a theologian I have difficulties with some of the prescriptions. As far as the issue of outside donors is concerned, the arguments I have already advanced and which I believe to be valid, still apply. However, I think that in this brochure, too high a premium is placed on the trustfulness of people. There is too naive an acceptance that a person can guide someone to accepting a certain situation, and we do so without taking into account the capriciousness of human nature, and without bearing in mind that by the next day he might have forgotten about his previous acceptance, even if he has sealed it with his signature. When fickleness and jealousy come to the fore, this can have a destructive effect on the marriage in spite of the wonderful prescription provided in this regard.

To conclude, I wish to reiterate that we on this side of the House will support the Second Reading of this Bill. We do so in the confidence that the hon. the Minister will give very sympathetic consideration to the problems I pointed out, which I shall raise again in the Committee Stage when discussing the clauses concerned.

Mr. Speaker, listening to the hon. member for Koedoespoort highlights the fact that there are certain clauses in this Bill which have deep religious overtones and which affect one’s conscience. It is for this reason that we in the NRP are having a free vote. Some might call it local option, but that is the way it is. We believe this is a matter of conscience and therefore the points which I will be making should not be construed as the official statement of this party.

Is there a split in your party?

I should just like to say that I was always taught that good breeding has two ingredients, the two ingredients being good manners and sportsmanship. I wonder whether the hon. member for Hillbrow has ever heard of those two ingredients. [Interjections.]

The Bill before us can be welcomed because it has consolidated various other Bills and it is going to make it far easier as far as the medical fraternity is concerned.

I should like to start by referring to what the hon. the Minister said last night. He said—

I should now like to support the hon. member for Parktown in what he said last night. I should like to refer to the S. A. Medical Journal, vol. 62 of 11 December, which states—

It goes on to state—

The same paragraph ends off by saying—

I think the hon. the Minister’s answer lies in why so many doctors are not prepared to become involved in transplantations. If this is the position with the doctors—and here again I support the hon. member for Parktown—I believe that there is no reason why the Medical Association of South Africa and the hon. the Minister’s department cannot put their heads together in order to define what is accepted as brain death. This same journal, in its appendix, gives an example of the certificate that is required by Groote Schuur Hospital for this purpose. In describing the minimum criteria for the diagnosis of brain death it refers, inter alia, to respiration, to brain stem reflexes, body temperature, drugs, and the cerebral state. I support the hon. member for Parktown by suggesting again to the hon. the Minister that he should seriously consider writing this into the legislation.

When it comes to the disposal of bodies of deceased destitutes there are certain procedures to be followed before a destitute’s body is placed at the disposal of an inspector of anatomy. In terms of clause 10(4), however, these provisions are not required when the Minister grants exemption from such procedures. I want to ask the hon. the Minister to indicate, when he replies to the debate, under what circumstances exemption from these procedures will be granted.

I should like to refer now to clause 19, a clause about which some of us have serious misgivings. Clause 19 deals with the purposes of which tissue, blood or gametes of bodies of living persons may be used. In terms of clause 19(c ) (i) and (ii) there are certain prohibitions on the use of these substances. I believe there should be a further prohibition in order to cover habitual criminals as well. We are now entering an area about which, I believe, we do not really know very much, and I am convinced that it is our duty to give as much protection as possible to the child that is going to be conceived by way of artificial insemination, as well as to its parent. Clause 22 of the Bill deals specifically with artificial insemination. This has always taken place in accordance with a code of practice. I have had a look at the code of practice, and I should respectfully suggest that this document, entitled Artificial Insemination by Donor, is in fact a very permissive document. It is very permissive indeed, and it certainly contains nothing which is mandatory. I quote from the introduction to this document, as follows—

It then goes on to say—

I want to ask the hon. the Minister to tell us what sort of code this is, in which nothing is mandatory in terms of any law. All we find in this document are permissive recommendations.

In connection with the anonymity of the donor this document states as follows—

What I should like to know, is to whom he may or must disclose the identity of the donor. About the question of the maximum number of donations the following is stated here—

What happens now if the donor moves to another town or area? [Interjections.]

It also deals with the selection and counselling of recipient couples, and I quote again—

This is the point to which the hon. member for Koedoespoort expressed objection. There is nothing obligatory right through this whole document. I quote again—

I should like to know, Mr. Speaker, whether a doctor is in a position to know whether a couple are living in a state of harmony. Should a social worker not decide that question?

A doctor is sometimes very much better than a social worker.

I begin to wonder. How long can harmony last? Harmony can also break down. I want to quote further—

Who gives that counselling? Does the doctor give that counselling? As far as I am concerned, Sir, one can drive a horse and cart through this whole matter. I just want to remind the hon. the Minister that it was he who said just recently that the medical profession was not projecting a very favourable image at the moment. I know that the word “ethics” is going to be used—ethics, ethics, ethics. However, I want to put it to the hon. the Minister and to the hon. member for Parktown that in some cases—and I emphasize “some”—when ethical and financial considerations are involved, the ethical considerations fly out of the window. It is as easy as that, and I do not think that the hon. the Minister can deny it.

I do deny it. That is a very nasty suggestion indeed.

Not at all, Sir.

I appeal to the hon. member to keep the debate on a high level.

I am doing so. [Interjections.] I have had ethics thrown at me. I said that in some cases—and I stressed the word “some” …

You hate doctors. I have noticed that.

Mr. Speaker, I was very quiet last night when the hon. member for Parktown was speaking.

Oh, a doctor has never been found guilty of any criminal offence ever, has he?

Neither has a priest and neither has a member of Parliament.

Turn the halo over your head down. It is blinding me. [Interjections.] Scratch your back, your wings are itching you. [Interjections.]

Sir, I should like to go on.

Yes, I think there is sufficient life in the debate now. [Interjections.]

Well, Sir, it is obvious that I have cut someone a little and it hurts. That is apparently why we have a little controversy in this regard.

I should like now to discuss the question of the disposal of human tissue. Provision has been made that where an importer imports tissue in contravention of certain specified requirements, the Director-General has the right to dispose of that tissue or gamete or whatever it is that was imported. I do not believe that the expression “dispose of’ is strong enough because the manner in which such tissue may be disposed of is not defined. I feel that the expression here should be “destroyed” and at the Committee Stage I shall move an amendment accordingly because it is more emphatic in regard to how I feel such tissue should be treated. If tissue is imported and is not subject to certain provisions then I believe it should be destroyed.

Clause 34 deals with offences and penalties and I believe that in this case the penalty of R1 000 that is imposed will not act as a sufficient deterrent. I believe that this penalty should be increased. One sees from time to time—this happened again recently—that human limbs are offered for sale to certain witchdoctors. This is a practice that goes on and I believe it is something that has to be looked at. I also feel that the offences in this regard should be penalized to a far heavier extent.

In regard to the regulations, subsection (l)(k) is subject to clause 4 in terms of which the hon. the Minister has to cause draft regulations to be published in the Gazette for information and for comment. I believe that in this connection paragraph (1) should also be included in that recommendation.

The savings clause, of course, refers to the funeral industry or the funeral directing profession. I believe that this is a profession in regard to which the time has come for this whole industry to be examined very carefully. The White funeral industry is controlled by two major companies, the one being Homes Trust, a subsidiary of the Sanlam group, and the other being Avbob. There are some undertakers who have very high ethical standards, but there are others who leave a lot to be desired. I believe this is a situation which should be looked at and that a uniform set of regulations should be brought in right throughout the country. Let us have a look at one instance. One sees from time to time that wrong bodies are buried. This causes a tremendous amount of grief to the families concerned. I believe that this situation should be an offence and should carry penalty. I further believe that there should be a uniform set of regulations for the identification of bodies whether they are from Government institutions or removed from private homes. I believe this is an area where serious consideration is needed because for far too long this industry has done more or less as it pleases. It has to comply with certain local authority regulations, but that is only as far as refrigeration and that type of thing is concerned. I believe that the local authorities do not impose or carry out continual inspections on the prerequisites which are required.

I ask the hon. the Minister whether he will give it consideration that this aspect should be looked at with a view to regulations being made for this industry.

Mr. Speaker, we have been dealing with a very delicate subject this afternoon and I should like to direct my first remarks to the hon. members for Brits and Koedoespoort, both of whom have taken religious orders. I must say that I respect their views and it was very interesting indeed to listen to how both of them put their points of view although they might have been from opposite poles. It is a very sensitive subject when we are dealing with insemination and particularly insemination by a donor. I can well understand the misgivings of the hon. member for Koedoespoort but my point of view would be inclined to agree with that of the hon. member for Brits. I believe there should be empathy on the part of the church and I think there should be a positive approach. While I disagree with the point of view of the hon. member for Koedoespoort, I still have the greatest sympathy and consideration for his point of view, and it has to be taken into consideration, particularly when matching in this particular instance takes place.

As far as the hon. member for South Coast is concerned, I think he misunderstood the code of conduct from which he read. The code of conduct is not obligatory at the moment and it is this legislation that is going to make it obligatory. Therefore it can be put into practice by promulgating regulations, but I shall deal with that later on. I believe that his attack on the medical profession was quite uncalled for.

He never attacked the medical profession.

The Bill deals with the technicalities of artificial insemination of human beings on the one hand and with the transplantation of tissue on the other. The hon. member for Parktown told the House of the night they did the first heart transplant. I remember that on the following day I went to a very big research laboratory in Hamburg quite unaware of what had happened in South Africa. This research laboratory was not a medical laboratory, but a food research laboratory. The first person I met when I went there was the director of the laboratory in which there were about 40 Ph.Ds. and a large number of other people, he asked me whether I knew what had happened in South Africa. I said: “No, what has happened? Was there a revolution? He replied: “No, a medical revolution.” He said that he would never have believed that the first heart transplant would be done in South Africa. He said that nobody had ever even heard of my country, and yet probably one of the greatest operations of all time had been done for the first time in South Africa. I am consequently proud to be able to associate myself with the hon. member for Parktown. [Interjections.]

He did not do it. His brother did it.

In the first instance I wish to deal with some technical details involving how this Bill affects the practice of artificial insemination. In the second instance I wish to deal with the importance of eliminating, through the legislative functions of this House, the problem created by the judgment delivered by Mr. Justice J. Steyn in the case of B. vs. R., 1979, 3 SA 1006, TPD. I quote—

that is artificial insemination by a husband—

I think that these points are deserving of very serious consideration indeed.

There are two clauses in this Bill that are really clauses that look to the future in an endeavour to prevent any problem that might arise. I am referring to clauses 16 and 21 which deal with the transplantation of gonads. Gonad transplantation is not possible at the present time, and I therefore commend the hon. the Minister for having included this, at this particular stage, so as to prevent problems that might arise in the future. After people have carried out experiments and have found that such transplants can be done, it might then be necessary to amend this particular legislation, but this does make provision for certain possibilities arising in the future.

Throughout the world, at the present time, frozen animal semen, frozen animal ova and frozen embryo, are freely transported, as the hon. member for Brits has said. These techniques are now being applied as far as human beings are concerned. I want to say that we on this side fully support the Bill because it takes the whole matter of insemination into consideration. Clause 16, as I have said, deals with the “prohibition of the use of gonads from the body of a deceased person for transplanting into the body of a living person if the results of such transplantation may be procreation.” Four clauses are involved in this connection. Firstly there is clause 18 which states that no gamete may be removed from a human being except under prescribed conditions or with written consent. Clause 19 states that gametes can only be used for artificial insemination. Clause 21 says that there can only be gonad transplants from a living person with the consent of the hon. the Minister. Clause 22 states that artificial insemination shall in future be done in accordance with a certain code of practice. Having gone into this, I believe that this Bill precludes in utero fertilization. That is my opinion. I would, however, like the hon. the Minister to tell us whether this is so. It is therefore necessary to define the various methods of artificial fertilization that one encounters. I think it would be more correct to use the word “fertilization” than “insemination”, but that is the term that is used. The process is known as “artificial insemination”.

As we have been told by the hon. member for Brits and the hon. member for Koedoespoort, there is artificial insemination by the husband. Although the husband may be fertile, there can nevertheless be problems in regard to fertilization taking place. It is all a question of sperm counts and so on. On the other hand, the wife might be fertile and yet still have difficulty in being fertilized in the absence of some or other medical assistance from a medical practitioner. The medical practitioner then operates in order to affect the fertilization. This is considered to be completely legal because the fertilization is still a matter between the husband and the wife. On the other hand, as the hon. member for Brits has rightly said, in many cases there has to be artificial insemination by a donor. He is absolutely correct when he says that through no fault of their own there is overall a 30% to 40% incidence of male infertility. Between 10% and 15% of married couples in South Africa are not able to produce children. The terrible problem is that male infertility is irreversible. There may be no gametes or even inadequate gametes. Yet it is necessary for the psychological well-being of the people, as the hon. member for Brits has said, for them to desire to have children. This is a desire which is human and which I believe the hon. member for Koedoespoort fully understands as well.

What is the basic reason for the introduction of artificial insemination, particularly amongst Whites in South Africa? It is that the number of children available for adoption has dropped considerably. Therefore some substitute to adoption has to be found. Until now it has been very difficult to have such children because the techniques of AID had not been discovered. There has in recent years been a reduction in the number of children available for adoption. So, many childless couples are faced with AID as the only alternative.

I dealt just now with the legal situation that in the case of AID in terms of South African law as it now stands the child is an illegitimate child. There is a very good saying to the effect that the law is an ass, and it is this House which has the power to change that state of affairs and to solve the problem in a short time by passing the necessary legislation—I will deal with that later.

The hon. member for South Coast started quoting from the booklet which has been published by the department and which deals with the code of conduct in respect of artificial insemination. Let me say at this stage that the Department of Health and Welfare is to be congratulated on producing what is considered by the medical profession to be an ideal towards which every doctor who participates in artificial insemination should strive. It is an outstanding book and it sets an example of how matters should be carried out. I want to congratulate the department and I want to say that I cannot agree with the remarks made by the hon. member for South Coast under any circumstances.

First of all, centralization of strictly controlled donor services is recommended. Why? That is necessary because one should have highly qualified obstetricians or gynaecologists to carry out this work, although highly skilled general practitioners can do AID. I intend proposing that only a registered obstetrician or gynaecologist or a highly skilled G.P. should be allowed to do artificial insemination. I also intend proposing that the place where he does this work should be registered and that he should have the necessary laboratory facilities. An adequate supply of donors is necessary and they should be recruited by a medical practitioner attached to the AID service. In Cape town, for instance, AID work is carried out at Groote Schuur under the supervision of the medical staff there. In Johannesburg it is carried out at the Johannesburg Hospital. Why is it done there? Because the staff there are able to apply medical control and because they have a laboratory right next door to where they perform the operations in question. It is absolutely necessary that these conditions should be met. This could best be run by an organization possessing the necessary facilities which would include genetic and laboratory services and the attendance of medical personnel.

One of the results of this Bill will be that a tremendous amount of paperwork will be required. This is time-consuming, and to expect a doctor to fill in all the forms by himself and also to perform the operation is really expecting far too much. Therefore centralization is the right thing because by that means the record can be kept properly and inspected. I think that that is a very good suggestion.

The question of frozen sperm banks has been raised. Sperm banks as far as animals are concerned are kept and sperm is flown all over the world. One cannot just have production of semen on demand. It must be kept in a bank so that it can be used when the operation is performed.

I now come to the question of the anonymity of the donor. The medical practitioner must not disclose who the donor is. He might know who he is but it is not his job to disclose who he is. I am told by medical doctors who practise artificial insemination that most donors do not want their names disclosed under any circumstances. If their names were disclosed terrible problems would be experienced in that mothers would try to find out who the fathers were. I also agree that payment should not be made. However, certain minor expenses such as traveling expenses should be covered.

The last point raised by the hon. member for South Coast was the selection and counselling of the recipient couple. I do not think the hon. member realizes how much pre-pregnancy work has to be done in respect of counselling. Husbands and wives have to be brought before marriage counsellors, psychologists, psychiatrists and the doctors themselves, and a whole series of tests has to be done in order to ensure not only that they are physically able to accept artificial insemination but at the same time that after the child is born they will be happy together. Therefore I should like to ask the hon. member whether he would not consider that institutions or persons who carry out AID should be licensed, either by the department or the Medical Council, and that the actual medical practitioner who performs AID should be registered with the Medical and Dental Council so that malpractices could be effectively controlled.

Malpractices?

Of course there can be malpractices. Nobody says there cannot be. One problem arises, namely that the Bill determines that written consent should be given by donors. I believe there are going to be great difficulties in obtaining the actual written consent of male donors. I believe consideration should be given to this. From what I have been told they are not prepared to state who they are. They do not mind the doctor knowing who they are. He can even write their names down, but they are not prepared to put their signature to paper.

The hon. member for South Coast also talked about medical ethics. I have with me a book published by the Royal College of Physicians and Gynaecologists on the report of in vitro fertilization. I should just like to explain to the hon. member for South Coast what actually happens when somebody undergoes in vitro fertilization. A small operation is performed round about the bellybutton and the ova are removed and put into a glass. This is done by aspiration. It is not very serious. There are questions of ethics, and the Royal College says the following—

That is dealing particularly with artificial insemination or in vitro fertilization. And it agreed with his expression. I quote further—

I should like to say that I believe that where you have in vitro fertilization there should only be embryo replacement, i.e. the egg should then be returned to the mother donor. Embryo transfer, that is to a surrogate, should not be allowed because that presents a tremendous legal and psychological problem. The College of Obstetricians says that in vitro fertilization and embryo replacement should take place within marriage because that is where you have your best results. It also states—

This provides a very great future for a large number of people.

In conclusion I should like to deal with the South African law. For the lawyer, artificial insemination raises a plethora of questions: Can it constitute adultery? What is the status of a child born as a result of artificial insemination? What is the delictual liability of the doctor? Unfortunately, as a result of this case, the child is illegitimate. It is stated here—

I think the time has come for the hon. the Minister to correct this.

The result of this court case of J. Steyn was as follows—

Unfortunately it is not the child who chose to be illegitimate in terms of the law. I believe that the question is that the putative parent, i.e. the parent who was not the donor, not the natural father, should be entitled to assume the legitimacy of that child. There is another Bill on the Order Paper The Child Care Bill dealing with this matter, but legitimization of an AID or an IVT child cannot be done in terms of the human tissue Bill. I wish to recommend to the hon. the Minister that when we deal with this in the Child Care Bill, which we shall be dealing with very soon. It should be amended to introduce a clause legitimizing all children born through AID or IVT. The production of a certified copy of the letter of consent signed by both parents and countersigned by the medical practitioner who performed either the IVT or the AID, should be sufficient proof to the Department of Internal Affairs for legitimate registration. At the present moment, what is happening is that every parent who has had an AID child and who registers it is committing a criminal offence because such parents are not telling the truth when they go to the Registrar of Births and Deaths and say that it is their child. In terms of the law as it is now it can only be the natural father and the natural mother. It is most unfair that these children should be known as bastards in terms of the law, and I believe it should be changed. I therefore appeal to the hon. the Minister to react to this when he replies to the Second Reading debate. Clause 39 of the original draft Child Care Bill stated that any child conceived within wedlock by means of artificial insemination would for all legal purposes whatsoever be deemed to be the legitimate child of its mother’s husband if both the mother and the husband requested or consented in writing to such artificial insemination. It also stated that artificial insemination would include the artificial insemination of any woman with the semen of a donor who was not her husband.

There is a Latin expression that says “Mater certa pater incertus”. Each and every one of us here might be certain of our mothers; none of us can ever be certain of his father.[Interjections.]

Speak for yourself. [Interjections.]

Oh no! It is true that one can never know. That is exactly what that Latin expression means. It is a wise man who knows his own child, according to another Latin expression. We should take cognizance of this, Mr. Speaker. [Interjections.] I believe it is unfair and unjust that we in this House have, since 1979, not introduced legislation to legitimize those children who have been born in the past by what we allow to be done in terms of the law, and what we are going to allow once we have passed this Bill.

I therefore appeal to the hon. the Minister to take up this matter and to satisfy the request by the hon. member for Brits and by myself.

Mr. Speaker, today was an historic day in the history of the Republic of South Africa, because the Republic of South Africa Constitution Bill was introduced. The Bill we are now discussing reminded me of previous legislation which made possible the transplanting of hearts in South Africa. I still remember clearly that when the first heart was transplanted in South Africa, it was news throughout the world.

I believe that the legislation introduced here this afternoon, legislation which will probably become the constitution of the Republic of South Africa in future, will also receive the same publicity in the outside world as the news of the first heart transplant did. However, the question occurred to me whether it would not perhaps be possible in future to carry out political heart transplants on people.

Do you want help? Very well, we shall try.

That might help to get people to display an attitude which would be in the interests of the continued existence of the Republic of South Africa. [Interjections.]

This afternoon, particularly in connection with the legislation under discussion, considerable emphasis was placed on the matter of artificial insemination. Now the hon. member for Houghton must not take this amiss of me, but I do want to say that I asked myself why, since the hon. member for Houghton is the only female member of this House present today, she did not participate in the discussion of this Bill. Should she not perhaps have done so so that we could also have heard a woman’s point of view in regard to this legislation? [Interjections.]

The hon. member for Bezuidenhout will not hold it against me if I do not at this juncture react directly to what he said. However, I should like to say a few words about one aspect mentioned by the hon. member for Parktown. Yesterday evening the hon. member for Parktown said that the medical practitioner had the problem that he had no legal protection in respect of the fact that he was the responsible person who finally had to certify that a person was dead. The hon. member for Koedoespoort and the hon. member for Brits both referred to this as well.

There is a further matter I want to touch on which is also closely related to this and I should like to hear the standpoint of the hon. the Minister in this connection. In terms of the legislation before this House two medical practitioners of whom one is required to have been a registered medical practitioner for at least five years, have to certify a person who is involved as a tissue donor. Let us take as an example a person who is to be cremated. There is a requirement that the relevant medical practitioner who issues the certificate to the effect that that person may be cremated, has to examine that body personally before he issues the certificate, and he also has to certify that he in fact saw the body, although there is no uniformity in connection with the documentation for cremation.

Another matter that is causing me concern, in view of the problem mentioned by the hon. member for Parktown, is the fact that there are many people who die at home and in respect of whom a medical practitioner issues a death certificate on the grounds of a mere statement from a member of the family or an undertaker. The medical practitioner issues that death certificate without having examined the body or even having seen it. I realize that it would be a tremendous burden on a medical practitioner to have to examine the body of the dead patient in each of those cases. However, it worries me. [Interjections.] Let us accept for argument’s sake that that patient was in fact being treated by that medical practitioner. Then the medical practitioner would be expecting that patient to die. The fact remains that during the period prior to death many things could have happened, and many things did in fact happen in the past. This was proved at post-mortem examinations. I should like to hear the hon. the Minister’s standpoint in this connection.

Prior to 1952 we had no law on the Statute Book making provision for the removal of tissue from a deceased or a living person, and we have therefore made provision for this since then. If one reads the legislation before this House today, one sees that provision is being made for the donation of tissue which could lead to the creation of a new life. However, we also read that provision is being made in this legislation for what has to be done after the death of a person. One is justified in saying that as far as this legislation is concerned one’s life is being regulated from the cradle to the grave.

In his Second Reading speech the hon. the Minister mentioned that this Bill was a consolidation of laws, as we will note from the schedule. This is not the first time that a consolidation of this legislation has been attempted. Although the legislation will in future be known as the Human Tissue Act, it was previously known as the Anatomy Act. As far back as 1959 a Select Committee was appointed to examine the legislation. On that occasion the legislation was rewritten on the recommendation of the Select Committee. As one may observe from the report of that Select Committee, the objective at the time was to elucidate and modernize the legislation. At the same time the Dutch text was replaced by an Afrikaans text on the recommendation of the Select Committee.

In 1969 a further Select Committee was appointed which heard evidence and reported on anatomical donations and post-mortem examinations. This was what led to the drafting of Act 24 of 1970. If one looks to see who served on that Select Committee, one finds that seven of the twelve members of the committee were medical practitioners. If one considers the persons and bodies which gave evidence and made inputs to get the legislation placed on the Statute Book, one finds that some of the country’s best medical brain power, and I believe some of the best medical brain power in the world, was used to get that legislation placed on the Statute Book. I am referring in the first place to the heart transplant team of the University of Cape Town, but I am also referring to the transplant team of the University of Stellenbosch. What is also of importance is that I note in the report of the Select Committee that all our churches and some of our legal experts gave evidence on this matter. The universities as well as the provinces gave evidence on that occasion and one may also ascertain their standpoint from the report. The legislation was therefore placed on the Statute Book after there had been consultation with all the persons and bodies that could be affected by it. I am referring in particular to legal experts because the hon. member for Parktown also had problems yesterday evening with the wording of the Bill.

The administration of the legislation was transferred from the Minister of National Education, who was responsible for the schools of anatomy, to the Minister of Health and Welfare, where in my opinion it actually belonged.

I want to congratulate the persons who drafted this Bill. In the Bill all uncertainties in the existing legislation have been eliminated. In the second place I am appealing to our legal draftsmen to continue drafting legislation in language which is easy to read so that the ordinary man in the street is also able to understand it. The Bill is definitely legislation which will be held in high international esteem, as is the case with the existing legislation.

The donation of human bodies to schools of anatomy is important, as is the donation of human tissue. The hon. the Minister pointed out that there was a shortage of tissue as well as human bodies. I therefore want to appeal to the public to make donations of this kind. I think it is possible and necessary that we also bring the way in which such a donation may be made to the attention of the general public. Over the years the procedure has been greatly facilitated and simplified.

Because we are now experiencing a shortage of human tissue and human bodies at our schools of anatomy, I want to ask the hon. the Minister whether the available bodies are being used adequately. This afternoon I want to make the point that we are not making adequate use of the available material—here I am referring in particular to bodies. We are not making adequate use of the available sources. I want to motivate this, but in my motivation I am only going to refer to those towns and cities where there are in fact schools of anatomy. Do we ever take into consideration what large sums of money are spent on paupers’ funerals? Unfortunately I could not ascertain the number of cadavers involved in this. However, if I just mention the amounts involved here, I feel it will give hon. members an indication of the magnitude of the problem. In the first place I want to refer specifically to the area of jurisdiction of the West Rand Administration Board, under which Johannesburg falls. In 1981-’82 R37 210 was spent on pauper funerals in this area. Of course no use was made of these cadavers. Naturally I am aware of the fact that not all remains can be used. I realize that. But let me refer to Port Natal or what about the Western Cape? I really think this is a matter which should be thoroughly investigated to ascertain whether we make adequate use of remains which are available to our schools of anatomy in terms of this legislation. Possibly we should also ascertain whether remains cannot be transferred from areas outside the area in which a school of anatomy is situated.

A new principle contained in this legislation, which I should like to draw attention to, is the principle in connection with the donation of gametes, but in particular the restriction on the number of gametes used for successful insemination. The number is restricted to five. This is a new principle. I think that in this connection things went wrong in the past, and I therefore welcome this provision in the Act. In my opinion the matter of an authorized institution, about which there was uncertainty, has now been cleared up. Provision is also made for permits which the Director-General may issue in connection with the import and export of tissue, blood, blood products and gametes. Provision is also made for the appointment of anatomy inspectors, and their duties and responsibilities are very clearly defined in this piece of legislation. I should very much like to make an appeal to the hon. the Minister to see to it that we ensure—when it comes to the duties and responsibilities of anatomy inspectors—that human bodies, particularly at post-mortem examinations, but also after that, are handled with the necessary respect. I think this is a responsibility resting on the shoulders of the inspector.

This brings me to the matter of the publication of facts. Other hon. members have also referred to this. Yesterday evening the hon. member for Parktown said he had no problems with this if both parties agreed in writing to facts concerning a donation or transplant being published. However, I have a problem in this regard. When gametes are donated two parties are of course involved, namely the donor and the recipient, and I think we have to be extremely careful about the publicity we give this, because this could lead to great unhappiness for many people.

In the final instance I should just like to refer to clause 38 which is concerned with the delegation of powers. I am in favour of powers being delegated, but on condition that this always takes place with the greatest circumspection and that powers are only delegated to competent persons.

When one looks at the Bill as a whole, one sees that it is aimed at allowing tissue to be donated and that the whole intention is to alleviate suffering, prolong lives and bring happiness in so far as this is scientifically possible. With these few thoughts I take pleasure in supporting this Bill.

Mr. Speaker, I do not have much of a quarrel with the hon. member for Witbank. I think he has approached this matter in a rational and sensible way. He has high-lighted the main problem I have with the Bill, namely the death aspect, which I shall come to in a moment. I agree with him that any delegation of powers must obviously be done with the greatest circumspection in view of the very delicate nature of what is involved and the tremendous implications involved in transplants.

At the outset I should like to thank the hon. the Minister for introducing this Bill in which the relevant aspects of the Health Act, the Anatomy Act and the Anatomical Donations and Post-Mortem Examinations Act have been consolidated so that we will now have a comprehensive Act covering the whole aspect of human tissue and artificial insemination and so that from the medical point of view we are now, in 1983, entering a new era.

As far as the contribution of the chief spokesman of the official Opposition on this matter is concerned, I believe that all of us in the House were actually privileged to be in a position to listen to a man who is probably one of the leaders in the world in the field of transplants and who took part in the famous transplant in 1967 with his brother, thereby putting South Africa on the map and opening up a new era of medical research and advances in the medical field to give life and improve conditions of life for people in South Africa. I believe we owe him a debt of gratitude. We listened with great respect to what he had to say last night and we could not have wished for a greater expert to listen to than the hon. member who has been honoured for work in this field not only nationally but internationally in at least five or six other countries in the world.

On religious grounds we cannot agree.

I shall come to that in a moment.

Medicine has of course come a long way. We have to keep up with trends in medicine. We are able to prolong life and must solve the problems created by longevity and the need to look after the older people, because I think it is clear that we are able to advance life by at least a further ten years, compared with, say, 50 years ago. So much for modern medicine.

Talking of modern medicine, I think it would be in keeping for me to express a word of praise for South Africa’s doctors who enjoy an international reputation and a status comparable to that of doctors anywhere else in the world. They are consulted by people from other countries …

Thank the Barnards.

I have thanked the Barnards. The standard of our doctors is such that today there is very little need for South Africans to go overseas for consultation and medical treatment. That would be rare today. I have, however, heard of cases where people who went overseas for this reason were asked: Why are you coming here when you have the finest doctors in this particular field in South Africa?

I speak today as a layman. Where the medico-legal aspect comes in, perhaps I have a contribution to make. I should also, perhaps, declare my interest: I am personally involved with the National Kidney Foundation of South Africa and also with Lions International whose main theme is to look after the blind in the country.

Let me deal with the first problem arising from this Bill, namely the question of death. That is most important. The hon. member for Parktown has quite correctly asked whether it is possible to provide a definition of death. I do not know whether this is possible or whether we will have to leave this as an open, undecided question. Obviously, when the heart has stopped, the brain is dead within a few minutes and the patient is dead. However, when the heart is beating and the brain is dead the question arises whether that person is clinically dead. Are we then entering the field of euthanasia, which has been suggested, or do we in fact certify such a person as dead? We know that in terms of clause 7(2), to which the hon. member for Witbank referred a little while ago, the patient must be certified dead by two doctors, one of whom must be a practitioner of at least five years’ standing, but are they going to say that that person is dead only because the brain is not functioning even though the heart may still be beating? They must bear in mind that that living, beating heart is required for a heart transplant and the heart, having been taken out, must be kept beating in order to be placed into a recipients body.

I had a look at the legal definition of “death”. In Stroud’s well-known legal dictionary it is defined as follows—

Even this legal definition does not help to solve our problem at all, because the problem is: When does a person cease to live? We are then back to square one and to the problem of whether the brain is still functioning. I do not know how we are going to resolve this problem. I admit I do not think we are able to come up with a definition. However, I do think proper guidelines should be laid down and the matter should not be left to any question of discretion or opinion as to whether a person is dead or not.

I received a letter from a woman who experienced problems when her husband died. I do not have to go into all aspects regarding his death, but let me just read one paragraph from her letter, which forms part of her correspondence with the Transvaal Provincial Administration. Her husband had an operation and was in hospital and she went to visit him. I quote from her letter—

I do not want to mention his name—

That must have been a terrible decision for this woman to take. If she said yes, was that an act of euthanasia? The doctor had told her that her husband was clinically dead. But was he in fact dead? This is the problem which we are facing, particularly in the case of transplants. One now has to look at this position in the light of the possible transplant of a cornea, kidney or a heart, or any other organ. Obviously one does not want to do a transplant from a body that is not absolutely dead. This is where the problem comes in. Religious objection also comes in here, but that is an entirely different thing. However, this is what we have to try to resolve if we can. I think the hon. the Minister and perhaps the medical profession themselves, together with the legal profession, should hold a medico-legal conference in order to discuss this matter to try to resolve the issue.

I want to deal now with the question of kidney transplants. According to the annual report of the department 195 kidney transplants took place. Here again I think South Africa has made tremendous strides in the successful transplant of kidneys and the country is well-known for it throughout the world. However, there are not enough kidneys at the moment for donation. At least 500 kidneys per year are needed in order to keep abreast of the requirements. There is certainly a need for donors. I want to deal with the question of donors on a general basis. Even though a deceased may have donated his kidneys in his will and even though there may have been some certificate or request for the donation, the doctors will still not regard that as a final authority in order to transplant the organ from that body unless they get permission from the nearest and dearest relatives, and rightly so. They will still do so because it is a traumatic moment for them. Nevertheless, it is at a stage when they are very distressed, obviously owing to the death of that person. It is difficult to obtain consent in circumstances such as those, and particularly when the organ is required as soon as possible. Therefore records of willingness to donate can be made and I think should be made in a book of life because a person carries a book of life. An entry should also be made on the back of a driver’s licence, as is done in the USA. For example, a person can state that he is willing to donate his eyes, his kidneys or his heart, as the case may be. I make this suggestion subject to the condition that such an instruction be signed by two witnesses. I think that it is essential that one of those witnesses should be the nearest or dearest relative of such a donor, and his relationship to the donor should be stated as well. For example, it could be the husband, the wife, the daughter or the son, as the case may be. Then, when such a donor is certified dead and one of his organs is required, the transplant can take place as soon as possible in the interests of saving a human life or perhaps giving a new life to another person, which is the only important aspect as to why a transplant should be performed. The required forms, therefore, when given out should be witnessed in that particular way. I want to ask the hon. the Minister whether he would consider conducting a national survey in South Africa in order to ascertain the feelings of South Africans as to whether they are prepared to make donations of their organs. If such a survey were held the hon. the Minister and the medical profession would have a fairly good idea of what is involved and they would know how willing people are to make these donations. Such a survey, of course, would not only gain that information but it would also bring about a public awareness of the need for transplants, particularly with regard to corneas and kidneys and even hearts.

As far as corneas are concerned, the hon. member for Parktown told us that there are something like 30 000 blind people in South Africa. As the hon. the Minister will know better than I, a cornea must be removed within eight hours after death and the transplant should take place with in 48 hours. This was not possible in South Africa before 1975. Hon. members will not take it amiss of me if I mention the name of Leslie Simon. I think the hon. the Minister has corresponded with him. He is a member of Lions International who have as their project the provision of aids for blind people. This man has travelled to many parts of the world. He has helped in arranging cornea transplants and he has also helped in the formulation of the legislation which is before us today. He tells the story of how in 1974 a young, very beautiful Indian girl who was blind was brought to him by the headmaster of a school, who asked him whether anything could be done for this girl who was blind in both eyes. He replied by saying that he thought that it was in the hands of God, but that he would nevertheless send her to an ophthalmic surgeon in Durban who would have a look at her. The ophthalmic surgeon examined the girl and told her that she was suffering from a disease of the cornea, but that if corneas could be obtained he could do a transplant and perhaps there would be a chance of her regaining her sight. There being no corneas available in South Africa at that time, Mr. Simon contacted one of his Lions International colleagues who was in Ceylon. At that stage Ceylon had an abundance of corneas. He then tried to arrange for the transfer of the corneas to South Africa, but at that stage, owing to international flight schedules, it was not possible to bring the corneas to South Africa in time to do the transplant. However, by a stroke of luck, a few weeks later, BOAC, as British Airways were then known apparently changed its flight schedule and by flying via the Seychelles were able to get to South Africa within 16 hours. The corneal graft took place and sight was restored to one eye. The girl was delighted and asked whether the other eye could be operated on as well. Eventually, a corneal transplant was done on the other eye and the girl now has sight in both eyes. Just imagine the world of good that this can do. How can one describe the feeling that a person has who was blind and is now given sight? This underlines the importance of corneal grafts. He also mentions the case of China where because of their culture over a period of 5 000 years, they were not permitted to tamper with the body in any respect at all. He then persuaded the Ministers in charge of legislation there that one could not notice any difference in a body if a cornea was removed or not. He eventually convinced them in this regard and, as I say, after 5 000 years of their culture to the contrary, they changed their laws so that corneal grafts could be done.

As far as South Africa is concerned, we have been able to build up quite a large corneal reserve, so much so that I believe we are even able to export some. In this regard, I believe that we export to Zambia, the Argentine, Malawi and Mauritius and I believe that in Mauritius alone 61 people had their sight restored because of this assistance. To date between 1 600 and 1 700 underprivileged people have had their sight restored to them in South Africa.

I should like to refer briefly to clause 23 which deals with blood donors. Here too, I think it would be in keeping for us to express a word of thanks to all those people who have donated blood to blood transfusion organizations and who in the process have helped to preserve, and to save lives. I think we owe them a debt of gratitude. Clause 23 provides that this should be done under the supervision of a medical practitioner. In my younger days I used to donate blood as well and I know that the law was different then. I do not remember anybody but a nurse attending to me when I donated blood. As I say, I donated blood quite often and I was just wondering whether it would be adequate if under the present circumstances as well as a qualified nursing sister attended to the patients.

Clause 6 provides that when a person at the time of his death is wearing a prescribed identity tag, such a person shall be deemed to have made donation either of his body or of body tissue. As I have said before, however, this sort of thing does not take place in practice and the nearest relative will always be consulted.

In regard to clause 28, I agree that any payment in respect of any body tissue whatsoever be prohibited. This, of course, is a well-established practice and must be upheld particularly where there are people who are alcoholics or drug addicts or otherwise completely destitute who wish to sell some of their organs for money. I think this is contra bonos mores, it is against public policy and should not be countenanced.

The hon. member for Bezuidenhout mentioned the case in regard to legitimacy. I think the question of adultery has been solved by the court. Obviously, it cannot be adultery if there has not been carnal intercourse and therefore artificial insemination could never amount to adultery. As far as legitimacy is concerned, I think we have the adage in law, as hon. members know, pater est quem nuptiae demonstrant —the father is he who is indicated by the marriage. Unless such father is going to refute the legitimacy of the child himself, the child remains legitimate. I think that is a well-accepted fact in court and in law.

As far as inheritance after death is concerned, I think that if a doctor’s certificate can be produced indicating the death of the patient the Master can make the necessary arrangements for such an estate to be administered. However, as far as illegitimacy is concerned, there could be problems in regard to intestate succession. That may perhaps need some clarification at some stage or other.

Finally, I should just like to refer to the attitude of my hon. friends in the NRP. They have asked for the vote on this legislation to be a free vote. I do not understand what they mean by asking for a free vote on this matter. Obviously, hon. members are free to give their points of view but are we now to understand that some hon. members of the NRP are going to vote for this Bill and some against it? Why otherwise would they ask for this to be a free vote? Perhaps we could have some explanation from them in this regard.

Mr. Speaker, I want to thank all hon. members who have given me their support in this very important measure. I also want to thank hon. members for the excellent level on which they conducted the discussion of this Bill. There has, however, been one exception, but I think I should rather leave it at that.

Yesterday evening, Mr. Speaker, I listened carefully to the speech made by the hon. member for Parktown. Allow me to be very candid about it, Mr. Speaker. I enjoyed listening to the hon. member for Parktown. I do not always find it enjoyable to listen to him but when he has something about which he can talk sense, one can indeed listen to him. I thank the hon. member for his support as well.

*When I tell the hon. member for Parktown that I appreciate his standpoint, I mean it. I mean it because it must be quite clear to everyone that this is a man who knows what the essence of this Bill is. If we could reach the position in this House where we could always discuss only essence of legislation, because we have the knowledge to do so, we would go a long way. Only too often, however, hon. members talk here just for the sake of talking. However, I appreciate the remarks made by the hon. member for Parktown.

The hon. member referred to a few specific aspects of the legislation. In the first place, let us consider the question of why this legislation has become necessary. It includes certain other pieces of legislation, of course, such as the Anatomy Act, an Act which is many years old. Now all those old Acts are being consolidated into one piece of legislation, a step which will greatly facilitate matters for the medical practitioners, of course. Why has this legislation become necessary? It has become necessary because a human body or human organs or tissue have become important in other respects as well, apart from having to be treated with respect and to be buried. In South Africa, these things have become particularly important because of that unique heart operation which took place here in Cape Town in 1967. Then people suddenly realized that medical practitioners in this country had been responsible for an achievement of world standard.

When we consider the legislation, however, it appears that those medical practitioners may have been guilty of a crime because they had no legal sanction for what they did and because they did not enjoy any legal protection either. Therefore the legislation has been formulated to provide for certain actions taken by people in the medical profession, actions which were aimed purely at improving the quality of life of people and at prolonging human life. Medical practitioners who act in this way might be acting illegally if the legislation were to remain unchanged.

I personally had the privilege of sitting on the Select Committee which considered the original legislation. Many interesting views emerged there. The hon. member asked why we had not provided a definition of the moment of death, or why we had not clearly defined what death actually was. Up to that stage, of course, we have never had any problems with the question of what “death” meant. Usually there was enough time to decide whether a person was dead or not. Because that operation took place, however, it subsequently became important for people to be able to determine the precise moment of death, so that an organ or tissue could be used for transplant as soon as possible after the moment of death. For transplant, after all, one needs an organ which is still in a usable and viable condition, so that it can be transplanted into the still living body of another patient in order to save or prolong his life. Therefore is has become essential to be able to determine precisely the moment of death. Even on that Select Committee we argued about what the moment of death was. When we were drafting the Bill, we again studied the matter very seriously. I give this assurance unequivocally. The law advisers, the department and I found it absolutely impossible to formulate a definition of the moment of death which could be embodied in legislation.

Surely one can make use of an electro-encephalogram?

It is possible that one could use an electro-encephalogram to register brain waves, but before on can use that, one has to have such an apparatus available. If the person concerned is not near such an instrument, one will therefore not be able to use the material which would otherwise have been available. However, this is only one of the problems which one faces. Apart from that, medical people are still arguing with one another about what those brain waves should look like. There is still no consensus about that.

I believe that the best way in which we can embody this in the legislation is by providing that there should be two medical practitioners, one of whom should have at least five years’ experience. So the legislation requires that there should be at least six years’ experience. In most cases, these people will be specialists who have been working on this for a further five or six years and who have also received five or six years’ training, of course. One may take it, therefore, that there will usually be two experienced medical practitioners with about 20 years’ experience between the two of them. Together they will have to decide whether or not the person is dead.

I understand how difficult it is for them to decide. I understand that only too well, but I do not think we would be making their task any easier by embodying something in the legislation which we cannot altogether defend.

The hon. member also referred to the question of a reasonable time. I am replying to his speech in some detail, because I realize that he has been faced with the practical problems. The way I see it, the question of a reasonable time will arise where the district surgeon has to give his permission. The urgency of the proposed transplant will also determine what a reasonable time is. There will have to be a certificate by two medical practitioners, indicating how urgent it is that the proposed transplant be done. Therefore the district surgeon will have certain aids.

As far as I am concerned, the hon. member actually gave the answer himself, because he said that they still preferred to try to get hold of the nearest relative in order to ask his permission. Of course this is important. A medical practitioner who is doing such important work can never allow any suspicion to arise that he has been guilty of any improper conduct towards a patient. If such a suspicion were to arise, he would be destroying his entire project and the future of his research. That is why it is important, and I believe we should accept it.

The hon. member wanted to know why we did not state explicitly that a gonad of a deceased person could not be transplanted into a living person, while nevertheless saying that another transplant in this connection may not be done without the Minister’s consent. Let me be frank with the hon. member. The gonad of a deceased person is not transplanted into a living person in South Africa. I am not aware of this ever having been done. Therefore it is basically unnecessary to write it in, but at the same time, it is not wrong to do so. Hon. members may ask why the Minister’s consent is required in this one respect. Personally I am not in favour of the transplanting of gonads in order to bring about procreation, as provided for in the legislation. Why do we do transplants? One must realize, of course, that there are people who have moral, theological or other objections to the transplanting of gonads, and we should not dismiss those objections as being of no importance. One should respect them. But why does one do transplants? One does transplants in order to improve the quality of people’s lives. I do not think that applies in this case. One does transplants in order to prolong a person’s life. I do not think this applies in this case either. Furthermore, one does transplants if that is the only way of treating a patient and allowing him to receive certain benefits. In my opinion, that does not apply in this case either, because there are other methods mentioned in this legislation, methods to which certain other hon. members did have objections, but which are nevertheless more acceptable. That is why I think it is necessary. Hon. members may ask: But why create the possibility of transplants? For the simple reason that 20 years ago, we never conceived of the possibility of a heart transplant and what it will be possible to do with gonad transplants in future, when further experiments have been conducted, is something we shall have to ascertain. Therefore we are leaving the matter at that, just in case requests are received in certain cases which may merit consideration. These are basically the questions which the hon. member asked me, or at least, all the more important questions. Oh yes, the hon. member asked me one more question. He asked whether we should not arrange for every patient who is admitted to hospital to sign a statement to the effect that if he died, his body could be used for donations. [Interjections.] Yes, he should at least be asked whether this could be done.

[Inaudible.]

I understand. However, it comes to the same thing. He should sign in any case, and unless he objects, his organs can be used for purposes of donation. [Interjections.] My personal feeling is that any hospital which tried this would very soon have to close down. [Interjections.] I do not think it would be acceptable to sick people to sign anything of that nature. I accept that it would solve many problems for medical practitioners. However, let people rather put a sticker or something of that nature in their cars saying “I donate my body for certain purposes”. Then we shall all know in advance. Then the person will have done it of his own accord, however. I think it is wrong to ask a sick person: Do you not want to donate your body? I think we would be making a mistake by doing that. That is just my feeling about the matter. The way I read the legislation, however, it would be perfectly in order to investigate the possibility. It seems to me that it would not be a contravention of the legislation in any event.

The hon. member for Witbank spoke, among other things, of medical practitioners who issued certificates without having seen the remains. I do not wish to express any opinion on the correctness of this, but the fact remains that the medical practitioner who signs the certificate is responsible for what he is certifying. One cannot get away from that certificate in the way some other people do when they are so quick to sign something and then forget about it. [Interjections.]

The other hon. members who spoke—the hon. member for Brits, the hon. member for Koedoespoort, the hon. member for South Coast, the hon. member for Bezuidenhout and the hon. member for Hillbrow—all basically dealt with the question of artificial insemination. I do not wish to dwell on this. I greatly appreciate the fact that the hon. members conducted the discussion on this matter at such a high level. I enjoyed listening to the hon. member for Koedoespoort and have great respect for his opinion. My problem is, however, that we have the same situation today that we had in 1967, when things took place against which patients were not protected and against which medical practitioners were not protected by law. This is an irrefutable fact. I can tell the hon. member for Koedoespoort that I share his feelings on the matter. I would not allow this to be done; I would not allow it to be done to my people, my family. However, I realize that there are people who need it. There are people who have the right to take such a decision. I know it is against the doctrine of the hon. member’s church, which is the view of my church as well, but I also know that there are other churches that do not object to it. We enjoy freedom of religion in this country, and therefore we cannot enforce these things by law.

The matter is now being regulated by law in the most proper and honourable way possible. When the hon. member says that his church is opposed to it, I can say that I agree with him, because I do not like it, but then that is my personal feeling. However, I realize that abuses are taking place. In certain cities they are taking place on such a scale that there may be a hundred or more children fathered by some donators. In the light of this the hon. member will realize that I have no choice; I simply have to act. There are certain matters which one cannot legislate for. One does not wish to complicate the task of those people or churches that have conscientious objections to these things, but one wants to create the opportunity to facilitate their task for them. That is why we have drawn up a code in this connection. The hon. member for South Coast had objections to the code. I realize that a code is not a law. I realize that it leaves plenty of loopholes for dishonest people, but it does lay down certain conditions. The first is that only a doctor is allowed to do the work.

In the second place, it may only be done in a registered hospital. Let us see who composed this publication containing the code. We see the names of Prof. J. Metz, Director of the South African Medical Research Institute, Prof. Hansen, head of the Department of Paediatrics at the University of the Witwatersrand, Prof. S. A. Strauss of the Faculty of Law of the University of South Africa, the greatest expert on medical jurisprudence in South Africa, and others. These are the people who composed this publication.

What do our people do, however? Our people are prepared to visit these doctors and to put their own lives and those of their wives and children into their hands, but when they come back, they criticize these doctors, saying that they are dishonest and that they are doing it purely for money. To me this is unacceptable.

I want to make one further remark. The hon. member referred to certain funerals. The department is drawing up a new set of regulations in terms of which control will be exercised over undertakers. This will be published and undertakers will be accorded the opportunity of commenting on it.

Question agreed to.

Bill read a Second Time.

Mr. Speaker, I move—

Agreed to.