Case Law[2025] ZAGPPHC 356South Africa
N.M v Minister of Health and Another (032161/2024) [2025] ZAGPPHC 356 (14 April 2025)
High Court of South Africa (Gauteng Division, Pretoria)
14 April 2025
Judgment
begin wrapper
begin container
begin header
begin slogan-floater
end slogan-floater
- About SAFLII
About SAFLII
- Databases
Databases
- Search
Search
- Terms of Use
Terms of Use
- RSS Feeds
RSS Feeds
end header
begin main
begin center
# South Africa: North Gauteng High Court, Pretoria
South Africa: North Gauteng High Court, Pretoria
You are here:
SAFLII
>>
Databases
>>
South Africa: North Gauteng High Court, Pretoria
>>
2025
>>
[2025] ZAGPPHC 356
|
Noteup
|
LawCite
sino index
## N.M v Minister of Health and Another (032161/2024) [2025] ZAGPPHC 356 (14 April 2025)
N.M v Minister of Health and Another (032161/2024) [2025] ZAGPPHC 356 (14 April 2025)
Download original files
PDF format
RTF format
make_database: source=/home/saflii//raw/ZAGPPHC/Data/2025_356.html
sino date 14 April 2025
SAFLII
Note:
Certain
personal/private details of parties or witnesses have been
redacted from this document in compliance with the law
and
SAFLII
Policy
FLYNOTES:
FAMILY
– Children –
Gamete
ownership
–
Applicant seeks permission to use her late husband’s stored
gametes to extend their family – Competing
interpretations
considered – Rigid interpretation persuasive –
Reproductive material should not be treated as
conventional
property due to ethical and legal complexities – Deceased
had consented to using his sperm for procreation
– No
evidence that deceased withdrew consent – Application
succeeds –
National Health Act 61 of 2003
, reg 18.
IN THE HIGH COURT OF
SOUTH AFRICA
GAUTENG DIVISION,
PRETORIA
Case No.
032161 / 2024
(1) REPORTABLE: YES/NO
(2) OF INTEREST TO OTHER
JUDGES: YES/NO
(3) REVISED: YES
DATE 14/4/2025
SIGNATURE:
In the matter between:
NM
APPLICANT
and
MINISTER
OF HEALTH
FIRST
RESPONDENT
MINISTER
OF SOCIAL DEVELOPMENT
SECOND
RESPONDENT
CENTRE
FOR CHILD LAW
AMICUS
CURIAE
JUDGMENT
NEUKIRCHER J
[1]
This court was convened at the direction of the
Judge President in order to consider whether any order contrary to
the provisions
of Regulation 18 of the National Health Act 61 of 2003
(NHA) can be granted and, if so, on what terms.
[2]
The background to this direction is the following:
a)
at the time the full court was convened, two
applications served before it:
(i)
the first was the matter this judgment seeks to
address;
(ii)
the
second was a surrogacy application
[1]
in which the commissioning parents sought relief that they are the
owners of any zygote(s) or embryo(s) created in terms of the
written
Surrogate Motherhood Agreement.
[3]
The surrogacy application was withdrawn at the
hearing and therefore the relief is moot, and it is unnecessary for
this Court to
consider it. However, the other application was argued,
and it is to this that we direct our attention.
[4]
The relief sought in this application was framed
in the alternative: the main prayer was for a declaratory order that
ownership
in reproductive material is capable of being transferred;
in the alternative, the applicant seeks an order that the ownership
in
certain sperm straws vest in her. In truth, this application turns
on whether or not the applicant (NM) should be granted permission
to
use her late husband’s (the deceased) stored gametes to extend
their family and to give their existing child a sibling.
[5]
Whilst this sounds simple enough, there are two
important considerations that give pause for thought: the first is
that the provisions
of the National Health Act 61 of 2003 (NHA) and
its Regulations (in particular Regulation 18) are silent on the issue
of posthumous
use of gametes; the second lies in the manner in which
the relief sought in the Notice of Motion was couched.
[6]
The Minister of Health chose to file an
explanatory affidavit and made submissions to this court. The
Minister of Social Development
simply filed a Notice to Abide. The
Centre for Child Law was appointed by the court as
amicus
curiae
. We are indebted to them for
their helpful and insightful submissions. Neither of the Ministers
oppose the relief sought. The
amicus
supports the applicant’s request to use the
frozen blastocysts and frozen sperm of the deceased to conceive a
child through
artificial fertilisation, but the
amicus
does not support a finding that classifies
reproductive material as property. I will deal with this issue in due
course.
[7]
At the hearing, the applicant did not persist with
the main prayer. She simply asked for the declarator that the
ownership of the
sperm straws vests in her.
Background
[8]
The applicant is an (almost) 40-year-old woman who
was married to the deceased in 2015. The deceased was diagnosed with
Hodgkin’s
Lymphoma and before he underwent chemotherapy
treatment he was advised to freeze his sperm for use should he want
children later.
Subsequent to doing that, the deceased received a
bone marrow transplant during approximately February 2015.
[9]
The
applicant and the deceased consulted Dr Gobetz
[2]
at Vitalab Fertility on 28 December 2015. At this stage, the deceased
was in complete remission. Because they were unable to conceive
naturally, the applicant underwent fertility treatment the result of
which was that on 8 February 2016 a total of sixteen eggs
were
retrieved from her by Dr Gobetz under conscious sedation by
transvaginal ultrasound guidance. Only nine of the eggs were mature
and the others had to be discarded as they were not suitable for the
Intracytoplasmic Sperm Injection
[3]
.
Two sperm straws were used for the latter procedure.
[10]
Eleven
straws remained cryopreserved, and six embryos were also
cryopreserved as blastocysts.
[4]
[11]
According to Dr Gobetz, the first double embryo
transfer was performed in March 2016 but without success. The second
transfer was
performed in May 2016 which resulted in the live birth
of the applicant and the deceased’s daughter (GGM) on 2
February 2017.
[12]
Of the original six blastocysts, two remain.
Eleven sperm straws remain cryopreserved.
[13]
The
deceased passed away on 10 August 2017
[5]
without stipulating in writing what should happen with the remaining
eleven sperm straws. Dr Gobetz states that Vitalab did not
enter into
an agreement with the applicant as to what would happen with the
gametes and embryos in the event of the death of either
the applicant
or the deceased.
[14]
There
is also no Ownership Disposition Agreement that applicant and the
deceased signed that can provide guidance on what should
happen with
the eleven sperm straws upon the death of the deceased. The only
written instruction
[6]
is to be
found in paragraph 5 of the deceased’s Last Will and Testament
which provides:
“
5.
Should my wife survive me:
5.1
I leave my estate to my wife N…M…
”
[15]
According to Dr Gobetz, the applicant’s
situation is not unique – Vitalab has other clients in a
similar position. He
states that:
“
[it]
is a policy at Vitalab that we do not proceed with any IVF procedure
pertaining to the human reproductive material i.e. sperm,
gametes
because of the uncertainty surrounding the transferability of
ownership of the sperm, gametes, etc
.”
[16]
He lastly states that he supports the present
application as “
it will bring
clarity not only to the applicant but also to Vitalab and other
people in similar circumstances
.”
[17]
As stated, the Minister of Health filed an
Explanatory Affidavit setting out the framework of the current
application. Unfortunately,
the affidavit is of little assistance –
other than superficially setting out the provisions of Regulation 18
of the NHA,
the Minister of Health offered no insight, no legal
analysis and no discussion of whether the relief sought is tenable
given the
provisions of Regulation 18 or the remainder of the
legislative framework that informs the use/ownership/transfer of
gametes posthumously
in South Africa.
[18]
At the outset, it needs to be said that the Court
has great difficulty with the concept of “ownership” as
it relates
to reproductive material. The word “ownership”
is introduced in Regulation 18, which I will discuss later in this
judgment.
Suffice it to say at this introductory stage, that a
different concept is required to describe the relationship between
the reproductive
material and the person/institution that has the
right to dispose of the material. I align myself with the sentiments
of Robbie
Robinson in the article “The Legal Nature of the
Embryo, Legal Subject or Legal Object”, which, although
specifically
aimed at the legal standing of embryos, is to my mind
also applicable to other reproductive material. Nonetheless, the
legislative
scheme that is currently applicable is based on the
concept of “ownership”. – whether that is true
ownership
in terms of the common law concept of ownership, or
something lesser, is not defined at all in the Act (as discussed
below).
[19]
One
aspect of this case that deserves comment is that the applicant does
not require this court to confirm her ownership of the
two remaining
blastocysts. The reason for this is that they contain her gametes
over which she retains ownership/possession even
though they contain
the deceased’s genetic material as well.
[7]
[20]
To explain:
a)
the NHA defines a “gamete” as “either
of the two generative cells essential for human reproduction.”;
b)
these “generative cells” are the egg
(oocyte) and the sperm (spermatozoa);
c)
a
“zygote” is defined by the NHA as “the product of
union of a male and a female gamete” which is produced
when the
gametes are fertilised in vitro – the fertilised gametes are
known as a zygote
[8]
.
[21]
The fetus develops in various stages:
a)
day zero in the embryology laboratory is the day
after the gametes have been placed together in the lab;
b)
on days two and three of a fertilised oocyte, the
embryos are cellular structures: on day two it is usually a four-cell
structure
and on day three it is usually an eight cell structure;
c)
on day four, the fertilised oocytes look like
Mulberries;
d)
by day five or six of the process, the zygote is
known as a blastocyst and it is at this stage that it is either
frozen or implanted;
e)
approximately fourteen days after fertilisation,
the blastocysts become an embryo and for the next six weeks the
embryonic cells
continue to develop until they form a fetus.
[22]
Thus it appears that the fertilised oocyte at the
heart of this matter is not an embryo, but rather a blastocyst –
an important
developmental distinction.
[23]
As
stated, it is because that blastocyst contains applicant’s
gamete that she retains “ownership”
[9]
and these can be implanted without permission of this court. It needs
to be said however, that where implantation of the
blastocyst is to
occur via a surrogate mother and not in the applicant herself, the
provisions of Chapter 19 of the Children’s
Act 38 of 2005 must
be applied.
[24]
However, if implantation of these blastocysts is
unsuccessful and the blastocysts do not develop into embryos, there
will be only
two avenues available to applicant to provide a genetic
sibling to GGM:
a)
she will either have to have her oocytes harvested
again and use the deceased’s cryopreserved sperm straws to
fertilize them;
or
b)
she will have to use a surrogate and the
deceased’s sperm – this may have its own legal
challenges, but as this is not
an issue before us, I make no finding
or further comment on this.
[25]
What is before us stems from the scenario sketched
in paragraph 16 supra. Dr Gobetz requires an order from this court in
order to
use the deceased’s cryopreserved sperm to create the
embryo.
The legislative
framework
[26]
Government Gazette No R.180, published on 2 March
2012, provides for the general control of human bodies, tissue,
blood, blood products
and gametes. According to these requirements:
a)
“
artificial fertilisation” means the
introduction by other than natural means of a male gamete or gametes
into the internal
reproductive organs of a female person for the
purpose of human reproduction and includes
b)
“
artificial insemination” which means
“in vitro fertilisation, gamete intrafallopian tube transfer,
embryo intrafallopian
transfer or intracytoplasmic sperm injection.”
[27]
The
legislative framework that governs the transfer of “ownership”
of reproductive material in South Africa is informed
by several
provisions of the NHA and its Regulations. Section 56(1) of the NHA
allows for the use of gametes withdrawn from a
living
person
with
the written consent of the person
[10]
only for such medical purposes as may be prescribed. The current
matter does not offend section 56, as the deceased was still alive
when the gametes were withdrawn.
[28]
Whilst all this is well and good in respect of a
living
donor,
the issue at hand is what to do if the donor passes away before the
gamete is used for fertilisation?
[29]
Section
62 of the NHA makes provision for the donation of a person’s
body “or any specified tissue
[11]
thereof” to be used after their death where:
“
(1)(a)
A person who is competent to make a will may –
(i)
in the will;
(ii)
in a document signed by him or her and at least
two competent witnesses; or
(iii)
in an oral statement made in the presence of at
least two competent witnesses,
donate his or her body or
any specified tissue thereof to be used after his or her death …
for any purpose provided for in
this Act.”
[30]
Section 62 is not applicable to this case. The
definition of “tissue” in the NHA specifically excludes
gametes. There
is thus no legislative provision that deals with the
donation of reproductive material or with its disposal post-mortem.
[31]
It is
then towards Regulation 18
[12]
that one must look. Unfortunately, this is not a model of clarity
either.
[13]
Regulation 18
provides for the “ownership” of gametes, zygotes and
embryos. It states:
“
18(1)
Before artificial fertilisation, the ownership of a gamete donated
for the purpose of artificial fertilisation
is vested -
(a)
in the case of a male gamete donor but –
(i)
before receipt of such gamete by the authorised
institution to effect artificial fertilisation by the authorised
institution which
removed or withdrew the gamete; and
(ii)
after receipt of such gamete by the authorised
institution that intends to effect artificial fertilisation, in that
institution;
(b)
in the case of a male donor for the artificial
fertilisation of his spouse, in that male gamete donor; and
(c)
in the case of a female gamete donor, for the
artificial fertilisation of a recipient in that female gamete donor.
(2)
After artificial fertilisation, the ownership of a
zygote or embryo effected by donation of a male and female gametes is
vested
-
(a)
in the case of a male gamete donor, in the
recipient; and
(b)
in the case of a female donor, in the recipient.”
[32]
The legislative framework can therefore be
summarized as follows:
a)
gametes may not be removed from living persons
without their written consent. In this instance, the deceased’s
consent was
obtained when he was still alive;
b)
those gametes may only be used for the artificial
fertilisation of another person;
c)
the ownership of the male gamete:
(i)
prior to artificial fertilisation “of his
spouse” vests in the male donor; and
(ii)
after artificial fertilisation, in the recipient.
[33]
The Director General: National Department of
Health (the DG) states in his explanatory affidavit that:
a)
the NHA is not explicit on whether human
reproductive material can be transferred or not;
b)
that although the Regulations do not provide for
the transfer of gametes but only for ownership, the Regulations do
not prohibit
the transfer of gametes;
c)
that had it been the intention of the Regulations
to prohibit the transfer, Regulation 19 would have expressly provided
for this;
d)
that
s68(1)(p)
[14]
of the NHA
envisages a situation where there may be a need to acquire gametes as
it empowers the Minister to make regulations in
relation to the
acquisition of gametes for any purposes.
[34]
The DG then states:
“
Acquisition
may be another way of establishing ownership of something (gametes in
the current case). Furthermore, acquisition may
also entail the
transfer of what has been acquired (gametes). Although Regulation 18
does not expressly provide for the transfer
of the gametes, it does
not prohibit such transfer. The Act also acknowledge[s] the need of
acquisition which will ordinarily also
include the transfer of what
has been acquired.”
[35]
Although
not expressly stated, it is clear from the facts that the
requirements set out in paragraphs 32(a) and 32(b)
supra
have
been complied with. It is also clear that, during his lifetime, the
deceased gave his consent
[15]
for the use of his gametes to create a family with the applicant.
This is confirmed by Dr Gobetz who used the deceased’s
sperm to
fertilize oocytes of the applicant on two occasions, the last of
which resulted in the birth of GGM. This being so, it
is also clear
that, at his passing, the deceased was the owner of the 11 sperm
straws that had been cryopreserved.
[36]
The use of the word “ownership” in
Regulation 18 is, as I have said, unfortunate. We were informed at
the hearing that
the Minister of Health published draft regulations
in 2021 in which Regulation 18 was removed, but these have yet to be
implemented.
Thus, Regulation 18, as it presently stands, has led to
a conundrum on several issues the most notable of which are: can
“ownership”
of reproductive material be transferred? And
what is meant by the word “ownership”? This is
effectively the applicant’s
argument: ie that the deceased’s
transferred ownership of the 11 sperm straws to her in his last Will
and Testament.
[37]
It is important to note that there is no specific
provision in either the Act or the Regulations that deal with the
issue of transfer
of ownership of gametes, save Regulation 18. As the
DG states, whilst the legislation does not expressly prohibit it, it
does not
expressly allow it either. A further issue is that neither
the Act nor the Regulations define “ownership”. Although
Regulation 18 vests ‘ownership’ of the gametes in the
deceased, it does not, it seems to me, exclude his right to determine
its further use.
[38]
In an
article titled “
Can
Ownership of Reproductive Material be Transferred
?”
[16]
,
Professor Thaldar argues that a broad interpretation of Regulation 18
should be followed that allows for a transfer of ownership.
He terms
this “the supple interpretation”. He argues that
Regulation 18 determines the default positions regarding
ownership of
reproductive material which can be changed by the parties
involved.
[17]
[39]
The so-called “rigid interpretation”
is the permanent immutable default position regarding ownership of
reproductive
material.
[40]
Prof
Thaldar argues that our law differentiates between the original
acquisition of ownership and the derivative acquisition of
ownership.
[18]
Original
acquisition occurs when the subject matter has independent existence.
He states “in the context of medically assisted
reproduction,
examples of new legal objects coming into existence would be when
gametes are separated from a human body, or when
an embryo is
created…”.
[19]
[41]
The argument is the following: gametes exist as
physical subjects prior to being separated from the human body. Once
separated,
they become legal objects. And finally, once a woman is
inseminated with sperm or an embryo implanted, the gametes lose their
status
as legal objects and, once again, become part of the woman’s
legal subject status.
[42]
The point to the argument is that any separated
reproductive material is external from the person, has the status of
a legal object
and is therefore subject to the control of the person
who donated it, and therefore ownership of the reproductive material
may
be transferred from one person to another. This is in accordance
with what the author advocates is a “supple interpretation”
of Regulation 18.
[43]
However,
Robbie Robinson
[20]
disagrees.
He argues that the NHA does not indicate expressly the legislator’s
viewpoints on the status of an embryo or any
of the products,
including tissue and gametes, listed in Chapter Eight
[21]
of the NHA. He argues that they should not be viewed as “property
in the sense of legal objects” and that:
“…
these
provisions
[22]
should not be
understood as conveying a clear intention on the part of the
legislature. In fact, it is submitted that the wording
is instead
indicative of a lacking apposite terminology to convey the true
nature of the relationship. In the first place, one
of the rules
pertaining to the interpretation of statutes makes it clear that the
legislator must alter the common law explicitly
if it wishes to do
so
[23]
. If it goes without
saying that the wording of the Act and Regulations does not meet this
requirement…”
[44]
Robinson
also argues
[24]
that:
a)
the exact characterization of an embryo in South
African law remains unknown and will have to be dealt with on a
case-by-case basis
taking into consideration relevant factors; and
b)
the
use of the word “ownership” in the NHA Regulations “is
problematic and should have been replaced with a ‘proprietary
interest’, which denotes something different from the legal
understanding of ownership
[25]
.”
[45]
In my
view, Robinson’s argument as set out
supra
is
persuasive. To argue, as Prof Thaldar does, that reproductive
material is a “legal object” which can be acquired
and in
regard of which ownership may be transferred, may lead to legal and
ethical considerations regarding, for example, the rights
of the
person who did not consent to the use of their genetic material for
conception. This was also the argument advanced by the
appointed
amicus
curiae
.
[26]
[46]
In most of the international law cases cited
before us, the main issue courts were tasked with was vis-à-vis
the fate of
embryos created from the parties’ genetic material.
Some of those cases were decided based on written agreements entered
into between the parties and thus those courts avoided an
interpretation of “ownership” and rather enforced the
terms
of the parties’ written agreements or prevailing
legislation. It is not necessary for purposes of this judgment, and
the
conclusion reached, to cite all, but to illustrate the principle
the following are of interest:
a)
in the
Australian matter of
G
v G
[27]
the dispute arose because Mrs G wanted embryos to be discarded, while
Mr G believed this to be his only remaining opportunity to
procreate.
Mr G requested that the embryos be transferred into his custody. His
intention was not to use them personally, but rather
to donate them
to an infertile couple. However, prior to freezing the embryos, the
couple had signed an agreement in which they
indicated that the
frozen embryos were to be discarded in the event of their separation.
The court ordered that the embryos be
destroyed based on the
overriding consideration for the court's decision was that Mr G did
not want to use the embryos to give
effect to his own right to
procreate and no decision was made on whether the embryos were
“property”;
b)
in
Findley
v Lee
[28]
a Californian Court was called upon to decide whether embryos could
be classified as property. The dispute involved the disposition
of
embryos created by the parties after the wife had been diagnosed with
breast cancer. In this case, the parties had entered into
an
agreement with the IVF program in which they clearly indicated that,
in the event of divorce, the embryos were to be destroyed.
In respect
of the status of the embryos as property, the court found that:
"To
suggest that this Court should find that these five 'viable' embryos
are simply property undermines not only the express
language in the
Consent & Agreement, but ignores the very
reason couples undergo the emotionally and financially draining
process of IVF to
have a child.
It
simply is not necessary in this case to categorize the embryos as
'life' or 'property.' The reality is that the embryos and their
creators, Lee and Findley, deserve something more nuanced ... the
embryos in this case represent the nascent stage of five human
lives.
They are not property, nor are they fully formed human beings. They
are, in the construct of the law, sui generis and will
be deemed as
such in this statement of decision."
[29]
The parties were
ultimately held bound to the contract they concluded and the embryos
were destroyed.
[47]
Davis
v Davis
[30]
(
Davis)
is
significant as it was the first case that set out an analytical
framework for disputes between divorcing couples regarding the
disposition of embryos. In
Davis
,
the plaintiff filed for divorce from his wife. While the parties were
able to reach an agreement regarding the terms of the dissolution
of
their marriage, they were unable to do so regarding the seven embryos
stored in a fertility center. The Supreme Court
of Tennessee
began its analysis by attempting to clarify the legal status of the
pre-embryos. It concluded that the pre-embryos
were not persons or
property, but in a special category that deserved “special
respect because of their potential for human
life.” The court
found that:
a)
therefore, based on their interest in (rather than
their ownership of) the pre-embryos, the parties have decision-making
authority
over its disposition;
b)
the Court examined the right to privacy and
concluded that “the right of procreational autonomy is composed
of two rights
of equal significance – the right to procreate
and the right to avoid procreation”;
c)
after balancing these two conflicting
constitutional interests, the Court concluded that Mr Davis’s
interest in avoiding genetic
parenthood outweighed his ex-wife’s
right to procreate by donating the embryos to another couple. The
Court, however, noted
that it would have reached a different outcome
if Mrs Davis had wanted to use the embryos herself and had no other
means of achieving
parenthood. The court stated that:
“
when
weighed against the interests of the individuals and the burdens
inherent in parenthood, the State’s interest in the
potential
life of these pre-embryos is not sufficient to justify any
infringement upon the freedom of these individuals to make
their own
decisions as to whether to allow a process to continue that may
result in such a dramatic change in their lives as becoming
parents”.
[31]
[48]
In
Kass
v Kass
,
[32]
the New York court of appeal held that
Davis
v Davis
required
that a court first determine whether there is an agreement. If there
is, it should be considered as valid and binding.
Where no such
agreement exists, the court must resolve the dispute by weighing the
interests of both parties. In such a case, the
choice of one party to
avoid procreation should trump the other party’s right to
procreation. However, this proposition is
only appropriate where the
party denied the opportunity to use the reproductive material has a
reasonable possibility of achieving
parenthood without having
recourse to the embryos.
[33]
[49]
In
Parillo
v Haly
[34]
the applicant and her partner stored five embryos. After his death,
she wanted to donate them for scientific research but the IVF
clinic
refused to release them as there was a legislative ban on the use of
embryos. The applicant approached the European Court
of Human Rights
which ultimately decided that embryos cannot be reduced to
“possessions” within the meaning of article
1 of Protocol
1.
[35]
[50]
Posthumous
use of embryos is prohibited in France in terms of the French Public
Health Code.
[36]
In
Baret
and Caballero v France
,
[37]
Ms Caballero, sought leave to export the remaining embryos, conceived
using her and her deceased husband's gametes, to Spain where
assisted
reproduction is permitted posthumously. She had explicit written
consent from her deceased spouse to use the embryos for
posthumous
reproductive purposes. Her request was denied by the French
authorities due to the absolute ban on posthumous reproduction
under
French law, which also bans the cross-border movement of gametes and
embryos for purposes prohibited on national territory.
She then
approached the European Court of Human Rights (ECHR ) claiming that
the French Public Health Code violates her rights
to privacy under
article 8 of the European Convention on Human Rights, which includes
the right to make decisions regarding procreation.
The ECHR found
that the ban was legitimate. It balanced the applicant's interests in
her pursuit of the parental plan she made
with her deceased spouse
against the general moral and ethical interests that French law aims
to safeguard. The Court noted that
a wide margin of appreciation
should be afforded to the State given the ethical sensitivity of the
issue at stake and the lack
of a European consensus on posthumous
reproduction.
[38]
[51]
Germany
[39]
has banned posthumous reproduction. Apart from a ban on artificial
fertilisation using the sperm of a deceased person, the use
of
embryos is limited in respect of the number of embryos that may be
created at one time and embryos may only be cryopreserved
in
extremely limited circumstances. Therefore, the is no possibility of
the use of an embryo where genetic material is that of
a deceased
spouse.
[52]
The
one notable case cited by the
amicus
that
is comparable to the case before us, is that of
Bazley
v Wesley Monash IVF (Pty) Ltd
.
[40]
In this case, the husband froze his sperm while undergoing cancer
treatment. He died before the sperm was used and after his death
his
wife sought to use his sperm to conceive a child through artificial
insemination. As the deceased had not left behind a written
expression of his intention, the respondent refused to assist her
based on the Ethical Guidelines on the Use of Assisted Reproductive
Technology in Clinical Practice and Research of the National Health
and Medical Research Council of Australia. The court ultimately
concluded that the semen straws were property, and that ownership had
vested in the deceased while alive and in his wife after
his death.
However, full reasons for this decision were not set out by the
court.
[53]
It is therefore clear that courts internationally
have, where possible, avoided a classification of genetic material as
“property”.
There have, therefore, been instances
internationally in which the posthumous use of reproductive material
has been prohibited.
[54]
In my view, section 39(2) of the Constitution is
relevant. It provides:
“
(2)
When interpreting any legislation, and when developing the
common law or customary law, every court, tribunal or forum
must
promote the spirit, purport and objects of the Bill of Rights.”
[55]
This is relevant as the intention of the
legislature has been obscured by its use of the word “ownership”
in Regulation
18. This is so because neither the NHA nor the
Regulations define what “ownership” is. If the
Legislature indeed intended
to confer true ownership of any nature,
it is paradoxical that the ownership is restricted to living persons
and that there is
no provision for posthumous use in cases such as
that
in casu
.
But in my view, a reading in of such a provision would not be
appropriate. It must be left to the Legislature to amend the NHA
and/or its Regulations in circumstances where it has conceded that
these provisions require proper consideration, are ambiguous
and
where it has already proposed an amendment which has yet to be
effected.
[56]
I thus agree with the submission of the
amicus,
and with the opinion of Robinson, that the court
should adopt a purposive and contextual approach to the
interpretation of Regulation
18 given the specific facts of each
case. This being so, in my view and on the facts of this case it is
unnecessary to expand the
common law either.
[57]
Furthermore, no hard and fast rule can be laid
down as to what should happen to reproductive material in cases such
as those
in casu
.
It may well be that, given the facts of a different matter, a court
would refuse the relief sought. However, from the facts of
this
matter, it is clear – and stands uncontested - that the
deceased intended the straws to be used for the further expansion
of
their family. There is also no evidence before us that the deceased
withdrew consent for use for that purpose at any time.
[58]
I am also of the view that the notice of motion in
this case (whether the main relief or the alternative) is couched in
terms that
are too broad and may be interpreted as laying down a
general principle – this would not be appropriate.
[59]
It is unfortunate that there is no formal contract
or written instrument that sets out the express wishes of the
deceased vis-à-vis
the use of his sperm straws. Instead, we
are left to infer his wishes and intentions from the facts set out in
paragraph 35 supra.
Thus, in my view, the applicant’s argument
that the deceased’s will transfers ownership to her is simply
an arrow in
her quiver, but is not decisive of the matter.
[60]
Given my views set out supra, it is clear that the
deceased intended for his genetic material to be used with that of
the applicant’s
to create their family. The applicant’s
case is therefore adequately made out on the papers and on the facts
without the
necessity to load the bow with the arrow of ownership.
[61]
This being so, and in my view, there being nothing
contra bonos mores
in
granting the relief in the restricted circumstances of this case, and
it being the express wish of the applicant to produce a
genetic
sibling for GGM, I see no bar to granting the application, but in
terms of the order set out below.
[62]
As a result of the facts with which this court was
presented, and the conclusion reached on those facts, the question
with which
we were tasked must be left open. This is not the
appropriate case to lay down any hard-and-fast rule.
THE ORDER
[63]
Thus the order is the following:
The
applicant is entitled to use sperm straws of the deceased, C[...]
M[...], for purposes of providing GGM
[41]
with a biological sibling.
B NEUKIRCHER
JUDGE OF THE HIGH
COURT
GAUTENG DIVISION,
PRETORIA
J
SWANEPOEL
JUDGE OF THE HIGH
COURT
GAUTENG DIVISION,
PRETORIA
RETIEF J
INTRODUCTION
[1]
I have
read the judgment penned by Neukircher J which constitutes the
majority judgment. I have reflected on the content and reasoning
thereof and am grateful for the different perspective it brings to
the set of facts. Having said that, save that I am in agreement
with
the majority view that the meaning of the word “ownership”
is not defined in the NHA nor the applicable Regulations
and that it
is not to be interpreted as ownership in the true sense, our paths on
how that should be applied to the facts, the
relief sought and the
applicable legislative prescripts, do not cross again. Having regard
to our common ground, I am reminded
that the provisions of the
NHA
[42]
clearly limit the use
of gametes, the provisions prescribe the conditions within which
gametes can be used and the provisions limit
rights to dispose
[43]
gamete freely [limitations]. These limitations can apply to a gamete
donor, a recipient, an authorised institution
[44]
or competent person.
[45]
Such
limitations render the exercise of full and absolute control over a
gamete impossible. Therefore, because of these limitations
an
intended meaning of the word ‘ownership’ emerges, even if
the word is not specifically defined. On this basis, I
agree that the
meaning of the word ‘ownership’ where it appears in the
Regulations
[46]
pertaining to
reproductive material
[47]
is
incapable of the common law meaning attributed to ownership of an
object or
res
.
[2]
The applicant appreciated the existence of the
limitations
per se
without
dealing with them in any detail and, stated that as a result thereof,
‘ownership’ of embryos could never mean
owning them as
property. The applicant however confined this reasoning to embryos
only and contended that gametes were different.
She argued that a
distinction lay in the fact that embryos had the potential to give
life, seemingly then, gametes did not. Gametes
she argued because of
the difference, notwithstanding the limitations, could be viewed as
property. Moving from this contention
she argued that gametes, viewed
as property which vested in the deceased estate at his death and were
capable of being inherited
[applicant’s case].
[3]
Of
interest, the applicant in support of her case does not challenge the
provisions of Regulation 18.
[48]
She applied the provisions, moving from the premise that the
deceased, at the time of his death, was the lawful owner of the sperm
in as much as she accepted that she is the owner of the blastocytes
in terms of Regulation 18
[49]
which she intends to use without seeking permission. Therefore, the
applicant does not challenge the provisions of Regulation 18,
it
would simply be counterproductive. She, by aligning herself with the
provisions of the regulation, demonstrates her right of
ownership to
the deceased’s sperm v
ia
succession
upon his death.
[4]
The applicant therefore did not call for the
interpretation of Regulation 18, nor did she raise any Constitutional
challenge. In
this judgment I therefore deal with the applicant’s
case as against the relief she prayed for. This is not only what is
required
but it too assists parties who may wish to test a
proposition in circumstances of legal uncertainty. This stance is of
particular
importance when dealing with matters in developing fields
like medical science, in particular reproductive medicine. Many
matters,
much like this application may, call for a re-analysis of
the approach to how rights are viewed and exercised in relation to
human
bodies and body products.
[5]
Moving
from this stance the applicant does not pray for permission to use
the sperm of her late husband, C[...] M[...] [the deceased].
If she
had, she would have prayed for such permission and clearly set out
the basis for the judicial oversight and the source thereof.
Conversely the applicant requires this Court “-
to
declare that the ownership of the sperm straws vest in the
applicant.
”
[declaratory
relief]. In other words, she seeks a declarator to affirm that she is
the lawful owner of the sperm straws
[50]
which she seeks Dr Gobetz
[51]
to use in the process of artificial fertilisation. On the facts it
appears that it is Dr Gobetz who requires the affirmation of
her
right to the sperm, notwithstanding her contention that she possesses
such a right. Without commenting on the formulation of
the prayer
sought, a declarator moves from the premise of an existing,
contingent or future right. In consequence there is no permission
required merely the establishment of an interest in an already
existing, or future or contingent right.
[6]
The declaratory relief in its form was not the
main relief sought but the relief in the alternative. At the date of
the hearing,
the applicant’s Counsel abandoned the main relief
in which the applicant initially sought the Court ‘-
to
declare ownership of reproductive material to be transferrable.
”
The abandonment occurred amidst the evidence by
the applicant that: “
I have been
advised that there is uncertainty by academics as to whether
ownership of human reproductive material can be transferred
and that
the
focus of this application
(own emphasis)
is for
the Honourable Court to declare that ownership is transferable”.
[7]
Absent argument that abandoning the main relief
effected the purpose of this application, if any, I appreciated the
fact, if the
application succeeded as pleaded, a principle relating
to gametes will be established that gametes are property, and that
ownership
thereof is transferable in similar circumstances. In that
way the alternate relief caters for the outcome of the main relief as
it applies to gametes only and not embryos.
[8]
In
summary, the adjudication of this application requires an enquiry
into whether the applicant, on the facts, has established an
interest
in a right to the deceased’s sperm, as pleaded. If successful,
it will only then trigger an enquiry into whether
this case is a
proper one for the Court to exercise its discretion to grant the
declarator in favour of the applicant. What is
clear is that the nub
of the issue turns on the basis upon which the applicant asserts she
has established an existing right because
her interest in using the
sperm is clear. The test set to be applied in this application was
clearly set out in the Cordiant matter
[52]
a
matter supported by the applicant’s Counsel in her written
argument. I, therefore, as invited, apply this test to the facts
to
determine whether declaratory relief is successful.
[9]
The adjudication of the declarator relief cannot
be entertained in a vacuum either and must result in an effective
order. The relevance
thereof will become clearer but suffice to say
at this stage that consideration of Regulation 7 and 8 of R.175 is
required to ensure
that the competent person possess the necessary
statutory authority to perform the artificial fertilisation
notwithstanding the
recipient’s intention.
[10]
To commence then, a consideration of all the
parties and their respective stance vis-à-vis the relief
before dealing with
the material legislative prescript and the
argument advanced by the applicant.
THE PARTIES
[11]
The
applicant, a 40 year old widower
[53]
and
mother of a single child conceived with the assistance of artificial
fertilisation, she now wishes to extend her family to ensure
that her
daughter has a sibling. To realise her desire, the applicant intends
to undergo an intended embryotic transfer of two
cryopreserved
[54]
blastocytes.
[55]
These
blastocytes were created with her own oocytes
[56]
and
the sperm
[57]
of
before his death. However, the applicant contends that if the
embryotic transfers does not result in a live birth, she
wants to
make use the deceased’s remaining cryopreserved sperm for the
process of artificial fertilisation
via
intracytoplasmic
sperm injections.
[58]
[12]
The
amicus curiae,
the Centre
[
amicus
]
made many insightful submissions, for which I am grateful but, sadly,
didn’t fully address, engage nor consider the basis
upon which
the applicant sought to establish her right of ownership to the
sperm. The
amicus
did
however engage with the main relief by discussing ownership of
reproductive material, in general terms, it considered and weighed
international trends on the subject matter. In conclusion, the
amicus
,
inter alia
,
informed the Court that although it did not support the basis the
applicant relied, in principle, it supported the notion that
the
applicant should be able to use of the deceased’s sperm.
Supporting the notion and not the basis, however noble, remains
unhelpful.
[13]
The first respondent, the Minister of Health
[Minister of Health], the delegatory power, did not oppose the
application but elected
to file an explanatory affidavit. What the
evidentiary weight of such an affidavit remains unclear as uniform
rule 6 certainly
does not provide for such an affidavit. However,
what is clear is that the Minister of Health’s intention was
not to oppose
the relief but to primarily refer to the applicable
provisions. The Minister of Health in speaking to Regulation 18
merely stated
that the NHA did not explicitly state whether ownership
of reproductive material could be transferred. Other than the that
the
Minister of Health did not engage with the basis advanced in
support of the relief nor did the Counsel. As such, the Minister’s
input was unhelpful.
[14]
The second respondent, the Minister of Social
Development, simply filed a notice to abide. This is a pity
considering that chapter
19 of the Children’s Act 38 of 2005
[Children’s Act] speaks directly to the process of artificial
fertilisation of
a surrogate mother. Such artificial fertilisation
includes circumstances of a surrogate mother being the genetic parent
by using
her own gamete in the process of artificial fertilisation.
This donation is for the benefit of others, the intended parents.
Surrogacy,
although not the subject matter of this application,
can statutorily only take place by means of artificial fertilisation
and because a surrogate mother is entitled, in terms of section 298
of the Children’s Act, to terminate a surrogate motherhood
agreement based on the recognition given to her by the Legislator of
her genetic input
via
her
gamete donation, it may have provided another perspective through
which ownership and use of a gamete, in general terms, could
been
viewed. It was not argued and as such not considered in this
judgment.
THE RELEVANT
LEGISLATIVE FRAMEWORK AND DISCUSSION
[15]
The control, use, prescribed conditions and
further limitations of the use of gametes is primarily governed by
the NHA in Chapter
8 and the applicable regulations. The NHA was
repealed and replaced with the Human Tissue Act, 65 of 1983 and came
into operation
on the 2 May 2005. Chapter 8 thereof was however only
fully enacted on the 2 March 2012.
[16]
This
application concerns the specific reproductive healthcare process of
artificial ferritization and therefore demands a closer
look at the
interplay between a donor, a recipient and the competent person who
will affect the artificial process.
[59]
To
understand the process and the interplay is to familiarise oneself
with the relevant legislative framework. In doing so doing
it is
helpful to answer the following questions: What is a gamete? What is
the purpose of gamete removal and, what are the limitations
of use
its once removed? What is the relevance of the prescribed conditions
at the stage when artificial ferritization is about
to take place
?
As
against these answers, the applicant’s argument and relief will
be considered.
What
is a gamete
?
[17]
According
to the NHA a gamete is one of the two generative cells
essential
for human reproduction
.
[60]
The
one generative cell male [sperm] and the other female [oocyte]. A
gamete in the NHA is not regarded as tissue nor as an organ
by
specific exclusion.
[61]
A
gamete in the Regulation R.175
[62]
is not
defined however, sperm is and, is defined as a male gamete as too an
oocyte which is defined as a female gamete. In the Regulations
Relating to the use of Human Biological Material
[63]
[Regulation
R.177] a gamete is considered biological material which includes,
inter
alia,
cultured
cells, embryos and small tissue biopsies. In the Regulations
regarding the General Control of Human Bodies, Tissue, Blood,
Blood
Products and Gametes,
[64]
[Regulation
R.180] a gamete is not specifically defined. Finally in the
Regulations Relating to the Import and Export of Human Tissue,
Blood,
Blood Products, Cultured Cells, Stem Cells, Embryos, Fetal Tissue,
Zygotes and Gametes,
[65]
[R.182]
a gamete together with tissue, blood and blood products is defined as
‘a substance’.
[18]
In short, it is a generative cell essential for
human reproduction and purposefully, by exclusion, it is not
considered to be human
tissue nor an organ. It flows then that a
gamete is essential to give life unlike human tissue or an organ that
is required to
sustain another’s life. In consequence the
applicant’s contention that a gamete should be considered
differently from
an embryo because it is only the latter which gives
life, is flawed. A gamete is an essential cell for human
reproduction.
Both gametes and embryos are defined as reproductive
material because both possess the ability to reproduce a human and as
such
possess the ability to result in life.
What
is the purpose of gamete removal and, what are the limitations of its
use once removed
?
[19]
The
provisions of the NHA
[66]
and
R.180 are clear that the use of a gamete which has been withdrawn
from a living purpose may only be used for prescribed medical
and
dental purposes which include artificial fertilisation
[67]
and in
terms of R.177 for genetic testing. This is the only identifiable
purpose. Artificial fertilisation is a prescribed medical
purpose.
[20]
Logically to use a gamete for a prescribed purpose
entails that the gamete/s be removed or withdrawn from a human body.
Such act
of removal and withdrawal results in the physical detachment
of the gamete from a specific donor’s body. The detachment must
be performed under prescribed. conditions Turning to explore such
conditions in the NHA, Section 55 states that:
“
55.
Removal
of tissue, blood, blood products or gametes from living persons.
A
person may not
(own
emphasis) remove tissue, blood, a blood product or gametes from the
body of another living person for the purpose referred
to in section
56 unless it is done –
(a)
with the written consent of the person
(own emphasis) from
whom the tissue, blood, blood product or gametes are removed granted
in the prescribed manner; and
(b)
in accordance with the
prescribed
conditions
(own emphasis).
”
[21]
The person contemplated in section 55(a) who must
provide written consent is the gamete donor. A gamete donor in
Regulation R.175
means: “
a living
person from whose body a gamete or gametes are removed or withdrawn,
for purposes of artificial fertilisation
.”
The person who is to remove the gametes in accordance with the
prescribed conditions is a competent person.
[22]
Section 55 speaks both to written consent for the
removal in terms of section 56, such removal to occur in prescribed
conditions.
The latter conditions are prescribed in Regulation R.175.
[23]
Section 56(1) referred to in section 55 as
previously mentioned, limits the purpose of the removal of gametes to
medical or dental
purposes only and reads:
“
Use
of tissue, blood, blood products or gametes removed or withdrawn from
living persons.
56. (1)
A person may use tissue or gametes removed or blood or a blood
product withdrawn from a living
person only for such medical or
dental purposes (own emphasis) as may be prescribed.”
[24]
Both section 55 and section 56(1) limit the
freedom to use of a gamete in the hands of both the donor and the
competent person and,
the provisions introduce the fact that certain
conditions are imposed when exercising that limited use.
[25]
Not only is the use of a gamete limited but
section 60(4)(a) unequivocally prohibits the ability of a gamete
donor to receive financial
remuneration or other reward for the
donation itself other that reasonable costs incurred by such donor to
provide the donation.
In other words, a gamete itself as a
reproductive product, in the hands of the donor, in terms of section
60(4)(a) can’t
be reduced to cash.
[26]
Section 60(4)(b) furthermore restricts the
commercial viability of a gamete even further by prescribing that no
person, which includes
the donor, is entitled to sell or trade in
gametes, except as provided for in Chapter 8. Section 60(1)(a) in
Chapter 8 which deals
with the import and export of
inter
alia
gametes, does not, by definition,
include a gamete donor. In consequence, a gamete as a reproductive
product cannot be reduced to
cash nor sold nor sold for profit in the
hands of the gamete donor. In consequence, it has no commercial value
in these circumstances.
It can therefore not be regarded as an asset
in the hands of a donor. Of significance is that non-compliance of
section 60(4) attracts
a criminal sanction for non-compliance.
[27]
The
use of and the donation of a gamete is prescriptive in the NHA
[68]
.
It is therefore of interest that the Legislator appears to have
purposefully excluded the possibility of
mortis
causa
donation
of reproductive material in Section 62
[69]
of the
NHA. This purposeful exclusion is repeated in R.180, by definition,
in that the word ‘
donation’
used
in context,
[70]
is
limited to the donation of a human body, blood or any specific tissue
of a deceased in accordance with the NHA.
[28]
It
appears then that no provision in the NHA nor the regulations deal
with the donation of reproductive material
mortis
causa
whether
by a last will, whether by a signed document nor, for that matter,
whether by oral statement in the presence of two competent
witness.
[71]
This may be due
to the fact that reproductive material, as discussed, gives life and
is not donated by a deceased to sustains another
life. Yet, regarding
gametes there may also be another logical explanation. Meaning that,
if the prescribed conditions in the Regulations
[72]
and the NHA are complied with, at the stage of removal of the gametes
from a living donor as envisaged, then nothing precludes
a recipient
from undergoing the artificial process and, no prohibition exists for
the competent person to assist her even if the
donor at the time of
artificial process has passed away. Death of the gamete donor is not
an impediment under these circumstances.
[29]
The prescribed conditions referred to in section
55 and 56 dealt with in R.175 and are also prescriptive attracting
criminal sanction
for non-compliance. The provisions of R.175 appear
not only to regulate the entire process artificial fertilisation of
persons,
the before and the after, but reference to persons included
the protection of the donor’s interest in future parentage, the
recipient and guide for the competent person through all the stages.
In this way giving credence to the object of the NHA.
What
is the relevance of the prescribed conditions at the stage when
artificial ferritization is about to take place
?
[30]
The
relevance of the prescribed conditions is not only apparent at the
time of the removal of the gametes but, as will be demonstrated,
relevant every time the process of artificial fertilisation is to be
performed with the same donor’s gametes. This is
of
relevance to a competent person who may be precluded from affecting
the process when he/she is unable to determine compliance.
[73]
[31]
Regulation
6 of the R.175 places a restriction on the donation of gametes. The
provisions of Regulation 6 restrict the ability of
process of a
competent person to remove gametes from a donor, no matter what their
wishes,
[74]
if the donor’s
gametes have been used in the conception of a maximum of six (6)
children through artificial fertilisation
already.
[75]
The regulations are practical in that the provisions which follow
from Regulation 6 set out,
inter
alia
,
how a competent person can comply with both Regulation 6 in respect
of ascertaining the number children born from the same gamete
donor
and/or compliance of the donor’s own wishes of parentage (of
how many times their gametes may be used in the process
of artificial
fertilization).
[76]
[32]
The prescribed conditions and how fulfilled are
important considering the Regulation 6 restrictions and informed
consent in terms
of Regulation 8(1)(iv) because a lapse of time may
occur between the moment of the removal of gamete/s and the actual
processes
of artificial fertilisation to be affected thereafter. Of
course, it too is envisaged that gametes from one donor can be used
several
times assisting several or one recipient. The Regulations in
certain circumstances have tried to cater for the time lapses and
uncertain outcomes by trying to control the conditions at each stage
of the process when the same gamete donor’s gametes are
used
repeatedly over time. The regulation purposefully provides mandatory
instructions directed to the competent person.
[33]
Regulation R.175 specifically sets out these
prescribed conditions. Reference only to the most relevant
sub-regulations having regard
to this application will be dealt with.
Having regard to Regulation 6, 7 to 10 follows.
[34]
Regulation 7 stipulates that a competent person
who intends to remove or withdraw a gamete from the body of a gamete
donor must
follow certain mandatory steps. Sub-regulation 7(e)(iii)
states that a competent person must obtain informed consent from a
gamete
donor
to make available to the
competent person who is to affect the artificial fertilisation and to
the recipient
, certain particulars
contemplated in Regulation 8(1)(a)(ii), (iii) and (iv), (b), (c) and
(f). This informed consent is to be in
written form.
[35]
Regulation 7(e)(iii) clearly and unequivocally
states that:
“
7.
Prerequisites
for removal or withdrawal of gametes
A
competent person who intends to remove or withdraw a gamete, or cause
a gamete to be removed or withdrawn from the body of a gamete
donor,
shall
before such removal or withdrawal
(own
emphasis), –
(a)-(d)
(e)
obtain informed consent from the gamete donor relating to –
(i)
-(ii)
(iii)
particulars contemplated in regulation 8(1)(a)(ii), (iii) and (iv),
(b), (c) and (f) being made available
to the
recipient
and the competent person who is to perform the artificial
fertilisation
(
own
emphasis)
;
”
[36]
Regulation 8, in particular, Regulation
8(1)(a)(iv) and (e) referred to in 7(e)(iii) states that:
“
8.
Gamete
donor files, availability of information and destroying of gametes
(1)
The competent person must immediately record
(own emphasis) the following information and
documents in the gamete donor’s file
before
(own emphasis) a gamete is removed or
withdrawn.
(a)
the gamete donor’s –
(i)
-(iii).
(iv)
subject to regulation 6(a),
wishes in respect of the number of
artificial fertilisations for which he or his gametes may be used
(own emphasis);
(b)
-(d)
(e)
the
informed consent and
documents
(own emphasis)
contemplated in
regulation 7(e
)
(own emphasis).
”
[37]
Applying Regulation 7(e)(iii), the competent
person, before the removal of any gamete/s, must have obtained
informed consent from
the gamete donor regarding his/her wishes of
parentage (
how many times
his/her gametes may be used in the process of
artificial fertilization). This is not a record of a donor’s
wish to use his
gametes to start a family. This informed consent must
be recorded and must be made available to the competent person
and
the recipient. Because these documents are to be
made available to the competent person who is to perform the
artificial fertilisation,
it logically must be provided at the time
or time leading up to when the artificial fertilisation is to be
affected. This means
every time the same gametes are to be used as,
in this way, the monitoring of compliance of Regulation 6 restriction
and the donor’s
wishes of parentage are possible. Dr Gobetz and
the applicant are silent on such compliance. The facts infer that
both the applicant
and Dr Gobetz do not know the deceased’s
wish of parentage.
[38]
In terms of Regulation 8 the informed consent is
to be recorded. The records making up the gamete donor’s file
must, in terms
of Regulation 8(2)(a), be kept in safekeeping and the
competent person
is not entitled to
destroy the file
except, with written
permission of the Director-General. Regulation 8(2)(b) again
reiterates that the competent person must make
available,
inter
alia
, the particulars referred to in
Regulation 8(1)(a)(ii), (iii) and (iv), (b), (c) and (f), to the
recipient and the competent person
who is to affect the artificial
fertilisation.
[39]
Of importance, non-compliance of Regulation 7(e)
prevents a competent person from using the gamete for artificial
fertilisation.
This preclusion is set out in Regulation 10(1)(b).
Regulation 10 speaks of,
inter alia,
the competent person’s control over
artificial fertilisation and sub-regulation (1)(b) states that no
gamete from a gamete
donor may be used for artificial fertilisation
if the tests, analysis or examination referred to in Regulation 7(e)
to (g) are
not yet available. Regulation 7(e) to (g) not only refers
to the outcome of a physical examination but examination of the donor
through questioning and recorded responses (Regulation 7(e)(i) and
(iii). This includes recorded particulars contemplated in terms
of
8(1)(a)(ii), (iii) and (iv), (b), (c) and (f).
[40]
A competent person who wishes to affect the
artificial fertilisation too, must ensure compliance with Regulation
8(1)(a)(i) to (iv)
before effecting the artificial fertilisation.
Regulation 11 deals with the requirements for artificial
fertilisation and embryo
transfer. Sub-regulation (c)(1) states that
the competent person who effects
must
ensure
that,
inter
alia
:
“
11(c)(1)
The gamete donor’s particulars and/or
wishes
referred to in regulation 8(1)(a)(i) to (iv
)
(own emphasis
)
are
conformed with.”
[41]
Mandatory compliance of the sub-regulations of
Regulation 8(1)(a) by both the competent person who removes and who
effects the process
is repetitive and inescapable. No distinction is
made between a known recipient or an unknown recipient at the time of
the removal
and/or at the time of the artificial fertilisation.
Flowing from the Regulations then ownership of a gamete is not the
barometer
through which a right to use a gamete is measured and
absent compliance of Regulation 7-8, notwithstanding a donor’s
wishes
as prescribed, the competent person is prohibited from
performing artificial fertilisation.
[42]
Without such information an effective and
competent order, no matter how granted, is not possible
BACKGROUND FACTS
AND DISCUSSION OF THE EXISTING RIGHT RELIED ON
What
are the material facts
?
[43]
The deceased and the applicant were married to
each other on the 25 October 2015. However, prior to that, the
deceased was diagnosed
with Hodgkin’s lymphoma, a form of
lymphatic cancer for which he underwent chemotherapy and a bone
marrow transplant. The
bone marrow transplant took place early in
2015. Prior to his chemotherapy, although the date is not set out,
the deceased “
- was advised to
freeze his gametes (sperm) for later use should he want children in
the future
”
. Following such
advice, the applicant states that “
C[...]
donated sperm at Cape Fertility Clinic for fertility preservation.
Thirteen straws were frozen.”
Other
than that fact, no further facts were provided, in particular
compliance with the prescribed conditions in terms of the Regulations
by Cape Fertility Clinic nor a copy of the deceased donor’s
file.
[44]
Dr Gobetz, who the applicant asked to affect the
artificial fertilisation deposed to an expert affidavit. This was
attached to and
referred to in the founding papers. Unfortunately, Dr
Gobetz was silent on whether the content of the deceased’s file
in
terms of Regulation 8 has been made available to him or for that
matter the applicant as the proposed recipient.
[45]
Be that as it may both the applicant and the
deceased consulted with Dr Gobetz on the 28 December 2015 as they
wished to start a
family. At the time, the deceased’s cancer
was in remission and because they were unable to conceive naturally
and, considering
the sperm preservation she underwent fertility
treatment to stimulate the recovery of her eggs. On the 8 February
2016 a total
of 16 (sixteen) eggs were retrieved from the applicant,
only 9 (nine) of the eggs were mature and the others had to be
discarded
because they were not suitable for intracytoplasmic sperm
injection. Two sperm straws were used for the latter procedure.
[46]
Eleven sperm straws and 6 (six) embryos as
blastocysts were cryopreserved. In March 2016, the applicant
underwent her first double
embryo transfer at Vitalab by Dr Gobetz.
Such a transfer was without success. The second transfer was
performed in May 2016 which
was successful and resulted in the live
birth of the applicant and the deceased’s daughter (GGM) on the
2 February 2017.
After the birth of GGM, 2 (two) blastocysts and 11
(eleven) sperm straws remained cryopreserved. The deceased’s
known wish
regarding the use of his gametes for the process of
fertilisation, as provided orally, and not in compliance of
Regulation 7 to
8 of R.175 appeared to be achieved prior to the date
of his death. No further information is provided as required from
this date.
[47]
Shortly after GGM’s birth and on the 4 June
2017, the deceased signed his Last Will and Testament [Will].
According to paragraph
5 of the Will, the bequeathed his entire
estate to his wife, the applicant. The deceased sadly passed away on
the 10 August 2017.
According to the applicant, the deceased in his
Will did not deal with the remaining 11 (eleven) sperm straws, nor
did they, prior
to his death, enter into an ownership disposition
agreement. The applicant nor her legal team expanded on the terms of
a disposition
agreement and how the conclusion thereof would change
the present position and the applicable law. However, Dr Gobetz does
state
under oath that the applicant and deceased did not
enter into any agreement with Vitalab Clinic about what should happen
with the gametes in the event of the deceased’s death. No
further explanation of what the terms of the envisaged agreement
would regulate was provided. However, because of such omission Dr
Gobetz explained that he was not to proceed with the process
and
informed the applicant that he is concerned that Regulation 18 “-
is
silent at to a deceased donor’s ownership of the gametes that
it should be advisable to obtain independent legal advice
–“
.
As it turns out it is not Regulation 18 silence but the silence of
compliance of Regulation 7-8 of R.175.
[48]
Returning
to the intention of the applicant, she tells this Court that she
first intends to make use of the remaining two embryos
to achieve her
goal to provide GGM with a sibling and only, in the event that such
intended procedure does not result in a positive
pregnancy and viable
birth, is it her intention to use the 11 (eleven) remaining straws to
achieve artificial fertilisation
via
intracytoplasmic
sperm injection.
[77]
The
applicant pins her right to own these straws in terms of paragraph 5
of the Will
via
succession.
What
is the origin of the existing right relied on
?
[49]
The legal advice which the applicant received from
her attorney was that Regulation 18 is silent about “-
a
deceased donor’s ownership (control)”
and
that it is assumed that upon the donor’s death, the ownership
will then devolve in terms of succession law, thus advised
her
attorney, the gamete vests in the estate.
[50]
The
applicant argues that a person’s right to gamete could be
viewed as a right which is exercised over property and as such,
gametes can be viewed as property. To advance this argument the Court
was invited to consider
Yearworth
v North Bristol NHS Trust
[78]
[Yearworth
matter]. The applicant then, applying Regulation 18 of R.175 and
accepting that a gamete is property argued that, at
the deceased
death, he
de
facto
was
the owner of his sperm. At this point it is important to mention that
reference to Regulation 18(2) in the applicant’s
Counsels
written argument and to 18(2) in the founding papers where it
appears, is incorrect as Regulation 18(2) deals with ownership
embryos after the process of artificial ferritization has taken
place, which is not the applicant’s case. This is an
unfortunate
mistake which was not correct in argument however, having
regard to the application, it must have been a typographical error as
reference to Regulation 18(1)(b) would be the correct reference.
Regulation 18(1)(b) deals with ownership of a gamete before
artificial
fertilisation. The subject matter of this application.
[51]
Moving from this premise, the applicant then
argues that applying paragraph 5 of the Will the sperm formed part of
the deceased’s
property, vested in his estate which she
inherited applying paragraph 5 of the Will. Considering herself the
owner of the sperm,
she now wants to exercise her ownership rights to
use the sperm for the purpose of artificial fertilisation to provide
a sibling
for her daughter.
[52]
To
unpack the argument, as invited, I consider the Yearworth matter
where the Court sat as a Court of appeal in London, United Kingdom.
The reason for the invitation by the applicant appears to be because
the appeal was upheld and the Court considered the applicant’s
sperm, for the purpose of their claims of damages for the destruction
of thereof as a product of their body, their own property.
Relying on
this outcome the applicant contended that the ownership of gametes
referred to in Regulation 18 was ownership of property
and as such,
developed her argument. At first blush, the reliance and argument
appeared persuasive but, considering the reasoning
of the Court of
appeal gives further perspective to the outcome. The Court was clear
that it was only seized with the consideration
of whether the common
law principles applicable in tort (delict) and bailment
[79]
applied
in respect of damage to bodily substances, namely sperm of the
applicants and their intended use of it in the future, and
that they
were not invited to consider if there would be a significant
difference between their claims and those in which the sperm
was
intended for use by other persons, for example donated sperm. In
other words, and in the facts, all the applicants were men
who had
been treated for cancer who had placed their sperm in the safekeeping
with the respondent’s storage facility for
a possible later
use. If a possibility of use did not arise or if the applicant did
not want to use his sperm, the Court determined
that such applicants
could, at their own discretion even destroy their own sperm. In other
words, the property right to use or
to destroy the applicant’s
own sperm could be identified as property rights in the hands of
those who, themselves alone,
had generated and ejaculated the sperm
with the object that might later be used for their benefit.
[53]
On the facts, the deceased possessed the right to
use or to destroy his own sperm. Relying on the Yearworth matter to
determine
whether those rights (use and destruction) to his own body
product translated into transferable ownership of such property with
such rights to another and
via
succession is another enquiry all together and one
which the Court in the Yearworth matter clearly did not entertain.
Thus, distinguishable
on fact and law. The Court by reference and
exclusion was not invited to entertain any claim of whatever nature
other than that
which was vested in the applicant at a time when they
could still exercise such rights. The proposition of the applicants’
death and the ability to transfer those rights was also not
envisaged. I am not convinced that the Yearworth matter is therefore
a foundation for the proposition relied on by the applicant.
Furthermore any reliance the applicant placed on the academic
articles,
which reliance is not clear, written by Professor Donrich
Thaldar titled “
Can ownership of
reproductive material be transferred?
”
and
by Prof Robbie Robinson titled: “
The
Legal Nature of The Embryo: Legal Subject or Object
”
do not assist with the foundation the applicant
wished to achieve with reference to the Yearworth matter, namely that
gametes as
property which automatically vest in an estate of a
deceased and therefore are capable of being inherited.
[54]
Even if I am incorrect, the applicant failed
dismally to convince me that sperm, even if viewed as property,
vested in a deceased’s
estate at his death and therefore
capable of being inherited. The applicant’s Counsel did not
even deal with the provisions
of the
Administration of Estates Act,
66 of 1965
to give support to the argument that the sperm are
capable,
per se
,
of forming part of the deceased’s estate.
[55]
To appreciate the argument compels one to enquire
what is meant by an “
estate.
”
Briefly, the application of the
Administration of
Estates Act, 66 of 1965
is concerned with the custody, control,
realisation and distribution of the assets of a deceased person which
are within the borders
of the Republic of South Africa at the time of
the deceased’s death. Simply put, when a person dies leaving
assets of any
sort, such assets constitute the estate which must be
wound up in accordance with the laws of the country where those
estates are
situated. Assets are commonly defined as anything
tangible or intangible that has a positive economic value. In other
words, that
it can be converted into cash.
[56]
Applying the provisions of
section 60(4)
of the
NHA, a gamete does not have a positive commercial value in the hands
of the deceased and therefore can never be regarded
as an asset
forming part of his estate. The applicant’s argument must
fail.
CONCLUSION
[57]
Applying the test in the Cordiant matter the
applicant has failed demonstrate an existing right, future or
contingent right as pleaded
to the deceased’s sperm from which
an interest therein can be established. She certainly has an interest
in the use of the
sperm, but she has pinned her vested right of
ownership by applying paragraph 5 of the Will.
[58]
Failure of the first stage of the Cordiant test
means that an exercise of discretion is not triggered. Furthermore,
considering
the applicant’s failure to assure this Court of the
compliance of
Regulations 7
-
8
and applying
Regulation 10
, Dr Gobetz
is not statutorily authorized to commence with the artificial
fertilisation with the use of the decease’s sperm.
Such use
will attract the possibility of a criminal sanction, notwithstanding
any permission obtained by the applicant to use the
sperm.
[59]
Permission of use without considering and being
satisfied of compliance is to overlook the provisions of the
legislative prescripts
and is not a competent nor effective. The
applicant’s application, at this stage, and how sought stands
to be dismissed,
each party to bear their own costs.
L.A. RETIEF
JUDGE OF THE HIGH
COURT
GAUTENG DIVISION,
PRETORIA
This judgment was
prepared and authored by the judges whose names are reflected and is
handed down electronically by circulation
to the parties/their legal
representatives by email and by uploading it to the electronic file
of this matter on CaseLines.
The date for hand-down is deemed
to be 14 April 2025.
For the
Applicant
:
Adv A de Vos
SC with Adv H Botma
Instructed
by
: Adele
van der Walt Inc
For the First
Respondent :
Adv Mkhari (watching Brief)
Instructed
by
: Office of
the State Attorney
For
Amicus
Curiae
:
Adv C
du Toit
Instructed
by
: The
Centre for Child Law
Matter heard on
:
10 September
2024
Judgment
date
: 14
April 2025
[1]
Ex
parte
CJ
and Others, Case Number 046454/2024.
[2]
A
fertility gynecologist / reproduction medicine specialist working at
Vitalab. He has practiced as a sub-specialist in reproductive
medicine for 34 years.
[3]
This
is a microscopic procedure where one sperm is inserted in an egg
with a glass needle which is fourteen times thinner than
a human
hair.
[4]
A
pre-implantation embryo consisting of an outer layer, which forms
the placenta and a 30 to 200-cell inner cell mass that develops
into
the fetus.
[5]
i.e.,
6 months after GGM’s birth.
[6]
On
applicant’s version.
[7]
Because
of the provisions of
Regulation 18(2)
of the NHA – see par 31
below.
[8]
The
zygote is the fertilised organism from the moment of fertilisation
until 4 days thereafter.
[9]
The
word used in
Regulation 18.
[10]
Per
s55
of the NHA.
[11]
“
Tissue”
is defined by the NHA as “human tissue, and includes flesh,
bone, a gland, an organ, skin, bone marrow or
body fluid,
but
excludes blood or a gamete
.”
(my emphasis).
[12]
GN
R175 in GG 35099 of 2 March 2012.
[13]
As
was conceded by the Minister of Health during argument.
[14]
“
S68(1)
The Minister may make regulations regarding-
(p) the acquisition,
storage, harvesting, utilisation or manipulation of tissue, blood,
blood products, organs, gametes, oocytes
or human stem cells for any
purpose…” (my emphasis).
[15]
Although
no written document is placed before us, on the probabilities, the
consent was at least an express verbal consent.
[16]
Donrich
Thaldar (2023) 140
The
South
African Law Journal
(SALJ)
page 495.
[17]
At
page 499.
[18]
Where
an owner acquires ownership from a previous owner e.g. when one buys
groceries, the shop owner transfers ownership of the
goods
purchased, to the purchaser.
[19]
References
excluded.
[20]
In
The
Legal Nature of the Embryo: Legal Subject or Legal Object
PER /
PELJ 2018.
[21]
Which
is titled “Control of use of blood, blood products, tissue and
gametes in humans”.
[22]
i.e.,
those of
Regulation 18
and the use of the word “ownership”.
[23]
See
e.g. Gordon
v Standard Merchant Bank
1983
3 SA 68
(AD); Seluka
v Suskin and Salkow
1912
TPD 265
and Johannesburg
Municipality v Cohen's Trustees
1909
TS 811
,
where the court explained on 823 that "[I]t is a sound rule to
construe a statute in conformity with the common law rather
than
against it, except where and so far as the statute is plainly
intended to alter the course of the common law."
(italics
added).
[24]
With
reference to Van Niekerk 2017 Obiter 170.
[25]
Robinson
at page 17 par 4.1.
[26]
The
Centre for Child Law.
[27]
[2007]
FCWA 80.
[28]
No
FDI-13-780539 (Cal. Super. Ct. Jan. 11, 2016).
[29]
Findlay
v Lee para 82.
[30]
Davis
v Davis 842 S.W.2d 588 (Tenn. 1992).
[31]
Davis
v Davis at 602.
[32]
Kass
v Kass at 179.
[33]
Davis
v Davis at 604.
[34]
App
no 46479/2011.
[35]
"Every
natural or legal person is entitled to the peaceful enjoyment of his
possessions. No one shall be deprived of his
possessions except in
the public interest and subject to the conditions provided for by
law and by the general principles of
international law. The
preceding provisions shall not, however, in any way impair the right
of a State to enforce such laws as
it deems necessary to control the
use of property in accordance with the general interest or to secure
the payment of taxes or
other contributions or penalties."
[36]
Para
311.
[37]
Articles
L.2141-2 and L.2414-11.
[38]
Simana,
S "Creating life after death: should posthumous reproduction be
legally permissible without the deceased's prior
consent?"
(2018) Journal of Law and the Biosciences 329 —354.
[39]
Section1
and 4 of the Embryo Protection Act 1990.
[40]
[2010]
QSC 118.
[41]
For
purposes of privacy, the minor child’s name is redacted in
this judgment, but the order given to the applicant will
contain the
full name of the minor child.
[42]
National
Health Act 64 of 2003
[NHA].
[43]
See
section 56(1)
,
000000">
60(
2>
4),
and
63
of
the NHA.
[44]
In
terms of
section 1
of the
National Health Act, 61 of 2003
[NHA], an
“
authorised
institution
”
means
any institution designated as an authorised institution in terms of
section 54.
Section 54(1)
of the NHA states that the Minister may,
by notice in the Gazette, designate any institution other than an
institution contemplated
in
section 63
as an authorised institution.
Section 63
, see par
[40].
[45]
“
Competent
person
”
in
relation to artificial fertilisation means a person registered as
such in terms of the Health Professionals Act, 56 of 1974;
who is:
“
(a)
a medical practitioner specializing in gynecology with training in
reproductive medicine;
(b)
a medical scientist, medical technologist, clinical technologist,
with training in reproductive biology
and related laboratory
procedures.
”
[46]
Regulation
18, National Department of Health, Notice 175: Government Gazette
2012 [R.175].
[47]
Eggs,
sperm and embryos.
[48]
Regulation
18(2)(b) of R.175.
[49]
Ibid.
[50]
11
(eleven) straws.
[51]
A
specialised reproductive specialist, the competent person. See
footnote 45.
[52]
Cordiant
Trading CC v Daimler Chrysler Finance Services (Pty) Ltd
2005
(6) SA 205
(SCA) [Cordiant matter].
[53]
A
surviving spouse.
[54]
In
terms of National Department of Health, Notice 175: Government
Gazette, 2012 Regulations dealing with the artificial fertilsation
of persons [R.175], “
freezing
or cryopreservation means freezing or cryopreserving genetic
material including ova, sperm, embryos, ovarian tissue or
stem cells
by an authorised institution
”
.
[55]
A
pre-implantation embryo consisting of an outer layer, which forms
the placenta and 30 to 200-cell mass which develops into the
fetus.
[56]
Female
gamete commonly referred to as the egg.
[57]
Male
gamete.
[58]
A
microscopic procedure to bring about fertilisation of an egg with a
male sperm outside the body in an authorised institution.
[59]
“
Artificial
fertilisation
”
means
the introduction by either the natural means of a male gamete or
gametes into the internal reproductive organs of a female
person for
the purposes of human reproduction and includes artificial
insemination, in vitro fertilisation, gamete intrafallopian
tube
transfer, embryo intrafallopian transfer or intracytoplasmic sperm
injection.
[60]
Section
1 of the NHA definition of a “
gamete
”
means
either of the two generative cells essential for human reproduction.
[61]
Section
1 of the NHA defines “
tissue
”
means
human tissue, and includes flesh, bone, a gland, an organ, skin,
bone marrow or body fluid, but excludes blood or a gamete.
An
“
organ
”
in
terms of section 1 of the NHA means any part of the human body
adapted by its structure to perform any particular vital function,
including the eye and its accessories, but does not include skin and
the appendages, flesh, bone, bone marrow, body fluid, blood,
or a
gamete.
[62]
Supra
footnote
54.
[63]
National
Department of Health, Notice 177: Government Gazette, 2012 [R.177].
[64]
National
Department of Health, Notice 180: Government Gazette, 2012 [R.180].
[65]
National
Department of Health, Notice 182: Government Gazette, 2012 [R.182].
[66]
Section
56(1) of the NHA.
[67]
Section
56(1) of the NHA read with Regulation 3(1)(c) of Regulation R.180.
[68]
Section
63 confines the donation of gametes by person in terms of section
55(a) and by purpose in terms of section 56.
[69]
Section
62(1)(a) permits donation of the human body and tissue by means of a
Will, in a document signed by the competent donor
and by at least
two witnesses or by an oral statement in the presence of two
witnesses.
[70]
See
Regulations 6, 7 and 8 of R.175.
[71]
See
footnote
73.
[72]
See
Regulations 7 and 8, 10 and 11 of R.175
.
[73]
Regulation
10(1)(b) of R.175 read with paragraph [39].
[74]
With
reference to number of uses of a donor’s gametes to secure
live births.
[75]
See
Regulation 6(a)-(c) of R.175.
[76]
Regulation
8(1)(iv) of R.175.
[77]
This
is a microscopic procedure where one sperm is inserted in an egg
with a glass needle which is 14 times thinner than a human
hair.
Notwithstanding the fact that this microscopic technology occurs
outside the body it is included in the definition of artificial
fertilisation in the Regulations to the NHA.
[78]
[2009]
EWCA Civ 37.
[79]
“
Bailment
”
refers
to a legal relationship where one person (the bailee) takes
temporary possession of another person’s property (the
bailor)
for a specific purpose, with the obligation to take reasonable care
of the goods and return them in the same condition
once the purpose
if fulfilled. Essentially it is the legal framework governing the
temporary transfer of possession of personal
property while
maintaining ownership with the original party.
sino noindex
make_database footer start
Similar Cases
T.M v Minister of Police (33413/2015) [2025] ZAGPPHC 46 (21 January 2025)
[2025] ZAGPPHC 46High Court of South Africa (Gauteng Division, Pretoria)99% similar
M.K v Minister of Home Affairs (2025-046181) [2025] ZAGPPHC 468 (11 April 2025)
[2025] ZAGPPHC 468High Court of South Africa (Gauteng Division, Pretoria)99% similar
Ndaba v Minister of Police and Another (A137/23) [2025] ZAGPPHC 135 (14 February 2025)
[2025] ZAGPPHC 135High Court of South Africa (Gauteng Division, Pretoria)99% similar
Mabasa v Minister of Police (14551/2019) [2025] ZAGPPHC 718 (15 July 2025)
[2025] ZAGPPHC 718High Court of South Africa (Gauteng Division, Pretoria)99% similar
Maboko v Minister of Police and Others (2025-033306) [2025] ZAGPPHC 389 (11 April 2025)
[2025] ZAGPPHC 389High Court of South Africa (Gauteng Division, Pretoria)99% similar