Proposition 50K0077

Projet de loi modifiant l'article 7 de la loi du 13 juin 1986 sur le prélèvement et la transplantation d'organes.

General information ¶

Authors

CD&V Jo Vandeurzen
Vooruit Hubert Brouns

Submission date

Sept. 9, 1999

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

bio-ethics organ transplant public health

Contact form ¶

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Discussion ¶

Oct. 17, 2001 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, before I take the floor as a reporter, I have the following question and therefore I would have appreciated that the Minister of Finance had been present here, but that must be elsewhere. First, I had asked in the committee whether the approval of the European Commission was needed. That authorisation is no longer necessary, since it is no longer a VAT measure. Secondly, I had asked about the budgetary impact of the proposal. Under Parliament’s regulatory provisions, in addition, a proposal submitted must include a report on the budgetary impact. Well, I would like to hear from the government what the cost of the proposal to reduce some rights is.

Mr. Leterme, I read that you asked that question at the committee meeting. From the government, only Ms. Aelvoet is present. Do you, on behalf of the Minister of Finance, have an answer to Mr. Leterme’s question? I realize that the subject is not easy.

This point has not been brought to my attention. I have been told that the bill has long been discussed and negotiated in a much wider circle than the classical majority. As a political main point, an arrangement was to come out of the bus that would take into account the different situations in Flanders and Wallonia. An agreement was reached on this. My only task here is to confirm that there is consensus on this and that the text gives a correct fulfillment to the problem. The accord reflects a very precise balance and must therefore be preserved as such. I have not been informed of the budget impact.

Mr. Speaker, I would like to highlight that point before presenting the report, so that the Minister has time to gather information. At the end of June or early July we had the first and now we are in the second reading of the proposal. I have always asked about the estimated budgetary impact. I think the government should be able to give an answer. If I can’t get that answer later, I would like to hear it tomorrow when dealing with that point. It is not impossible to name a number.

I think Mr. Leterme is right. I understand that you are not responsible. I therefore dare to urge the Minister of Finance to communicate his estimate tomorrow before the vote.

Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker, Mr. Speaker. Mr. Poncelet has withdrawn; I leave in the middle whether his choice was timely or not. Furthermore, the title of the proposal no longer corresponds to the content of the legal provision that is likely to be adopted tomorrow.

The bill is part of the so-called Lambermont Agreement. Its first version aimed to reduce the VAT rate for renovation and renovation works on school buildings from 21% to 6%. This requires the approval of the European Commission. The Minister of Finance had announced at the meeting of 6 July 2001 that he would address a question in this regard to the European Commission.

On 5 July 2001, the proposal was returned to the competent committee in the plenary session of the Chamber. It re-discussed it at its meetings of 17, 18 and 19 July 2001.

During the meeting of 17 July 2001, Ms. Moerman and consortia submitted two amendments, namely amendments 10 and 11. Those amendments replaced the measure reducing the VAT rate by a measure relating to, on the one hand, the Code of Registration, Mortgage and Registration Rights and, on the other hand, the Code of Succession Rights. As a result, the question of the agreement of the European Commission became subjectless. The way in which the bill was returned to the committee on 5 July by the plenary session of the Chamber – at the last moment, at the request of Mr Tavernier – clearly demonstrated, according to your rapporteur, that the question of adequate response to the aspirations of the French-speaking parties is not without importance. The reason for the return appeared to lie in the fact that the measure, as it was originally outlined in the proposal of law by colleague Poncelet, was unilateral and concerned only the situation on the French-speaking side of the language border, while it should be intended to favour the networks on the opposite sides of the language border in a similar way with this measure.

As mentioned, for that reason two new amendments were submitted, which were signed by a lot of colleagues of majority and opposition. During the discussion that took place after the return to the committee, a number of important questions were addressed, including the meaning of the definition: "buildings exclusively for educational purposes", as included in amendments 10 and 11. After all, school buildings often include sections that are not used for education itself, but, for example, as a concierge residence. Schools are sometimes housed in monasteries. Therefore, several colleagues asked the Minister how the tax administration would interpret the amendments presented by Ms. Moerman cs, if they were adopted. Their

Mr Desimpel regretted that the present bill does not apply to the new construction of schools, which Mr Desimpel considers to be a mistake, as this would have been a very welcome incentive for the construction sector. Ms. Moerman emphasized that, as former educational vessels of the city of Gent, she was committed to the needs of all schools, whatever the educational network they belong to, and that she personally supports the reduction of the VAT rate, but that this proved impossible and unattainable in the European context.

Mr Viseur, co-contributor of the proposal, indicated during the discussions that Mr Poncelet’s bill was from the outset intended for the educational buildings of all educational networks throughout the country. However, because in Belgium the education is not organized solely by the government, there arose a problem with VAT. In other countries, Mr. Viseur noted, it is the same government that organizes education and pays VAT on the school buildings and at the same time receives VAT. Collega Viseur welcomed the fact that through the amendments presented by Ms. Moerman cs, the proposal would better meet the needs of education in all parts of the country.

Mr van Weddingen intervened to make a number of corrections in the text of amendment 10 and later also in the text of amendment 11. The committee voted in this regard. To the questions related to the interpretation of the concept of "education" in the text of amendments 10 and 11, the Minister replied that the concept of education would be interpreted broadly in order to avoid any discrimination against taxpayers. As regards the concept of "exclusively educational purposes", according to the Minister, the tax advantage would be granted only for the parts of an immovable property that are exclusively intended for education. According to the Minister, it is obvious in this regard that a concierge house located in an educational institution does contribute to the educational contract in the broad sense of the word and therefore falls within the scope of the preferential measure.

When asked by Commission Chairman Olivier Maingain whether the tax advantage in the subsidised confessional education also applies to that part of a building that is intended for education and is used for worship, the Minister replied that the proposed limitation refers to the direct connection with the educational activity. This direct link must be present. He gave the example of a swimming pool built in a school that is primarily intended for school activities but is also accessible to the public.

Your rapporteur noted with satisfaction that the Minister gives a very broad interpretation of the concepts "education" and "exclusive purpose" and therefore your rapporteur abstained from a sub-amendment which could have aimed at replacing in amendments 10 and 11 the words "which have an exclusive purpose" with the words "which have a predominant purpose". In this regard, however, it was noted that a chapel integrated into a school institution used in the week for Eucharistic celebrations with the pupils shows a very clear link with the educational activity. That band is even much more direct than in the case of a concierge home.

Finally, the Minister stated that the benefit of the measure does not apply to real estate intended for a type of education other than community education and subsidised education. Amendments 10 and 11 by Ms. Moerman cs. The amendments were adopted by 12 votes against one abstinence and eventually the amended text was unanimously adopted in second reading. The title of the bill has also been amended. Until then, the reading of the report was approved by nine votes with one abstinence.

Mr. Speaker, I would like to make two comments. First, the note is correct that there should be a direct link between "a part of the building" and the educational function. The Minister has been very clear about this.

Second, I must forward the question of knowing the impact on the budget to the competent minister. Nevertheless, I would like to draw attention to the fact that registration rights are transferred from 1 January 2002 so that this is no longer a federal concern. Of course you have the right to request information on this and I will therefore send you the entire question.

July 17, 2001 | Plenary session (Chamber of representatives)

Full source

Mr Brouns’s bill aims to amend Article 7, § 1 of the Act of 13 July 1986 on the removal and transplantation of organs. The current legislation stipulates that organ removal from minors is subject to two conditions: the removal must not have serious consequences for the donors and must relate to regenerable organs. Originally in the law "or" must refer to regenerable organs, so that the two conditions were not cumulative. The proposed legislation aims to ensure that both conditions are met, so that minors will only be allowed to hand over regenerable organs and tissues such as bone marrow to a brother or sister if the removal does not have serious consequences for the donors.

The main discussion point on this bill raised with regard to the rights of the sick child and the minor potential donor to still be able to decide on their own to give up a non-regenerable organ. This was especially true for young people who approached the age of 18. Can young people between the ages of 15 and 18 decide whether or not to give up a non-regenerable organ? These comments were made by Mr Denis, Mrs Descheemaeker, Mrs Avontroodt and myself. On the basis of the discussion, a number of opinions were requested, namely the Commissioners for Children’s Rights, the Bioethics Advisory Committee and the Belgian Transplantation Council. After the arrival of those opinions, the discussion was held again. Most or all of the opinions were in favour of Mr. Brouns’ bill. Their

The Commissioners for the Rights of the Child had a number of additional comments, after which Mr Brouns submitted an amendment to his proposal. This adds a new article that reduces the age from when the minor donor must give his consent himself to 12 years. This reflects the opinion of the Commissioner for the Rights of the Child, which states that young people over 15 years of age currently have no veto right, which is contrary to Article 12 of the Convention on the Rights of the Child, adopted in New York on 20 November 1989. On the basis of this amendment, Ms. Descheemaeker once again pointed out that a contradiction was introduced, since a child from 12 years of age has the right to be heard, while a child of 17.5 years of age cannot independently decide to give up one of his organs.

The Minister’s position was clear. She pointed out, on the one hand, the positive opinions and, on the other hand, the situation abroad, where similar arrangements apply everywhere. After the discussion, Articles 1 and 2 of the bill were unanimously adopted. Mr Brouns’ amendment was adopted by 6 votes in favour and 3 abstentions. The entire bill was adopted with 10 votes in favor and 1 abstinence.

I abstained from the final vote in the committee. I would like to clarify the reason for this.

Mr Brouns’s bill aims to better protect the position of minors. Of course, I have no objections to this. I approved the article myself. I would like to make it clear that I am also in favor of the protection of minors. However, the amendment also implies that the minor up to the age of 18 can not give up a non-regenerable organ — in fact, it can only be a kidney — until the age of 18. However, the limit conditions for transplantation are clearly defined in the current law: only in a life-threatening situation, only for a brother or a sister and only if there is no full-fledged alternative. In my opinion, Mr Brouns’ proposal contains a clear contradiction with regard to the rights of minors. The protection of minor candidate donors is extended, but the rights of the minor brother or sister who is in danger of life are reduced. There is another contradiction. At the same time, the bill considers a person under the age of 18 incapable of independently judging and deciding on such a situation.

Almost as a crying in the desert, I have referred to the current legislation. I noticed that that legislation dates back to the period when the age of majority was reached at 21 years. The option existed for the minor at that time from 18 years old, i.e. three years earlier. So I found it quite logical that the same three years would be reflected in the new proposal.

Mr. Brouns, you followed that reasoning when in an article it was about transplantation of regenerable organs. There you have lowered the age from which the child had to give his consent, from 15 years to 12 years. My idea was to reduce the age of transplantation of non-regenerable organs from 18 years to 15 years, too. The majority age is now reached at 18 years. One can assume that a 15-year-old is in most cases capable of deciding for himself whether to give his kidney to a deadly sick brother or sister. This was my problem in the final vote in the committee. I remained with my abstinence. I felt that there was too much contradiction.

Mr. Brouns, you answered me that there are few cases in which an organ of a brother or a sister is necessary, and where there is no alternative. It may be so, but why do you want to change the law? In any case, I decided to abstain in the final vote.

I will not return to the discussion that we have had in the committee. Ms Descheemaeker defended her abstention with the arguments she also cited in the committee. The only defense I want to stand against is reality. The reality tells us that indeed little appeal is made to minor siblings for the transplantation of a non-renewable organ. People wait until they are mature before being asked if they want to give up a kidney.

The two opinions obtained in that regard do not speak in the sense you state. The proposal aims to enhance the protection of living minors donors. The first amendment — the original purpose of the bill — was in fact to correct an error in the text in the Act of 1986. It is clear from the memo of explanations and the comments concerning this law that it was not intended at all to incorporate so textually what was stated in the law. After all, when already it was pointed out the substantially extending consequences of the fact that the word "or" was used instead of the word "and". In principle, the law of 1986 allowed organ harvesting from a person under the age of 18 to a brother or sister, provided that it did not result in serious consequences for the donor or that it is a regenerable organ. The bone marrow is an example of this as the tissue recovers itself.

Living donors can also give up a kidney or part of the liver, but these organs do not recover.

The current text of the law allows minors to also hand over a kidney or part of the liver to a brother or sister, although this was never intended by the legislator in 1986. Therefore, the word "or" in the text had to be replaced by the word "and".

Following discussions and consultations with the Commissioner for the Rights of the Child and the Transplant Council, their proposal reduced the age from 15 to 12 years. The law also stipulated that children under 12 years of age should in any case be allowed to express their views.

This fully achieved the goal set in 1986, namely the protection of living minors donors. Immediately greater involvement of the children was achieved.

I thank both the rapporteur and the Commissioners for their positive cooperation with regard to this bill, despite Mr Descheemaeker’s understandable abstinence.