1576
activated and perhaps degraded T cells of large quantities of cytokines seems to play a crucial role. Possibly the symptoms of the disease, and the gross fluid inbalance that arises, are cognate in part with the capillary leakage syndrome seen in graft-versus-host disease after bone marrow transplantation in man.18 In these patients T-cell activation is also likely to be a major component of the syndrome and this, rather than the directionality of the attack of the graft against the host, may well have an adverse effect on the condition of the patient.
Conclusions The argument throughout this paper has been confined to consideration of the effects of T-cell activation; we do not exclude the possibility that comparable effects can follow the large-scale stimulation of other and perhaps all cells capable of synthesis and release of paracrine hormones. If our speculations are correct, many infectious diseases may have serious consequences that are byproducts of activation of the immunological apparatus. Equally, when cytokine-producing cells undergo malignant transformation, we can expect effects on adjacent cells or on the recruitment of cells into the tumour. Such influences need not be interpreted as directional immune responses but perhaps as indicators that cell-to-cell interactions, mediated by paracrine hormones, are common consequences of somatic cell activation. In such diseases an alternative to eliminating the prime cause might be to suppress the cytokines that are responsible for symptoms. In a series of elegant experiments Clark19 has shown that the symptoms of certain experimental malarial infections can be simulated by injection of a cytokine (tumour necrosis factor) and that immunisation against the cytokine can prevent the genesis of symptoms on subsequent introduction of an active infection. Equally, in certain tumours with a substantial infiltrative component, relief of symptoms might well be obtained by attack on the infiltrating host cells rather than simply on the tumour. The use of corticosteroids in the treatment of many cancers exemplifies what might be achieved. We thank Prof P. G. Isaacson, University College and Middlesex School of Medicine, and Dr J. P. Sloane, Royal Marsden Hospital, for critical reading of this paper. Work at the Institute of Cancer Research is supported by the Cancer Research Campaign.
REFERENCES 1. Leuchars E, Cross AM, Davies AJS, Wallis VJ. A cellular component of
thymic function. Nature 1964; 203: 1189. AJS, Festenstein H, Leuchars E, Wallis VJ, Doenhoff MJ. A thymic origin for some peripheral-blood lymphocytes. Lancet 1968; i:
2. Davies
183-84. 3. Balkwill FR, Burke F. The cytokine network. Immunol Today 1989; 10: 299-301. 4. Editorial. Immunological orchestra. Lancet 1968; i: 185-86. 5. Sprent J, Basten A. Circulating T and B lymphocytes of the mouse. II. Lifespan. Cell Immunol 1973; 7: 40-46. 6. Gleichmann E, Gleichmann H, Wilke W. Autoimmunization and lymphomagenesis in parent-F1 combinations differing at the major histocompatibility complex: model for spontaneous disease caused by altered self-antigens? Transplant Rev 1976; 31: 156-224. 7. Dunn TB. Normal and pathological anatomy of the reticular tissue in laboratory mice, with a classification and discussion of neoplasms. J Natl Cancer Inst 1954; 14: 1281-433. 8. Wallis VJ, Chaudhuri M, Jacob MC, Valkova BA, Davies AJS. Neoplasms arising in CBA mice after transfer of spleen cells from syngeneic old donors. Immunology 1984; 53: 769-77. 9. McCarron M, Osborne Y, Story CJ, Dempsey JL, Turner DR, Morley AA. Effect of age on lymphocyte proliferation. Mech Age Devel 1987;
41: 211-18.
10. Brittle
MP, Jacob MC, Gomer KJ. Induced type-B reticulum cell neoplasia of CBA mice. II. Functional similarities between tumorigenic reticulum cells and normal accessory cells. Immunology 1985; 55:
663-69. 11. Brittle MP, Wallis VJ, Chaudhuri M, Goucher RA, Gomer KJ. Induced type-B reticulum cell neoplasia in mice. III. The importance of T-cell proliferation and cellular relocation in accessory cell transformation. Br J Cancer 1988; 57: 378-84. 12. Purtilo DT. Epstein-Barr-virus-induced oncogenesis in immunedeficient individuals. Lancet 1980; i: 300-03. 13. Pileri S, Rivano MT, Raise E, et al. The value of lymph node biopsy in patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS related complex (ARC): a morphological and immunohistochemical study of 90 cases. Histopathology 1986; 10: 1107-29. 14. Ewing EP, Chandler FW, Spira TJ, Brynes RK, Chan WC. Primary lymph node pathology in AIDS and AIDS-related lymphadenopathy. Arch Pathol Lab Med 1985; 109: 977-81. 15. Marrack P, Blackman M, Kushnir E, Kappler J. The toxicity of staphylococcal enterotoxin B in mice is mediated by T cells. J Exp Med 1990; 171: 455-64. 16. Morrison WI, Goddeeris BM, Brown WC, Baldwin CL, Teale AJ. Theileria parva in cattle: characterization of infected lymphocytes and the immune responses they provoke. Vet Immunol Immunopathol 1989; 20: 213-37. 17. Morrison WI. A comparison of the responses of cattle inoculated with purified T or B lymphocytes infected with Theileria parva. ILRAD Annual Scientific Report 1988; 20. 18. Depledge MH, Barrett A, Morgenstern G, Sloane JP, Powles RL. Pulmonary oedema with leaky endothelial syndrome. Exp Hematol 1982; 10 (suppl): 113. 19. Clark IA, Chaudhri G. Relationships between inflammation and immunopathology of malaria. In: Stevenson MM, ed. Malaria: host responses to infection. Boca Ratton, CRC Press, 1989: 127-46.
VIEWPOINT Academic freedom in South Africa
speech and academic freedom are widely acknowledged prerequisites for the relentless, objective, scholarly pursuit of knowledge and truth for the advancement of the human condition. Freedom of speech at universities in many countries has often been hindered by vigorous protest against allowing speakers with fascist, communist, or racist persuasions the privilege of a campus platform. Such protest and dissension has disrupted lectures and silenced speakers. Freedom of speech allows for protestors to dissent, but cannot rationally be extended to "licence to gag", since this would stifle presentation of contentious issues and prevent public exposure of flawed arguments. The need to preserve opportunities for open debate is greatest during times of rapid social change if anarchical and tyrranical forces are to be countered. It is, however, at just such times that the greatest threats are posed to freedom of speech and association and to academic freedom, which are essential for democratic politics and for the primary task of a university-to discover and disseminate knowledge by means of research and teaching.12 Freedom of
Academic
freedom can be considered from two viewpoints-that of the individual academician and that of ADDRESS Department of Medicine, University of Cape Town, and Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa (Prof S. R. Benatar, FRCP).
1577
institution. These two interrelated aspects of the right to academic freedom are not synonymous and should not be conflated. From the institutional viewpoint, academic freedom-better described as university autonomy-refers to the independence of the university’s governing body from political interference, the university’s right to decide who should teach, what should be taught, who should be taught, and who should graduate (setting standards), with the primary objectives of pursuing the advancement of knowledge and seeking the truth. Academic freedom from the viewpoint of the individual is a different and less clear-cut concept and consists of several components. I understand its fundamental component to be the right of an individual to pursue his academic workteaching, researching, and publishing-in accordance with scientific and scholarly convictions and in conformity with the academic ethos, without fear of persecution on the grounds of private views and conduct (eg, religious beliefs, sexual preferences), provided these do not interfere with his academic work. The extension of academic freedom beyond the right to hold private views to the right to incorporate these into teaching when this is relevant is not disputed. Whether academic freedom should be extended further to the right to act on these beliefs in the teaching milieu is, however, contentious. It is certainly considered unacceptable for the teacher to coerce students to accept his private views, since this action infringes on the rights of students to pursue their academic studies free of interference with their private preferences. In any society the right of freedom of speech is necessary before academic freedom can be truly fulfilled. Academic freedom in turn ensures: (a) that it is only academic and scholarly qualities that justify a secure place in the university; and (b) that the potential for advancing knowledge in the university setting will not be adversely affected by factors extraneous to academic ability. In 1960 Prof C. W. de Kewiet defined the concept of academic freedom more broadly in his T. B. Davie Memorial Lecture at the University of Cape Town: "The Definition (of academic freedom) which seems to have the most dignity and creative meaning is the right of scholarship to the pursuit of knowledge in an environment in which the emancipating powers of knowledge are the least subject to arbitrary restraints. This means that scholarship and the teaching or writing in which it expresses itself must be free to deal with the major problems or issues of the age. It is vital to go beyond freedom to pursue knowledge for its own sake, and claim for scholarship today a greater and freer role in relieving mankind of inequality, injustice, deprivation, fear, an
ignorance or anger ...".1 Academic freedom in South Africa Before the 1959 extension of the University Education Act and associated legislation, the Universities of Cape Town and the Witwatersrand were "open" universities in the sense that students were admitted on academic criteria without regard to their race, colour, or creed. These universities’ unequivocal and publicly stated opposition to the racial restrictions imposed on universities1,3has been reiterated and vigorously defended over the past 30 years, during which time the restrictions on freedom of speech, movement, and political expression have been progressively imposed on South African society, and university autonomy has continued to face many threats. It is against this background that the English language universities of Natal,
Rhodes, Cape Town, and the Witwatersrand have
on
occasions reaffirmed their commitment to intellectual freedom and have indeed extended the concept of academic freedom in a changing society. 3,4 The debate on freedom of speech and academic freedom in South Africa is complicated by the cultural and ideological diversity that characterises a heterogeneous society in which long entrenched racial discrimination has had profoundly adverse effects. "Worlds apart" is an apt description of the different environments in which whites and blacks live in South Africa. It is necessary to recognise, and be sensitive to, the different perspectives from which freedom is seen by those who have been privileged to grow up in an environment of freedom as compared with those whose whole lives have been restricted in a myriad of ways. The complexity of relationships between blacks and whites needs to be understood in the context of generations of domination and subordination that have resulted in mutual fear, mutual disrespect, a sense of otherness, and a persuasive feeling by blacks of malign neglect. These are the ingredients of a social environment that has engendered a deep feeling of inferiority in blacks and a deep sense of guilt in whites. It is perhaps not surprising that in this context the "language" used to communicate ideas and perceptions does not necessarily have the same meaning to all the participants in the debate. The background to these differences also raises the question of the extent to which it is justifiable for universities and academics to claim that there is academic freedom in an oppressive society (a) in which limitations are imposed on freedom of speech by legislation or emergency powers, (b) in which universities are not fully academically free in an institutional sense, and (c) in which until recently these limitations were in danger of becoming more stringent. The increasingly expressed challenge to universities in South Africa to become "Africanised" is also highlighted in this debate. It must be conceded that within the context of South African history universities have collectively (although not necessarily individually or to the same extent) mirrored and served to support the deep cleavages within this radically divided society, although usually unintentionally and despite the hope that universities would be the focus of conciliation.6 How should a university react to events that affect it in a society such as exists in South Africa? What action should be taken against those who "obstruct" academic freedom by disrupting and preventing lectures, and how should such obstructions (which are claimed by some to be actions for future greater freedoms) be viewed in the context of university life in this country? What ought to be its attitude to the idea of academic boycott? How can universities contribute to the peaceful development of a democratic and
numerous
just society? The need to take a moral stand against apartheid and all its implications is undisputed and in this regard the position of several South African universities is quite clear and has for many years been on public record. The nature and extent of actions that should be taken to express the moral stand are hotly debated. Pragmatic, economic, and sociopolitical considerations inevitably influence the ability to implement change. Many hold the view that even the most outspoken universities have taken inadequate action. Open universities in South Africa are part of the international academic community, but have become increasingly (externally) isolated over the past 30 years.
1578
Censorship within South Africa has served
to
(internally)
isolate South African academics from life around them. Both forms of isolation and the consequent academic impoverishment frustrate rather than facilitate intellectual and social progress, and are thus antithetical to the concept of academic freedom. The viewpoint espoused by liberal universities is that freedom of speech and academic freedom are important, even in their incompletely fulfilled states, since South African universities are neither the cause of, nor perpetuators of, injustice in our society. Indeed quite the converse applies since they encourage and allow dissension against such injustices. This view calls for the protection of even imperfect academic freedom to enable universities to contribute to the reasoned dialogue required to develop a new, more just, and peaceful society in which universities can continue to carry out their universal function of
advancing knowledge. An alternative view, expressed by some who continue to advocate academic boycotts, is that the so-called universal function is more Eurocentric than universal, that even the central knowledge and truth seeking work of universities is not neutral, and that its protection by academic freedom helps to perpetuate racism and oppression by: (a) reproducing forms of power relations that reinforce elitist dominance in society, (b) suppressing the collective will of the people, and (c) frustrating progress towards the elimination of an illegitimate government and its replacement by a democratically elected leadership. Opponents of freedom of speech and proponents of academic boycott in such a context justify their stand as appropriate political strategies which, by contributing to the isolation of South Africa, could facilitate the removal of an unjust regime and lead to greater academic and other freedoms in the future. Crucial to this notion has been the time anticipated for such change to occur. The time frame has already been so long that many individuals and organisations, including the African National Congress, are openly expressing concern for the now obvious adverse effects on a whole generation of schoolchildren of the slogan "liberation now, education later". This course of events, which has contributed to a generation inculcated with a culture of violence, has seriously undermined both the usefulness and the morality of school boycotts and other restrictions on freedom of speech and academic interchange. The road ahead Persistence in trying to view the experiences of others only through the prism of our own life experiences will not suffice. This applies both within nations and between nations. Empathy, and a willingness to communicate at more than a mere superficial level, are prerequisites to understanding the deep cultural, economic, and ideological gaps that separate opposing groups, and to developing the mutually enriching and desperately needed dialogue that is essential for peaceful progress into the future. The "politics of protest" is becoming obsolete and must be replaced by the "politics of transformation". By this means the adverse effects of obstructing academic freedom and of total academic boycott are already being acknowledged, and it is being conceded that even selective boycott poses many problems. As a result some who previously proposed academic boycott are now retracting7 and the morally justifiable status of selective support8 is gaining recognition.9-11 I hope that those who still believe that obstructing academic freedom is a necessary part of the
struggle will soon also move away from this counterproductive and self-defeating stand and contribute to a momentum for peaceful progress. Building a new South Africa will demand a pattern of thought and action that transcends the rhetoric of protest. REFERENCES 1. The open universities in South Africa and academic freedom 1957-1974. Published on behalf of the Academic Freedom Committees of the University of Cape Town and the University of the Witwatersrand. Cape Town: Juta. 2. Shils E. The academic ethos. In: van der Merwe H, Welsh D, eds. The future of the university in South Africa. Cape Town: David Phillip, 1977: 5-22. 3. Open universities in South Africa. Johannesburg: Witwatersrand University Press, 1957. 4. File J, van den Heever A, Saunders SJ. Towards the day of hard choices. Nature 1989; 341: 96-98. 5. Steele S. The recolouring of campus life. Harper’s Magazine, February 1989: 47-55. 6. Welsh D, Savage M. The university in divided societies: the case of South Africa. In: van der Merwe H, Welsh D, eds. The future of the university of Southern Africa. Cape Town: David Phillip, 1977: 130-47. 7. NAMDA and the academic boycott of South Africa. Special Bull Jan 2, 1989.
8. Benatar SR. An alternative to academic
boycott. Nature 1990; 343:
505-06.
9.
Apartheid medicine: health and human rights in South Africa. A report to
the American Association for the Advancement of Science, America Psychiatric Association, American Public Health Association, Institute of Medicine of the National Academy of Sciences. AAAS Publ 1990 (publication number 90-09S). 10. Crawshaw R. Academic sanction. JAMA 1989; 262: 1499-503. 11. Henderson G. Rethinking the presence of American scholars in China.
JAMA 1990; 263: 992-93.
From The Lancet Medical electors Some serious and some jocose objections have been raised by several of our literary and political contemporaries to the course which we have adopted in applying what is called a medical test to Captain Grosvenor, one of the candidates for the political representation of Westminster. These objections, however ably and amusingly urged, have failed to satisfy us that we should be justified in allowing to pass unchallenged his claims to represent a borough which includes, perhaps, a greater number of medical electors than any other borough in the country. One of the most important questions which can arise in the mind of an elector, when called upon to exercise his right of voting for a parliamentary representative, is involved in the consideration of the fitness of that candidate to express opinions upon matters of imperial interest, and on which the elector has definite views. If it were true that the connexion of the Grosvenor family with a system of organized medical imposture involved only private interests, or related only to matters of scientific importance, it would, we agree, be ill-judged and improper to consider that connexion as being of moment in deciding a purely political issue. We might indeed, individually, hold a low opinion of the intelligence of a person who was deluded by the transparent follies of the imposition which is involved in the globulistic practice of infmitesimalism in medicine. But however meanly we might think of his powers of mind and his capacity for forming a judgment, we should be well disposed to treat these individual follies as undeserving of any serious or public notice. For aught we know, there may be believers in perpetual motion amongst the working legislators of the House of Commons, and an enthusiastic study of the means of squaring a circle may not be incompatible with the perfect fulfilment of official duties.
(24 June 1865)
activated and perhaps degraded T cells of large quantities of cytokines seems to play a crucial role. Possibly the symptoms of the disease, and the gross fluid inbalance that arises, are cognate in part with the capillary leakage syndrome seen in graft-versus-host disease after bone marrow transplantation in man.18 In these patients T-cell activation is also likely to be a major component of the syndrome and this, rather than the directionality of the attack of the graft against the host, may well have an adverse effect on the condition of the patient.
Conclusions The argument throughout this paper has been confined to consideration of the effects of T-cell activation; we do not exclude the possibility that comparable effects can follow the large-scale stimulation of other and perhaps all cells capable of synthesis and release of paracrine hormones. If our speculations are correct, many infectious diseases may have serious consequences that are byproducts of activation of the immunological apparatus. Equally, when cytokine-producing cells undergo malignant transformation, we can expect effects on adjacent cells or on the recruitment of cells into the tumour. Such influences need not be interpreted as directional immune responses but perhaps as indicators that cell-to-cell interactions, mediated by paracrine hormones, are common consequences of somatic cell activation. In such diseases an alternative to eliminating the prime cause might be to suppress the cytokines that are responsible for symptoms. In a series of elegant experiments Clark19 has shown that the symptoms of certain experimental malarial infections can be simulated by injection of a cytokine (tumour necrosis factor) and that immunisation against the cytokine can prevent the genesis of symptoms on subsequent introduction of an active infection. Equally, in certain tumours with a substantial infiltrative component, relief of symptoms might well be obtained by attack on the infiltrating host cells rather than simply on the tumour. The use of corticosteroids in the treatment of many cancers exemplifies what might be achieved. We thank Prof P. G. Isaacson, University College and Middlesex School of Medicine, and Dr J. P. Sloane, Royal Marsden Hospital, for critical reading of this paper. Work at the Institute of Cancer Research is supported by the Cancer Research Campaign.
REFERENCES 1. Leuchars E, Cross AM, Davies AJS, Wallis VJ. A cellular component of
thymic function. Nature 1964; 203: 1189. AJS, Festenstein H, Leuchars E, Wallis VJ, Doenhoff MJ. A thymic origin for some peripheral-blood lymphocytes. Lancet 1968; i:
2. Davies
183-84. 3. Balkwill FR, Burke F. The cytokine network. Immunol Today 1989; 10: 299-301. 4. Editorial. Immunological orchestra. Lancet 1968; i: 185-86. 5. Sprent J, Basten A. Circulating T and B lymphocytes of the mouse. II. Lifespan. Cell Immunol 1973; 7: 40-46. 6. Gleichmann E, Gleichmann H, Wilke W. Autoimmunization and lymphomagenesis in parent-F1 combinations differing at the major histocompatibility complex: model for spontaneous disease caused by altered self-antigens? Transplant Rev 1976; 31: 156-224. 7. Dunn TB. Normal and pathological anatomy of the reticular tissue in laboratory mice, with a classification and discussion of neoplasms. J Natl Cancer Inst 1954; 14: 1281-433. 8. Wallis VJ, Chaudhuri M, Jacob MC, Valkova BA, Davies AJS. Neoplasms arising in CBA mice after transfer of spleen cells from syngeneic old donors. Immunology 1984; 53: 769-77. 9. McCarron M, Osborne Y, Story CJ, Dempsey JL, Turner DR, Morley AA. Effect of age on lymphocyte proliferation. Mech Age Devel 1987;
41: 211-18.
10. Brittle
MP, Jacob MC, Gomer KJ. Induced type-B reticulum cell neoplasia of CBA mice. II. Functional similarities between tumorigenic reticulum cells and normal accessory cells. Immunology 1985; 55:
663-69. 11. Brittle MP, Wallis VJ, Chaudhuri M, Goucher RA, Gomer KJ. Induced type-B reticulum cell neoplasia in mice. III. The importance of T-cell proliferation and cellular relocation in accessory cell transformation. Br J Cancer 1988; 57: 378-84. 12. Purtilo DT. Epstein-Barr-virus-induced oncogenesis in immunedeficient individuals. Lancet 1980; i: 300-03. 13. Pileri S, Rivano MT, Raise E, et al. The value of lymph node biopsy in patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS related complex (ARC): a morphological and immunohistochemical study of 90 cases. Histopathology 1986; 10: 1107-29. 14. Ewing EP, Chandler FW, Spira TJ, Brynes RK, Chan WC. Primary lymph node pathology in AIDS and AIDS-related lymphadenopathy. Arch Pathol Lab Med 1985; 109: 977-81. 15. Marrack P, Blackman M, Kushnir E, Kappler J. The toxicity of staphylococcal enterotoxin B in mice is mediated by T cells. J Exp Med 1990; 171: 455-64. 16. Morrison WI, Goddeeris BM, Brown WC, Baldwin CL, Teale AJ. Theileria parva in cattle: characterization of infected lymphocytes and the immune responses they provoke. Vet Immunol Immunopathol 1989; 20: 213-37. 17. Morrison WI. A comparison of the responses of cattle inoculated with purified T or B lymphocytes infected with Theileria parva. ILRAD Annual Scientific Report 1988; 20. 18. Depledge MH, Barrett A, Morgenstern G, Sloane JP, Powles RL. Pulmonary oedema with leaky endothelial syndrome. Exp Hematol 1982; 10 (suppl): 113. 19. Clark IA, Chaudhri G. Relationships between inflammation and immunopathology of malaria. In: Stevenson MM, ed. Malaria: host responses to infection. Boca Ratton, CRC Press, 1989: 127-46.
VIEWPOINT Academic freedom in South Africa
speech and academic freedom are widely acknowledged prerequisites for the relentless, objective, scholarly pursuit of knowledge and truth for the advancement of the human condition. Freedom of speech at universities in many countries has often been hindered by vigorous protest against allowing speakers with fascist, communist, or racist persuasions the privilege of a campus platform. Such protest and dissension has disrupted lectures and silenced speakers. Freedom of speech allows for protestors to dissent, but cannot rationally be extended to "licence to gag", since this would stifle presentation of contentious issues and prevent public exposure of flawed arguments. The need to preserve opportunities for open debate is greatest during times of rapid social change if anarchical and tyrranical forces are to be countered. It is, however, at just such times that the greatest threats are posed to freedom of speech and association and to academic freedom, which are essential for democratic politics and for the primary task of a university-to discover and disseminate knowledge by means of research and teaching.12 Freedom of
Academic
freedom can be considered from two viewpoints-that of the individual academician and that of ADDRESS Department of Medicine, University of Cape Town, and Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa (Prof S. R. Benatar, FRCP).
1577
institution. These two interrelated aspects of the right to academic freedom are not synonymous and should not be conflated. From the institutional viewpoint, academic freedom-better described as university autonomy-refers to the independence of the university’s governing body from political interference, the university’s right to decide who should teach, what should be taught, who should be taught, and who should graduate (setting standards), with the primary objectives of pursuing the advancement of knowledge and seeking the truth. Academic freedom from the viewpoint of the individual is a different and less clear-cut concept and consists of several components. I understand its fundamental component to be the right of an individual to pursue his academic workteaching, researching, and publishing-in accordance with scientific and scholarly convictions and in conformity with the academic ethos, without fear of persecution on the grounds of private views and conduct (eg, religious beliefs, sexual preferences), provided these do not interfere with his academic work. The extension of academic freedom beyond the right to hold private views to the right to incorporate these into teaching when this is relevant is not disputed. Whether academic freedom should be extended further to the right to act on these beliefs in the teaching milieu is, however, contentious. It is certainly considered unacceptable for the teacher to coerce students to accept his private views, since this action infringes on the rights of students to pursue their academic studies free of interference with their private preferences. In any society the right of freedom of speech is necessary before academic freedom can be truly fulfilled. Academic freedom in turn ensures: (a) that it is only academic and scholarly qualities that justify a secure place in the university; and (b) that the potential for advancing knowledge in the university setting will not be adversely affected by factors extraneous to academic ability. In 1960 Prof C. W. de Kewiet defined the concept of academic freedom more broadly in his T. B. Davie Memorial Lecture at the University of Cape Town: "The Definition (of academic freedom) which seems to have the most dignity and creative meaning is the right of scholarship to the pursuit of knowledge in an environment in which the emancipating powers of knowledge are the least subject to arbitrary restraints. This means that scholarship and the teaching or writing in which it expresses itself must be free to deal with the major problems or issues of the age. It is vital to go beyond freedom to pursue knowledge for its own sake, and claim for scholarship today a greater and freer role in relieving mankind of inequality, injustice, deprivation, fear, an
ignorance or anger ...".1 Academic freedom in South Africa Before the 1959 extension of the University Education Act and associated legislation, the Universities of Cape Town and the Witwatersrand were "open" universities in the sense that students were admitted on academic criteria without regard to their race, colour, or creed. These universities’ unequivocal and publicly stated opposition to the racial restrictions imposed on universities1,3has been reiterated and vigorously defended over the past 30 years, during which time the restrictions on freedom of speech, movement, and political expression have been progressively imposed on South African society, and university autonomy has continued to face many threats. It is against this background that the English language universities of Natal,
Rhodes, Cape Town, and the Witwatersrand have
on
occasions reaffirmed their commitment to intellectual freedom and have indeed extended the concept of academic freedom in a changing society. 3,4 The debate on freedom of speech and academic freedom in South Africa is complicated by the cultural and ideological diversity that characterises a heterogeneous society in which long entrenched racial discrimination has had profoundly adverse effects. "Worlds apart" is an apt description of the different environments in which whites and blacks live in South Africa. It is necessary to recognise, and be sensitive to, the different perspectives from which freedom is seen by those who have been privileged to grow up in an environment of freedom as compared with those whose whole lives have been restricted in a myriad of ways. The complexity of relationships between blacks and whites needs to be understood in the context of generations of domination and subordination that have resulted in mutual fear, mutual disrespect, a sense of otherness, and a persuasive feeling by blacks of malign neglect. These are the ingredients of a social environment that has engendered a deep feeling of inferiority in blacks and a deep sense of guilt in whites. It is perhaps not surprising that in this context the "language" used to communicate ideas and perceptions does not necessarily have the same meaning to all the participants in the debate. The background to these differences also raises the question of the extent to which it is justifiable for universities and academics to claim that there is academic freedom in an oppressive society (a) in which limitations are imposed on freedom of speech by legislation or emergency powers, (b) in which universities are not fully academically free in an institutional sense, and (c) in which until recently these limitations were in danger of becoming more stringent. The increasingly expressed challenge to universities in South Africa to become "Africanised" is also highlighted in this debate. It must be conceded that within the context of South African history universities have collectively (although not necessarily individually or to the same extent) mirrored and served to support the deep cleavages within this radically divided society, although usually unintentionally and despite the hope that universities would be the focus of conciliation.6 How should a university react to events that affect it in a society such as exists in South Africa? What action should be taken against those who "obstruct" academic freedom by disrupting and preventing lectures, and how should such obstructions (which are claimed by some to be actions for future greater freedoms) be viewed in the context of university life in this country? What ought to be its attitude to the idea of academic boycott? How can universities contribute to the peaceful development of a democratic and
numerous
just society? The need to take a moral stand against apartheid and all its implications is undisputed and in this regard the position of several South African universities is quite clear and has for many years been on public record. The nature and extent of actions that should be taken to express the moral stand are hotly debated. Pragmatic, economic, and sociopolitical considerations inevitably influence the ability to implement change. Many hold the view that even the most outspoken universities have taken inadequate action. Open universities in South Africa are part of the international academic community, but have become increasingly (externally) isolated over the past 30 years.
1578
Censorship within South Africa has served
to
(internally)
isolate South African academics from life around them. Both forms of isolation and the consequent academic impoverishment frustrate rather than facilitate intellectual and social progress, and are thus antithetical to the concept of academic freedom. The viewpoint espoused by liberal universities is that freedom of speech and academic freedom are important, even in their incompletely fulfilled states, since South African universities are neither the cause of, nor perpetuators of, injustice in our society. Indeed quite the converse applies since they encourage and allow dissension against such injustices. This view calls for the protection of even imperfect academic freedom to enable universities to contribute to the reasoned dialogue required to develop a new, more just, and peaceful society in which universities can continue to carry out their universal function of
advancing knowledge. An alternative view, expressed by some who continue to advocate academic boycotts, is that the so-called universal function is more Eurocentric than universal, that even the central knowledge and truth seeking work of universities is not neutral, and that its protection by academic freedom helps to perpetuate racism and oppression by: (a) reproducing forms of power relations that reinforce elitist dominance in society, (b) suppressing the collective will of the people, and (c) frustrating progress towards the elimination of an illegitimate government and its replacement by a democratically elected leadership. Opponents of freedom of speech and proponents of academic boycott in such a context justify their stand as appropriate political strategies which, by contributing to the isolation of South Africa, could facilitate the removal of an unjust regime and lead to greater academic and other freedoms in the future. Crucial to this notion has been the time anticipated for such change to occur. The time frame has already been so long that many individuals and organisations, including the African National Congress, are openly expressing concern for the now obvious adverse effects on a whole generation of schoolchildren of the slogan "liberation now, education later". This course of events, which has contributed to a generation inculcated with a culture of violence, has seriously undermined both the usefulness and the morality of school boycotts and other restrictions on freedom of speech and academic interchange. The road ahead Persistence in trying to view the experiences of others only through the prism of our own life experiences will not suffice. This applies both within nations and between nations. Empathy, and a willingness to communicate at more than a mere superficial level, are prerequisites to understanding the deep cultural, economic, and ideological gaps that separate opposing groups, and to developing the mutually enriching and desperately needed dialogue that is essential for peaceful progress into the future. The "politics of protest" is becoming obsolete and must be replaced by the "politics of transformation". By this means the adverse effects of obstructing academic freedom and of total academic boycott are already being acknowledged, and it is being conceded that even selective boycott poses many problems. As a result some who previously proposed academic boycott are now retracting7 and the morally justifiable status of selective support8 is gaining recognition.9-11 I hope that those who still believe that obstructing academic freedom is a necessary part of the
struggle will soon also move away from this counterproductive and self-defeating stand and contribute to a momentum for peaceful progress. Building a new South Africa will demand a pattern of thought and action that transcends the rhetoric of protest. REFERENCES 1. The open universities in South Africa and academic freedom 1957-1974. Published on behalf of the Academic Freedom Committees of the University of Cape Town and the University of the Witwatersrand. Cape Town: Juta. 2. Shils E. The academic ethos. In: van der Merwe H, Welsh D, eds. The future of the university in South Africa. Cape Town: David Phillip, 1977: 5-22. 3. Open universities in South Africa. Johannesburg: Witwatersrand University Press, 1957. 4. File J, van den Heever A, Saunders SJ. Towards the day of hard choices. Nature 1989; 341: 96-98. 5. Steele S. The recolouring of campus life. Harper’s Magazine, February 1989: 47-55. 6. Welsh D, Savage M. The university in divided societies: the case of South Africa. In: van der Merwe H, Welsh D, eds. The future of the university of Southern Africa. Cape Town: David Phillip, 1977: 130-47. 7. NAMDA and the academic boycott of South Africa. Special Bull Jan 2, 1989.
8. Benatar SR. An alternative to academic
boycott. Nature 1990; 343:
505-06.
9.
Apartheid medicine: health and human rights in South Africa. A report to
the American Association for the Advancement of Science, America Psychiatric Association, American Public Health Association, Institute of Medicine of the National Academy of Sciences. AAAS Publ 1990 (publication number 90-09S). 10. Crawshaw R. Academic sanction. JAMA 1989; 262: 1499-503. 11. Henderson G. Rethinking the presence of American scholars in China.
JAMA 1990; 263: 992-93.
From The Lancet Medical electors Some serious and some jocose objections have been raised by several of our literary and political contemporaries to the course which we have adopted in applying what is called a medical test to Captain Grosvenor, one of the candidates for the political representation of Westminster. These objections, however ably and amusingly urged, have failed to satisfy us that we should be justified in allowing to pass unchallenged his claims to represent a borough which includes, perhaps, a greater number of medical electors than any other borough in the country. One of the most important questions which can arise in the mind of an elector, when called upon to exercise his right of voting for a parliamentary representative, is involved in the consideration of the fitness of that candidate to express opinions upon matters of imperial interest, and on which the elector has definite views. If it were true that the connexion of the Grosvenor family with a system of organized medical imposture involved only private interests, or related only to matters of scientific importance, it would, we agree, be ill-judged and improper to consider that connexion as being of moment in deciding a purely political issue. We might indeed, individually, hold a low opinion of the intelligence of a person who was deluded by the transparent follies of the imposition which is involved in the globulistic practice of infmitesimalism in medicine. But however meanly we might think of his powers of mind and his capacity for forming a judgment, we should be well disposed to treat these individual follies as undeserving of any serious or public notice. For aught we know, there may be believers in perpetual motion amongst the working legislators of the House of Commons, and an enthusiastic study of the means of squaring a circle may not be incompatible with the perfect fulfilment of official duties.
(24 June 1865)
