Thursday, September 27, 2012

ECtHR published a new factsheet on the right to life

The ECtHR published a factsheet on cases in realtion with the right to life. From a bioethical perspective the factsheet contains two interesting topics: the first is the collection of cases related to the question of the beginning of a person's life. In this respect the document reiterates the Court decision in Boso v. Italy (Application no. 50490/99) which found that "granting a foetus the same rights as a person would place unreasonable limitations on the Article 2 rights of persons already born".  The other one is the group of cases concenring the hypothetical right to die.

Contents:

1. Beginning of Life:
- Vo. v. France (Application no. 53924/00)
- Evans v. United Kingdom (Application no. 6339/05)

2. Right to die?:
- Pretty v. United Kingdom (Application no. 2346/02)
- Koch v. Germany (Application no. 497/09)

Wednesday, September 26, 2012

Research Report: Bioethics and the case-law of the Court

In May 2012 the ECtHR published an updated research report on its case-law in relation with bioethics. The report was prepared by the Redearch Division of the Court and finalised in 2009. However, due to certain developments within the case-law of the Court, the Division updated its earlier working document.

The report follows a sistematic approach, starting from bioethicsal issues raised in recent judgments. This includes reproductive rights, medically assisted procreation, assisted suicide, consent, issues concenring HIV, retention of biometric data. In its second part, the document contains examples of cases in which the Cour expressly referred to the Convention on Human Rights and Biomedicine or the work of CDBI.

Here is the summary:
The term “bioethics ” has been understood for the purposes of this report to encompass the protection of the human being (his/her human rights and in particular human dignity) in the context of the development of biomedical sciences. Specific issues which come under this term and are addressed in the report include reproductive rights (prenatal diagnos is and the right to a legal abortion), medically assisted procreation, assisted suicide, consent to  medical treatment or examinations, ethical issues concerning HIV, retention of biological data by the authorities and the right to know one’s biological identity. These complex issues are increasingly bei ng raised before the European Court of Human Rights, and we can perhaps expect more applications touching subjects such as gene therapy, stem cell research and cloning in the future. The cases cited raise important questions and often highly sensitive issues under Articles 2, 3, 5, 6 and most often Artic le 8 of the European Convention on Human Rights. [...]

References to the Oviedo Convention on Human Rights and Biomedicine of 4 April 1997 (ETS no. 164), or the work of the Council of Europe in  this area, have been found in a number of cases before the European Court of Human Rights.

Tuesday, September 25, 2012

Communicated cases by the ECtHR

Here are some communicated cases of the Court dealing with bioethical issues:

1. M.P. and Others v. Romania (Application no. 39974/10): The first two applicants complain, relying on Articles 2 and 8 of the ECHRon behalf of the third one, their child as regards his right to life, which has allegedly been infringed by his birth as a result of medical negligence.  The first two applicants also complain under Article 8 of the Convention that the birth of a child with a disability, as a result of medical negligence, infringed their right to the protection of their private and family life.

Special refences:

Articles 5, 10 and 24 of the Convention on Human Rights and Biomedicine
Princples 4, 8 and 14 of the Principles set out in the report of the Ad Hoc Committee of Experts on Progress in the Biomedical Sciences (CAHBI), 1989
Articles 6 and 20 of the Universal Declaration on Bioethics and Human Rights

2. Elberte v. Latvia (Applivcation no. 61243/08): The applicant complains relying on Article 8(1) of the ECHR of a breach of her deceased husband's physical integrity. She also complains that her right to respect for her private and family life was infringed on account of not having been asked to give or refuse consent to the removal of tissue from her deceased husband's body. She submitted that she was forced to bury her deceased husband with tied legs and that at a time, being in a state of shock after her loss and being pregnant with their second child, she could not imagine that it was due to the fact that her husband's body had been desecrated.

Special refences:

Articles 1, 16-17 of the Additional Protocol to the Convention on Human Rights and Bioethics concerning Transplantation of Organs and Tissues of Human Origin

3. Petrova v. Lativa (Application no. 4605/05): The applicant complains under Article 8 of the ECHR of interference with her son’s physical integrity on account of the removal of his organs without his prior consent. In addition, the applicant submits that while her son was still alive an analysis of the organs later removed from him was carried out and blood tests were performed in order to determine their compatibility for transplantation purposes with the potential recipient’s body. Lastly, the applicant submits that the interference was not in accordance with the law on account of the insufficient clarity of the law.

Special refences: 

Thursday, September 13, 2012

Article on WHO guidelines in relation with safe abortion

Mahmoud F. Fathalla and  Rebecca J. Cook published the editorial Women, abortion and the new technical and policy guidance from WHO in the current issue of the Bulletin of the WHO.

The basis of this was the publication of the updated Safe Abortion: technical and policy guidance for health systems by the WHO. The authors expressed their concerns "that until abortion is decriminalized, the tragedy of unsafe abortion will continue to haunt us and to threaten the life, health and rights of women. Furthermore, research aimed at developing simpler, improved methods for performing induced abortion has the potential to save the lives of millions of women globally".

The WHO guidelines are available here.

Tuesday, September 4, 2012

ECJL comments on Costa and Pavan v. Italy

Grégor Puppinck, director of the European Centre for Law and Justie (hereafter referred to as ECJL) published his critics in reltaion with the judgment of the Court in the case of Costa and Pavan v. Italy (Application no. 54270/10).[1]

Puppinck's argues that in its judgment the Court formulated a "right to eugenics". On the other hand it did not assert that the prohibition of preimoplantation genetic screening is in itself not contrary to the Convention, but rather assessed the proportionality of the Italian legislation regarding other elements of the Italian legal system. Finally, according to Puppinck, the ECtHR only exmained the case in the light of the results of the contested legislation and did not take into account the "principles", such as human dignity and the protection of the embryo, underlying the law.

I would like to comment on the above.

1) Whether the so-called right to eugenics has been formulated, we must assess the current European legal background, in particular the Fundamental Charter of the EU and the Convention on Human Rights and Biomedicine.

Article 3 (2b) of the Charter of Fundamental Rights proclaims that in the fields of medicine and biology, the prohibition of eugenic practices, in particular those aiming at the selection of personsthe must be respected. According to the commentary the prospect of eugenics, originally aiming that "society must foster the breeding of those who possessed favourable traits and to discourage the breeding of those who did not", faded after WWII and the crimes committed by the Third Reich, however, it has been raised again in recent years, in particular in relation to pre-implantation genetic diagnosis. Nevertheless,
the reference to eugenic practices, in particular those aiming at the selection of persons, relates [among others] to more serious situations in which selection programmes are organised and implemented, involving campaigns for sterilisation, forced pregnancy, compulsory ethnic marriage among others!
Practises of eugenics constitute grave violations of human rights, such as the prohibition of inhuman or degrading treatment, and crimes against humanity as well. However this should not lead to the conclusion that only such serious eugenic practices are covered by the explicit prohibition of eugenic practices. In this repsect a question arises: Does the possibility of genetic tests carried out on embryos of foetuses for the purpose to identify if the offspring carries a genetic disease constitutes a practise contrary to Article 3 (2b) of the Charter? Due to the lack of further references or provision within the Charter, we shall examine the Convention on Human Rights and Biomedicine.

The commentary to the Charter also mentions that the Convention on Human Rights and Biomedicine (note that is has not been ratified by Italy) does not explicitly contain any special provision related to the prohibition of eugenics. However Article 12 of the CHRB states that
[t]ests which are predictive of genetic diseases or which serve either to identify the subject as a carrier of a gene responsible for a disease or to detect a genetic predisposition or susceptibility to a disease may be performed only for health purposes or for scientific research linked to health purposes, and subject to appropriate genetic counselling.
The Explanatory Report of the CHRB states in this regard that through the use of genetic testing it is possible to identify with great precision whether a person carries specific genes for major single gene disorders or not. This document for example mentions as a targeted disease  cystic fibrosis. On the other hand, due to concerns related to the use of genetic testing for employment or insurrance purposes, the CRHB strictly limits the applicability of these tests to health purposes for the individual.  However the Explanatory Report also contains the following:
Article 12 as such does not imply any limitation of the right to carry out diagnostic interventions at the embryonic stage to find out whether an embryo carries hereditary traits that will lead to serious diseases in the future child.
It is therefore possbile to provide someone the possibility of preimplantation genetic test with due regard to other provisions of the CHRB and, of course, the ECHR. Contrary to Puppinck's arguments, we cannot conclude that a right to eugenics has been formulated in the judgment since the possibility of preimplantation genetic screening can be legal and can comply with human rights protection guarantees.[2]

2) To determine whether the Court did not take into account the principles underlying the Italian law, such the protection of the embryo, we shall rely on the relevant part of the judgment where the ECtHR stressed that the concept of "child", mentioned by the Government as the basis for the necessity for the intervention posed by the legislation, can not be equated to that of "embryo". It further expressed its doubts on how
the protection of the interests [of the child] is consistent with the possibility for the applicants to conduct a therapeutic abortion when the foetus is sick, especially given that this entails both the foetus, whose development is obviously more advanced than an embryo's, the parents, particularly the woman
It is clear from the Court's reasoning that it applied a differentiated approach concerning the status of the unborn.A child is entilted to full legal protection, the foetus and the embryo may, depending on the decision of the states within their margin of apprection, enjoy a lower lever, but due to Explanatory Report of the CHRB it shall be entilted to certain guarantess.[3] In this respect, the Court noted that due to inconsistencies in the Italian legal system, the foetus is less protected than the embryo. This cannot be construed as disregarding the protection of the embryo, rather the Court pointed out a serious differenciation which lacks objective grounds.

[1] The ECLJ intervened as a third party in the procedure before the court and submitted an amicus curiae as well.
[2] It shall be noted, however, that Article 2 (2a) of the Additional Protocol to the Convention on Human Rights and Biomedicine, concerning Genetic Testing for Health Purposes (which has not yet came into force) excludes from its scope genetic tests on the human embryo and foetus.
[3] Paragraph 19 states that "it was acknowledged that it was a generally accepted principle that human dignity and the identity of the human being had to be respected as soon as life began".