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Ethical issues and law-making power: how European case law has rewritten Italian law on medically assisted reproduction

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Abstract

The paper relates to the actual extent of the “margin of appreciation” of national law-making power in Europe when it takes ethical issues into consideration. This occurs when the use of technoscience may affect fundamental interests. The discretion of the legislature is limited, particularly by the transnational system arising from the European legal integration within both the European Union and the Council of Europe. The two schemes of integration, although there are differences between them, converge to put national legislation under pressure, particularly when it considers ethical matters. As a matter of fact, ethical issues cannot be approached at the national level alone but must be addressed at least at the continental level. An important role in the work of shaping the ethical rules from a continental perspective is played not by the national legislatures, but by the dialogue between the different levels of the judiciary. This role is inescapable and cannot be replaced by legislation, even if it is approved in a transnational plan. The function of the case law in regulating phenomena with ethical implications is studied, taking into consideration the case of Italian Law no. 40 of 2004 concerning medically assisted reproduction. Over the last 15 years, this law, which is inconsistent with many fundamental ethical principles, but has not been amended by the legislature, has been in the process of being corrected by the dialogue between European and national case law.

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Notes

  1. The expression “ethical principles” is contained, for example, within the legal texts of the European Union regulating the funding for research activities, such as Regulation (EU) 1290/2013 and Regulation (EU) 1290/2013 concerning the Programme “Horizon 2020”. Among the ethical principles to be observed by the beneficiaries of EU grants, one can find “the principle of proportionality, the right to privacy, the right to the protection of personal data, the right to the physical and mental integrity of a person, the right to non-discrimination and the need to ensure high levels of human health protection” [Article 19, para. 1, Regulation (EU) 1291/2013]; the protection of the human embryo [Article 13 Regulation (EU) 1290/2013]; the wellbeing of animals subject to experimentation [Article 23, para. 10, Regulation (EU) 1290/2013], etc.

  2. However, since the end of 1950, draft laws on the subject were submitted. In any case, until the adoption of Law 40/2004, the matter had been regulated in circulars from the Minister of Health (now Health), such as that of 1 March 1985. On the process leading to the approval of Law 40/2004, see Casini et al. (2004).

  3. With respect to the year 2010, see the survey in Shenfield et al. (2010). In any case, the flow of Italian couples who have gone to other European countries appears to have been constant over the last 10 years. See the reports published at http://www.osservatorioturismoprocreativo.it/.

  4. EGE, ‘Ethical aspects of research involving human embryo in the context of the 5th Framework Programme’, Opinion No. 12, 23 November 1998.

  5. Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164), opened for signature on 4 April 1997 in Oviedo.

  6. Regarding the legal implications of a pre-implantation analysis according to Italian and the European case law, see Stefanelli (2016).

  7. This fundamental right includes, among other things, the right to establish and develop relationships with other human beings (see Niemietz v. Germany, 16 December 1992, para. 29, Series A no. 251-B), the right to “personal development” (see Bensaïd v. the United Kingdom, no. 44599/98, para. 47, ECHR 2001-I) and the right to self-determination (see Pretty v. the United Kingdom, no. 2346/02, para. 61, ECHR 2002-III). Aspects such as sexual identity, orientation and life are also considered covered by Article 8 (see, for example, Dudgeon v. the United Kingdom, 22 October 1981, para. 41, Series A no. 45, and Laskey, Jaggard and Brown v. the United Kingdom, 19 February 1997, para. 36, Reports of Judgments and Decisions 1997-I).

  8. See Evans v. the United Kingdom [GC], no. 6339/05, para. 71, ECHR 2007-IV, and A, B and C v. Ireland [GC], no. 25579/05, para. 212, 16 December 2010; R.R. v. Poland, no. 27617/04, para. 181, ECHR 2011. See also ECHR, Dickson v. the United Kingdom [GC], no. 44362/04, para. 66, ECHR 2007-V, in which the Court considered the refusal of the authorities to provide the applicants—a prisoner and his wife—with the facilities for artificial insemination to be a violation of Article 8 of the European Convention.

  9. Once the Constitutional Court declared the unconstitutionality of the prohibition against heterologous fertilisation, other judges affirmed that right. Thus, the Consiglio di Stato (acting as an administrative judge of appeal) affirmed that a health authority (i.e. the Lombardia Region) is not entitled to discriminate against heterologous fertilisation in favour of other techniques by refusing to reimburse the expenses borne by the concerned couples. Other forms of discrimination have been condemned by other administrative judges, such as limiting access to heterologous fertilisation based on age (see Administrative Tribunal of Veneto, judgement of 8 May 2015, no. 501 against the regulation of the Veneto Region).

  10. ECJ 4 October 2012, C-249/11, Hristo Byankov/Glaven sekretar na Ministerstvo na vatreshnite raboti, para. 40, not yet published; see also ECJ 10 July 2008, C-33/07, Jipa, ECR 2008 p. I-5157, para. 23; Id., 17 November 2011, C-430/10, Gaydarov, para. 33, not yet published. Regarding the limitation on the free movement of persons, see Pizzolo (2013).

  11. In leggiditalia.it.

  12. In 2009, the Tribunal of Rome rejected an action concerning the denial of paternity promoted by the brothers of a man, who was an Italian citizen, and who was married to another man in accordance with UK law. See Garibaldi (2009) and Molaschi (2010).

  13. In Foro Italiano, 2016, 5, 2, 286; in Diritto Penale e Processo, 2016, 8, 1085.

  14. Conseil d’État, La révision des lois de bioéthique, Paris, 2009, in legifrance.gouv.fr.

  15. The Court of Strasbourg in Evans v. United Kingdom affirmed that human embryos are not a legal subject of rights and duties, and that both members of a couple have the right to choose the fate of the embryos.

  16. With respect to the concept of dignity in the EU Charter, see, among others, Jones (2012); for dignity in bioethics, see Andorno (2009).

  17. See the opinion (submitted on 18 March 2004) by Advocate General Christine Stix-Hackl in the Omega case, ECJ judgement 14 October 2004, C-36/02, Omega Spielhallen- und Automatenaufstellungs-GmbH v. Oberbürgermeisterin der Bundesstadt Bonn, ECR 2004, I-p. I-9609.

  18. The principle of proportionality, in terms of the coherence of the means and the purposes, especially when the law limits a right recognised by the supranational legal system, is also affirmed by the case law of the Court of Justice. See, for example, the judgement Volker (ECJ, 9 November 2010, cases C-92/09 and C-93/09, Volker und Markus Schecke y Eifert, ECR [2010], p. I-11063, para. 72 and 74); Id., judg. 8 June 2010, C‑58/08, Vodafone et al., ECR [2010], p. I-p. I-4999, para. 51; Id. judg. 8 April 2014, C-293/12 and C-594/12, Digital Rights Ireland et al., para. 46.

  19. Nevertheless, according to the international instruments, this kind of analysis is considered as legitimate in order to avoid malformations and diseases of the child, see Council of Europe, Explanatory Report to the Convention on Human Rights and Biomedicine, 1997, para. 83. At the national level, only two European countries (Austria and Switzerland) other than Italy have banned the pre-implantation analysis, see ECtHR, judgement Costa and Pavan v. Italy, ref., paras. 29–33.

  20. See the decree of the Tribunal of Cagliari of 5 June 2004 in Famiglia e diritto, 2004, p. 500.

  21. In Rivista italiana diritto e procedura penale, 2009, 928 ff.; in Foro Italiano, 2009, 9, 1, 2301; in Famiglia e Diritto, 2009, 8-9, 761; in Corriere Giuridico, 2009, 9, 1213.

  22. Tribunal of Florence, 12 December 2012, in Nuova giurisprudenza civile commentata, 2013, I, 589.

  23. See Articles 2141-5 and 2141-6 of the Code de la Santé Publique in France, which provide the “accueil de l’embryon” in case the couple does not want to follow the process of assisted procreation.

  24. D’Amico (2014) pointed out that the Italian Constitutional Court waited for the judgement of the Court of Strasbourg before taking its decision.

  25. See S.H. and Others, cited above, para. 94; Evans, cited above, para. 77; X, Y and Z v. the United Kingdom, 22 April 1997, para. 44, Reports of Judgements and Decisions 1997-II; Fretté v. France, no. 36515/97, para. 41, ECHR 2002-I; Christine Goodwin v. the United Kingdom [GC], no. 28957/95, para. 85, ECHR 2002-VI and A, B and C v. Ireland, cited above, para. 232.

  26. Among other legal sources, Article 27 of the Convention of Oviedo allows national rules providing a wider measure of protection with regard to the application of biology and medicine, as well as Opinion No. 15, adopted on 14 November 2000 by the European Group on Ethics in Science and New Technologies to the European Commission, Resolution 1352 (2003) of the Parliamentary Assembly of the Council of Europe on Human Stem Cell Research and Regulation (EC) No. 1394/2007 of the European Parliament and of the Council of 13 November 2007 on advanced therapy medicinal products (see paragraph 58, point III letter F and point IV letter B above). Other European dispositions prohibit the creation of human embryos for research purposes (see Article 3 of the EU Charter of Fundamental Rights and Article 18 of the Oviedo Convention) and ban patenting scientific inventions where the process involves the destruction of human embryos (see the judgement of the Court of Justice of the European Union, Oliver Brüstle v. Greenpeace eV of 18 October 2011).

  27. See the Dissenting Opinion of Judge Sajó, para. 13.

  28. See the judgement ECHR, decision X, Y and Z v. the United Kingdom of 22 April 1997, Reports of Judgements and Decisions 1997-II.

  29. See among others: Carbone (2014), Casonato (2014), D’Amico (2014), Morrone (2014), Musumeci (2014), Penasa (2014), Pioggia (2014), Rodomonte (2014), Ruggeri (2014), Sorrenti (2014), Tigano (2014), Tripodina (2014) and Violini (2014).

  30. See S.H. and Others v. Austria [GC], no. 57813/00, para. 82, ECHR 2011.

  31. See ECtHR, judg. 11 July 2002, Christine Goodwin v. United Kingdom, no. 28957/95, para. 74, ECHR 2002-VI; Id. judg. 28 May 2002, Stafford v. United Kingdom [GC], no. 46295/99, para. 68, ECHR 2002-IV.

  32. See among others: Carbone (2014), Casonato (2014), D’Amico (2014), Morrone (2014), Musumeci (2014), Penasa (2014), Pioggia (2014), Rodomonte (2014), Ruggeri (2014), Sorrenti (2014), Tigano (2014), Tripodina (2014) and Violini (2014).

  33. See in particular the judgements as follows: ECJ 24 January 2002, C-372/99, Comission/Italy, ECR 2002, p.I-819; Id. 8 June 1994, C-382/92, Comission/United Kingdom, ECR 1994, p. I-2435, par. 36; Id. 29 May 1997, C-300/95, Comission/United Kingdom, ECR 1997, p. I-2649, par. 37.

  34. ECJ 9 March 1978, 106/77, Amministrazione delle finanze dello Stato/Simmenthal, ECR 1978, p. 629.

  35. See, for example, ECJ 26 September 1996, C-168/95, Arcaro, ECR 1996, p. I-4705, par. 41–43.

  36. See ECJ 6 July 1995, C-62/93, BP Soupergaz/Greece, ECR 1995, p. I-1883.

  37. Scott and Stephen (2006) quote the case law of the US Supreme Court, especially the judgement in Sosa v. Alvarez-Machain, 542 U.S. 692 (2004), which supported the idea that the federal courts can use international law; see also Medellin v. Dretke, 544 U.S. 660 (2005); Roper v. Simmons, 543 U.S. 551 (2005).

  38. See, for example, Spielman (1995). In Italy, the legal literature and the case law affirm that the European Convention of Human Rights is directly applicable. See, among others, Nunin (1991). For the case law, see, for example: Corte di Cassazione, 27 May 1975, no. 2129, in Gius. it., 1976, I, p. 970; Id. 2 February 2007, no. 2247, in Nuova giur. civ. comm., 2007, p. 1195.

  39. Conseil d’État, La révision des lois de bioéthique, Paris, 2009.

  40. See ECJ, judg. 26 February 2008, C-506/06, Mayr, ERC 2008, p. I-1017, para. 38.

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    Roberto Cippitani

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Cippitani, R. Ethical issues and law-making power: how European case law has rewritten Italian law on medically assisted reproduction. Monash Bioeth. Rev. 37, 46–67 (2019). https://doi.org/10.1007/s40592-018-0088-8

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