Commentary: Access to medical-assisted reproduction and PGD in Italian law: A deadly blow to an illiberal statute? Commentary to the European court on human rights's decision costa and pavan v Italy

Medical Law Review

Volumn 21, Issue 3, 2013, Pages 474-486

  Biondi, Stefano ^a  

^a UNIVERSITY OF FLORENCE   (Italy)

Author keywords

Italian law on assisted reproduction; Margin of appreciation; Medically assisted reproduction; PGD; Right to private and family life; Therapeutic abortion

Indexed keywords

EMBRYO DISPOSITION; FEMALE; GENETIC DISEASES, INBORN; HUMAN; INFERTILITY THERAPY; ITALY; LEGAL ABORTION; LEGAL ASPECT; LEGISLATION AND JURISPRUDENCE; PRENATAL DIAGNOSIS; ARTICLE; GENETIC DISORDER; ITALIAN LAW ON ASSISTED REPRODUCTION; MARGIN OF APPRECIATION; MEDICALLY ASSISTED REPRODUCTION; PGD; RIGHT TO PRIVATE AND FAMILY LIFE; THERAPEUTIC ABORTION;

ABORTION, LEGAL; EMBRYO DISPOSITION; FEMALE; GENETIC DISEASES, INBORN; HUMANS; ITALY; PREIMPLANTATION DIAGNOSIS; REPRODUCTIVE TECHNIQUES, ASSISTED;

ITALIAN LAW ON ASSISTED REPRODUCTION; MARGIN OF APPRECIATION; MEDICALLY ASSISTED REPRODUCTION; PGD; RIGHT TO PRIVATE AND FAMILY LIFE; THERAPEUTIC ABORTION;

EID: 84883205620     PISSN: 09670742     EISSN: 14643790     Source Type: Journal    
DOI: 10.1093/medlaw/fwt010     Document Type: Editorial

References (56)

1. Tribunale di Salerno, Ordinanza of 13/01/2010, in which the court ordered a medical centre to perform IVF and PGD with the gametes of a fertile couple affected by type 1 spinal muscular atrophy. Available at,http://www. personaedanno.it/index.php?option=com_content&view=article&id=33107.
2. The Government had used the word 'child'. The ECtHR (§62) pointed out, possibly with some irony, that there was a difference between embryos and children (and between the legal regimes respectively applicable).
3. [58§] In its analysis of relevant international legal instruments, the court noted (at §§ 21-28) that the Oviedo Convention permits PGD as a means to avoid the transmission of genetic conditions (Art 12 and §83 of the Explanatory Report). Additionally, it quoted the report of the European Commission's Joint research Centre 'Preimplantation Genetic Diagnosis in Europe' (EUR 22764 EN), in the part where it points out that prohibiting PGD while permitting therapeutic abortions is inherently contradictory and that, in the case of Italy, it has led to 'procreative tourism' to other EU countries (§§ 26-27).
4. In S.H. and Others v Austria (app. 57813/00), it had been established that, although states enjoy a wide margin of appreciation on issues as controversial as MAR, the ECtHR retains the authority to scrutinise if it has been exceeded. In the instant case, the Grand Chamber, reversing the previous ECtHR's decision, upheld the Austrian legislation prohibiting ova, but not sperm, donation.
5. The Court noted that similar prohibitions exist in Switzerland and Austria, although Switzerland is considering their repeal (§29)
6. See below, section II.B-particularly subsections (1) (b) and (c)-and section II.C, particularly N 58.
7. http://www.governo.it/Presidenza/Comunicati/dettaglio.asp?d=69911
8. It should be noted that Italian law has a system of judicial review of unconstitutional statutes. All Italian courts faced with a case requiring the application of a statute which they suspect of being unconstitutional should action a special incidental procedure, whereby they interrupt the trial and refer the statute in question to the Constitutional Court. This latter only rules on the constitutionality issue, and quashes the statute if it finds it unconstitutional. After its decision, the case is referred back to the original court, which adjudicates on the merits (L. Cost. 1/1948). Statutes that contrast with the ECHR are also unconstitutional (Arts 10 and 117 of the Constitution provide that legislation should comply with international law, including treaties), and the Constitutional Court is the sole domestic authority with the authority to strike them down (Constitutional Court, judgments 348/2007 and 349/ 2007, www.cortecostituzionale.it.). However, individuals may not challenge a statute's constitutionality directly-it is exclusively up to courts to refer statutes to the Constitutional Court, and there is no guarantee that this will happen. It is the author's opinion that, in cases such as Costa and Pavan, the judicial review procedure's existence hardly amounts to an 'effective remedy' as defined by the ECtHR.
9. MFreeman, 'Assisted Reproduction', in A Grubb (eds), Principles of Medical Law (OUP, Oxford 2004), 639, at note 209. Art 42 of the 1998 Doctors Code of Conduct contained some guidelines on assisted reproduction; cloning had also been banned by a sub-legislative instrument (Ministry of Health, Ordinanza of 05 March 1997, confirmed by the Ordinanza of May 2003).
10. Eg the Spanish Ley 35/1988, the English Human Fertilisation and Embriology Act (1990), the German 1990 Embryonenschutzgesetz, and the French Loi 29 juillet 1994
11. A Palazzo, La Filiazione (Giuffre'́, Milano 2007), at 10-11, n 17. The Italian Parliament had studied how to regulate MAR since Louise Brown's birth (1978), particularly with the Santosuosso (1984) and Busnelli (1995) expert commissions.
12. Tribunale di Monza, 27 October 1989, in (1990) 1 Giurisprudenza Civile commentata 357;
13. Corte Appello di Salerno, Decreto 25 febbraio 1992, in (1994) 1 Nuova giur. civ. commentata, 177 (denying the validity of surrogacy agreements)
14. Tribunale di Roma, Ord. 14-17 February 2000, in (2001) I Giur. it 2 300 (upholding gratuitous surrogacy agreements).
15. Corte Costituzionale Sentenza 347/1998; Cassazione Sentenza 2315/1999 (denying male partners who consent to heterologous MAR to challenge the child's paternity)
16. Eg the Spanish Ley 35/2003 and Ley 14/2006, the English Human Fertilisation and Embryology Act 2008
17. The Catholic Church condemns procreation not resulting from conjugal acts, and permits MAR only within marriage and only '... for those cases in which the technical means is not a substitute for the conjugal act but serves to facilitate and to help so that the act attains its natural purpose' (Congregation for the Doctrine of Faith, 'Donum Vitae' Instruction on respect of human life in its origin and on the dignity of procreation, 22 February 1987: AAS 80 (1988), 70-102, at §6).
18. For a more detailed analysis of the statute, see R Fenton, 'Catholic Doctrine v. Women's rights. The New Italian Law on Assisted Reproduction' (2006)
19. [1(] Med L Rev 73
20. Civil Code, Art 1. See F Gazzoni, 'Osservazioni non solo giuridiche sulla tutela del concepito e sulla fecondazione artificiale', in Diritto di Famiglia e delle Persone, 34 (2005) 1 168, 186
21. P Zatti and V Colussi, Lineamenti di Diritto Privato (Padova, Cedam 1998) 138
22. Corte Costituzionale, Sentenza 48/2005, which stated that Art 1 of Law 40/2004 is a 'programmatic' norm that adds nothing substantial to the statute's content,www. cortecostituionale.it.
23. 'Legal subjectivity' is a notion distinguished from 'legal personality' elaborated by some Italian scholars long before Law 40/2004 was enacted to define the unborn's peculiar status (ie not a person but enjoying some legal protection). See G Baldini, 'Il danno da procreazione: evoluzione dei profili di responsabilita' alla luce delle nuove tecniche di riproduzione artificiale' (1995) Rivista Critica di Diritto Privato 481.
24. Italian Constitution, Art 32: '(1)The Republic safeguards health as a fundamental right of the individual and as a collective interest, and guarantees free medical care to the indigent. (2) No one may be obliged to undergo any health treatment except under the provisions of the law. The law may not under any circumstances violate the limits imposed by respect for the human person',http://www.senato.it/documenti/repository/istituzione/ costituzione_inglese.pdf.
25. Ministero della Salute, Decreto 21 July 2004, Art 13
26. This contrasts with the catholic doctrine and with Italian law's failure to recognise de facto couples (as of Law 184/1983, singles and cohabiting partners are not normally allowed to adopt)
27. Offenders face between 3 months and 2 years' imprisonment and fines between 600,000 and 1,000,000 Euros (Art 12.3).
28. Transgressors are fined between 300,000 and 600,000 Euros (Art 4.3).
29. However, the male partner consenting to sperm donation may not contest the child's paternity, gamete donors never acquire legal parenthood, and children born through MAR may not be given for adoption at birth (Art 9)
30. Criminal Code Art 546, combined with Art 54 (defence of necessity)
31. Art 32 Constitution (see n 28, above)
32. Corte Costituzionale Sentenza 27/1975. The Court stated that no comparison could be drawn between the right to life and health '... of who is already a person, like the mother, and the protection of the embryo, which still has to become a person' (available at,www.cortecostituzionale.it.).
33. A medical certification is sufficient to prove such threat (Art 7)
34. Cassazione, Sentenza 14488/2004,http://www.altalex.com/index.php? idnot=2391.
35. Corte Costituzionale Sentenza 39/1997, which declared a referendum aimed at liberalising abortion inadmissible, and Sentenza 26/1981, which declared a referendum aimed at restricting abortion inadmissible (see below, n 46). Both available at,www.cortecostituzionale.it.
36. Selective abortions are allowed after implantation as in other pregnancies (Art 14.4).
37. http://www.repubblica.it/salute/medicina/2012/03/28/news/turismo_ procreativo_4_000_coppie_in_fuga_nel_2011_met_all_estero_senza_ motivo-32355960/.
38. Pursuant to Constitution Art 75, a referendum to abolish a parliamentary statute or some of its provisions may be called through a petition signed by 500,000 citizens. In order to be admissible, the Constitutional Court must find that its positive outcome would not lead to an unconstitutional legislative framework. Results are valid if the majority of voters participates.
39. See above, n 46. Only 25.9% of voters participated (Ministero dell'Interno, Comunicato 13 June 2005), so the results were invalid.
40. C Casonato, 'Legge 40 e principio di non contraddizione: una valutazione di impatto normativo', http://www.google.it/url?sa=t&rct=j&q=&esrc=s& frm=1&source=web&cd=1&sqi=2&ved=0CCEQFjAA&url=http%3A%2F% 2Fwww.forumcostituzionale.it%2Fsite%2Findex3.php%3Foption%3Dcontent %26task%3Dview%26id%3D230&ei=DkmdUIqxJsr4sgall4DICA&usg=AFQ jCNGKNR82Bcr8vYbmtwJVyvsCdv6ldQ&sig2=ievqpvGOSAJeH3Iwxw-Org.
41. In Ordinanza 369/2006, the Court rejected a referral on the PGD prohibition, because it had been poorly formulated by the remitting court; in Ordinanza 97/2010, rejected another referral on PGD, because it addressed issues that had already been considered in judgment 151/2009 (see below, n 51); in Ordinanza 150/2012, the Court rejected a referral regarding the prohibition to perform heterologous PGD, because the remitting courts had not had the chance to consider the ECtHR Grand Chamber's ruling in S. H. v Austria (see above, n 9). Judgments available at,www.cortecostituzionale.it.
42. Decision 151/2009, available at,www.cortecostituzionale.it. The reasons for the decisions occupy about one page, while the preceding seventeen simply summarise the facts and procedure.
43. The Constitutional Court does not only have the authority to quash unconstitutional provisions, but it can also make small modifications-including additions-to their wording when a certain solution is 'imposed' by the Constitution
44. E Dolcini, 'Embrioni nel numero "strettamente necessario": il bisturi della Corte costituzionale sulla legge n. 40 del 2004' (2009) 2 Rivista Italiana di Diritto e Procedura Penale 950.
45. L Violini, 'Note minime ad una decisione problematica. Il punto di vista dei giuristi' in M D'Amico and I Pellizzone (eds), I diritti delle coppie infertili (Franco Angeli, Milano 2010) 191.
46. Tribunale di Cagliari Sentenza 24/09/2007,http://www.altalex.com/index. php?idnot=38969.
47. Tribunale di Firenze Ordinanza 17 December 2007,http://www.altalex. com/index.php?idnot=39813.
48. Tribunale di Bologna Ordinanza 29 June 2009,http://www.altalex.com/index.php?idnot=47182.
49. Tribunale di Cagliari, Ordinanza 09 November 2012,http://www.asso ciazionelucacoscioni.it/sites/default/files/documenti/Testo%20ordinanza_ cagliari%20%281%29%20%281%29.doc. (the latter, relying on Costa and Pavan, maintained that, since domestic law must be interpreted in line with the ECHR, fertile bearers of genetically transmissible diseases may access IVF and PGD).
50. TAR Lazio-Roma, Sentenza 398/2008,http://www.altalex.com/index. php?idstr=20&idnot=39930.
51. Ministero della Salute Decreto 30/04/2008
52. See above, n 3. The Court interpreted the Guidelines' infertility definition extensively.
53. Pretty v United Kindgdom, App 2346/02
54. X v UK (1981) 3 EHRR 408 (on abortion); Evans v UK App 6339/05 (on assisted reproduction) §91
55. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and theWorld Health Organization (WHO), in their Revised Glossary on ART Terminology define infertility as a disease ((2009) 24 (11) Hum Reprod 2683 at 2686)
56. S. H. v Austria Chamber Judgment (2010) §74. * I am indebted to an anonymous reviewer for his insightful comments and suggestions. I retain, however, responsibility for all the contents herein.