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ESĽP: Taliansky zákon o asistovanej reprodukcii porušuje čl. 8 Dohovoru


 | 30.8.2012 | komentárov: 299

Európsky súd pre ľudské práva predvčerom (28.8.) rozhodol v prípade Costa a Pavan v. Taliansko (sťažnosť 54270/10). Rozhodnutie súdu, ktoré zatiaľ nie je konečné, jednomyseľne konštatuje porušenie článku 8 Európskeho Dohovoru na ochranu ľudských práv a základných slobôd (právo na rešpektovanie súkromného a rodinného života).

Obrazok

Súd dal v rozhodnutí za pravdu talianskemu manželskému páru, ktorý namietal, že znemožnenie prístupu k asistovanej reprodukcii a predimplantačnej diagnostike je porušením práv páru podľa Dohovoru. Vo vzťahu k talianskej regulácii súd de facto zrušil obmedzenie, na základe ktorého nebola asistovaná reprodukcia ani predimplantačná diagnostika prístupná pre zdravé páry, konkrétne články 13 a 4 zákona o asistovanej reprodukcii. Článok 13 zakazuje „akékoľvek experimenty s ľudským embryom“, zatiaľ čo článok 4 stanovuje, že metódy ART sú prístupné len pre neplodné páry. „Žiadosť o asistovanú reprodukciu sa pripúšťa len vtedy, ak bola potvrdená nemožnosť inak odstrániť  prekážky počatia, a preto je vyhradená pre prípady sterility alebo  infertility objasnené a zdokumentované lekárskou správou a prípady sterility a infertility spôsobené príčinou, ktorá je potvrdená lekárom."  Do včerajšieho rozhodnutia boli obmedzenia zákona „zlomené“ len raz, a to v januári 2010, keď súd v Salerne dovolil podstúpiť predimplantačnú diagnostiku zdravému páru, ktorý bol nositeľom dedičnej svalovej atrofie.

Skutkový stav

Manželia, Rosetta Costa a Walter Pavan,  sú zdravými nositeľmi genetického ochorenia, cystickej fibrózy. Túto skutočnosť zistili po narodení prvorodenej dcéry. Pri druhom tehotenstve podstúpila pani Costa prenatálny screening, ktorý preukázal, že dieťa trpí cystickou fibrózou. Preto sa sťažovateľka rozhodla pre umelé prerušenie tehotenstva zo zdravotných dôvodov. Manželia v snahe zabrániť prenosu ochorenia na ďalšieho potomka mali záujem podstúpiť in vitro oplodnenie a tzv. predimplantačnú diagnostiku, avšak taliansky zákon o asistovanej reprodukcii (legge 40/2004) túto techniku zakazuje. Zároveň môžu asistovanú reprodukciu podľa jeho ustanovení podstúpiť len manželské páry, ktoré trpia neplodnosťou alebo tie,v ktorých je partner (manžel) nositeľom sexuálne prenosnej choroby (AIDS, hepatitis B a C).

Manželia podali v roku 2010 sťažnosť na Európsky súd pre ľudské práva. V sťažnosti namietali, že predmetný zákaz porušuje ich právo na rešpektovanie súkromného a rodinného života podľa článku 8 Dohovoru, ako aj ich právo na nediskrimináciu podľa článku 14 Dohovoru  v porovnaní s inými pármi, ktoré môžu podstúpiť asistovanú reprodukciu, pretože trpia neplodnosťou alebo partner trpí sexuálne prenosnou chorobou. K sťažnosti sa ako tretia strana vyjadrili aj organizácie Európske centrum pre právo a spravodlivosť  (The European Centre for Law and Justice, ECLJ), Hnutie za život (Movimento pre la vita),organizácia „Luca Coscioni“ ai., ako aj 52 talianskych poslancov.

Rozhodnutie súdu

Súd vyniesol rozhodnutie v zložení Françoise Tulkens (Belgicko), Dragoljub Popović (Srbsko), Isabelle Berro-Lefèvre (Monako), András Sajó (Maďarsko),Guido Raimondi (Taliansko), Paulo Pinto de Albuquerque (Portugalsko), Helen Keller (Švajčiarsko) a Françoise Elens-Passos (zapisovateľ sekcie). Za predpokladu, že sa žiadna zo strán v trojmesačnej lehote od doručenia rozhodnutia nepodá žiadosť o postúpenie sťažnosti Veľkej komore, rozhodnutie Európskeho súdu pre ľudské práva bude konečné.

V rozhodnutí súd konštatoval nekonzistentnosť talianskeho práva, ktoré zakazuje podstúpenie embryonálneho screeningu z dôvodu možného prenosu dedičnej choroby na plod, ale povoľuje prerušenie tehotenstva v prípade, že fetus vykazuje známky dedičného ochorenia. Súd ďalej vyhlásil, že zásah do práv sťažovateľov na rešpektovanie súkromného a rodinného života bol neprimeraný.

Porušenie článku 8

Súd bol toho názoru, že túžba sťažovateľov uchýliť sa k predimplantačnej diagnostike a asistovanej reprodukcii v záujme počatia dieťaťa, ktoré by netrpelo cystickou fibrózou, je formou vyjadrenia ich súkromného a rodinného života, ktorá spadá pod ochranu podľa článku 8 Dohovoru. Keďže v tomto smere manželia nemohli podniknúť náležité kroky, došlo k zásahu do ich práva na rešpektovanie súkromného a rodinného života, ktoré bolo „v súlade s právom“, pretože sledovalo legitímny cieľ ochrany morálky, práv a slobôd iných.

Talianska vláda ospravedlňovala zásah potrebou chrániť zdravie matky a dieťaťa, potrebou chrániť dôstojnosť a slobodu svedomia zdravotníckych pracovníkov a snahou vyhnúť sa zneužitiu metódy na eugeniku. Súd poznamenal, že pojmy embryo a dieťa by sa nemali zamieňať. Zároveň nedokázal pochopiť, ako môže byť prerušenie tehotenstva v prípade, že plod trpí dedičným ochorením, v súlade s takto stanovenými požiadavkami vlády.  Ďalej konštatoval, že aj keď otázka prístupu k predimplantačnej diagnostike otvára citlivé otázky morálnej a etickej povahy, legislatívna úprava prijatá parlamentom nevylučuje dohľad súdu. Z 32 krajín, ktoré sú členmi Rady Európy, je predimplantačná diagnostika zakázaná len v Taliansku, Rakúsku a Švajčiarsku. Súd zaznamenal nekonzistentnosť v talianskom práve, ktoré zakazuje implantáciu „len zdravých“ embryí, ale na druhej strane povoľuje potraty plodov, ktoré majú symptómy choroby. Za takýchto podmienok mali sťažovatelia len jedinú možnosť, a to možnosť plnú úzkosti a utrpenia- počať prirodzeným spôsobom a ukončiť tehotenstvo v prípade, že prenatálna diagnostika preukáže výskyt ochorenia. Podľa názoru súdu bol takýto zásah do práva na rešpektovania súkromia a rodinného života neprimeraný a porušoval článok 8 Dohovoru.

Článok 14

Diskrimináciou podľa článku 14 Dohovoru je odlišné zaobchádzanie s ľuďmi v podobných situaciách bez objektívneho a rozumného ospravedlnenia. Tu súd usúdil, že pokiaľ ide o prístup k predimplantačnej diagnostike, s pármi, v ktorých je muž nositeľom sexuálne prenosného ochorenia sa nezaobchádza odlišne než so sťažovateľmi, keďže zákaz predimplantačnej diagnostiky sa vzťahuje na všetky kategórie osôb. Túto časť sťažnosti preto zamietol ako neodôvodnenú.
 
Na základe týchto záverov má Talianska republika zaplatiť sťažovateľom 15 tisíc eur na kompenzáciu nemajetkovej ujmy a 2500 euro na pokrytie nákladov na právne zastúpenie.

Dopady rozhodnutia na zákon o asistovanej reprodukcii

V Taliansku vyvolalo rozhodnutie ohlas odbornej verejnosti a organizácií angažovaných na oboch stranách názorového spektra. Mnohí predpovedajú revíziu alebo zrušenie pôvodného zákona. Podľa Marie Antoinetty Fariny Cosciony, čestnej predsedníčky Asociácie Luca Coscioniho, „zo zákona o asistovanej reprodukcii ostane už len zákaz použitia embryí na výskumné účely. Je na novom parlamente, aby predložil a odhlasoval nový zákon, ktorý bude konečne korešpondovať s verejnou mienkou.“ Gynekológ Carlo Flamingi, otec asistovanej reprodukcie a zakladateľ Národnej komisie pre bioetiku, hovorí „o výbornej správe, keďže zo zákona o asistovanej reprodukcii ostali v skrini už len niektorí strašiaci.“ Opačný názor má Eugenia Rocchella, autorka ešte nevydaných smerníc ministerstva zdravotníctva k zákonu o asistovanej reprodukcii: "Sme si istí tým, že naša vláda vie aj v tomto prípade obhájiť zákony odhlasované parlamentom a že podá žiadosť o postúpenie veci Veľkej komore.“ Zákon o asistovanej reprodukcii obhajuje aj organizácia Veda a život, združenie katolíckych organizácií založené v roku 2005 na podporu zákona. „Zákon č. 40 nie je ani zákonom ideologickým ani zákonom založenom na vierovyznaní, je to zákon určený na ochranu práv všetkých zainteresovaných subjektov, a to vrátane práv počatého dieťaťa“, konštatuje vo svojej správe.

Pokiaľ ide o názory odbornej lekárskej obce, Corriere della Sera citujú Eleonoru Porca, z Centra pre neplodnosť a asistovanú reprodukciu bolonskej univerzity, ktorá poukazuje na komplikácie spojené s priamym účinkom rozhodnutia na výkon asistovanej reprodukcie na talianskych klinikách. Tie totiž musia byť po technickej stránke pripravené na realizáciu predimplantačnej diagnostiky. Okrem toho nesúhlasí s rozhodnutím súdu a domnieva sa, že medzi zákonom o asistovanej reprodukcii a možnosťou pristúpiť k potratu za podmienky, že tu sú zdravotné dôvody, rozpor nie je. Ďalej poukazuje na to, že určenie či cieľom predimplantačnej diagnostiky je zdravie embrya alebo či ide o eugeniku, je náročné. „Vezmime si Downom syndróm: vieme, že dieťa bude mať počas života množstvo problémov, ale kto rozhodne, že to je dostatočný dôvod pre zničenie embrya?“ Námietky poukazujúce na možné zneužitie tejto metódy na eugeniku vyvracia gynekológ Severino Antinori, ktorý háji techniku s tým, že sa vykonáva len v 15-20 prípadoch patologických ochorení od cystickej fibrózy po  talasémiu (anémiu Stredomoria), a nie napríklad pre výber farby vlasov potomka.

S ohľadom na prijaté rozhodnutie, sme toho názoru, že určenie hranice medzi eugenikou a prijateľnými účelmi realizácie predimplantačnej diagnostiky, je citlivou etickou otázkou, ktorej riešeniu sa skôr či neskôr nevyhne nielen taliansky zákonodarca, ale rovnako celé európske spoločenstvo. Komparácia právnych úprav jednotlivých štátov zatiaľ poukazuje na silnú „hodnotovú“ determináciu v regulácii asistovanej reprodukcie.

Spracovala: Zuzana Zoláková
Foto: echrblog.blogspot.com

 

Zdroje: Corriere della Sera, tlačová správa Európskeho súdu pre ľudské práva dostupná tu





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