PRÍPAD COSTA A PAVAN V. TALIANSKO | Medicínske právo
              

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PRÍPAD COSTA A PAVAN V. TALIANSKO


 | 11.2.2014 | komentárov: 382

Sťažnosť č. 54270/10, Rozhodnutie, Štrasburg 28. august 2012, Prípad Costa a Pavan v. Taliansko rozhodovala Druhá sekcia (Komora) Európskeho súdu pre ľudské práva v zložení: F. Tulkens - predseda, sudcovia: D. Popović, I. Bello-Lefèvre, A. Sajó, G. Raimondi, P. Pinto de Albuquerque, H. Keller, zastupujúci sudcovia: D. Jočienè, I. Karakaş a F. Elens-Passos - zapisovateľ sekcie. Prípad bol prejednaný na neverejnom zasadnutí 10. júla 2012, rozhodnutie bolo prijaté 28. augusta 2012. Rozsudok sa zakladá na sťažnosti č. 54270/10, ktorá bola podaná proti Talianskej republike v súlade s článkom 34 Európskeho dohovoru o ochrane ľudských práv a základných slobôd (ďalej len Dohovor), dvoma štátnymi príslušníkmi Talianska, pani Rosettou Costa (ďalej len sťažovateľka) a pánom Walterom Pavanom (ďalej len sťažovateľ), 20. septembra 2010. Sťažovatelia sú zdravými nositeľmi genetickej choroby, cystická fibróza. Vo svojej sťažnosti namietali nemožnosť prístupu k predimplantačnej genetickej diagnostike (PGD), a teda výberu embrya, ktoré nie je postihnuté týmto genetickým ochorením. Manželia sa opierali o článok 8 Dohovoru, ktorý im garantuje právo na rešpektovanie súkromného a rodinného života, ako aj o článok 14 Dohovoru, podľa ktorého majú právo na nediskrimináciu.

Obrazok

OKOLNOSTI PRÍPADU

Sťažovatelia sa narodili jednotlivo v rokoch 1977 a 1975, a žijú v Ríme. Po narodení ich prvorodenej dcéry v roku 2006 zistili, že sú zdravými nositeľmi cystickej fibrózy a ich dieťa sa narodilo s týmto genetickým ochorením. Počas druhého tehotenstva, vo februári 2010, podstúpila sťažovateľka prenatálny screening, ktorý potvrdil, že plod (fetus) trpí cystickou fibrózou. Sťažovatelia sa preto rozhodli pre umelé prerušenie tehotenstva.

V úmysle vyhnúť sa ďalšiemu prenosu genetického ochorenia sa manželia rozhodli využiť technológie asistovanej reprodukcie (ďalej len ART) a taktiež predimplantačnú genetickú diagnostiku, ktorou sa identifikujú genetické abnormality embryí počatých pri oplodnení in vitro (IVF), ktorú však taliansky zákon č. 40/2004 zakazuje a súčasne obmedzuje prístup k ART len pre sterilné a infertilné páry, teda páry, ktoré trpia neplodnosťou alebo dvojice, v ktorých partner trpí sexuálne prenosnou chorobou (AIDS, hepatitída B a C).

PRÍSLUŠNÉ VNÚTROŠTÁTNE PRÁVO

1. Zákon č. 40/2004 o asistovanej reprodukcii

Článok 4(1) zákona o asistovanej reprodukcii stanovuje: „Prístup k možnostiam ART môže byť schválený, iba ak existuje dôkaz o nemožnosti odstránenia prekážok počatia a mal by byť obmedzený na prípady lekársky overenej sterility alebo infertility.“  

2. Rozhodnutie č. 12474/09 Súdu v Salerne, 13. januára 2010

V danom rozhodnutí súd v Salerne prvý krát schválil podstúpenie predimplantačnej genetickej diagnostiky (PGD) dvojici, ktorá bola zdravým nositeľom dedičnej svalovej atrofie. Sudca vyhlásil, že by bolo nezmyselné odobrať matke právo na zistenie stavu embrya metódami PGD, ak požíva právo na prerušenie tehotenstva z dôvodu nezdravého plodu.

PRÍSLUŠNÉ EURÓPSKE PRÁVO

1. Dohovor o ľudských právach a biomedicíne, Oviedo (4. apríl 1997) - nebol ratifikovaný talianskou vládou.

Článok 12 - Prediktívne genetické testy: „Skríningové testy genetických chorôb alebo také, ktoré slúžia na identifikáciu nosičov génu recesívnej choroby alebo detekciu predispozície, alebo náchylnosti k chorobe, možno vykonať výhradne na zdravotné účely a vedecký výskum s nimi spojený, pričom ho musí sprevádzať primerané genetické poradenstvo.“

2. „Predimplantačná genetická diagnostika v Európe“ - správa vypracovaná JRC (Joint Research Centre), ktoré je referenčným centrom Európskej Únie pre vedu a techniku, publikovaná v decembri 2007.

Správa poukazuje nato, že mnoho pacientov odchádza za účelom podstúpiť PGD do krajín, v ktorých to nie je zakázané. Talianski pacienti spravidla chodia do Španielska, Belgicka, Čiech alebo na Slovensko. Štúdia ďalej zdôrazňuje nejednotnosť legislatívnej úpravy, ktorá zamedzuje prístup k PGD, avšak povoľuje prenatálnu diagnostiku a prerušenie tehotenstva za účelom predchádzania vážnym genetickým chorobám u detí.  

3. Právna komparatistika

Predimplantačná diagnostika je schválená v týchto krajinách: Nemecko, Belgicko, Dánsko, Španielsko, Fínsko, Francúzsko, Gruzínsko, Grécko, Nórsko, Holandsko, Portugalsko, Česká republika, Spojené kráľovstvo, Rusko, Srbsko, Slovinsko a Švédsko. V Slovenskej republike nie je PGD špecificky upravená.

PGD je zakázaná v troch členských štátoch Rady Európy a síce v Rakúsku, Švajčiarsku a Taliansku.

PRÁVO

Konštatované porušenie článku 8 Dohovoru


Sťažovatelia vo svojej sťažnosti namietajú porušenie práva na rešpektovanie ich súkromného a rodinného života garantovaného článkom 8 Dohovoru. Podľa spomenutého článku, štátny orgán nemôže do výkonu tohto práva zasahovať okrem prípadov, keď je to v súlade so zákonom a nevyhnutné v demokratickej spoločnosti v záujme národnej bezpečnosti, verejnej bezpečnosti, hospodárskeho blahobytu krajiny, predchádzania nepokojom a zločinnosti, ochrany zdravia alebo morálky alebo ochrany práv a slobôd iných, podľa §2 článku 8 Dohovoru.

Manželia namietali porušenie vyššie spomenutého práva v tom, že ich jedinou možnosťou ako priviesť na svet dieťa, ktoré netrpí genetickým ochorením, je počať ho prirodzeným spôsobom a tehotenstvo umelo prerušiť, v momente, keď prenatálny screening preukáže ochorenie plodu.

Vládny návrh

Talianska vláda zaznamenala, že sťažovatelia sa v podstate opierali o „právo mať zdravé dieťa“, ktoré nie je Dohovorom garantované, a preto namietala neprijateľnosť ich sťažnosti. Vláda ďalej skonštatovala, že rovnako ani článok 8 Dohovoru zaručujúci právo na rešpektovanie súkromného a rodinného života, nie je aplikovateľný na tento prípad.

Vláda sa domnievala, že toto právo nebolo porušené zákazom predimplantačnej diagnostiky, nakoľko takéto opatrenie bolo v súlade s právom a nevyhnutné v demokratickej spoločnosti na zabezpečenie ochrany zdravia dieťaťa aj matky, a taktiež na ochranu dôstojnosti a slobody svedomia zdravotníckych pracovníkov.  

Z dôvodu absencie konsenzu v danej oblasti v rámci Európy, mali štáty široký priestor na uváženie tejto spornej otázky.

Návrh sťažovateľov

Sťažovatelia skonštatovali, že „právo na rešpektovanie rozhodnutia stať či nestať sa rodičom“, predovšetkým v zmysle genetiky, spadalo pod ich právo na rešpektovanie súkromného a rodinného života. V tejto súvislosti by sa štát mal zdržať akýchkoľvek zásahov do rozhodovania jednotlivcov v otázke plodenia detí.

ROZHODNUTIE SÚDU

Účel sťažnosti a jej kompatibilita s právami garantovanými článkom 8 Dohovoru


Podľa názoru Súdu, je „súkromný život“ veľmi širokým pojmom, do ktorého okrem iného spadá právo na rozvoj vzťahov s ostatnými, právo na osobnú autonómiu, osobný rozvoj, ako aj právo rozhodnúť sa, či sa stať či nestať rodičom. V súlade s článkom 8 Dohovoru, Súd ďalej priznáva jednotlivcom právo na rešpektovanie rozhodnutia stať sa biologickým rodičom (pozri prípad Dickson v. Spojené kráľovstvo) a usúdil, že článok 8 sa uplatňuje aj na heterológnu insemináciu pri oplodnení in vitro (pozri prípad S.H. a ostatní v. Rakúsko). Súd má zato, že túžba sťažovateľov priviesť na svet dieťa, ktoré nebude trpieť genetickým ochorením, ktorého nositeľmi sú jeho rodičia  a využiť za týmto účelom metódy ART a PGD, podlieha ustanoveniam článku 8 Dohovoru.   

Súlad s článkom 8 Dohovoru

Súd skonštatoval, že v súlade s talianskym právom je asistovaná reprodukcia dostupná len pre páry, ktoré trpia neplodnosťou alebo párom, v ktorých je partner nositeľom sexuálne prenosného ochorenia (AIDS, hepatitída B a C). Keďže sťažovatelia nespadajú do žiadnej z týchto kategórií, je im prístup k ART znemožnený. Súd ďalej poznamenal, že talianska legislatíva je v tejto oblasti nejednoznačná a na jednej strane zakazuje limitovať implantáciu na „zdravé“ embryá, kým na druhej strane povoľuje sťažovateľom podstúpiť umelé prerušenie tehotenstva v prípade plodu postihnutého ochorením.

Dôsledky tejto nejednotnosti v legislatíve sú zrejmé. Za účelom ochrany svojho práva priviesť na svet dieťa, ktoré nebude trpieť genetickým ochorením, ktorého sú obaja sťažovatelia zdravými nositeľmi, zostáva sťažovateľom len jediná možnosť, a to počať dieťa prirodzeným spôsobom, a potom tehotenstvo umelo prerušiť v prípade výskytu ochorenia u plodu.    

S ohľadom na už spomenutú nejednoznačnosť talianskej právnej úpravy v tejto oblasti, Súd usúdil, že došlo k neprimeranému zásahu do práva sťažovateľov na rešpektovanie ich súkromného a rodinného života, a teda k porušeniu článku 8 Dohovoru.

Pre vyššie uvedené dôvody, Súd, jednomyseľne,

Rozhodol , že došlo k porušeniu článku 8 Dohovoru.


Spracovala: Simona Beňová
Foto: archív Z.N.



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