# Potpomognuta oplodnja > Potpomognuta oplodnja > Zakoni o medicinski potpomognutoj oplodnji (MPO) >  profesor prava o restrikcijama u europskim MPO zakonima

## pino

Članak profesora prava iz New Yorka - koji fenomen traženja inozemne pomoći kod prokreacije proglašava problemom koji sigurno ne doprinosi moralnom i političkom pluralizmu u demokratskim državama. 

http/humrep.oxfordjournals.org/content/early/2010/10/12/humrep.deq270.full

Sažetak:


> Zabrana općeprihvaćenih oblika MPO otežava put parovima koji žele ostvariti svoje reproduktivne ciljeve medicinskom pomoći. Jedna posljedica restriktivnih MPO zakona koju su mnogi zapazili je putovanje na liječenje u inozemstvo. U Europi, takvo putovanje je dozvoljeno politikom slobodnog kretanja koja je temelj demokratske i ekonomske stabilnosti u Europskoj zajednici. Putovanje u inozemstvo u reproduktivne svrhe ne podržava moralni i politički pluralizam u demokratskim državama zbog tri važnih razloga. 
> 
> Prvo, mogućnost pacijenata da idu u inozemstvo na liječenje oslabljuje organizirani otpor zakonu i omogućava vladi da donese veća ograničenja nego bi to inače bilo moguće. 
> 
> Drugo, pokazalo se da MPO izvan granica ima štetne vanteritorijalne posljedice koje se protive dane razloge za restriktivne reproduktivne zakone. 
> 
> Treće, zakoni koji izazivaju potražnju za MPO izvan granica često NE zadovoljavaju standard proporcionalnosti koji restrikcije na MPO moraju zadovoljavati.


Zaključak:



> Potražnja za MPO izvan granica može također značiti da restriktivni MPO zakoni ne zadovoljavaju standard proporcionalnosti. U stvarima velike ljudske važnosti, kao zasnivanje obitelji, demokracije ograničavaju moć većinskog stava o općem dobru da prevagne iznad svega ostalog. Umjesto toga, poštovanje i tolerancija za drugačija uvjerenja o privatnim stvarima su uobičajene i često zacementiranje u okvirima koji postavljaju granice vlade/države. U područjima tako važnim i osjetljivima kao što je ljudska prokreacija nije dovoljno da restriktivni zakon prođe test minimalne racionalnosti. Potrebno je više od toga da većinski ne bi ugušila manjinske, možda manje popularne, osjećaje o obiteljskom životu.


Postirat ću i dijelove njegovog članka, koji je odličan i informativan, iako se većinom odnosi na problem zabranjivanja donorskih postupaka u nekim zemljama.

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## ina33

Potiraj dijelove i na engl, ne kužim kako to tražiti, a kroz prijevod (vjerojatno i kroz orig. tekst) teško se probijati kroz konstrukcije i pojmove - meni je teško razumljivo - što je ta proporcionalnost itd.

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## aenea

> _U područjima tako važnim i osjetljivima kao što je ljudska prokreacija nije dovoljno da restriktivni zakon prođe test minimalne racionalnosti._


Mda. Naš ni to ne bi prošao.  :Rolling Eyes:

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## pino

proporcionalnost je pojam da zabrana mora biti proporcionalna steti koja se ocekuje ako zabrane ne bude

u ovom slucaju zabrana je zabrana zamrzavanja zametaka
ta stvarno ne prolazi test ni racionalnosti ni proporcionalnosti

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## pino

Introduction
When countries enact restrictions on assisted reproduction as a
sincere expression of their convictions about the proper scope of
human reproduction, cross-border reproductive travel often ensues.
Since countries in a democratic system committed to the free movement
of persons can do little to restrict such movements, restrictive
legislation can appear meaningless, except in a very powerful symbolic
sense and except to the extent that individuals are prevented from
crossing borders because of their own financial circumstances.
Because of the easy access to cross-border reproductive travel, the
commitments of stakeholders taking part in debates about restrictions
on reproduction are affected. Since each side can be assured of attaining
its goals, there is little to be gained from either caution on the one
hand or resistance on the other. Those who desire a procedure are
apt to be less concerned about whether it becomes outlawed, at
least if they have the means to travel in order to acquire it. Those
who wish to prohibit the procedure may feel justified in assuming a
stricter position than they otherwise might, knowing that cross-border
reproductive care will temper resistance to the law.
The fear that cross-border reproductive care might result in harm,
either at home or abroad, is no longer a matter of mere speculation.
Emerging evidence shows that those who have obtained risky reproductive
services abroad and require extensive pre- and post-natal
care upon their return can place a strain on national health services
(McKelvey et al., 2009; Smith et al., 2010). The extent of the
harm posed to citizens in destination countries by cross-border
reproductive travel is also becoming increasingly understood (Merlet
and Se´ne´maud, 2010). In view of these developments, restrictive reproductive
laws that contribute to cross-border reproductive travel should
be more carefully scrutinized.When scrutinized under the microscope of
important democratic principles, the availability of cross-border reproductive
care proves inadequate for promoting or sustaining moral pluralism.
A better response to restrictive reproductive laws, impinging as
they do on matters of great human importance, is to require them to
exhibit a high degree of proportionality in the first instance.

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## pino

Moral and political pluralism in democratic states

Moral or value pluralism refers to the view that values that may conflict
with one another may nonetheless be equally correct (Galston, 2005).
Political pluralism is the belief that diverse voices are what give a
society a robust and salutary political life (Galston, 1999). *The multiplicity
of voices and perspectives on assisted reproduction poses a
challenge to a democratic state in deciding whether and how assisted
reproduction should be regulated. The state’s specific task is to find a
way to allow moral pluralism to flourish within a political system where
legislation tends to reflect the majority’s will. In doing so it must decide
what sorts of restrictions on individuals’ freedom to act according to
their value systems are permissible.*

Although the legislative function in a democracy operates according
to the principle of majority rule, *an ideal democratic process will strive
to acknowledge and accommodate differences of opinion through a
good faith negotiation between competing factions that leads to a collective
consensus about what best promotes the common good*
(Cohen, 1999). *The process works only if it is authentically participatory,
no one is forced to assimilate to anyone else’s position, and the
state is not itself biased in any one direction.* These ideal conditions
admittedly are difficult to achieve. In plural societies, consensus on
all issues tends to prove elusive (Elstub, 2006). To curb the harm
that can arise from majoritarianism, *democracies require legislation
at the very least to satisfy the test of rationality*. This limit, placed at
the extremes, allows legislatures a wide margin of appreciation to
take positions on policy as long as their actions are not arbitrary or
capricious (Ratner, 1978).

Most aspects of civic life fare quite well under this deferential legislative
standard. Others, such as human reproduction, are so fundamental
to human experience and evoke such deeply held and
diametrically opposed moral reactions that dispassionate dialogue
leading to mutual respect, tolerance and consensus is unlikely. *The
risk of overreaching by the majority is so pronounced in such cases
that mere rationality of legislation is not high enough of a standard
to satisfy the needs of a democratic society*. Instead, the standard is
raised to what is variously called a heightened level of rationality or
proportionality (Evans v. United Kingdom, 2007). Because of the fundamental
nature of the rights at issue in such cases, *the margin of
appreciation accorded the state is narrowed to what has been
described as ‘the only or the least intrusive means of achieving the
aim pursued’* (S.H. and Others v. Austria, 2010). Such a standard is
meant to counteract the potential for majoritarian sentiment on volatile
issues to smother the interests of the minority. In this way, democracy
respects autonomy in matters of great human importance and
strives to avoid the oppression of minority points of view.

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## pino

Assisted reproduction and the proportionality principle

The primary problem with restrictive reproductive laws that contribute
to cross-border reproductive travel is that they do not satisfy
important democratic standards defining the limits of legislative competence.
As a general matter, a legislature is free to enact laws that
regulate everyday life as long as those laws are rationally related to
achieving the legislature’s legitimate aims. Restrictions on procreative
choice, though, must satisfy the higher standard of proportionality.
Proportionality requires that the restriction align closely, albeit not
necessarily seamlessly, with the ends the restriction is intended to
achieve (Arai-Takahashi, 2002). This standard does not prevent a
state from codifying normative or ethical perspectives in its laws regulating
reproductive technology. But it does prevent a legislature from
imposing restrictions that have little or nothing to do with the achievement
of those normative goals.

The recent case of S.H. and Others v. Austria illustrates this point.
The European Court of Human Rights was asked to evaluate provisions
of Austria’s Artificial Procreation Act that banned egg donation
altogether and sperm donation for IVF. The court held that the
decision to use medically assisted reproduction to have a child fell
within the scope of the right to be free from state interference in
matters of private and family life. Even though Austria raised weighty
justifications for its restrictions, among them the exploitation of egg
providers and the risk that using third-party gamete donation for IVF
would lead to the discriminatory selection of traits, the court nonetheless
found the prohibitions disproportionate ‘unless . . . [they were] the
only means of effectively preventing serious repercussions’ (S.H. and
Others v. Austria, 2010). Since the government could count on
medical professionals, guided by their code of ethics, to safeguard
against and minimize the risks of harm from assisted reproduction, the
court admonished Austria to choose ‘the only or the least intrusive
means of achieving’ its aims. Although the court suggested throughout
its opinion that Austria was entitled to a wide margin of appreciation in
regulating assisted reproduction, its decision to permit Austria to elect
only the least intrusive means and justify them with ‘particularly persuasive’
arguments signals its establishment of proportionality as the
most appropriate standard for legislating in this context. Indeed,
toward the end of its opinion, the court stated plainly that ‘where a
particularly important facet of an individual’s existence or identity is
at stake, the margin allowed to the State will be restricted’.
Italy’s well-known restrictions on assisted reproduction, enacted in
2004, have also come under increased scrutiny by its own constitutional
court. Earlier this year, the Constitutional Court of Italy
struck down provisions in the Italian law mandating the production
of at most three embryos in any one IVF cycle and requiring the
immediate return of all embryos produced to the woman’s uterus.
The primary objection of the court was that, in purporting to
protect embryonic life, the law took no account of the medical fact
that ‘it is impossible to procreate without a certain degree of early
embryo loss’ (Benagiano and Gianaroli, 2010). A second objection
was that the law rendered clinical judgment practically irrelevant in
the treatment of patients despite the individualized circumstances
different patients invariably present. Like the European Court of
Human Rights in S.H., the Constitutional Court of Italy was unwilling
to defer to the legislature under a standard of rationality where a
less intrusive approach—the resort to medical judgment—was
available.

Other aspects of the Italian law may also fail the test of proportionality.
In outlawing all forms of heterologous reproduction, the legislature’s
stated goal was to reaffirm the heterosexual couple as the only
appropriate locus for family formation and to avert the dangers that
attend the introduction of third-party gametes into the reproductive
process, namely (i) the threat to a couple’s relationship of having children
not biologically related to both of them; (ii) the psychological
danger to a child who does not know the identity of and is not
raised by both of his biological parents; and (iii) injury to Italian
society at large due to increases in marital breakdown and
psychologically damaged children.

Ironically, it is cross-border reproductive care itself that calls into
question whether Italy’s ban on heterologous reproduction is adequately
proportional to the aims of the law. Via cross-border reproductive
travel, which admittedly cannot be outlawed if it takes place
within the European Union, all of the feared dangers to patients, children
and society become subject to importation into Italy when
patients return from abroad and give birth. Nonetheless, Italian legislators
have not moved to enact provisions to combat these dangers or
temper their ill effects. Despite the supposed importance of biological
ties, the law itself makes clear that a gamete provider has no parental
rights or obligations and that the commissioning couples are indisputably
the child’s parents. Despite the fragility of family bonds that are
thought to attend reproduction with third-party gametes, the law contains
no provision requiring the couple to adopt the child so as to solidify
those bonds. It fails even to make a symbolic gesture in favor of
the child’s right to know his biological parents. Absolutely no consequences
whatsoever attend the use of third-party gametes abroad;
indeed, life proceeds as normal upon the delivery of the child in Italy.

This slippage between the claimed harms and the law enacted to
address those harms is uncharacteristic of legislation that adheres to
the proportionality principle. Now that the European Court of
Human Rights has signaled its willingness to narrow the traditionally
wide margin of appreciation member states have enjoyed in regulating
assisted reproduction, Italy may be in a position to rethink provisions
of its law beyond those that its own constitutional court has declared
infirm.

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## drndalica

Ovaj tekst i argumenti su odlični i zahtjevaju određeni napor od strane onog tko čita da bi se 'probavili' i razumjeli u potpunosti.
Nažalost, te kapacitete nemaju oni koji o toj tematici odlučuju u Hrvatskoj (naši 'uvaženi' sabornici). Oni imaju 'svjetonadzor', i priproste pričice i argumente servirane sa oltara... tako je jednostavnije, ravnati se po 'uputama' iz knjige napisane prije 2000 god. :Mad:

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## ina33

Ovo bi eventualno moglo bit "meso" za pravnu argumentaciju. Slažem se s Drndalicom, iako je sad nešto jasnije za čitati kad se dobilo cijeli tekst, pročitala sam prvi i mogu reći da mi je jasno kako dostupnost usluga u okolini ruši entuzijazam za aktivizam u vlastitoj zemlji...

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