The Principle of Dignity in Germany and Its Irradiating Effect with Regard to Biomedicine

Furkel, Francoise

doi:10.1007/978-3-319-99112-2_3

The Principle of Dignity in Germany and Its Irradiating Effect with Regard to Biomedicine

Francoise Furkel⁵

Chapter
First Online: 20 November 2018

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Part of the book series: Ius Gentium: Comparative Perspectives on Law and Justice ((IUSGENT,volume 71))

Abstract

In Germany, dignity features in the first article of the Fundamental Law and is held to be ‘intangible’, with an almost sacred-like quality. In biomedicine, the principle of dignity protects every person from being treated as an object. But dignity also protects an individual from herself, in particular by ensuring the integrity of the human body and preventing all forms of commercialisation. Influenced by Kantian philosophy, the principle of dignity is ever-present in today’s Germany, where the greatest respect is given to every person.

Main German abbreviations used: AG = Amtsgericht/District Court; BGB = Bürgerliches Gesetzbuch/Civil Code; BGBl. = Bundesgesetzblatt/Federal Official Journal; BGH = Bundesgerichtshof/Federal Court of Justice; BGHZ = Entscheidungen des Bundesgerichtshofes in Zivilsachen/Bulletin of decisions of the Federal Court of Justice in civil cases; BSG = Bundessozialgericht/Social Federal Court; BVerfG = Bundesverfassungsgericht/Federal Constitutional Court; BVerfGE = Entscheidungen des Bundesverfassungsgerichts/Decisions of the Federal Constitutional Court; FamRZ = Zeitschrift für das gesamte Familienrecht (periodical); JZ = Juristenzeitung (periodical); KG = Kammergericht/Higher Regional Court of Berlin; LG = Landgericht/Regional Court; LSG = Landessozialgericht/Regional Social Court; NJW = Neue Juristische Wochenschrift (periodical); NVwZ = Neue Zeitschrift für Verwaltungsrecht (periodical); OLG = Oberlandesgericht/Superior Regional Court; OVG = Oberverwaltungsgericht/Administrative Court of Appeal; RGZ = Entscheidungen des Reichsgericht in Zivilsachen/Bulletin of decisions of the Supreme Civil Court; StGB = Strafgesetzbuch/Criminal Code; VG = Verwaltungsgericht/Regional Administrative Court; ZfL = Zeitschrift für Lebensrecht (periodical).

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Notes

1.
Conference entitled “Diversity, partnership, respect”, announced during a special session devoted to human dignity on the occasion of the 60th anniversary of the Organisation (press release no. 2005-113).
2.
G. Dürig, “Der Grundrechtssatz von der Menschenwürde”, in Archiv des öffentlichen Rechts, 1956, vol. 81, p. 125 et seq.
3.
In particular P.H. Kunig, “Art. 1, Würde des Menschen, Grundrechtsbindung”, in Münch/Kunig, Grundgesetz- Kommentar, Beck, 2012, p. 57 et seq.
4.
See in particular H-J. Sandkühler, “La dignité humaine et la transformation des droits moraux en droits positifs”, in J. Poulain and H-J. Sandkühler, La dignité humaine, Perspectives transculturelles, P. Lang, 2009, p. 3 et seq.
5.
E. Kant, Fondements de la métaphysique des moeurs, 1785, traduction V. Delbos, éd. électronique, http://perso.club-internet.fr/folliot.philippe/fondem.htm, 2006, p. 39.
6.
The Basic Law, the model for a number of countries in the immediate post-war era, has remained the German Constitution since 23 May 1949. Initially the Constitution of West Germany, it became that of the entire country after the reunification of 3 October 1990.
7.
G. Dürig, “Der Grundrechtssatz von der Menschenwürde”, op. cit., p. 127.
8.
The qualifier is strong and is only used once in the Basic Law. This echoes the preamble of the Universal Declaration of Human Rights of 1948.
9.
Art. 1 subpara. 3 of the Basic Law (BL). For a detailed analysis of the meaning and legal impact of the fundamental rights, in French, see CH. Autexier, Introduction au droit public allemand, PUF, Coll. Droit fondamental, 1997, p. 116 et seq.
10.
It is effectively a dualistic conception of the relationships between international law and domestic law that prevails in Germany. For more details on this conception, see Cl. Witz, Le droit allemand, Coll. Connaissance du droit, Dalloz, 2013, p. 32 et seq.
11.
Although the European Convention on Human Rights makes no mention of dignity, its case law has fully incorporated the principle of dignity. See in this book, J.P. Marguenaud, p. 141.
12.
G. Dürig, “Der Grundrechtssatz von der Menschenwürde”, op. cit., p. 127 et seq.
13.
PH. Kunig, “Art. 1, Würde des Menschen, Grundrechtsbindung”, op. cit., p. 85.
14.
§ 211 StGB.
15.
Art. 102 LF.
16.
See in particular a much discussed decision of the Federal Constitutional Court of 31 March 1987, BVerGE 75, 1.
17.
See below.
18.
BVerfG, 21 June 1977, BVerfGE 45,187; See also BVerfG, 24 April 1986, BVerfGE 72, 105. A new text in this sense (§ 57 a StGB) has been adopted. Germany currently has a statutory life sentence, and a period of at least fifteen years’ imprisonment must be served before any release.
19.
BVerfG, 27 February and 13 March 2002, 2 BvR 553/01 and 2 BvR 261/01.
20.
§ 1 subpara. 1 Sozialgesetzbuch I.
21.
BSG, 23 November 2006, B11b AS 1/06R; for the provision of accommodation for the homeless, OVG Munster, 4 March 1992, NVwZ 1993, p. 202.
22.
BVerfG, 09 February 2010, BVerfGE 125, 175.
23.
For further details, see C. Fercot, “The parameters of the right to a minimum subsistence in line with human dignity: concerning the decision” “Hartz IV of the Federal Constitutional Court of 9 February 2010”, Review of health and social law, 2010, p. 653 et seq.
24.
More recently, the Federal Constitutional Court reaffirmed the absolute nature of the right to a guarantee of minimum subsistence conditions, ruling that “the right to respect for human dignity cannot be dependent on immigration policy considerations” (BVerfG, 23 July 2014, FamRZ 2014, p. 1765 et seq.).
25.
Deutsche Bischofskonferenz, Pressemeldung 18/07/12, no. 113.
26.
See above, concerning the prohibition of extradition to some countries.
27.
Covered in article 2, subpara. 2 LF.
28.
Luftsicherheitsgesetz, 11 January 2005, BGBl. 2005, I, 78 et seq.
29.
§ 14 subpara. 3 Luftsicherheitsgesetz.
30.
BVerfG, 15 February 2006, BVerfGE 115, 118.
31.
See, among others, concerning telephone tapping, BVerfG, 3 March 2004, 1 BvR 2378/98; with regard to a Benetton advert deemed to be a violation of dignity, BGH, 6 Dec. 2001, NJW 2002, p. 1200 et seq.
32.
See in particular R. Andorno in “Is the notion of human dignity superfluous in bioethics?” Revue générale de droit médical, 2005, p. 95 et seq.
33.
In French, M. Fromont, “L’autonomie de la volonté et les droits fondamentaux en droit privé allemand” in Études à la mémoire du Professeur Alfred Rieg, Bruylant. 2000, p. 339.
34.
Gesetz zum Schutz von Embryonen (Embryonenschutzgesetz), 13 December 1990, BGBl.1990, I, 2746 et seq. (See the French translation in the Revue Ethique, La vie en question, no. 1, Paris, 1991, p. 101 et seq.).
35.
In fact, two articles of the law seemed to prohibit this practice: § 2, subpara. 1 of this text, which sanctions any use of a human embryo for a purpose other than that of saving its life, and § 8, subpara. 1, according to which the removal of totipotent cells for analysis appears to be implicitly proscribed.
36.
See in particular R. Andorno, “Le diagnostic pré-implantatoire dans les législations des pays européens: sommes- nous sur une pente glissante?” in Bioethica Forum, vol. 1, no. 2, 2008.
37.
Still under the influence of the past, Germans always seem to find it difficult to distinguish between totalitarian eugenics and humanist eugenics.
38.
On the position of the Catholic Church with regard to PGD, see Stellungnahme der Deutschen Bischofskonferenz zur Präimplantationsdiagnostik, Pressemitteilungen der Deutschen Bischofskonferenz, 2011.
39.
On this subject, see U. Scheffer, “Zur Zukunft des Präimplantationsdiagnostik in Deutschland”, ZfL 2011, p. 9 et seq.
40.
Stellungnahme der Evangelischen Kirche in Deutschland zum Präimplantationsdiagnostikverordnung, 2012.
41.
Abschlussbericht der Enquête-Kommission “Recht und Ethik der modernen Medizin”, 14 May 2002, Bundestagsdrucksache 14/9020.
42.
On ART see the position of the National Ethics Council, in Deutscher Ethikrat, Präimplantationsdiagnostik, Stellungnahme, 2011.
43.
Präimplantationsdiagnostikgesetz, 21 November 2011, BGBl, 2011, I, 2228 et seq.
44.
Embryonenschutzgesetz, 13 December 1990, referred to above.
45.
Thus named on account of its President, Ernst Benda, former president of the Federal Constitutional Court; See in French, Rapport Benda, 1985, Fécondation in vitro, analyse du génome et thérapie génique, La Documentation française, 1987.
46.
Verhandlungen des 56. Deutschen Juristentages, Gutachten A, Beck, 1986, p. 34. See also Keller, Günther, Kaiser, Embryonenschutzgesetz, Kohlhammer, 1992, p. 179, 180, 194. For the Churches, see in particular “Stellungnahme der Evangelischen Kirche Deutschland zum Entwurf des Stammzellengesetzes”, Berlin, 8 March 2002.
47.
See the law on stem cells (Stammzellengesetz), 28 June 2002, BGBl. 2002, I, 2277 et eq., amended in 2008, BGBl.2008, I, 1708 et seq.
48.
Practice made possible by a gap in the Law on the protection of embryos of 1990, referred to above.
49.
Judgment O. Brüstle/Greenpeace, 18 Oct. 2011, C-34/10.
50.
Begründung zu § 6 RegEntw Embryonenschutzgesetz.
51.
“Klonen zu Fortpflanzungszwecken und Klonen zu biomedizinischen Forschungszwecken”, Stellungnahme 2004, p. 42 and 65.
52.
Max-Planck-Gesellschaft zur Förderung der Wissenschaften - Arbeitskreis Ethische und rechtliche Fragen der Humangenetik.
53.
Abschlußbericht der Bund/Länder -Arbeitsgruppe “Fortpflanzungsmedizin”, referred to above.
54.
See in particular the directives of the German Federal Medical Association concerning genetics (Richtlinien der Bundesärztekammer zur Gentherapie beim Menschen), 1989, Deutsches Ärzteblatt, 1989, vol. no. 41, A-2957 et seq.
55.
Rapport Benda, see above. It will be seen that the last three practices referred to, like all forms of cloning, are now prohibited by the law on the protection of embryos of 1990 (Embryonenschutzgesetz).
56.
Among others, the aforementioned directives of the Federal Medical Association concerning genetics (Richtlinien der Bundesärztekammer zur Gentherapie beim Menschen), op. cit.; also with regard to research on embryos, Richtlinien zur Forschung an frühen menschlichen Embryonen, December 1985, Deutsches Ärzteblatt, 1985, vol. no. 50, A-3757 et seq.; more recently for PGD, (Muster-) Richtlinie zur Durchführung der assistierten Reproduktion, February 2014, Deutsches Ärzteblatt, 2014, vol. no. 13, A-554 et seq.
57.
BVerfG, 11 January 2011, BVerfGE 128, 109.
58.
Law on transsexuals (Transsexuellengesetz), 10 September 1980, BGBl.1980, I, 1654 et seq., amended on 17 July 2009, BGBl.2009, I, 1978 et seq.
59.
Covered in article 2, subpara. 1 LF.
60.
BGH, 25 May 1954, BGHZ, 13, 334 et seq.
61.
BVerfG, 31 January 1989, BVerfGE 79, 256.
62.
On this important ruling, see, D. Giesen, “Genetische Abstammung und Recht” JZ 1989, p. 368 et seq.; also, in French, M. Fromont, “République fédérale d’Allemagne – La jurisprudence constitutionnelle en 1988 et 1989”, Rev. dr. publ. et sc. po. en France et à l’étranger, 1992, p. 1048 et seq.
63.
See above.
64.
Benda Report, 1985, op. cit., 2.2.1.1.2.
65.
Final report of the joint working group of the Federation and the Länder on assisted reproductive technologies (Abschlußbericht der Bund/Länder-Arbeitsgruppe “Fortpflanzungsmedizin”, Bundesanzeiger, 6 January 1989).
66.
OLG Hamm, 6 February 2013, Az I-14U7/12.
67.
BGH, 28 January 2015, XII ZR 201/13.
68.
LG Passau, 26 Nov. 1987, NJW 1988, p. 144 et seq. See also BVerfG, 18 January 1988, FamRZ 1989, 147 et seq.
69.
While this current case law is essential in terms of the principles, the difficulties likely to arise in the case of a refusal by the mother to tell the child the name of the biological father have not been settled in practice!
70.
See above.
71.
BSG, 15 April 1997, 1 RK25/95.
72.
See the law of 18 June 2009 (Patientenverfügungsgesetz), now integrated in the BGB.
73.
Although a subtle distinction is sometimes established between the terms “autonomy” and “self-determination”, these terms are used as synonyms here.
74.
F. Furkel, “Adolescent and medical treatment in the Federal Republic of Germany. A growing autonomy despite the regrettable silence of the legislator” in Adolescent, Autonomy and Medical Treatment, B. Feuillet-Liger, R. Ida and T. Callus (eds.), Bruylant, 2012, p. 57.
75.
See above.
76.
E. Kant, Fondements de la métaphysique des mœurs, Paris, Delagrave, 1982, p. 42.
77.
See above.
78.
On sterilisation, see Laufs, Katzenmeier, Lipp, Arztrecht, Beck, 2009, p. 225.
79.
Embryonenschutzgesetz, 13 Dec. 1990, referred to above.
80.
§ 1 subpara. 1, no. 7 Embryonenschutzgesetz. In this condemnation, the legislature is targeting both the woman carrying her genetic child and the woman carrying a foreign embryo. The criterion for GS is the agreement given by the carrying mother prior to the birth of the child to hand the child mover to a third party individual or couple.
81.
V.D. Coester-Waltjen, “Rechtliche Probleme der für andere übernommenen Mutterschaft”, NJW 1982, p. 2528 et seq.
82.
See above.
83.
See above.
84.
Fifth Act reforming criminal law, 18 June (Fünftes Gesetz zur Reform des Strafrechts, BGBl.1974, I, 1297 et seq.).
85.
BVerfG, 25 February 1975, BVerfGE 39, 1.
86.
For more details on the history of abortion in Germany, see Deutsch, Spickhoff, Medizinrecht, Springer, 2014, p. 691 et seq.
87.
Law of 27 July 1992 on aid to pregnant women and families (Das Schwangeren- und Familienhilfegesetz, BGBl.1992, I, 1398 et seq.).
88.
BVerfG, 28 May 1993, BVerfGE 1988, 203.
89.
BVerfG, 25 February 1975, referred to above.
90.
In this ruling, the judges asserted that the consultation the pregnant woman had to agree to before the abortion was not designed to adequately protect the embryo.
91.
Art. 79 LF. For more details, see in French M. Fromont, “R.F.A.: jurisprudence constitutionnelle”, RDP 1995, p. 324 et seq.
92.
Moreover, it is an affirmation expressly made in the aforementioned decision of 28 May 1993. On this subject, see A. Löhmer, “Unterlassungstäterschaft, Garantenstellung und Nothilferecht beim Schwangerschaftsabbruch”, ZfL 2011, p. 38 et seq.
93.
See Deutsch, Spickhoff, Medizinrecht, op. cit, p. 692.
94.
In this regard, let us refer to the Medicines Act of 24 August 1976 (Arzneimittelgesetz, BGBl.1976, I, 2445 et seq.) which, in articles 40 and 41, ensures the protection of human dignity in experimentation on drugs and medicines.
95.
See the Act on the removal and transplantation of organs (Transplantationsgesetz), 5 Nov. 1997, BGBl.1997, I, 2631 et seq. This Act was amended on 4 Sept. 2007, BGBl.2007, I, 2206 et seq.
96.
“Medizinischer Forschritt auf wessen Kosten”, Jahrestagung, 2013, p. 23 et seq.
97.
See the well-known Mephisto case, BVerfG, 24 Feb. 1971, BVerfGE 30, 173.
98.
On these prohibitions and their motivation on the basis of dignity, see B. schmidt Am Busch, “Postmortaler Würdeschutz und gesetzgeberische Gestaltungsfreiheit”, Der Staat 2010, vol. 49, no. 2, p. 211 et seq.
99.
See, among others, OVG Rheinland-Pfalz, 4 Feb. 2010, 7 A 11390/09; BVerfG, 28 Feb. 1979, BVerfGE 50, 256.
100.
These bodies are preserved by the plastination technique, developed by Professor Gunther Von Hagens.
101.
Particularly VG Augsburg, 4 September 2009, Az.Au 7 S o9.1266; VG Berlin, 26 May 2010, Az.21 k 48.10. Contra: VG Berlin, 10 Feb. 2015, 21 L 29.15.
102.
On this principle, see in French M. Fromont, “Le principe de proportionnalité”, AJDA 1995, p. 156 et seq.
103.
BGH, 29 October 2014, Az. XII ZB 20/14.
104.
The term euthanasia remains taboo in Germany due to the atrocities committed during the National Socialist period.
105.
The paragraph 217 of the Penal Code sentences to prison anyone helping a patient to die on professional and/or commercial basis. Physicians can be sentenced to prison if they help a patient to die while previously they were only risking to lose their license to practice.
106.
J. Taupitz, “Empfehlen sich zivilrechtliche Regelungen zur Absicherung der Patientenautonomie am Ende des Lebens?”, in Gutachten A zum 63. Deutschen Juristentag, Beck, 2000, A 32.
107.
AG Siegen, 28 Sept. 2007, 33XVII B710.
108.
§ 216 StGB. Suicide or attempted suicide, on the other hand, are not subject to any criminal sanctions.
109.
For the Protestant Church, in 2014: http://www.ekd.de/aktuellpresse/news201405092jungsterbehilfe.html; for the Catholic Church, see the Conference of German Bishops: http://www.spiegel.de/panorama/gesellschaft/katolische-kirche-bischoefe-fordern-verbot-organisierter-sterbehilfe-a-945804.html.
110.
It must be noted that the principle of dignity is often used for totally different purposes in this regard. Indeed, it is not uncommon for this principle to be invoked to make it possible for the patient to “die with dignity”.
111.
See above.
112.
Art. 21. It should be noted that Germany has not yet signed the 1997 European Convention on Biomedicine, considering it too lax on certain points.
113.
Art. 3 subpara. 2. Certainly, the Charter has no mandatory value in Germany; it nevertheless has a broad influence on German law. On the other international texts establishing the prohibition of the commercialisation of the body, see J. Taupitz, Kommerzialisierung des menschlichen Körpers, Springer, 2007, p. 2.
114.
§ 138 BGB.
115.
Reichsgericht, 9 February 1928, RGZ, 120, p. 148. On this concept of public morals, see, in French, F. Ferrand, Droit privé allemand, Précis Dalloz, Dalloz, 1997, p. 249.
116.
See above.
117.
See the aforementioned Act on the removal and transplantation of organs (Transplantationsgesetz), 5 Nov. 1997.
118.
BSG, 15 April 1997, referred to above.
119.
§ 17 Transplantationsgesetz, 5 Nov. 1997, referred to above.
120.
Amtliche Begründung zum Transplantationsgesetz, 16 April 1996, Bundestags-Drucksache 13/4355.
121.
Among others, LSG Niedersachsen, 30 August 1985, L 4 Kr 256/95.
122.
See above.
123.
Embryonenschutzgesetz, 13 Dec. 1990, referred to above.
124.
OLG Hamm, 2 Dec. 1985, NJW 1986, 781.
125.
KG, 1 August 2013, 1 W 413/12.
126.
See, again recently, KG, 8 Nov. 2013, 5 U 143/11.
127.
It should however be emphasised that while sperm donations are not prohibited, they are only very reluctantly allowed in Germany, as has been frequently pointed out.
128.
Calling into question the principle of the non-commercialisation of the body appears to be unjustified in this case. As with breast milk that can be purchased on the Internet, blood effectively becomes an object without the integrity of the subject being actually violated.
129.
O. Jouanjan, “The dignity of the human person in the case law of the Karlsruhe Constitutional Court”, speech at the 7th conference-debate of the Centre of Comparative and Public Law at the Université Panthéon-Assas Paris II, 30 October 2014: Revue générale du droit on line, 2014, no. 18315.
130.
BVerfG, 20 October 1992, BVerfGE 87, 209.

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Francoise Furkel

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Brigitte Feuillet-Liger
Columbia University, New York, USA
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Furkel, F. (2018). The Principle of Dignity in Germany and Its Irradiating Effect with Regard to Biomedicine. In: Feuillet-Liger, B., Orfali, K. (eds) The Reality of Human Dignity in Law and Bioethics. Ius Gentium: Comparative Perspectives on Law and Justice, vol 71. Springer, Cham. https://doi.org/10.1007/978-3-319-99112-2_3

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