Human Dignity as a Fundamental Principle in Biomedicine: A Spanish Perspective

San Julián Puig, Verónica

doi:10.1007/978-3-319-99112-2_7

Verónica San Julián Puig⁵

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

492 Accesses
1 Citations

Abstract

Human dignity holds a key place in the Spanish legal system. The Constitution considers it as ‘the basis of public order and social peace’ and it is at the heart of all the rules and regulations of law, including biomedicine. As the cornerstone of our legal system, its role is to protect the individual in any intervention that affects him/her. Hence, human dignity is also the backbone of the right to healthcare. Despite the undisputed progress in biomedicine, there is a potential danger of commodifying the human being (either in medical research or in other practices). This is why dignity should serve to protect the rights of individuals, particularly, the most vulnerable people.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Chapter: USD 29.95; Price excludes VAT (USA)

eBook: USD 129.00; Price excludes VAT (USA)

Hardcover Book: USD 169.99; Price excludes VAT (USA)

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

1.
Article 10.1 of the Spanish Constitution (the first article of Part I, devoted to the fundamental rights and duties of citizens): “The dignity of the person and the inviolable rights inherent to the person, the free development of the personality, the respect for the law and for the rights of others are the foundation of political order and social peace.”
2.
It should be noted that the terminology used in Spain is somewhat vague with regard to legislation and doctrine. In addition to the two expressions mentioned above, there are a number of others: the “dignity of the human person”, “the dignity of the human being”, “the dignity of the individual”, and “the dignity of all members of the human family”. At the judicial level, both the Supreme Court and the Constitutional Court mostly use the terms “human dignity” and “dignity of the person”, terms which are also used as synonyms (DE LA CUESTA AGUADO, P.M., ‘Persona, dignidad y derecho penal’, in Homenaje al Dr. Marino Barbero Santos, In memoriam, Vol. I, Nieto Martín (Coordinator), Cuenca, 2001, pp. 211–212). This is why I will use both terms in this chapter.
3.
García García, C. (2003). El derecho a la intimidad y dignidad en la doctrina del Tribunal Constitucional. Murcia: University of Murcia, 55.
4.
Pascual Lagunas, E. (2009). Configuración jurídica de la dignidad humana en la jurisprudencia del Tribunal Constitucional. Barcelona: Bosch, 159.
5.
García Cuadrado, A. M. (2011). Principios de Derecho Constitucional. León: Eolas Ediciones, 521; y Serna Bermúdez, P. (1990). Positivismo conceptual y fundamentación de los derechos humanos. Pamplona: Eunsa, 149.
6.
Lucas Verdú, P. (1984). Estimativa y política constitucionales. Madrid: University of Madrid, 117.
7.
García Cuadrado, A. M. Principios de Derecho Constitucional, op. cit., 523.
8.
While human dignity is a key aspect in practically all ancient religious and humanist learning, its foundation varies. Human dignity is based on people’s status as children of God (Christianity), the faithful (Islam), living beings (Jainism, Buddhism), reason (Enlightenment) or the individual’s personal status as a human being (Confucianism). Marina, J. A. (2002). Dictamen sobre Dios. Barcelona: Anagrama, 221.
9.
There are two major traditions in this area: the Anglo-Saxon and the Continental inspired by Kant. Spain falls within the second category. Kant secularises the concept of dignity which, according to him, stems from the absolute autonomy of the human being, from being an end in oneself. According to this tradition, each individual has a dignity that is his alone and that consequently represents an asset to be protected. This dignity prohibits, in particular, the use of the person as a means to achieve other ends, Ayllón, J. (2003). Biotecnología dignidad humana en la jurisprudencia. In Biotecnología, derecho y dignidad humana, ed. N. Martínez Morán, 84 and following. Grenade: Comares.
10.
García Cuadrado, A. M. Principios de Derecho Constitucional, op. cit., 524.
11.
Constitutional Council judgment 215/1994, of July 14. Legal doctrine also maintains that the fundamental rights are concrete manifestations of human dignity. De La Cuesta Aguado, P. M. Persona, dignidad y derecho penal, op. cit., 214.
12.
González Pérez, J. (2011). La dignidad de la persona. Cizur Menor: Civitas, 26.
13.
“Regardless of how low humankind can fall or how serious its degradation may be, there remains a person with the dignity this status implies”. González Pérez, J. La dignidad de la persona, op. cit., 27.
14.
Article 1 of the UDHR: “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood”. In its Preamble, this Declaration states that: “the recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world”.
15.
Jacques Maritain (1882–1973) is a French philosopher, part of the personalism school of thought. Personalism places the emphasis on the person, it sees man as a relational, free and transcendent being with an intrinsic value that prevents him being converted into an object.
16.
Records of the UNESCO General Conference. Records of debates, 2nd session, Mexico, 1947, 57.
17.
Ayllón, J. Biotecnología dignidad humana en la jurisprudencia, op. cit., 83.
18.
Marina, J. A. Dictamen sobre Dios, op. cit., 221.
19.
Truyol Y Serra, A. (1977). Los derechos humanos: declaraciones y convenios internacionales. Madrid: Tecnos, 31.
20.
From its beginning, human dignity was at the heart of the construction of the European project. The 2007 Berlin Declaration, adopted on the occasion of the 50th anniversary of the Treaty of Rome, refers to it in Article 1: “In the European Union, we are turning our common ideals into reality: for us, the individual is paramount. His dignity is inviolable. His rights are inalienable”, Garitagoitia Eguía, J. R. (2009). Dignidad de la persona y derechos fundamentales en el proceso de constitucionalización de la Unión Europea. Madrid: Temas del Senado, 19 and s.
21.
They have all been ratified by Spain.
22.
International Covenant of December 19, 1966.
23.
International Covenant of December 19, 1966.
24.
The European Social Charter of October 18, 1961 constitutes the realisation, for Europe, of the provisions of the International Covenant on Economic, Social and Cultural Rights. Here, dignity is linked to a fair wage, a minimum working age to protect children in the labour sector, a guaranteed break for women after giving birth, etc.
25.
Helsinki Conference of August 01, 1975.
26.
Charter of Fundamental Rights of the European Union of 7 December 2000 (Chapter 1 on “Dignity”).
27.
The Declaration on the Promotion of Patients’ Rights in Europe (Amsterdam, March 28–30, 1994), put forward by the Regional Office for Europe of the World Health Organisation.
28.
Convention for the Protection of Human Rights and of the Dignity of the Human Being with regard to the Application of Biology and Medicine of April 04, 1997.
29.
This by means of “integration”, which is a legal technique making it possible to establish a legal rule in the event of a legislative gap. This will be done while taking into consideration general principles like that of dignity. González Pérez, J. La dignidad de la persona, op. cit., 113 and 118.
30.
García Cuadrado, A. M. Principios de Derecho Constitucional, op. cit., 526.
31.
De La Cuesta Aguado, P. M. Persona, dignidad y derecho penal, op. cit., 212.
32.
Ibid., 210. Case law does not allow claims based on dignity and does not base any decision exclusively on dignity. References to this concept are always made in tandem—they are always associated with a right curtailed or violated (dignity—autonomy, dignity—freedom of expression, dignity—privacy, dignity—equal treatment, etc.). Reference to dignity is ad abundantiam (Ibid., 212 and 213). As a principle, it cannot be directly backed up in criminal matters (Ibid., 227).
33.
Iñigo Corroza, E. et al., (2014). Iuspoenale. Universidad de Navarra, 38 and 44. Dignity is always referred to in relation to the person to be sentenced. If the sentence is subject to one of these three principles, it is justified and lawful; but as soon as it violates one of them, it becomes an abuse of power (Ibid., 45).
34.
De La Cuesta Aguado, P. M. Persona, dignidad y derecho penal, op. cit., 209.
35.
Wolter, J. (1995). Derechos humanos y protección de bienes jurídicos en un sistema europeo del Derecho penal. In Fundamentos de un sistema europeo del Derecho penal. Livre hommage à Claus Roxin, ed. S. Sánchez, translation by B. Lavilla, 40. Barcelona: Bosch.
36.
Illegal detention and kidnapping, threats and coercion, torture and violations of the moral integrity of the person.
37.
Sexual assault, abuse and harassment, the corruption of minors.
38.
Like slander and verbal abuse.
39.
González Pérez, J. La dignidad de la persona, op. cit., 138. Although this may not be the basis of this aggravating circumstance for all offenders.
40.
Article 22, 4 of the Criminal Code of 1995.
41.
When it imposes a criminal sanction on inhuman treatment inflicted on an enemy who has surrendered or has no means of defence.
42.
Articles 69, 70 and 76 respectively of the Military Criminal Code of 1985.
43.
Among others: Alonso Olea, M. (1980). El Estatuto de los trabajadores. Texto y comentario breve. Madrid, 38; González Pérez, J. La dignidad de la persona, op. cit., 191.
44.
Sagardoy Bengoechea, J. A. (2005). Los derechos fundamentales y el contrato de trabajo. Madrid: Thomson-Civitas, 27.
45.
Article 4, 2, e) of the Workers’ Statute of 1995.
46.
Idem.
47.
Articles 8, 11 and following of Royal Decree-Law 5/2000 of August 04, concerning approval of the revised wording of the Law on labour offences and sanctions.
48.
Pacheco Zerga, L. (2007). La dignidad humana en el Derecho del trabajo. Cizur Menor: Thomson-Civitas, 38; and Montoya Melgar, A. (2005). Derecho del Trabajo, 26th ed. Madrid: Tecnos, 308.
49.
Supreme Court judgments of September 24 1985/RJ1985, 4361/ and October 11, 1989/RJ 1989, 7167/.
50.
Supreme Court judgment of November 26 2004/RJ 2005, 2888/. Harassment can be sanctioned administratively as it is a very serious offence, or under criminal law if it is an offence covered by legislation (non-combinable actions). And in all cases compensation for non-pecuniary damage caused may be sought.
51.
In its judgment 224/1999 of December 13, the Constitutional Council states that, in the case of sexual harassment, there is a violation of the fundamental right to privacy that is based on human dignity. This concerns a “violation in an extremely personal sphere, that of sexuality, to the detriment of human dignity (legal basis no. 2)”.
52.
Supreme Court judgment of December 04, 1987/RJ 1987, 8828/.
53.
Supreme Court judgment of March 21, 1990/RJ 1990, 2208/ and Central Labour Court judgments of 20 May 1986/RTCT 1986, 3483/ and 27 May 1987/RTCT 1987, 11344/.
54.
Constitutional Court judgment 282/2000 of November 27, concerns the case of an employee who took legal action against his company for communicating internally, after his dismissal, the reasons for said dismissal, with a view to setting an example for other workers. The Constitutional Council rejected the complaint on the grounds that, although the constitutional notion of honour includes professional discredit, this cannot be the result of a simple criticism of the employee’s professional activity, but rather the disqualification implying an offence against his personal honour.
55.
An employer who wants to install a closed circuit system for surveillance of work stations must satisfy three requirements: the proportionality, necessity and pertinence of the measure (Constitutional Court judgment 186/2000, of July 10). If these requirements are not met, there is a violation of the worker’s privacy and dignity (Constitutional Court judgment 98/2000, of April 10).
56.
Article 100.1 Law of 1992 on legal arrangements for the public administration and joint administrative procedure (amended in 1999).
57.
González Pérez, J. La dignidad de la persona, op. cit., 201 and 202.
58.
Cotino Hueso, L. (1999). Relaciones de especial sujeción: su diversa evolución en Alemania y España (Particular seguimiento de la jurisprudencia constitucional, contencioso-administrativa y militar de la presente década. Revista del Poder Judicial, 55:318.
59.
The personality rights are defined as “subjective rights” stemming from human nature and the inherent dignity of the person, intended to protect the most immediately personal sphere of the human being, in both his physical aspect (rights to life and physical integrity) and in his spiritual aspect (rights to honour, privacy and image). Martinez De Aguirre, C. (2011). Curso de Derecho Civil I. Derecho de la persona. Madrid: Colex, 546.
60.
López Jacoiste, J. J. (2010). La responsabilidad civil extracontractual. Una exploración jurisprudencial y de filosofía jurídica. Madrid: Editorial Universitaria Ramón Areces, 435.
61.
Article 1255 CC.
62.
Article 792 CC.
63.
Article 793 CrimC.
64.
Although none of these articles specifically refers to a violation of dignity, it is the consequence in which part of doctrine results. For all, see González Pérez, J. La dignidad de la persona, op. cit., 186 and following.
65.
Promulgated by law 25/2010 of July 29, Book II of the Catalan Civil Code entered into force on January 01, 2011.
66.
Follia Camps, R. (2012). La defensa de la dignidad de la persona en el Libro II del Código Civil de Cataluña. Medios para su protección. La Notaría, 2:38.
67.
Article 212-7 of Book II of the Catalan Civil Code.
68.
Article 231-1 and following of Book II of the Catalan Civil Code.
69.
Article 235-13 of Book II of the Catalan Civil Code, for cases of assisted fertilisation.
70.
Article 236-1 and following of Book II of the Catalan Civil Code.
71.
De Castro, F. (2008). Derecho Civil de España, vol. II. Madrid: Thomson-Civitas, 37 and s.
72.
Pacheco Zerga, L. La dignidad humana en el Derecho del trabajo, op. cit., 130.
73.
Constitutional Council judgment 53/1985, of April 11.
74.
Constitutional Council judgment 57/1994, of February 28.
75.
Constitutional Council judgment 120/1990, of June 27.
76.
Constitutional Council judgment 181/2004, of November 02.
77.
García Cuadrado, A. M. Principios de Derecho Constitucional, op. cit., 526.
78.
From a constitutional point of view, the reference to the dignity of the person constitutes an affirmation of “the priority of the person—in other words, of each individual—over the State”. This means that the public authorities “are an instrument in the service of human beings and not the other way round. Human beings must never be treated as instruments to be used with regard to the purposes and policies of the State”. Díez Picazo, L. M. (2008). Sistema de Derechos Fundamentales. Madrid: Thomson-Civitas, 70 and 71.
79.
Constitutional Court judgement of January 29, 1982. The case concerned freedom of thought, and the right of assembly and demonstration, and we can read: “Every right has its limits […]. Accordingly, we must affirm that neither freedom of thought nor the right of assembly and demonstration include the possibility of exercising on a third party moral violence of intimidating scope, as this is contrary to the constitutionally protected assets such as the dignity of the person and the right to moral integrity”.
80.
That is the opinion of Pacheco Zerga, L. La dignidad humana en el Derecho del trabajo, op. cit., 130; and of Ojeda Avilés, A. and Igartua Miró, M. T. (2008). La dignidad del trabajador en la doctrina del Tribunal Constitucional. Revista del Ministerio de Trabajo y Asuntos Sociales, 73:152.
81.
Constitutional Council judgment 53/1985, of 11 April.
82.
For all: Aparisi Miralles, A. (2004). El significado del principio de dignidad humana: un análisis desde la Ley 41/2002 sobre derechos de los pacientes. In La implantación de los derechos del paciente, ed. L. Sanz, 80 and 82. Pamplona: Eunsa.
83.
Ibid., 85, 89, 91 and 92.
84.
Aparisi Miralles, A. (2013). El principio de la dignidad humana como fundamento de un bioderecho global. Cuadernos de Bioética, 81:205 and 218. Some writers qualify it as an ethical and legal principle (García Cuadrado, A. M. [2012]. Problemas constitucionales de la dignidad de la persona. Persona y Derecho, 67(2): 476).
85.
General law 14/1986 on health: rules relating to the removal and transplantation of organs and tissues (Law 30/1979 on the removal and transplantation of organs, Royal Decree 1088/2005 on blood donation, Royal Decree 1723/2012 on the acquisition, use and territorial coordination of the transplantation of organs, Royal Decree 9/2014 concerning tissue and cell donations); Law 41/2002 on the autonomy of the patient; Royal Decree 223/2004 on clinical trials of medications; Law 14/2007 on assisted reproduction; Law 3/2007 on biomedical research; Law 3/2007 on the correction of civil status in cases of transsexualism; Law 2/2010 on sexual and reproductive health; and regional laws on death with dignity pronounced in 2010–2011, etc.
86.
This form of diagnosis, integrated into the Social Security system, may result in an abortion when foetal anomalies incompatible with life or an extremely serious and incurable illness at the time of the diagnosis are detected (Article 15 of law 2/2010 of March 03 on sexual and reproductive health).
87.
PGD making it possible to detect serious hereditary diseases not susceptible to post-natal curative treatment or other deformations that could threaten the viability of the pre-embryo is authorised. Likewise, the law permits PGD for therapeutic purposes for third parties by authorising the selection of in vitro embryos, to find a cure for a sick brother or sister already born (Article 12.2 Law 14/2006 of 26 May on assisted reproductive technologies).
88.
Torre Díaz, F. J. and González Arnaiz, G. (2008). Dignidad humana y bioética. Madrid: Universidad Pontificia Comillas, 126.
89.
These are a few of the questions asked by Torre Díaz, F. J. and González Arnaiz, G. Dignidad humana y bioética, op. cit., 126 and s.
90.
See the start of Part I above.
91.
Law 2/2010 of March 03 on sexual and reproductive health. In its preamble, it states that the development of sexuality and the woman’s capacity to procreate are intimately linked to “the dignity of the person and the development of the personality”. Thus, the decision to have children, and to choose when to have them, constitutes one of the most deeply personal questions of a person’s life, and the public authorities are obliged not to interfere in these sorts of decisions….
92.
On the instrumentalization of the weakest in favour of the most powerful in economic terms in the case of GS and on the resulting violations of dignity, see Lasarte Álvarez, C. (2012). La reproducción asistida y la prohibición legal de maternidad subrogada admitida de hecho por vía reglamentaria. La Ley, 6.
93.
Article 10, Law 14/2006 of May 26 on assisted reproductive technologies.
94.
Such registration was initially refused on the grounds that this practice is considered to be an evasion of the law (Resolution of the Directorate General of Registers and the Notaria of February 18, 2009 and Supreme Court judgment of February 12, 2015). Currently, and following a judgment of the European Court of Human Rights (Judgments of June 26, 2014, cases 65192/11 Mennesson v. France and 65941/11 Labassee v. France) ruling against France for refusing the transcription of the paternity of a child born as a result of GS as regards the biological father, a debate has begun in Spain about the transcription of parentage. On the fact that the prohibition of the recognitions of the parentage link constitutes “interference by the state in the privacy of the family” in contradiction to the provisions of the European Convention on Human Rights, see Flores Rodríguez, J. (2014). Vientres de alquiler: más cerca de su reconocimiento legal en Europa. Diario La Ley, 8363: 5.
95.
The right to personal and family privacy has deep roots in human dignity, see above.
96.
Article 1.3, Law 14/2006 of May 26 on assisted reproductive technologies.
97.
Article 11 of UNESCO’s Universal Declaration on the Human Genome and Human Rights of 1997.
98.
Elizari, F. J. (2002). Clonación humana reproductiva por transferencia nuclear: justificaciones de su rechazo ético. In Bioética, un diálogo plural, ed. J. J. Ferrer and S. J. Martínez, 61–82. Madrid: Universidad Pontificia de Comillas. This article contains an analysis of the reports of the National Bioethics Commissions of 4 countries (USA 1997, France 1997, Belgium 1999 and Spain 1999).
99.
It becomes a founding principle, “not entirely unsuccessful, but at least confused in situations that arise at the end of life”. Marcos Del Cano, A. M. (2003). Dignidad humana en el final de la vida y cuidados paliativos. In Biotecnología, derecho y dignidad humana, ed. N. Martínez Morán, 240. Granada: Comares.
100.
Marcos Del Cano, A. M. Dignidad humana en el final de la vida y cuidados paliativos, op. cit., 254.
101.
Torre Díaz, F. J. and González Arnaiz, G. Dignidad humana y bioética, op. cit., 134.
102.
The Committee was set up on 22 October 2008 as a result of Law 14/2007 of July 03 on biomedical research (website: http://www.comitedebioetica.es/). Likewise, there are regional and autonomous Bioethics Commissions (17 Bioethics Committees or Commissions with their own regulations).
103.
Report on the organic law draft bill for the protection of the life of the conceived child and of the rights of the pregnant woman approved on May 13, 2014.
104.
Declaration of 2013, the analysis of which is based, among other things, on Recommendation 1418 (1999) of the Parliamentary Assembly of the Council of Europe concerning the protection of the human rights and dignity of terminally ill and dying patients.
105.
Joint report by the Spanish Bioethics Committee and the Portuguese National Council of Ethics for Life Sciences of October 31, 2012. At the time of the presentation of the recommendations to be implemented in the collection and preservation of genetic material, this report stated, among other things, the requirement to guarantee the “respect of the dignity of the persons involved”.
106.
Iñigo Corroza, E. et al., 2014. Iuspoenale, op. cit., 46.
107.
Pereira Menaut, A. C. and Pereira Saez, C. (2014). De nuevo sobre la dignidad humana. Cuadernos de Bioética, 84:232.
108.
“After two hundred years of modern constitutional history, we are now more aware of what has distinguished this evolution since its beginning: human dignity is, so to speak, the portal through which the egalitarian and universalist content of Morality is imported into the Law”. Habermas, J. La Constitución de Europa, Madrid: Trotta, 21.
109.
See above, part 1.
110.
Pereira Menaut, A. C. and Pereira Saez, C. De nuevo sobre la dignidad humana, op. cit., 237.
111.
Scheler, M. (2000). El puesto del hombre en el cosmos. La idea de la paz perpetua. Barcelona: Alba, 33.
112.
Martínez Morán, N. (ed.). (2003). Biotecnología, derecho y dignidad humana. Granada: Comares, X.
113.
Pereira Menaut, A. C. and Pereira Saez, C. De nuevo sobre la dignidad humana, op. cit., 236.
114.
Some experts say that human dignity and respect for human rights are the only limits to scientific research. Martínez Morán, N. (ed.). Biotecnología, derecho y dignidad humana, op. cit., XI.
115.
Pereira Menaut, A. C. and Pereira Saez, C. De nuevo sobre la dignidad humana, op. cit., 232.

Author information

Authors and Affiliations

Faculty of Law, University of Navarre, Pamplona, Spain
Verónica San Julián Puig

Authors

Verónica San Julián Puig
View author publications
You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Verónica San Julián Puig .

Editor information

Editors and Affiliations

University of Rennes, Rennes, France
Brigitte Feuillet-Liger
Columbia University, New York, USA
Kristina Orfali

Rights and permissions

Reprints and permissions

Copyright information

About this chapter

Cite this chapter

San Julián Puig, V. (2018). Human Dignity as a Fundamental Principle in Biomedicine: A Spanish Perspective. 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_7

Download citation

DOI: https://doi.org/10.1007/978-3-319-99112-2_7
Published: 20 November 2018
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-99111-5
Online ISBN: 978-3-319-99112-2
eBook Packages: Law and CriminologyLaw and Criminology (R0)

Publish with us

Policies and ethics