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Anja Hfelmeier Anna-Katharina Hbler (Hrsg.)

Ethik und Recht -


Die Ethisierung des Rechts
Ethics and Law -
The Ethicalization of Law

123
Max-Planck-Institut fr auslndisches
ffentliches Recht und Vlkerrecht
Beitrge zum auslndischen
ffentlichen Recht und Vlkerrecht

Begrndet von Viktor Bruns

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Band 240
Silja Vneky Britta Beylage-Haarmann
Anja Hfelmeier Anna-Katharina Hbler (Hrsg.)

Ethik und Recht -


Die Ethisierung des Rechts
Ethics and Law -
The Ethicalization of Law
ISSN 0172-4770
ISBN 978-3-642-37089-2 ISBN 978-3-642-37090-8 (eBook)
DOI 10.1007/978-3-642-37090-8
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Vorwort

Wohl wenige Dinge erfllen Rechtswissenschaftler so mit Unbehagen,


wie wenn es um die Grenzen oder gar die Aufweichung des Rechts
geht. Deswegen scheint uns der Untersuchungsgegenstand des vorlie-
genden Bandes so lohnend: Wenn es so etwas gibt wie die Ethisierung
des Rechts und ein Ziel der vorliegenden Beitrge ist, auch zu unter-
suchen, ob bzw. inwieweit und in welchem Sinne von einer Ethisierung
des Rechts sinnvoll gesprochen werden kann dann darf es die
Rechtswissenschaftler zwar mit Unbehagen erfllen, aber sie drfen in
keinem Fall den Blick davon abwenden. Es geht darum, dort genau hin-
zusehen, wo es die Rechtswissenschaft schmerzt oder zumindest
schmerzen knnte. Unser Blick soll dabei durch die Einsichten anderer
Disziplinen geschrft werden, insbesondere der Philosophie, die mit
uns ein neues, das Recht irritierendes Phnomen untersucht.
Der vorliegende Band entstand auf der Grundlage der Vortrge eines
Symposiums im Herbst 2011 in Freiburg zur Ethisierung des Rechts
Grundlagen, Gefahren und Chancen in interdisziplinrer Perspektive.
Das Symposium war Endpunkt und Anfang zugleich. Es war das Ab-
schlusssymposium der Heidelberger Max-Planck-Forschungsgruppe
zur Demokratischen Legitimation ethischer Entscheidungen, die seit
2006 den Grenzbereich von Ethik und Recht rechtsvergleichend, insbe-
sondere aber auch im Vlker- und Europarecht, untersucht hat. Es war
zudem der Beginn der weiteren Forschungen in diesem Bereich an der
Rechtswissenschaftlichen Fakultt der Universitt Freiburg.
Die Frage der Ethisierung beschftigt heute viele Disziplinen, wie jn-
gere Buchpublikationen zeigen.1 Was aber ist mit dem Begriff der
Ethisierung des Rechts gemeint? Unter einer Ethisierung des Rechts
wird hier zunchst in einem engen Sinne das Phnomen verstanden,
dass rechtliche Normen immer mehr durch ethische, auerrechtliche
Standards ergnzt, zum Teil auch ersetzt werden. Ethische Standards in
diesem Sinne sind als normative Standards solche, die die zwei ethi-

1 Zur Frage der Ethisierung der Macht aus philosophischer Sicht beispiels-
weise Byung-Chuk Han, Was ist Macht?, 2005, 122 ff. Zur Frage der Ethisie-
rung von Technikkonflikten aus Sicht der Soziologie vgl. Alexander Bogner,
Die Ethisierung von Technikkonflikten, Studien zum Geltungswandel des Dis-
senses, 2011.

V
VI Vorwort

schen Grundfragen mit Blick auf das Richtige prinzipiell unabhngig


von der herrschenden Moral und von dem positiven Recht beantworten
wollen: Wie soll ich handeln? Und: Warum ist diese Handlung richtig
bzw. falsch?
Damit wird nicht behauptet, dass dieses Phnomen an sich neu ist:
Denkt man an den Verweis auf die guten Sitten in zivilrechtlichen oder
selbst strafrechtlichen Normen, den Verweis auf die Moral als mgli-
ches Ziel der gerechtfertigten Einschrnkung von Menschenrechten
nach den internationalen Menschenrechtsvertrgen oder auch an den
Wortlaut des deutschen Grundgesetzes in Art. 2 Abs. 1, wonach eine
Grenze des Rechts auf die freie Entfaltung der Persnlichkeit das Sit-
tengesetz ist, dann kann dies auch unter den Begriff der Ethisierung des
Rechts gefasst werden.
Wir knnen jedoch ber diese allgemeinen Beispiele hinaus eine Zu-
nahme und Verstrkung der Ethisierung des Rechts beobachten.2 Dies
zeigt sich insbesondere im Zivilrecht,3 aber auch, wenn wir den Bereich
des ffentlichen Rechts im weitesten Sinn betrachten, und zwar natio-
nal, aber auch europa- und vlkerrechtlich: Es finden sich zunehmend
und zustzlich zu den genannten Bereichen in Gesetzen und rechtlichen
Normen sogenannte ffnungsklauseln, die ethischen Standards norma-
tive Relevanz gerade auch in der jeweiligen Rechtsordnung einrumen.
Solche ffnungsklauseln fr ethische Mastbe finden sich beispiels-
weise bei der Normierung der Forschungsrahmenprogramme der Eu-
ropischen Union, die rechtlich die Vergabe von Forschungsmitteln an
Erfordernisse ethischer Forschung knpft. Eine zunehmende Ethisie-
rung des Rechts zeigt sich zudem an der immer weitergehenden, recht-
lich gesttzten Institutionalisierung der Ethik durch Ethikgremien, also
Ethikkommissionen und Ethikrte. In der Bundesrepublik zeigte sich
dies zuletzt bei der Legalisierung der Primplantationsdiagnostik. Nach
den gesetzlichen Voraussetzungen des Embryonenschutzgesetzes ist ein
Votum einer Ethikkommission Voraussetzung dafr, dass die Auswahl-
entscheidungen ber befruchtete Eizellen getroffen werden drfen. Ein

2 Ausnahme ist das Strafrecht wegen des menschenrechtlichen Prinzips


nulla poena sine lege (scripta).
3 Vgl. beispielsweise im Bereich des Gesellschaftsrechts den Deutschen
Corporate Governance Kodex (http://www.corporate-governance-code.de/
ger/kodex/1.html), auf den in 161 AktG verwiesen wird und der auf dem
Deutschen Juristentag 2012 Gegenstand der Beratungen war, abrufbar unter:
http://www.djt.de/fileadmin/downloads/69/120809_djt_69_thesen_web.pdf, 54
ff.
Vorwort VII

weiterer Bereich einer Ethisierung des Rechts findet sich, wenn heute
grundstzlich unverbindliche (und damit nicht-rechtliche) Ethik-
Kodizes (Codes of Conduct)4 erlassen werden, die ethisches Handeln
vorschreiben und als ein Beispiel mit besonderer Relevanz fr das
Grundrecht der Wissenschaftsfreiheit Forscher verpflichten, ethi-
sche Forschung zu betreiben.
Im besten Fall wre es mglich, dass durch eine solche Ethisierung, als
ffnung des Rechts fr ethische auerrechtliche Standards bzw. Ver-
weis des Rechts auf ethische auerrechtliche Standards, das Recht eine
neue Dimension der Gerechtigkeit gewinnt: Dass das Recht nach all
der Betonung von Positivitt, Verfahrenslegitimation, Setzbarkeit und
auch Wandelbarkeit durch eine ffnung fr inhaltlich legitimierte
Sollensnormen eine Gerechtigkeitsdimension hinzugewinnen kann, die
bei der Setzung und Anwendung positiven Rechts zum Teil vernachls-
sigt wird.
Wenn durch diese Ethisierung des Rechts jedoch Defizite des positiven
Rechts und auch der Rechtssetzung bewltigt werden sollten, knnte
dies auch bedeuten, dass dem Recht nicht mehr zugetraut wird, seine
Mngel, Unzulnglichkeiten und (Gerechtigkeits-)Lcken innerhalb
des eigenen Systems zu lsen. Es knnte bedeuten, dass die Gerechtig-
keitsfragen ausgelagert werden und das Recht Konkurrenz bekommt.
Mit dieser Konkurrenz wrde wiederum die Verrechtlichung zurck-
genommen werden und damit auch alle ihre Vorteile wie die Vorher-
sehbarkeit von Rechtsregeln und die klaren Mglichkeiten und Metho-
den der (auch gerichtlichen) Durchsetzbarkeit.
Wenn dies der Fall wre, msste die Antwort der Rechtswissenschaftler
jedoch sein, dass eine Ethisierung des Rechts sinnvoll anders zu verste-
hen ist, nmlich inkludierend: Ethisierung des Rechts sollte dann nicht
als Beschreibung und Rechtfertigung auerrechtlicher ethischer Stan-
dards verstanden werden, sondern im Sinne des Ziels, gerechtes Recht
zu erreichen, so dass der Gerechtigkeitsgehalt des Rechts selbst wieder
betont wird.
Diesen grundstzlichen Fragen der verschiedenen Aspekte der Ethisie-
rung des Rechts soll in den vorliegenden Beitrgen nachgegangen wer-
den. Dabei wird untersucht, wie sich Ethik und Recht im 21. Jahrhun-

4 Zu Codes of Conduct im privatrechtlichen Bereich transnationaler Kon-


zerne vgl. statt anderer Vanisha H. Sukdeo, Transnational Governance Models:
Codes of Conduct, and Monitoring Agencies as Tools to Increase Workers
Rights, 13 German Law Journal, 2012, 1556 ff., vgl. http://www.germanlawjour
nal.com/index.php?pageID=11&artID=1491.
VIII Vorwort

dert zueinander verhalten, ob es eine Ethisierung des Rechts gibt, und


wenn ja, in welcher Art und Weise. Zudem wird analysiert, ob eine
Ethisierung des Rechts ein Ineinandergreifen von Ethik und Recht be-
deutet, einen verstrkten Gerechtigkeitsbezug des Rechts anmahnt und
/ oder eine Etablierung paralleler Sollensmastbe rechtfertigt.
Die Themen der Beitrge des Buches sind entsprechend weit gefchert:
Die deutschen Philosophen Julian Nida-Rmelin und Wilfried Hinsch
widmen sich den philosophischen Grundfragen und klren und vertie-
fen die theoretischen Prmissen weiter, die sich bei dem Zusammenwir-
ken von Recht und Gerechtigkeit bzw. Recht und Ethik stellen.5 Mar-
garet Somerville und Henk ten Have untersuchen aus einer internatio-
nalen, interdisziplinren Perspektive das Zusammenwirken von Bio-
ethik und Menschenrechten nher und blicken auf das Vlkerrecht und
dessen Offenheit fr ethische Normen.6 Der Rechtsphilosoph und
Rechtswissenschaftler Alec Walen zeigt, dass theoretische Fragen ber
die moralischen bzw. ethischen Grundlagen des Rechts sich exempla-
risch an den rechtlich und ethisch hchst heiklen Fragen der Internie-
rung von Gefangenen aufzeigen lassen.7 Kontrovers behandeln schlie-
lich die Rechtswissenschaftler Hans-Georg Dederer und Ralf Poscher
und der Philosoph und Ethiker Ludwig Siep das Thema des gerechtfer-
tigten Einsatzes von Ethikkommissionen.8
Daneben stellen eine Reihe von jungen Wissenschaftlern verschiedener
Disziplinen ihre Thesen zur Diskussion. Sie beschftigen sich zum ei-
nen, wie Daniel Gruschke und Michaela Hailbronner mit James Fow-
kes, mit den theoretischen Grundlagen der Ethisierung des Rechts.9
Zum anderen werden von Sigrid Mehring, Benton Heath und Mira
Chang konkrete und auch praktische Probleme des Zusammenwirkens
von Recht und Ethik aus unterschiedlichen Blickwinkeln analysiert.10
Sigrid Mehring geht es um das Zusammenwirken von Kriegsvlker-
recht und rztlicher Ethik. Dem Konzept der Menschenwrde im Straf-
recht nhert sich Benton Heath. Mira Chang widmet sich in ihrem Bei-
trag den rechtlichen und ethischen Grenzen grenzberschreitender
Arzneimittelstudien.

5 Teil A, 3 ff. und 17 ff.


6 Teil A, 67 ff. und Teil B, 149 ff.
7 Teil A, 103 ff.
8 Teil E, 423 ff., 433 ff. und 443 ff.
9 Teil A, 41 ff. und Teil D, 395 ff.
10 Teil B, 229 ff., 253 ff. und 177 ff.
Vorwort IX

Wiederum ein anderer umstrittener Aspekt einer Ethisierung des


Rechts wird von Fruzsina Molnr-Gbor und Franziska Sprecher auf-
gezeigt. Sie reflektieren kritisch die ethische Standardsetzung durch pri-
vate Akteure: Analysiert wird, ob Private in ethisch umstrittenen Berei-
chen, hnlich wie in anderen Bereichen, als Experten gerechtfertigt
Normen setzen knnen.11 Auf die Untersuchung des Fortschreitens ei-
ner Ethisierung des Europarechts konzentrieren sich schlielich Hans
Christian Wilms und Rafael Hcki.12

Silja Vneky
mit Britta Beylage-Haarmann, Anja Hfelmeier, Anna-Katharina
Hbler

11 Teil C, 325 ff. und Teil D, 353 ff.


12 Teil C, 285 ff. und 299 ff.
Preface

In this book we want to deal with questions concerning what we have


called the ethicalization of law. There are probably very few things
which make legal scholars as nervous as the limits and weaknesses of
the law and legal order. As a result, we think it is important to take a
very close look at the questions of the ethicalization of law. We will dis-
cuss this fairly new topic from an interdisciplinary perspective as other
disciplines might help to better understand and answer these questions
in a more accurate way.
What is meant when we speak about the ethicalization of law? One
could describe this notion by the phenomenon that legal rules are being
supplemented more and more by ethical, non-legal standards / norms.
We are not stating that this is a new phenomenon per se; but we think
that we can see it becoming more frequent. There are more and more
clauses in legal norms which give ethical (non-legal) norms some valid-
ity in a legal order: We can find such opening clauses for instance in
the Framework Programme of the EU; according to it, all research
shall be carried out in compliance with fundamental ethical principles.
Secondly, we can also observe an increase in the establishment of ethics
committees on a legal basis. There are more and more areas in public in-
ternational law, European law or national laws where the decision of an
ethics committee is necessary before any action is allowed for instance
in drug trials on human beings. A third area of the ethicalization of law
can be found when one looks to non-binding ethical codes of conduct,
which are submitted by private organisations.
Maybe by opening the law to ethical standards, it is gaining a new di-
mension of justice and hence promoting peace in society in a better
way. On the other hand, such an acceptance of ethical standards would
mean that questions of justice are not primarily questions of legal rules
anymore, and that all the positive aspects of having legal rules are di-
minished. Perhaps legal scholars should therefore at least try to under-
stand the notion of the ethicalization of law in a broader and more in-
clusive way: In such a way where the aim of law is to strive for justice.
As a result, the purpose of these contributions is to pursue the funda-
mental question of how ethics and law relate to one another, in particu-
lar whether an ethicalization of law exists and if so, how it manifests it-
self and to what extent it should be limited. Does the ethicalization of

XI
XII Preface

law entail an interlocking of ethics and law, a heightened impetus for


justice within the law and / or an establishment of parallel precepts?
Accordingly, the topics of the contributions in this book are diverse:
The German philosophers Julian Nida-Rmelin and Wilfried Hinsch
devote themselves to the fundamental, philosophical questions, further
exploring and clarifying the theoretical premises that arise in relation to
the interaction of law and justice or law and ethics.13 Margaret Somer-
ville and Henk ten Have investigate the interaction of bioethics and
human rights from an international, interdisciplinary perspective and
look to international law and its openness to ethical norms.14 The phi-
losopher of law and legal scholar Alec Walen shows that theoretical
questions about the moral or ethical foundations of law can be exem-
plarily identified by looking at the legally and ethically precarious issue
of detention of prisoners.15 Finally, the legal scholars Hans-Georg
Dederer and Ralf Poscher and the philosopher and ethicist Ludwig Siep
debate whether the use of ethics committees is justified.16
Alongside these contributions, a series of young researchers from dif-
ferent disciplines present their theses for discussion. On the one hand,
Daniel Gruschke and Michaela Hailbronner together with James
Fowkes address the theoretical foundations of the ethicalization of
law.17 On the other hand, Sigrid Mehring, Benton Heath and Mira
Chang analyze the specific and practical problems of the interaction of
law and ethics from different perspectives.18 Sigrid Mehring is con-
cerned with the interaction of the laws of war and medical ethics, Ben-
ton Heath focuses on the concept of human dignity in criminal law, and
Mira Chang investigates the legal and ethical limits in cross-border drug
studies.
A further controversial aspect of the ethicalization of law is demon-
strated by Fruzsina Molnr-Gbor and Franziska Sprecher, who con-
cern themselves with the ethical designation of standards by private ac-
tors: They consider, whether private actors can justifiably set standards
as experts in ethically-precarious areas, as well as in other areas.19

13 Part A, pp. 3 et seq. and pp. 17 et seq.


14 Part A, pp. 67 et seq. and Part B, pp. 149 et seq.
15 Part A, pp. 103 et seq.
16 Part E, pp. 423 et seq., pp. 433 et seq. and pp. 443 et seq.
17 Part A, pp. 41 et seq. and Part D, pp. 395 et seq.
18 Part B, pp. 229 et seq., pp. 253 et seq. and pp. 177 et seq.
19 Part C, pp. 325 et seq. and Part D, pp. 353 et seq.
Preface XIII

Lastly, Hans Christian Wilms and Rafael Hcki undertake the impor-
tant investigation of the progress of the ethicalization of European
law.20

Silja Vneky
together with Britta Beylage-Haarmann, Anja Hfelmeier, Anna-
Katharina Hbler

20 Part C, pp. 285 et seq. and pp. 299 et seq.


Inhaltsverzeichnis / Contents

A. Grundlagenfragen ......................................................................... 1
Julian Nida-Rmelin
Recht und Moral ................................................................................... 3

Wilfried Hinsch
Legitimacy: Where Justice Meets the Law ....................................... 17

Daniel Gruschke
Externe und interne Ethisierung des Rechts .................................... 41

Margaret Somerville
Law, Marching with Medicine but in the Rear and Limping a
Little: Ethics as First Aid for Law ............................................... 67

Alec Walen
Reflections on Theorizing About the Moral Foundations of the
Law: Using the Laws Governing Detention as a Case Study ....... 103

B. Ethisierung in internationaler Perspektive ....................... 127


Silja Vneky
Grundlagen und Grenzen der Ethisierung des Vlkerrechts ........ 129

Henk ten Have


Bioethics and Human Rights Wherever the Twain
Shall Meet .......................................................................................... 149

Mira Chang
Bioethics and Human Rights the Legitimacy of
Authoritative Ethical Guidelines Governing International
Clinical Trials .................................................................................... 177

XV
XVI Inhaltsverzeichnis / Contents

Sigrid Mehring
The Ethicalization of International Humanitarian Law:
Clarifying the Boundaries for Physicians ....................................... 229

J. Benton Heath
Mapping Expansive Uses of Human Dignity in International
Criminal Law .................................................................................... 253

C. Ethisierung in europischer Perspektive ........................... 283


Hans Christian Wilms
Ethisierung des Europarechts - Grundrechtliche Grenzen und
politische Praktiken .......................................................................... 285

Rafael Hcki
Die Zivilgesellschaft als einsame Verteidigerin der guten
Sitten? berlegungen zur Ethisierung am Beispiel des
Biopatentrechts ................................................................................. 299

Fruzsina Molnr-Gbor
Die Regelung der Organverteilung durch Eurotransplant
unzulssige ethische Standardsetzung? ........................................... 325

D. Ethisierung in nationaler Perspektive ................................ 351


Franziska Sprecher
Medizinisch-ethische Standards privater Organisationen und
ihr Einfluss auf die Rechtsgenese und Rechtsanwendung
am Beispiel der medizinisch-ethischen Richtlinien der
Schweizerischen Akademie der Medizinischen
Wissenschaften .................................................................................. 353

James Fowkes & Michaela Hailbronner


Courts as the Nations Conscience: Empirically Testing the
Intuitions Behind Ethicalization ..................................................... 395
Inhaltsverzeichnis / Contents XVII

E. Institutionalisierung der Ethik durch Ethik-


Kommissionen ............................................................................ 421
Ludwig Siep
Sinn und Grenzen von Ethik-Kommissionen aus
philosophischer Sicht ....................................................................... 423

Ralf Poscher
Was Juristen besser knnen als Ethiker: Ein interdisziplinres
Argument fr die gerichtliche Kontrolle von
Ethikkommissionen ......................................................................... 433

Hans-Georg Dederer
Gerechtfertigter Einsatz von Ethikkommissionen
Grundlagen und Grenzen ................................................................ 443

Autorenverzeichnis / List of Authors ........................................ 453


A. Grundlagenfragen
Recht und Moral
Julian Nida-Rmelin

Vorbemerkung1

Im blichen Verstndnis gibt es drei Opponenten, nmlich Rechtsposi-


tivismus, Naturrechtstheorie und Diskurstheorie des Rechts. Das, was
ich hier vortrage, steht im Kontext einer bestimmten Konzeption prak-
tischer Vernunft. Ich habe ihr gelegentlich den Namen Strukturelle
Rationalitt gegeben, was irrefhren kann, da sie mit Strukturalis-
mus im blichen Sinne nicht zusammenhngt.2 Es steht zweitens im
Kontext bestimmter erkenntnistheoretischer berlegungen zum Ver-
hltnis von Theorie, Philosophie, Wissenschaft einerseits und Lebens-
form, etablierter Verstndigungs- und Interaktionspraxis andererseits
(genau genommen macht es gerade den Kern dieser berlegungen aus,
dass dieses einerseits andererseits in die Irre fhrt3). Ich gehe in
sechs Schritten vor, die ersten drei im Bereich der Ethik, die zweiten
drei im Bereich der Rechtsphilosophie.

1 Das folgende ist die lediglich leicht redigierte Abschrift des ohne Ma-
nuskript gehaltenen Vortrags. Die grammatikalischen Besonderheiten einer frei-
en Rede wurden nicht getilgt.
2 Es ist in der Tat so, dass die Implikationen dieser Auffassung praktischer
Vernunft fr die Rechtsphilosophie sich bislang noch nie in meinen Publikatio-
nen niedergeschlagen haben abgesehen von einem kleinen Kapitel ber den
Begriff der Menschenwrde, vgl. Nida-Rmelin, ber menschliche Freiheit,
2005, Kap. 5. Insofern bin ich Silja Vneky dankbar fr den sanften Druck, die-
sem Missstand hier ein Ende zu bereiten und einen ersten Brckenschlag zu un-
ternehmen.
3 Der allerspteste Wittgenstein von ber Gewissheit ist hier ein Bnd-
nispartner, vgl. Nida-Rmelin, Philosophie und Lebensform, 2009, Teil I.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 3
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_1, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
4 Nida-Rmelin

I. Erster Teil: Ethik

1. Die Einheit praktischer Vernunft

Fhren wir uns zunchst ein im Grunde simples philosophisches Ar-


gument vor Augen. Dabei bediene ich mich einer Geschichte, die Ri-
chard Hare allerdings mit einer anderen, sprachphilosophischen In-
tention erzhlt: Ein junger Mann, faul und eher unwillig zu studieren,
ist mit seinem Onkel auf einem Boot auf hoher See. Der junge Mann
sagt zu seinem Onkel: Du weit, wie ich bin. Arbeit ist nicht meine
Sache. Am besten wre fr mich, ein regelmiges Einkommen zu ha-
ben, ohne arbeiten zu mssen. Das wei ich wohl, erwidert der On-
kel. Und nun der junge Mann: Du weit, wie es sich erbrechtlich dar-
stellt. Solltest Du sterben, wre ich Alleinerbe. Es gibt viele Haie hier.
Es wird mir niemand nachweisen knnen, dass das kein Unfall war. Al-
so sollte ich dich vom Boot stoen. Was soll der Onkel antworten?
Angenommen, die einzelnen Teile des Argumentes sind empirisch zu-
treffend, die Interessenlage des Neffen ist korrekt dargestellt, daher ist
auch klar, was fr ihn nun in dieser Situation rational ist. Der Onkel
msste dann zumindest zugeben, Ja, das wre in der Tat in Deinem In-
teresse, aber wir fnden es merkwrdig, wenn er daraus schlsse
Stimmt, das solltest Du jetzt tun.
Ein anderes Beispiel: Wir gehen zum Bankschalter, wollen eine be-
stimmte Summe mit einem vergleichsweise hohen Zinsertrag bei mittle-
rem Risiko anlegen. Der Bankangestellte empfiehlt uns eine bestimmte
Anlageform: Sie sollten diese gemischte Anlageform whlen. Ist das
ein normatives Sollen? Hare spricht von abtrennbaren und nicht-ab-
trennbaren Sollens-Stzen. Ist dieser Sollens-Satz abtrennbar oder
nicht? Im Falle des Schalterbeamten lsst sich der Sollens-Satz berset-
zen in einen rein deskriptiven Sachverhalt: Wenn Sie diese Anlageform
whlen, erwartet Sie ein vergleichsweise hoher Zinsertrag bei mittlerem
Risiko. Dieser Sollens-Satz ist also nichts anderes als eine deskriptive
Behauptung eines faktischen Sachverhaltes. Das Gleiche gilt, wie mir
scheint, fr den jungen Mann im Boot: Wenn er seinen Onkel vom
Boot stt, dann kann er sich seine Wnsche erfllen. Aber hier ist
nichts Normatives im Spiel. Dies ist jedenfalls meine These, welche je-
doch hoch umstritten ist. In der konomischen Theorie, aber auch ei-
nem Groteil der praktischen Philosophie berwiegt die Auffassung,
eine normative Rationalittstheorie beinhalte, dass man das tun sollte,
was den eigenen Interessen dienlich ist. In der politischen Philosophie
ist diese Auffassung in ihrer strikten Form im Hobbesianismus prsent,
Recht und Moral 5

abgeschwcht im Kontraktualismus insgesamt, bis hin zum Kantianer


John Rawls. Die immer wieder erneuerten Versuche, das Normative auf
das jeweilige Eigeninteresse zu reduzieren, zeigen die kulturelle Prge-
kraft eines Grundmotivs modernen Denkens.4 Die Vielfalt und Kom-
plexitt praktischer Begrndung soll durch ein vermeintlich einfa-
ches, im Idealfalle quantitatives Ma ersetzt werden, die Zuschreibung
zweier, miteinander verkoppelter Bewertungsfunktionen, die des Nut-
zens und die der Wahrscheinlichkeit.
Mit der Einheit praktischer Vernunft ist hier nicht diese radikale
Komplexittsreduktion praktischer Grnde, sondern die Einheit des
normativen Sollens gemeint: Es gibt nur ein Sollen, nicht das Sollen
der Rationalittstheorie, das Sollen der Ethik, das Sollen des Rechts. Es
gibt nur ein normatives Sollen und viele gute Grnde. Die Frage:
Was ist dieses Sollen genau? erscheint mir nicht mehr sinnvoll zu
sein. Wir verstehen gut, was Das solltest Du jetzt tun bedeutet, auch
wenn wir uneins sein mgen, was dafr oder dagegen spricht. Wir ver-
stehen einen solchen Satz ohne weiteres, wir bedrfen keiner Klrung
der Bedeutung, allenfalls der Begrndung. Damit schlage ich dieselbe
Strategie ein wie T. M. Scanlon5 hinsichtlich der Grnde: Wir wissen,
was Grnde sind, sie sprechen fr etwas, praktische Grnde fr Hand-
lungen, theoretische fr berzeugungen. Einheit praktischer Ver-
nunft heit also: In letzter Instanz gibt es immer ein normatives Sol-
len. Die Grnde, die dafr vorgebracht werden, mgen vielfltig sein,
darauf komme ich gleich zu sprechen. Am Ende stellt sich immer die
eine, ausschlaggebende Frage: Soll ich das tun?
Der zweite Schritt dieser Argumentation besteht nun darin, aufzuzei-
gen, dass eine Praxis bestimmte Kohrenzbedingungen erfllen muss,
wenn sie nicht scheitern soll. Diese Kohrenzbedingungen kann man
zum Teil auch mithilfe entscheidungstheoretischer und spieltheoreti-
scher Argumentationen przisieren. Da spielt das berhmte Nutzen-
theorem fr mich eine wichtige Rolle. Aber die bliche Interpretation

4 Wie attraktiv dieser Reduktionsversuch ist, zeigt sich an dem breiten


Spektrum ethischer Positionen, denen bei allen Unterschieden gemeinsam ist,
dass eine Institution oder eine Praxis gegenber einer Person genau dann be-
grndbar sei, wenn diese im je individuellen Interesse dieser Person ist. Es
reicht in Deutschland vom bekennenden Hobbesianer Norbert Hoerster ber
Otfried Hffes Konzeption der Gerechtigkeit als Tausch bis zum frhen und
spten Tugendhat, dazwischen liegen die Retraktationen in Reaktion auf Ur-
sula Wolfs Kritik.
5 Scanlon, What we Owe to Each Other, 1998.
6 Nida-Rmelin

der Entscheidungstheorie im Sinne einer konsequentialistischen, auf Ei-


gennutzen orientierten Rationalittstheorie ist keineswegs zwingend.6
Im Gegenteil: Es handelt sich um eine sehr einseitige und von den Be-
dingungen des Nutzentheorems, etwa in der Fassung von von Neu-
mann und Morgenstern, nicht gedeckte Interpretation auch wenn sie
der konomischen Theorie derzeit zugrunde gelegt wird.
Man kann sich das Ganze auch weniger abstrakt, eher anthropologisch,
vor Augen fhren: Es ist am Ende eine Person, die zu ihrer Praxis ste-
hen knnen muss, die angeben knnen muss, warum sie so und nicht
anders gehandelt hat. Und wenn sie sich dem dadurch zu entziehen
sucht, indem sie sagt Das war ja gestern und nicht heute. Gestern war
das alles noch ganz anders, oder jedenfalls fr mich., dann haben wir
Zweifel an ihrer mentalen Zurechnungsfhigkeit. Das heit, wir erwar-
ten, dass es eine gewisse Invarianz der (normativen) praktischen Grn-
de gibt. Dass ich Grund habe, wenn ich bestimmte Grnde aufgebe.
Maria Grazia Cucinotta, eine italienische Schauspielerin, hat in einem
Interview gesagt: Jeden Tag sehe ich einen neuen Zug an meinem Cha-
rakter. Das ist ja sympathisch, aber wenn das ein gewisses Ma ber-
schreitet, dann nehmen wir die Person nicht mehr als Akteur, als Auto-
rin ihres Lebens, ernst. Dann steigt sie aus den Interaktionen, speziell
den Verstndigungspraktiken, aus.

2. Die Pluralitt praktischer Grnde

Es spricht vieles dafr, dass man, erstens, bestimmte Kategorien prakti-


scher Grnde unterscheiden muss und dass es, zweitens, in die Irre
fhrt, zu glauben, man knne diese Vielfalt von Kategorien auf einen
bestimmten Typus reduzieren. Es scheint mir eine der groen Fehlent-
wicklungen in der modernen praktischen Philosophie und Ethik zu
sein, diesen reduktionistischen Versuch zu unternehmen. Ich bin mir
nicht sicher, ob die folgenden drei Kategorien wirklich erschpfend
sind, aber jedenfalls decken sie einen Groteil unserer alltglichen
(nicht epistemischen, sondern handlungsbezogenen) praktischen Be-
grndungspraxis.
Das sind erstens Rechte (lat. libertates): Individuen haben Rechte und
wir, die wir mit Individuen, die Rechte haben, umgehen, haben die

6 Vgl. Nida-Rmelin, Economic Rationality and Practical Reason, 1997,


Kap. 4.
Recht und Moral 7

Pflicht, Rechte zu achten. Es gibt einen Strang in der ethischen Theorie,


in der politischen Philosophie, den man als Libertarismus (engl. Liber-
tarianism) bezeichnen kann. Der Libertarismus lsst es bei den Rechten
bewenden. Er bezieht sich, wie Nozick, etwa auf Locke und sagt, alles
andere msse daraus abgeleitet werden. Das ist meines Erachtens nicht
plausibel, sondern vereinfacht die Dinge ber die Maen und verliert
damit wesentliche Aspekte vernnftiger Praxis.
Eine zweite Kategorie ist die der Verpflichtung (lat. Commisiva): Ich
habe einen Grund, etwas zu tun, aufgrund der Tatsache, dass ich zuvor
etwas getan habe, nmlich eine Verpflichtung eingegangen bin, ein Ver-
sprechen abgegeben habe etc.
Den dritten Typus kann man als Pflichten in einem besonderen Sinne
(lat. Officia) bezeichnen: Es handelt sich um Pflichten, die verbunden
sind mit bestimmten sozialen Rollen, paradigmatisch z.B. die Eltern-
pflichten gegenber ihren Kindern, die Lehrerpflichten gegenber ihren
Schlern usw.
Dies also sind drei Kategorien: Libertates, Commissiva, Officia. Mgli-
cherweise gibt es weitere Kategorien. Man kann nun grob folgende
Theorielandschaft damit in Verbindung bringen: Es gibt den Strang des
Kontraktualismus, der sagt, Commisiva sind die Grundlage, auf die al-
les zurckgefhrt werden muss. Es gibt den Strang des Libertarismus,
demzufolge Libertates (Rechte und Freiheiten) die Grundlage sind, auf
die alles zurckgefhrt werden muss. Und es gibt die Kommunitaristen,
die meinen, es sind die Officia, die letztlich ausschlaggebend sind. Ich
glaube, jede dieser drei Reduktionsversuche scheitert aufgrund eines
gemeinsamen, rationalistischen Missverstndnisses.
An dieser Stelle muss ich einen kleinen erkenntnistheoretischen Exkurs
machen. Man muss zwei Dinge sauber unterscheiden: Einmal das Be-
streben, eine mehr oder weniger systematische Theorie zu prsentieren,
z. B. eine systematische ethische Theorie. Die kann man so aufbauen
was heute fast niemand mehr macht dass sie sich aus Axiomen ablei-
ten lsst. Einige konomen haben das im Bereich der Ethik gemacht.
Nobelpreistrger John Harsanyi z. B. hat eine bestimmte regelutilitaris-
tische ethische Theorie axiomatisch prsentiert. Daraus folgt nicht
und das nenne ich das rationalistische Missverstndnis , dass diese Axi-
ome die Theorie begrnden, sondern die Theorie als Ganze muss sich
bewhren. Das ist jedenfalls die nicht-rationalistische Interpretation. Sie
muss sich bewhren an bestimmten Bewhrungsinstanzen. Und das
sind Flle, in denen wir uns darber einig sind, wie man sich verhalten
sollte. Und dann prfen wir, ob das entsprechend in einen vernnftigen
8 Nida-Rmelin

Zusammenhang gefhrt werden kann. Wenn ich also im Folgenden ge-


gen eine bestimmte Variante von Rationalismus und von Reduktionis-
mus in der Ethik, aber auch im Recht, argumentiere, schliee ich nicht
aus, dass eine systematische, auch axiomatisierte, normative Theorie
mglich ist. Aber die Begrndungsrelationen gehen nicht von den Axi-
omen zu den Implikationen dieser Theorie. Es sind nicht die Axiome,
die die Begrndungslast tragen.
An dieser Stelle mchte ich noch einen Schritt in die Tiefe gehen, um
klar zu machen, welche Brisanz diese These hat. Es gibt eine Jahrhun-
derte whrende Tradition in der modernen Ethik, wie man die Frage
beantwortet Warum soll ich meine Versprechen halten?. Von Kant bis
zu den Utilitaristen wird dann ein Prinzip prsentiert, aber das stellt die
epistemische Lage auf den Kopf. Wir haben eine bestimmte Praxis, die
wir fr eine philosophische Theorie mit Sicherheit nicht aufgeben wol-
len. Die Theorie hat sich folglich an dieser Praxis zu bewhren. Nicht
umgekehrt. Wir brauchen kein Prinzip, das uns in eindeutigen Situatio-
nen erst Sicherheit gibt, dass wir unser Versprechen halten mssen. Es
gibt sicherlich Sonderflle, in denen Pflichten zu kollidieren scheinen,
es gibt vielleicht sogar moralische Dilemmata usw. Aber im Kern haben
wir eine bestimmte Praxis und wir sind insofern Teil dieser Praxis, als es
selbstverstndlich ist, dass wir unsere Versprechen halten, dass wir
wahrhaftig sind usw. Es verhlt sich nicht umgekehrt. Wir brauchen da-
fr keine Theorie. Ein ganz analoger epistemologischer Irrtum ist der,
der im 19. Jahrhundert zu den absurden philosophischen Debatten zur
Existenz des Fremdpsychischen gefhrt hat. Das macht vielleicht Sinn
im philosophischen Oberseminar, aber jedenfalls nicht auerhalb.7

3. Die Rolle von Konventionen

blicherweise werden in ethischen und rechtsphilosophischen Lehrb-


chern verschiedene Typen von Normen und dabei das blo Konventio-
nelle von anderen Typen von Normen unterschieden. Es wird dann be-
hauptet, Konventionen htten einen anderen Status, seien blo konven-
tionell. Vorsicht - auch hier pldiere ich fr eine gradualistische, holisti-
sche Sichtweise. Nehmen wir folgendes Beispiel: Wenn ich als Nicht-
Katholik in eine sditalienische Kirche gehe, halte ich mich an die dort
geltende Regel, meine Schultern zu bedecken obwohl ich den Sinn

7 Vgl. Nida-Rmelin, Philosophie und Lebensform, 2009, Kap. 2.


Recht und Moral 9

dieser Konvention nicht verstehe. Wieso? Eine Antwort knnte sein:


Weil ich niemanden krnken will. Das wre dann eine Art eth-
nologische Sichtweise: Ich befinde mich in einer anderen Ethnie, wo
andere Verhaltensregeln gelten. Ich mache mir diese nicht zu Eigen.
Aber die Zugehrigkeit zu einer moralischen Gemeinschaft beinhaltet,
dass ich mir als Teilnehmer einer gemeinsamen Praxis die normativen
Essentialia dieser Gemeinschaft zu Eigen mache. Den objektiven, dis-
tanzierenden Standpunkt, den ethnologischen Standpunkt, kann man
nur in engen Grenzen einnehmen. Das heit, sofern wir berhaupt Teil
einer moralischen Gemeinschaft sind wie gro diese auch immer ist
(das kann auch die Menschheit als Ganze sein) teilen wir normative
Haltungen. Das macht uns erst verstndigungsfhig, aktionsfhig,
handlungsfhig. Die rein objektive Einstellung steht uns gar nicht offen.
P. F. Strawson hat in seinem berhmt gewordenen Aufsatz Freedom
and Resentment8 von der objektiven vs. subjektiven Einstellung ge-
sprochen. Diese Terminologie gefllt mir gar nicht, aber er sagt etwas
ganz Wichtiges: Man kann die objektive Einstellung nur um den Preis
radikaler Vereinsamung einnehmen. Das bringt etwas Wichtiges auf den
Punkt. Wir haben gute Grnde fr diese Praxis. Die teilen wir, wir sind
berzeugt, dass sie gelten. Was heit hier subjektiv? Auf jeden Fall in-
ter-subjektiv. Die geteilte Lebensform bildet also gewissermaen eine
Grenze, die die Theorie nicht berschreiten kann, eine Grenze der Dis-
tanzierung. Das ist kein Konventionalismus, aber es besteht vielleicht
die Gefahr eines, wie man das im Hinblick auf den spten Wittgenstein
genannt hat, Quietismus. Dass man sagt So ist es halt. Es gibt keine
Mglichkeit einer wirklich fundamentalen, normativen Kritik. Wenn al-
les kohrent wre und wir alle diese Praxis vllig unumstritten lebten,
dann gbe es in der Tat wenige Mglichkeiten zur Kritik. Der Ver-
nnftige hat bestimmte Zweifel nicht., heit es in Wittgensteins ber
Gewissheit gegen Descartes. Wenn wir keinen Grund htten, an ir-
gendetwas zu zweifeln, dann htten wir als Vernnftige keinen Grund
zu zweifeln. Das ist vielleicht die Position des spten Wittgenstein.
Aber wir haben zuhauf Grund zu zweifeln, weil unsere praktischen
Grnde, auch die epistemischen Grnde, regelmig kollidieren, weil
wir nicht wissen, was wir tun sollen. Das ist dann Grund fr Zweifel,
auch fr den Vernnftigen. Nicht nur fr den globalen Skeptiker, der ist
unvernnftig.

8 Proceedings of the British Academy 48 (1962), S. 1-25.


10 Nida-Rmelin

II. Zweiter Teil: Rechtsphilosophie

Hat das eben Gesagte nun irgendwelche Implikationen fr die Rechts-


philosophie? Der Ansatz, fr den ich argumentiere, ist gradualistisch,
holistisch. Wer will, kann auch sagen: pragmatistisch, aber das ist Miss-
verstndnissen ausgesetzt. Ich will drei Aspekte herausgreifen:

1. Verfahrensrationalitt als Scheidung von Recht und Moral?

Der erste Aspekt ist die Frage: Welche Rolle spielt eigentlich Verfah-
rensrationalitt? Ist das die saubere Scheidungslinie zwischen Recht
und Moral? Bei Habermas heit es, es sei typisch fr die posttradi-
tionelle Moralitt, dass wir das Recht als Fortsetzung einer posttraditi-
onellen Sittlichkeit entwickeln und bestimmte Verfahren brauchen, um
die Ungewissheiten zu bewltigen, die allein durch den Diskurs nicht
zu beheben sind.9 Aber der Diskurs ist letztlich die Legitimitt spen-
dende Quelle. Ich glaube nicht, dass es eine solche historische Ent-
wicklung gegeben hat. Die Verfahrensrationalitt spielte in der lebens-
weltlichen Moral ich verwende den Terminus jetzt anders als Haber-
mas und soweit man das fr unsere begrenzte, eurozentrische und
auch historisch begrenzte Sicht beurteilen kann, immer eine entschei-
dende Rolle. Ja mglicherweise schon in vorklassischen Zeiten Grie-
chenlands, wenn man sich den Beginn der Ilias vor Augen fhrt. Darf
Agamemnon Achill seine Lieblingssklavin wegnehmen? Das ist eine
Machtdemonstration, aber Achill ist ein Frst muss der sich das bie-
ten lassen? Nun, er zieht sich aus dem Kriegsgeschehen zurck, was
beinahe zum Untergang der Griechen vor Troja fhrt. Es gibt aus den
alten Reichen eine Vielzahl von Belegen fr die zentrale Rolle von ak-
zeptierten Verfahren der Entscheidungsfindung ansonsten gibt es
Krieg. Ich glaube nicht, dass Verfahrensrationalitt als Entscheidungs-
kriterium zwischen Recht und Moral taugt.
Dieses Missverstndnis kommt dadurch zustande, dass die normative
Kraft von etablierten Verfahren falsch eingeschtzt wird. Wenn eine
Gruppe von fnf Personen sich zu einer Bergwanderung aufmacht und
alle wissen, dass es gefhrlich ist, sich in schwierigen Situationen zu
trennen, dass man zu fnft eine hhere berlebenschance hat, dann
werden sie sich auf ein Entscheidungsverfahren einigen mssen. Sie

9 Vgl. Habermas, Faktizitt und Geltung, 1992.


Recht und Moral 11

werden sich beispielsweise darauf einigen, dass im Zweifelsfall der mit


der grten Erfahrung entscheidet. Oder darauf, dass abgestimmt wird
oder man sich nach dem Schwchsten richtet. Das ist alles nicht Recht,
das ist lebensweltliche Sittlichkeit. Und wenn die Gruppe sich dann in
einer Entscheidungssituation befindet, entfaltet die vorangegangene Ei-
nigung auf ein bestimmtes Verfahren eine gewaltige normative Kraft. Es
ist dann unter Normalbedingungen moralisch unzulssig, sich nicht an
die bereinkunft zu halten. Sie htten sich auch anders einigen knnen,
aber sie haben sich nun mal so geeinigt. Die normative Kraft der Ver-
fahrensrationalitt ist in der lebensweltlichen Sittlichkeit zutiefst veran-
kert und ich sehe nicht, dass das ein spezifisches Phnomen der Moder-
ne sein soll. Das wre eine historisierende Hypostasierung. Natrlich
gewisse Formen von Rationalitt gewinnen an Gewicht, andere treten
zurck, werden marginalisiert. Aber das ist kein Bruch, sondern allen-
falls eine graduelle Vernderung. Es gibt ethische Bedingungen fr Le-
gitimitt durch Legalitt und zwar auerhalb des etablierten positiven
Rechtes. Legalitt in dem Sinne, dass man sich auf bestimmte Verfahren
geeinigt hat. Wenn beispielsweise der ursprngliche Konsens durch
Drohung zustande gekommen ist, dann ist die moralische Verpflichtung
nicht mehr gegeben.
Man kann das Ganze auch einen Schritt tiefer angehen und sagen: Die
normative Kraft von bloen konventionellen Regeln, die dann die Ent-
scheidungen bestimmen, also von sekundren Regeln im Sinne H. L. A.
Harts, kann man sich auch so vor Augen fhren: Angenommen, wir
haben bestimmte Prinzipien der normativen Beurteilung, in denen wir
uns einig sind, dann wird je nachdem, wie diese Prinzipien gefasst
sind, und vielleicht mit der Ausnahme des Handlungsutilitarismus ein
groer Bereich inhaltlicher Unterbestimmtheit bleiben. Das gilt schon
fr den Regelutilitarismus, beim Handlungsutilitarismus nur in einem
einzigen Sonderfall, nmlich der Indifferenz des Erwartungswerts der
Nutzensumme. Aber schon im Regelutilitarismus nimmt dieser Bereich
der Unterbestimmtheit dramatisch zu. Er nimmt dramatisch zu bei
Kantischen Ethiken. Und natrlich muss diese Unterbestimmtheit be-
hoben werden, um eine kollektive Praxis zu ermglichen. Vielleicht
nicht jede Unterbestimmtheit, aber viele Unterbestimmtheiten.
Ein banales Beispiel, um jetzt einmal die Kantische Ethik heranzuzie-
hen: Die Maxime, rechts zu fahren, ist verallgemeinerbar im Straen-
verkehr. Die Maxime, links zu fahren, auch. Aber wenn die einen rechts
und die anderen links fahren, dann gibt es Chaos. Also muss es irgend-
eine Instanz geben, die diese Unterbestimmtheiten behebt. Und wenn
sie sie behoben hat, dann hat das normative Kraft, dann bin ich ver-
12 Nida-Rmelin

pflichtet, rechts zu fahren. Man kann es auch so sagen: Kooperation


verlangt einen gewissen Konsens ber Grundnormen wir nennen sie
vorsichtshalber nun mal Prinzipien, ohne sie genauer zu charakteri-
sieren die sich an Einzelfllen bewhren mssen. Aber diese reichen
nicht aus. Also bedrfen wir Verfahren der Aufhebung dieser Unterbe-
stimmtheit. Die knnen ganz unterschiedlich aussehen und sind tief
verankert in lebensweltlichen Sittlichkeiten.
Damit man sieht, welche Implikationen das hat: John Rawls kmpft in
seiner Gerechtigkeitstheorie mit der Frage, wie wir mit dem umgehen
sollen, was er ziemlich missverstndlich comprehensive moral
doctrines nennt. Sein Vorschlag ist dann zunehmend denn das vern-
dert sich ja zwischen A Theory of Justice und seinen spteren Schrif-
ten zu sagen: Wir haben einen gemeinsamen Gerechtigkeitssinn, der
sich im ffentlichen Raum zeigt. Der ist rein politisch, nicht metaphy-
sisch, und gewissermaen kompatibel mit den comprehensive moral
doctrines. Irgendetwas stimmt da natrlich nicht. Denn eine solche
Norm, die so fundamental ist fr unser Rechtssystem und fr unsere
lebensweltliche Sittlichkeit hoffentlich auch wie die der gleichen Frei-
heit der Menschen, die am Beginn der politischen Moderne und der
Entwicklung zur Demokratie und zum modernen Rechtsstaat steht, ist
nicht vereinbar mit der Pluralitt von comprehensive moral doctri-
nes, wenn die denn comprehensive berhaupt sind. Insofern gibt es
ein Spannungsverhltnis. Man kann sagen, ein Gutteil der politischen
Praxis besteht darin, genau diese Grenzen der Kompatibilitt in einem
schwierigen, konfliktreichen Prozess abzustecken. Diese Beschrnkung
des overlapping consensus auf die politische Sphre ist meines Erach-
tens eine Chimre. Ginge es so leicht, wre es ja schn aber so ist es
nicht.10
Und dann stellt sich die nchste Frage, ob nicht genau das die bedeu-
tende historische Lehre des 30jhrigen Krieges von 1618 bis 1648 in Eu-
ropa war: Wir mssen lernen, nicht nur mit Konflikten des Interesses so
umzugehen, dass es nicht zum Brgerkrieg kommt, sondern wir ms-
sen auch mit fundamentalen Wertungskonflikten, mit fundamentalen
Konflikten der Lebensform umgehen lernen. Ich kann nach wie vor
berzeugt sein, dass nur eine bestimmte Weise die richtige ist, um vor
Gott zu treten und Gott zu huldigen, und dass die andere falsch ist.
Und trotzdem muss ich bereit sein, dem anderen seine Lebensform,

10 Vgl. Nida-Rmelin/zmen, Zur Normativitt des Politischen in der s-


kularen, liberalen und sozialen Demokratie, in Jahrbuch fr Recht und Ethik,
Bd. 19 (2011), S. 51-64.
Recht und Moral 13

seine Weltorientierung, seine Praxis zuzugestehen. Das ist fr die heuti-


ge Zeit so gar nicht mehr nachvollziehbar, denn ob man protestantisch
oder katholisch ist, ist heute in Deutschland nicht mehr entscheidend.
Aber fr die Menschen des 17. Jahrhunderts war die Lsung nicht In-
differenz. Sondern die Lsung war, eine Form existenzieller Toleranz
nicht Toleranz aus Indifferenz! zu etablieren.

2. Teleologie versus Deontologie

Damit bin ich beim zweiten Punkt auch kritisch und vielleicht in der
Verkrzung etwas zu polemisch: Ich glaube nicht, dass man sich damit
behelfen kann, dass man eine im wesentlichen teleologisch verfasste, auf
gemeinschaftliche Praxis bezogene Lebenswelt (oder besser Lebens-
form) einer deontologisch verfassten, im ffentlichen Raum der Grnde
zu klrenden Moralitt und Rechtlichkeit gegenberstellen kann, wie
das Habermas in Faktizitt und Geltung tut. Ich will Folgendes dage-
gen setzen: Eine humane lebensweltliche Praxis ist gerade dadurch cha-
rakterisiert, dass sie nicht teleologisch ist, sondern deontologisch. Dass
sie nicht die bereinstimmung der Interessen und der Wertungen vor-
aussetzt, sondern mit Differenzen der Interessen und Wertungen um-
zugehen erlaubt ohne Gewalt.
Nochmal ein banales Beispiel: Wenn Ihr Lebensgefhrte raucht und Sie
die berzeugung haben, das sei fr ihn massiv gesundheitsschdlich,
dann haben Sie wahrscheinlich Recht. Und wenn der Arzt das auch
noch besttigt, dann ist es so gut wie sicher, dass Sie Recht haben. Des-
halb haben Sie aber nicht das Recht, ihm die nchste Zigarettenschach-
tel aus der Hand zu schlagen. Das ist lebensweltliche Praxis. Komisch
eigentlich, denn man knnte doch auch sagen: Wenn es mir mglich ist,
das Gute zu erreichen und das Gute sogar unumstritten ist, weshalb
darf ich das dann nicht umsetzen? Eben deshalb, weil das den Status als
Autor, als voll zurechnungsfhige Person, als Erwachsener, bedroht.
Das ist ein Beispiel dafr, dass deontologische Normen tief in unserer
alltglichen Lebensform verankert sind, und zwar nicht erst jetzt. Die
tiefe Verankerung deontologischer Normen in der lebensweltlichen
Sittlichkeit ist keine Erfindung der Moderne. Man knnte vielleicht von
einer Art holistischer Deontologie sprechen. Das, was da gelegentlich
als kommunitre Sittlichkeit der Tradition phantasiert wird11, gibt es je-

11 Vgl. z. B. MacIntyre, After Virtue: A Study in Moral Theory, 1981.


14 Nida-Rmelin

denfalls mit Sicherheit nicht mehr in der modernen Gesellschaft und


gab es vermutlich noch nie jedenfalls soweit wir das aus schriftlichen
Dokumenten unseres Kulturkreises berblicken knnen.
An dieser Stelle muss ich noch einmal kurz auf den Punkt eingehen, den
ich am Anfang gebracht habe, nmlich die Rolle eigener Interessen:
Man kann durchaus sagen: Da bestimmte Konfliktflle ansonsten zu
tglichen Auseinandersetzungen fhren wrden, gibt es, um den Frie-
den zu sichern, ein allgemeines, je individuelles Interesse daran, dass wir
den anderen respektieren. Dies ist in der Tat eine gute Begrndung fr
das Prinzip, respektvoll miteinander umzugehen. Ich glaube, es ist an
der Stelle wichtig zu sehen, dass der Rekurs auf eigene Interessen fr
sich genommen, per se, berhaupt nichts begrndet, sondern immer
nur der wertende und qualifizierende Rekurs auf eigene Interessen
wenn ich zum Beispiel der berzeugung bin, dass ich legitimerweise
bestimmte Interessen habe und dass der andere keine Interessen hat, die
dagegen sprechen, dass ich diese Interessen verfolge. Eigeninteressen
knnen also immer nur normativ-wertend eine wichtige Rolle spielen,
aber nie per se. Der bloe Verweis auf das eigene Interesse, wie etwa im
Beispiel Hares mit dem jungen Mann im Boot, gibt keinerlei normati-
ven Grund zu irgendetwas. Das heit aber, dass moralische (sittliche)
Praxis nur mglich ist, wenn ich mich hinreichend vom eigenen Interes-
senstandpunkt distanziere, um diese Wertung vorzunehmen.

3. Normativer Realismus

In einem bestimmten Verstndnis scheint mir eine realistische Interpre-


tation normativer Grnde unumgnglich zu sein. Ich will das kurz er-
lutern. Unter einem ethischen, normativen Realismus verstehe ich Fol-
gendes: Ob ein bestimmter normativer Grund angemessen ist und auch
wirklich ein Grund ist also verpflichtenden Charakter hat oder nicht
ist weder davon abhngig, ob das, was ich dann, diesem Grund folgend,
tue, meinen eigenen Interessen entspricht noch vom epistemischen Zu-
stand der Akteure. Wir knnen uns irren. Wenn man sagt, dass norma-
tive Sachverhalte oder die Frage, ob ein Grund tatschlich ein Grund
ist, unabhngig sind vom eigenen Interessenstandpunkt oder vom
epistemischen Zustand der Akteure, dann ist man ethischer Realist. Was
heit das? Nicht viel! Es heit nicht, wie manchmal angenommen wird,
dass wir eine Welt idealer normativer Gegenstnde, einen Wertehim-
mel oder irgend so etwas, annehmen mssen. Wir sind keineswegs ge-
Recht und Moral 15

zwungen, eine Ontologisierung von Werten und Normen vorzuneh-


men.
Ich habe fr diese Position, fr diesen gemigten Realismus (ich habe
ihn unaufgeregt genannt) einen Realismus ohne Ontologie, wenn
man so will sprachphilosophische Argumente, die sich insbesondere
auf Donald Davidson sttzen knnen. Eine der zentralen Thesen und
in dieser These geht Davidson wesentlich ber einige andere Sprachphi-
losophen der zweiten Hlfte des 20. Jahrhunderts hinaus ist, dass er
die Verstndigungspraxis (die Mglichkeit, eine Sprache zu lernen usw.)
davon abhngig macht, dass das Gros der berzeugungen wahr ist.
Nicht nur wahrhaftig und vertrauensvoll (das auch!), sondern auch
wahr ist. Es gibt gute Argumente, die ich jetzt gar nicht nochmal wie-
derholen will, die Davidson in seiner Sprachphilosophie dafr entwi-
ckelt hat.12
Wenn das stimmt, wre es schon uerst merkwrdig, wenn ein be-
stimmter Bereich unserer Verstndigungspraxis davon ausgenommen
sein soll. Wir haben normative berzeugungen hinsichtlich der Frage,
ob etwas ein guter Grund fr eine Praxis ist oder nicht. Da soll das alles
nicht mehr gelten? Das scheint mir nur bei einer sehr speziellen er-
kenntnistheoretischen Position vertretbar zu sein. Etwa derjenigen,
wonach nur das, was naturwissenschaftlich klrbar ist, berhaupt wahr-
heitsfhig sei, also bei naturalistischen Positionen. Wenn man diese
nicht einnimmt und aus meiner Sicht spricht nichts dafr, sie einzu-
nehmen13 dann ist das eine Merkwrdigkeit. Eine Merkwrdigkeit,
die brigens ein Philosoph auf den Begriff gebracht hat, nmlich John
Mackie.14 Der sagt: Ich bleibe Subjektivist, aber ich gebe zu, die Sprache
ist irgendwie anders also Error Theory of Morals: Wir irren uns je-
doch, indem wir so sprechen permanent. Vorsicht, das hat eine ungute
philosophische Tradition: Wir irren uns hinsichtlich des Fremdpsychi-
schen? Oder hinsichtlich der Existenz der Auenwelt? Globale Irr-
tumstheorien fhren auf philosophische Abwege.
Ich mchte das Gesagte zum Schluss konkretisieren: Mir scheint, dass
der Menschenrechtsdiskurs damit meine ich nicht die Praxis der Be-
folgung, sondern die Praxis, wie ber Menschenrechte gesprochen wird

12 Vgl. Davidson, Radical Interpretation, Dialectica 27 (1973), S. 313-328.


13 Die Naturalismus-Problematik wurde fr mich berraschend zum ro-
ten Faden der Diskussion in Sturma (Hrsg.), Vernunft und Freiheit. Zur prakti-
schen Philosophie von Julian Nida-Rmelin, Berlin: de Gruyter, i. E.
14 Mackie, Ethics. Inventing Right and Wrong, 1977.
16 Nida-Rmelin

und wie Menschenrechte begrndet werden ohne eine realistische In-


terpretation nicht sehr plausibel ist. Das gilt auch fr die von Juristen
gerne so genannte Ewigkeitsgarantie der Grundrechte unseres Grund-
gesetzes. Was knnte das rechtfertigen, wenn nicht die berzeugung,
dass unabhngig jetzt formuliere ich es in meiner Terminologie von
den epistemischen Zustnden der deutschen Bevlkerung oder der Poli-
tik in den Parlamenten diese Rechte gelten? (Ich verwende gelten
nicht in dem engen Habermasschen Sinne, sondern im Sinne von gute
Grnde fr sich haben, etwas zu tun oder etwas zu unterlassen.) Diese
realistische Interpretation ist selbstverstndlich das brauche ich nach
dem Vorausgegangenen nicht mehr nher zu begrnden kompatibel
mit der normativen Rolle von Konventionen, von Setzungen, mit der
normativen Relevanz von Verfahren und ist auch kompatibel mit de-
mokratischer Selbstbestimmung. Demokratische Selbstbestimmung
findet eben in den Grenzen von Menschenrechten statt und die Men-
schenrechte im normativen Sinne sind selbst nicht lediglich das Produkt
einer Verstndigungspraxis. In dem Sinne pldiere ich also fr einen
rechtsethischen Realismus ohne ontologische Hypostasierungen und
gegen die traditionelle Naturrechtstheorie, die Ausdruck einer Ontolo-
gisierung des rechtsethischen Realismus ist.
Legitimacy: Where Justice Meets the Law
Wilfried Hinsch

This article is about relations between justice and the law. Justice and
the law is a notorious topic of political philosophy since its beginnings
in ancient Greece. Perhaps it is the topic of political philosophy. Aris-
totle, Hobbes, and Kant among others have made important contribu-
tions to the subject. More recently it has received a good deal of atten-
tion, for example in the works of Herbert Hart, John Rawls, Ronald
Dworkin, and Joseph Raz. Notwithstanding the impressive collective
manpower that went into the discussion, the relations between justice
and the law do not seem to be fully understood yet. The more promi-
nent theories in the field give remarkably different accounts of what is
going on between justice and the law, but none of these accounts seems
to be safe from serious objections. I shall not pursue this historical
point any further.1 In any case, students of political philosophy may
still feel the need to find out on their own about the relations that exist
or do not exist between justice and the law. Furthermore, they may
be unsure of whether there is still something new to be discovered in
addressing the old issue again.
There are four points of a somewhat general and tentative nature that I
want to make in this article:
(1) A crucial element of the relationship between justice and the law
may be captured by a normative theory of legitimacy that is distinc-
tively different from a theory of justice and also from a theory of posi-
tive law.

1 Cf. Green, Leslie (2003), Legal Obligation and Authority, Stanford En-
cyclopedia of Philosophy, http://plato.stanford.edu/legal-obligation/.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 17
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_2, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
18 Hinsch

(2) The social role of legitimacy is the resolution of disagreements


about justice and other issues of public policy in a partly non-
argumentative procedural and factual way.
(3) Legitimacy as a particular way of social conflict resolution
presupposes and combines elements of basic justice and of positive law.
It is, as it were, the place where justice meets the law in order to become
the basis of a well-ordered society.
(4) Disagreement about justice readily translates into disagreement
about legitimacy. Reasonable disagreement about justice may, therefore,
be expected to constrain the reach of legitimate public policy in a ra-
tionally and procedurally irresolvable way.

I. Justice, Law, Legitimacy

For the purpose of this paper, we may think of justice as that part of
morality that, directly or indirectly, applies to social norms, which may
or may not conform with what we believe justice requires. Moreover,
justice is meant to refer to a set of substantive moral demands and not
just to a merely formal requirement of universalizability.
Let the term law refer to positive law (as opposed to natural law), i.e.
to existing systems of social rules that require and (in many cases) en-
force compliance and punish non-compliance. More specifically, I shall
conceive of positive law in the way Herbert Hart did, viz. as an estab-
lished system of primary and secondary rules for the regulation of hu-
man conduct that is backed up by sanctions.2 Primary rules are directly
regulative in imposing legal obligations on individuals to do or not to
do certain things. Following Hart, the existence of a legal system re-
quires that compliance with its primary rules will be generally enforced,
but not necessarily compliance with every single rule. Secondary rules
regulate how primary rules are established, changed, and applied to par-
ticular cases. A legal system derives its unity from a particular secon-
dary rule, the rule of recognition. This rule specifies the criteria of legal
validity that any rule, be it primary or secondary, has to meet in order
to be valid law in the respective legal system. In modern democracies,
the rule of recognition is typically embodied in the written constitution
of a state and refers to the process of democratic will-formation and de-

2 Hart, Herbert L. A. (1994), The Concept of Law, 2nd ed., Oxford, Chapter
V.
Legitimacy: Where Justice Meets the Law 19

cision-making. According to Harts concept of law, it is another condi-


tion of the existence of a legal system that its rule of recognition be
publicly recognized. It is of particular importance that the officials who
administer the legal system endorse the rule as their standard for the de-
termination of what the law is and generally act accordingly when in-
terpreting and applying the law. All rules of a legal system derive their
legal validity from meeting the relevant criteria specified by the rule of
recognition, except the rule of recognition itself. On Harts account,
this rule is binding law not because it conforms with another (higher)
rule or principle but because of the mere social fact that it is officially
recognized by the officials of the system.
Harts account of positive law shares with the tradition of classical legal
positivism the assumption of a conceptual gap between justice as a
moral notion and the law as a social phenomenon: Demands of justice
are not necessarily legal demands and legal demands are not necessarily
in conformity with what justice requires. The criteria of legal validity
specified by the rule of recognition in any given society, therefore, may
or may not involve requirements of justice. In principle, even grossly
unjust norms may be valid law in a given legal system if the established
rule of recognition does not contain any provisions to the contrary. A
law may, for instance, be unjustly discriminating against an ethnic mi-
nority or be the upshot of an unjust procedure of law-making and still
be a legally valid law. Legal validity merely requires that the law be in
conformity with the systems rule of recognition and not that it con-
forms to criteria of justice. If this rule, however, contains requirements
of justice, unjust norms would not qualify as valid law and, in the re-
spective system, legal validity would (contingently) hinge upon moral
requirements.3
Often we are not only legally but also morally obligated to comply
with unjust but legally valid laws. The high value of stable mutual ex-
pectations among fellow citizens who are subjects of the same legal sys-
tem, and the importance of social stability in general are strong moral
reasons to conform with the law irrespective of its morally defective
content or pedigree. In cases of grossly unjust laws, however, the stabil-
ity-related reasons for compliance will normally be outweighed by the

3 It is worth noting however, that, if this is all that legal positivists wish to
emphasize, then Thomas Aquinas is a legal positivist. Arguably, the whole point
of the natural law slogan lex iniusta non est lex is to emphasize that valid law
may lack normative authority (cf. Finnis, John (2000), The Incoherence of Le-
gal Positivism, Notre Dame Law Review 75, 1597-1612; 1606).
20 Hinsch

moral demand of not acting grossly unjust. Non-compliance with a le-


gally valid rule will then become morally permissible if not mandatory.
Even if requirements of justice are not seen as necessary criteria of legal
validity, they seem to be involved in explaining under what conditions
legally valid rules obtain normative authority.
Normative authority is a difficult and notoriously contested notion. It
is not easy to avoid confusion. A line of thought that goes back to
Hobbes, Bentham, and John Austin explains normative authority in
terms of effective control and the likeliness of punishment. Following
this line, a norm has normative authority if people generally comply
with it and if non-compliance carries the risk of punishment. I shall nei-
ther criticize nor endorse this approach here, but shall put it aside.
Another line of thought that can be traced back to Max Weber and that
is also prominent in Harts work is to say that a norm has normative
authority if it is socially recognized as a valid standard of conduct and if
there is social pressure to conform to it. The term standard of conduct
here refers to the justificatory role of a norm as a (direct or indirect)
reason for action, criticism, and punishment. Those who recognize the
norm as a standard believe that they should act in conformity with the
norm and take the very existence of the norm as a reason to act accord-
ingly. They also believe that a violation of the norm is a reason for criti-
cism and, in some cases, for punishment.
Note, that this understanding of normative authority unlike the first
one that focuses on effective control and the risk of punishment es-
sentially refers to subjective beliefs and attitudes that those who are
subjected to a norm, say by an established legal system, may or may not
have. We need to find out first whether individuals have the appropriate
beliefs and attitudes with regard to a given norm before we can tell
whether (and for whom) the norm has normative authority. Norms that
are generally accepted in a group and that apply to all members of the
group like legal norms may, therefore, have normative authority for
some members of the group but not for others. The difficulties in spell-
ing out in greater detail which kinds of beliefs and attitudes a person
needs to have in order to recognize a norm as a valid standard of con-
duct are a problem with this approach. One may hold that authority
requires more than effective control and that norms are reasons for ac-
tions, not simply patterns of convergent social behavior, and still be un-
sure about the relevance of moral beliefs and attitudes. Do we have to
believe, for instance, that a law meets minimal demands of justice in or-
der to recognize it as a standard of conduct? I shall not try to give a
Legitimacy: Where Justice Meets the Law 21

profound answer to this complicated question but only make two


points.
Firstly, if normative authority requires (minimal) justice, then legally
valid but grossly unjust rules cannot have normative authority and,
hence, cannot be seen as standards of conduct that we should comply
with. This, however, would seem to imply that they cannot be norms
that impose obligations. If legal obligations are a subspecies of obliga-
tions in general as Hart maintains in The Concept of Law4 , then it
would seem contrary to what Hart says that legally valid rules can-
not impose legal obligations. We would then not even be legally obli-
gated to comply with unjust positive law, and this will strike many as
paradoxical. I shall, however, not pursue this line of complications any
further.5
Secondly, consider the person who refuses to comply with a legally
valid but immoral norm, because she believes that the norm (or its ap-
plication in the given situation) is not in conformity even with minimal
requirements of justice. This person apparently ascribes normative au-
thority to the respective moral requirements. She believes that she
should act in conformity with justice, rather than with the (legally
valid) immoral law. If she also believes that she should do so because it
is a requirement of justice and because she could reasonably be criti-
cized (and perhaps even punished) if she did not, then the relevant con-
ditions of normative authority seem to be met. Then, the question of
whether this person can, nevertheless, consistently ascribe normative
authority also to the immoral law, solely in virtue of its legal validity,
arises. My hunch is that she cannot, for the following reason: If she as-
cribed normative authority to the legally valid but immoral law sim-
ply in virtue of its legal validity , she would subscribe to a general
norm like act in conformity with legally valid but immoral rules. We
assume, however, that she actually recognizes a moral standard like
never act in conformity with legally valid but immoral rules, and she
clearly cannot have it both ways.
I do not claim that this is the end of the story. The terms legal validity
and normative authority can surely be explained in ways that will
make legal validity a logically sufficient condition of normative author-
ity and normative authority a necessary condition of legal validity. But

4 Hart, Herbert L. A., supra note 2, 167-180.


5 Cf. Raz, Joseph (1979), The Authority of Law, Oxford, Chapters 12 and
13.
22 Hinsch

this is not how I shall use these terms in this article. Rather, I shall use
legal validity as explained in the first section, and normative author-
ity as a predicate for (legal) norms that do meet basic requirements of
justice. Those who for philosophical reasons feel uneasy about this may
just take it as a matter of linguistic convention. My digression about le-
gal validity and normative authority was meant to motivate this termi-
nological choice. Still, we want to know more about the relationship
between justice and positive law and especially about the requirements
of basic justice that laws supposedly have to meet in order to have
moral standing and normative authority.
Even if one assumes a conceptual gap between justice and positive law,
there are still various functional relations that in one way or other relate
to the question of normative authority. Positive law contributes to the
solution of co-ordination problems (e.g. by regulating traffic) and it
helps to stabilize schemes of voluntary social co-operation e. g. by giv-
ing all participants an additional incentive (the risk of punishment) to
honor agreed upon terms of co-operation and to play by the rules. At
least in ideal theory, all this is to the benefit (but not necessarily to the
equal benefit) of everybody. To the extent that there is agreement about
what justice requires, the deliverance of justice itself may also be seen as
a public good. Think of precepts like No Killing!, No Fraud!, or
Pacta sunt servanda! that are, in one way or other, part of all legal sys-
tems. In incorporating and enforcing these precepts, positive law is at
the same time an instrument of justice and of public good provision.
Positive law is also an instrument of justice when it protects the weak
against the strong or when it helps to bring about economic justice by
effecting and enforcing transfers from the rich to the poor, even though
this will arguably not benefit everybody. Another relation between jus-
tice and the law is that justice functions as a normative constraint on
positive law. As a matter of (formal) justice, we expect judges not to
make arbitrary distinctions between similar cases in their opinions and
to treat equal cases equally. Furthermore, out of respect for the value of
individual autonomy, we are critical about retroactive legislation. Peo-
ple should be able, we believe, to make informed decisions and know in
advance what to expect from the law. No doubt, much of the authority
that we normally attribute to the law is due to the fact that it de facto
incorporates elements of justice.
Another aspect of the intimate relationship between justice and the law
that is relevant with regard to the question of normative authority is
semantic. Many legal norms may be seen as specifications of more gen-
eral precepts or principles of justice. A principle like Pacta sunt ser-
Legitimacy: Where Justice Meets the Law 23

vanda, for instance, does not give us all the details of modern contract
law. It does not tell us anything about the conditions that contracts
must fulfill in order to be legally valid and enforceable or the conditions
under which we may renegotiate a contract or be permitted not to per-
form. One does not need to engage in comparative jurisprudence to see
that there are many alternative and mutually incompatible ways to
work out the details of contract laws as equally reasonable specifica-
tions of Pacta sunt servanda. The same is true for other precepts of jus-
tice like the prohibition of rape and torture or freedom of speech and
religious liberty. They all allow for different legal specifications that can
reasonably be seen as specifications of the same principle of justice,
even though there may be a disagreement with regard to their ranking
in terms of comparative justice. How, then, do we decide between dif-
ferent legal specifications of the more general requirements of justice as
regarding their normative authority? If we have a disagreement about
alternative legal specifications, all of which in spite of the disagree-
ment qualify as reasonably just specifications, none of the alternatives
can derive its normative authority as a legal norm merely from being in
conformity with what justice requires. Some other source of normative
authority is required.
The last, but by no means least important, relation between justice and
the law to be introduced here is procedural. It is an essential element in
our understanding of a constitutional democracy that elements of jus-
tice do not only figure as a content or as a constraint on the content of
the law, but also as a condition of law-making. The modern idea of lib-
eral democracy is closely tied up with the idea of political justice and
basic constitutional rights of political participation, e.g. the principles of
free speech and freedom of association, equal voting rights, and the idea
of decision-making by majority rule. Constitutional democracies in-
corporate these basic rights of political justice as conditions of law-
making and, hence, as criteria of their respective rules of recognition
and, hence, legal validity.
Legitimate rules and decisions, it is said, have normative authority.6
They are conceived as mandatory or binding by those who ascribe
legitimacy to them.7 Legitimacy applies primarily in the domain of the

6 Cf. Flathman, Richard E. (1993), Legitimacy, in R. Goodin/ P. Pettit,


eds., A Companion to Contemporary Political Philosophy. Cambridge, 527-
533; 527.
7 Legitimate secondary rules in Harts sense are not adequately described in
this way. They do not impose obligations and cannot be seen as binding in the
24 Hinsch

political and relates to the exercise of coercive state power. Assuming


that legitimate rules and decisions are mandatory, we think it appropri-
ate that they be enforced by state action should that prove necessary. In
any case, legitimacy is typically taken to be a necessary condition of
any justifiable use of state power, and it is taken to presuppose justice.8
Still, legitimacy is not simply justice addressed to a special area say the
coercive use of political power by means of positive law. Justice and
legitimacy are distinct normative concepts that operate in remarkably
different ways. Legitimacy is as close to legal validity and positive law
as it is to justice, and it is crucial for an appropriate understanding of
the relations between justice and the law. Legitimacy functions like a
bridge in connecting these two piers of social order, and it is hard to see
how the two piers could do without the bridge. Justice and the law
need legitimacy to fulfill their function as the two main elements of a
social order that is effective and has normative authority at the same
time and, hence, is more than just another way of coercing people into
doing what they would otherwise have no reason to do.
Our subject is the normative concept of legitimacy that we find in
moral and political philosophy and not the empirical concept of the so-
cial sciences. Unlike the empirical concept, the normative concept of le-
gitimacy is not meant to explain compliance with social rules but to jus-
tify these rules and to give an account of why we should accept certain
(legal) norms as standards of individual conduct and as reasons for ac-
tion. To say that a norm or institutional arrangement is legitimate in the
normative sense is to say that it meets certain substantive requirements
of justice and rationality irrespective of whether people believe that
they are met. Mere factual approval of social rules and institutions does
not suffice. Still, the normative concept involves moral approval on the
side of those who apply it to a norm or institutional arrangement. To
say that something is legitimate in the normative sense is to publicly
recognize that it has moral standing, and not merely to report that there

usual sense of the word. They may perhaps be seen as being indirectly binding,
because judges and other officials have an obligation to apply them correctly.
Literally speaking, however, a secondary norm like Contracts have to be signed
by their parties does not prescribe what judges have to do, but specifies a con-
dition that legally binding contracts have to fulfill (cf. Hart, Herbert L. A., su-
pra note 2, Chapter 3). I shall ignore this complication.
8 For this and the following explanation of legitimacy cf. Hinsch, Wilfried
(2010), Justice, Legitimacy, and Constitutional Rights, Critical Review of In-
ternational Social and Political Philosophy 13, 39-54.
Legitimacy: Where Justice Meets the Law 25

are people who believe that it has moral standing. Any normative con-
ception, therefore, has to expound its substantive criteria of legitimacy
in a way that explains why meeting these criteria actually confers nor-
mative authority: A conception of democratic legitimacy, for instance,
has to explain the capacity of democratic legislation to generate laws
that have normative authority and not only legal validity.
Principles of political justice are identified by means of rational argu-
mentation. If, after due consideration of all the relevant facts, values,
and principles, a reasonable disagreement concerning principles of basic
justice persisted, then the notion of political justice would, for precisely
this reason, remain indeterminate. But even if there was no disagree-
ment, it would be mere fancy to expect that a reasoned consensus about
basic justice could be extended to cover the whole range of norms and
institutional arrangements of a modern society. Even on the assumption
that the process of collective decision-making is fully rational and rea-
sonable, justified differences of opinion may persist and make it impos-
sible to find a collective decision against which no reasonable objections
can be raised. Given this prospect and given the aim of establishing col-
lectively binding norms that can be publicly justified and have norma-
tive authority , non-argumentative forms of collective decision-
making like voting or deciding by lottery have to be employed in order
to answer the question of which norms among those that arguably meet
the requirements of justice should become collectively binding. I take it
that legitimacy is about dissolving political disagreement most impor-
tantly disagreement about justice in procedurally and morally ade-
quate ways. Furthermore, the primary role of legitimacy in political
discourse and theory is to give normative authority to binding norms
and institutional arrangements that may be reasonably criticized as un-
just by at least some of those who are supposed to comply with them.
The notion of what is politically legitimate is, therefore, only partially
determined by criteria of justice and by moral argument. To a much
greater extent it is fixed by a non-argumentative procedure. As far as
constitutional democracies are concerned, the legitimate is determined
by majority voting. As a result, legislation may in many cases be put le-
gitimately into effect, against which reasonable objections can and will
be raised, at least on the part of some citizens. Such controversial deci-
sions cannot be fully justified on the basis of substantive argument
alone, but only by appealing to the fact that they are the result of a de-
cision-making process, recourse to which appears fair and reasonable
under the given conditions.
26 Hinsch

A conception of normative legitimacy specifies the conditions under


which collectively binding decisions can be reached by the factual
working of non-argumentative procedures like voting. To say, then,
that a norm is legitimate (normatively speaking) is to say not only that
the norm meets certain requirements of basic justice but also that it has
a certain factual pedigree. The factual pedigree element is crucial for a
normative conception of legitimacy. It explains at the same time the
fundamental difference between justice and legitimacy and the struc-
tural affinity between legitimacy and positive law. Nevertheless, the
procedural, non-argumentative element of legitimacy and its substan-
tive, non-procedural element (that relates legitimacy to justice) do not
have equal standing. Given the need to justify political authority, moral
argument and justice are prior to the non-argumentative forms of deci-
sion-making. Whether a particular political procedure (say voting or a
lottery) is a fair or just procedure is not itself to be decided by voting or
by lottery. It is to be determined by substantive argument. The question
of why we should prefer a democratic procedure over others is a ques-
tion of substantive justice.

II. Rawls Liberal Principle of Legitimacy

It is one of the functions of the political constitution of a democratic


society to set up a framework for collective political decisions and law-
making. In particular, a constitution has to enunciate the conditions
under which democratic voting produces legitimate legislation and gen-
erates laws with normative authority that may rightfully be enforced.
In this sense, Rawls liberal principle of legitimacy refers to the constitu-
tion of a liberal democracy as a normative standard for the appropriate
exercise of political power:
Our exercise of political power is fully proper only when it is exer-
cised in accordance with a constitution the essentials of which all
citizens as free and equal may be reasonably expected to endorse in
the light of principles and ideals acceptable to their common human
reason.9
Rawls principle has to be seen in the context of his contractualist con-
ception of justice that is based on an idea of free and equal citizenship.
Respect for citizens understood as autonomous agents with a sense of

9 Rawls, John (1993), Political Liberalism, New York, 137.


Legitimacy: Where Justice Meets the Law 27

justice requires that binding social norms and, in particular, the con-
stitutional norms that define the procedures of law-making can be
publicly justified. To expect citizens to comply with rules that must
seem arbitrary and partial to them is normally inconsistent with regard-
ing them as free and equal persons with a capacity for fair co-operation.
The constitutional essentials mentioned by the liberal principle of le-
gitimacy are conditions of legitimate government. They describe the
general structure and processes of government and define a political
process that is capable of generating legitimate norms in virtue of the
fact that it meets the relevant basic right requirements. These fall under
two headings: basic political and basic liberal rights. The former de-
scribes features of just decision-making procedures in a democracy
(freedom of speech, freedom of association, equal voting rights). The
latter defines a sphere of individual liberty that even procedurally cor-
rect, democratic decisions cannot violate without losing their legitimacy
(religious liberty, freedom of conscience, rule of law, privacy rights).
There are three critical points that I want to make with regard to Rawls
principle of legitimacy. Firstly, the principle obviously presupposes a
constitution as a normative framework for the fully proper exercise of
political power. The legitimacy of the constitution itself can, therefore,
not be explained on the basis of this principle. I shall come back to this
later. Secondly and closely related to the first point is the critique of
Jrgen Habermas that there is an unresolved tension in Rawls theory
between the democratic principle of popular sovereignty and the idea
that the basic constitutional rights have as elements of political justice
normative authority irrespective of popular consent.10 If the basic
rights are elements of justice, their content can, indeed, not be deter-
mined by a process of political deliberation and voting. Questions of
justice, we believe, are to be settled by argument and not by any kind of
factual political process that involves non-argumentative procedures
like voting. It may seem, then, that (pace Rawls) important elements of
liberal constitutions, the basic rights, have, indeed, been removed from
the processes of democratic decision-making and from the reach of
popular sovereignty.

10 Cf. Habermas, Jrgen (1995), Reconciliation Through the Public Use of


Reason: Remarks on John Rawlss Political Liberalism, The Journal of Phi-
losophy, XCII, 109-131.
28 Hinsch

One way to address the criticism of Habermas is to deny that the Rawl-
sian basic rights are constitutional rights.11 Unlike the moral basic right
requirements of the first principle of justice, the constitutional rights of
liberal democracies are legal rights. As legal rights, they are institution-
ally embodied and backed up by a framework of established legal struc-
tures that secure their orderly administration and enforcement. More-
over, legal rights are not established by moral argument but by a factual
process that may have involved a constitutional convention that ef-
fectively establishes a socially recognized rule of recognition in line
with the basic right requirements of liberal democracies. The basic
moral rights of political justice share with the constitutional rights of
liberal democracies their substance and the formal structure of rights (in
terms of Hohfeldian claim-rights, immunities, or powers), but they are
not constitutional rights because they are not legal rights.12 They are
constitutional essentials not in the sense of legal rights that are consti-
tutive parts of a real constitutional order. Rather, they are essentials in
the sense of moral requirements that these constitutions have to meet in
order to be basically just and to qualify as a source of legitimacy.
One important difference between the basic rights of justice and the
constitutional rights of liberal democracies is that the former are much
less specific than their constitutional correlates. A great variety of alter-
native constitutional rights may guarantee the same basic right re-
quirement of justice. This difference in specificity explains why
Habermas critique is not fatal for a contractualist theory. Since consti-
tutional rights are always more specific than the corresponding basic
rights, schemes of constitutional rights can never be fully justified
solely on the basis of those moral arguments that establish the basic
rights of justice. Furthermore, if all the constitutional schemes that ac-
tually incorporate and protect these basic rights are supposed to be
equally just, then there may be reasonable disagreement as to which
specific scheme should be established in a particular society as the most
appropriate way to realize political justice. In order to publicly justify
and to give normative authority to any such scheme, we need a partly
non-argumentative way of collective decision-making which, on the as-
sumption that democracy is a requirement of justice, will be a proce-

11 Cf. Hinsch, Wilfried, supra note 8. We must keep in mind, though, that
Rawls takes these basic rights and liberties to be constitutional rights: Rawls,
John, supra note 9, 228 f.
12 We may say they are proto-constitutional-rights (cf. Hinsch, Wilfried,
supra note 8).
Legitimacy: Where Justice Meets the Law 29

dure of democratic decision-making. There can be no legitimate consti-


tution with normative authority that has not been subject to an ade-
quately framed democratic process like a constitutional convention
which involves fair voting procedures to resolve disagreement in mat-
ters of political justice and expediency, and which also meets the basic
right requirements of political justice. In response to Habermas we may
say, then, that constitutional rights along with all other legal rights
obtain legitimacy and normative authority only by means of a factual
democratic process with non-argumentative elements that realizes the
idea of popular sovereignty.
A third and most critical point that has to be addressed with regard to
Rawls principle of legitimacy is that the principle presupposes a rea-
soned agreement on the basic elements of justice that comprise the
constitutional essentials. Jeremy Waldron has stressed this point in his
Law and Disagreement.13 Rawls principle does not give us any idea
about how to use political power properly when there is disagreement
about the constitutional essentials and how to proceed in order to han-
dle irresolvable dissent at the level of basic political justice. Reasonable
and unreasonable disagreement about justice at the level of ordinary
legislation is ubiquitous and, of course, taken into account by Rawls.14
It is, however, not much of a theoretical problem as long as it can be
handled by means of majority voting on the basis of an agreed upon
constitution that conforms with basic requirements of justice. Even dis-
agreement, reasonable and unreasonable, about questions of constitu-
tional design and the specification of the constitutional essentials in
terms of constitutional rights may (at least in theory) not be much of a
problem, provided that there is a sufficiently substantive agreement
about basic justice and the constitutional essentials themselves. If there
is such an agreement, one may have a constitutional convention and set
up a democratic procedure that meets the agreed upon requirements of
basic justice, and then choose among the alternative schemes of consti-
tutional rights and provisions by means of majority voting.
In the absence of an agreement on basic justice and the constitutional
essentials, or if there is explicit, reasonable disagreement, there can be
no legitimate constitution and in turn no legitimate legislation. Or

13 Waldron, Jeremy (1999), Law and Disagreement, Oxford, Chapter 7.


14 The question whether legislation is just or unjust, especially in connection
with economic and social policies, is commonly subject to reasonable differ-
ences of opinion. (Rawls, John (1999), A Theory of Justice, 2nd ed. Cambridge,
MA, 174 f.).
30 Hinsch

rather, this seems to be the case if we follow the contractualist path of


Rawls liberal principle of legitimacy. The principle seemingly offers no
conception of legitimacy for a world in which people do not only dis-
agree about god, the meaning of life or the practical details of ordinary
legislation, but also about the basics of political justice.15

III. Irresolvable Disagreement

Reliance on agreed upon conceptions of basic political justice may well


be seen as a fatal flaw for a theory of legitimacy and normative author-
ity. Disagreement about questions of basic justice is a common fact of
political life. A viable political theory may deal with it in one way or
other but it certainly must not deny the obvious. Waldron rightly em-
phasizes the unavoidability of our disagreements about justice:
We not only disagree about the existence of God and the meaning
of life; we disagree also about what counts as fair terms of co-
operation among people who disagree about the existence of God
and the meaning of life. We disagree about what we owe each other

15 This bleak diagnosis seems to be confirmed by what Rawls writes in A

Theory of Justice about the four stages in which his two principles of justice are
supposed to be applied in political practice (Rawls, John, supra note 14, Chap-
ter 31). The first stage is the stage of the original position in which the two
principles are to be identified by a hypothetically unanimous agreement. The
second stage is a hypothetical constitutional convention which serves to estab-
lish the main elements of the political constitution of a society. The constitu-
tional convention, like the deliberations in the original position, takes place be-
hind a veil of ignorance to ensure fair conditions of deliberation but the veil has
been lifted a little bit to allow the convening parties to draw on additional his-
torical and circumstantial information that is relevant for constitutional design
but not available in the original position. Note that in Rawls four stage se-
quence the constitutional convention is still fictional (like the original position)
and no disagreement is to be expected. Following Rawls, disagreement firstly
occurs at the third stage, the stage of the legislative process where the details of
social policy are specified and where disagreement as regarding the proper ap-
plication of the second principle of justice may occur. The fourth and final stage
is the stage of the application of norms by judges, administrators, and citizens
where, again, disagreement is to be expected but can be handled by the proce-
dures specified in the earlier stages.
Legitimacy: Where Justice Meets the Law 31

in the way of tolerance, forebearance, respect, co-operation, and


mutual aid.16
Indeed, in Waldrons view it may well be seen as the main task of politi-
cal philosophy to face the fact of persistent disagreement about justice.
Maybe what is definitive of political philosophy the philosophy
of politics, after all, is that it asks how a society can be well-ordered
in its procedures for debate and decision-making when its citizens
disagree, not only about the good, but also about justice.17
Again, I think that Waldron is right on this point, even though I should
like to point out that our notions of a well-ordered society may be
closely connected to our ideas of political justice and, hence, be no less
controversial than the latter.
Political dissent is ubiquitous but not all disagreement is reasonable and
even though a normative political theory has to deal with both kinds of
disagreement (reasonable and unreasonable), rational dissent in matters
of basic justice is special. There are philosophers who deny the possibil-
ity of reasonable disagreement regarding basic questions of the good
and the right.18 If they were right, disagreement about basic justice
could always, at least in principle, be traced back to factual errors or
logical inconsistencies. Procedures like majority voting that are de-
signed to deal with disagreement would then be understood as merely
pragmatic ways of dealing with ignorance, irrationality, or limited re-
sources of other kinds. Normally, voting is preferable to having a fight,
and most of the time the attractions of secession are limited too. The
fact that a controversial political issue was decided by a vote, however,
would, by itself, not confer legitimacy or normative authority on the re-
sult, say a particular legal regulation. The only source of legitimacy and
normative authority would be the true conception of the good and the
right. If we allow for reasonable disagreement, on the other hand, there
is no unambiguously true conception and voting as a non-argumenta-
tive decision-making procedure becomes a necessary part of the public
justification of social arrangements and does establish the normative au-
thority of the latter. Presumably, there is no proof that all disagreement
about the human good and basic justice is due to ignorance or lack of
rationality. Nevertheless, a normative political theory must take into

16 Waldron, Jeremy, supra note 13, 1.


17 Waldron, Jeremy, supra note 13, 158.
18 Cf. MacIntyre, Alisdair (1990), The Privatization of Good, Review of
Politics 52, 344-361.
32 Hinsch

account the possibility of reasonable disagreement at all levels of politi-


cal argument and decision-making, and be able to explain how legiti-
macy and normative authority are possible under this condition.
Let us say that, as a matter of ideal theory, we have a situation of rea-
sonable disagreement if the disagreeing parties have sufficiently strong
reasons to support their respective claims and positions, but no party is
capable of putting forward generally acknowledged reasons strong
enough to eliminate all competing claims.
Now it is one thing to allow for the possibility of reasonable disagree-
ment and another to claim that a reasoned agreement about justice is in-
feasible. The latter position has been taken by Amartya Sen in his re-
cent book The Idea of Justice.19 In the presence of incompatible consid-
erations of justice (need, desert, well-being, equality), Sen maintains
that no unambiguously just institutional arrangements can be identi-
fied, because any arrangements will have to strike a balance between
competing claims or set priorities in a way that can be reasonably chal-
lenged.20 Sen gives an example in which a flute is to be given to one of
three children, Anne, Bob, or Carla. Each of the children has a good
reason to claim the instrument. Unlike Bob and Carla, Anne knows
how to play the flute. Aristotelians may be expected to support her
claim. Used by Anne the flute would presumably contribute most to
the further development and exercise of higher human faculties. Utili-
tarians would perhaps take sides with Aristotelians in this case, expect-
ing that Annes beautiful play will increase overall happiness. Unfortu-
nately, Bob and Carla do not agree. Bob is the only one in the group
who has no toy on his own yet. This raises a claim of need and it also
speaks to our egalitarian intuitions. Carla, however, is the one who has
produced the flute and claims the instrument either as a just desert or
else in the name of a libertarian conception of just acquisition and pos-
session.
Sen maintains that the existing conflict between competing individual
claims of justice cannot be resolved by any uncontested account of jus-
tice21, and each of the respective claims development of human capaci-

19 Sen, Amartya (2009), The Idea of Justice, Cambridge, MA. For the fol-

lowing discussion of Sens infeasibility claim with regard to generally agreed


upon conceptions of justice, cf. Hinsch, Wilfried (2012) Ideal Justice and Ra-
tional Dissent. A Critique of Amartya Sens Idea of Justice, Analyse und
Kritik, forthcoming.
20 Sen, Amartya, supra note 19, 12-15.
21 Sen, Amartya, supra note 19, 13 ff.
Legitimacy: Where Justice Meets the Law 33

ties, happiness, need, equality, desert or just acquisition seems to in-


deed be well founded. Moreover, it is hard to see how the conflict could
be resolved in an incontrovertible manner by assigning relative weights
to the respective considerations or by invoking priority rules. As a con-
sequence, every feasible resolution of the conflict would not only let
two of the children go empty-handed. After all, this could be exactly
what justice requires. It would also be a resolution against which well-
founded considerations of justice could be advanced.22
Who should get the flute, then? I shall not try to answer this question.
Given the setting of the example, a non-arbitrary answer may be diffi-
cult to find, indeed. Still, there may be a uniquely right solution once
the institutional context of the distributional conflict, the existing
scheme of property rights, and perhaps additional circumstantial in-
formation is taken into account. Note also, that the flute example has a
number of features that do not apply to questions of basic institutional
justice. Anne, Bob, and Carla know their initial endowments of goods,
they know their capacities, preferences, and other personal characteris-
tics, and they are able to identify individual productive contributions.
The initial endowment is taken as a given constellation of circumstances
in the light of which any solution to the distribution problem has to be
judged. Moreover, Anne, Bob, and Carla face a singular distribution
problem with one indivisible good to be distributed, a good that has
been produced by one person, Carla, apparently without any kind of
social cooperation. Under these conditions, it may indeed be impossible
to find an unambiguously just solution, given the competing and prima
vista reasonable claims of Anne, Bob, and Carla, and given the scarce
information we have. This by itself, however, does not prove that we
cannot have a sufficiently unambiguous and uncontested conception of
justice when dealing with institutional structures and procedures of col-
lective decision-making in a society with equal citizens. The flute ex-
ample and Sens argument from incompatible claims simply does not
apply in any direct or obvious way to the problems of basic institu-
tional justice.
Still, there is a lot of disagreement about what justice (at all levels of
generality) requires and there is little reason to expect this situation to
change in the foreseeable future. Any viable normative political theory
has to accommodate this elementary truth. There are three prominent
strategies to cope with irresolvable political disagreement about basic

22 Sen, Amartya, supra note 19, 14.


34 Hinsch

justice that I shall briefly discuss in the following sections: (1) Minimal-
ism, (2) Hobbesian authoritarianism, (3) democratic proceduralism.
Minimalism says: If you find it hard to reach a consensus in a contested
area of social life, and if a generally binding regulation is needed, do not
claim more than the minimum necessary to settle the disputed issue.
Also try to justify your claims in terms of interests, values, or principles
that are shared by all those involved. Rabbis taught and employed
Minimalism early on when they worked out the Noachidic Law, a list
of seven laws that are a subset of all the imperatives of the Jewish
faith.23 The Noachidic laws were considered to be binding for all hu-
man beings, not just for Jews. They were seen as a normative minimum
the acceptance of which is, irrespective of differences in faith, necessary
for an orderly social life.24 In the spirit of minimalism, John Rawls has
pursued a method of avoidance, firstly in constraining the focus of his
work to the basic structure of society, and secondly, in justifying his
conception of justice as fairness only on the basis of fundamental ideas
that he believes are generally accepted in contemporary liberal democ-
racies.25 Sen also endorses a version of Minimalism: Incompatible con-
siderations of justice, he maintains, may be less of a problem than many
of us believe. All we actually need in political practice is a consensus on
particular cases of injustice and a shared understanding of the compara-
tive justice of the feasible alternatives at hand. Sen is optimistic that in
the case of gross injustices such a consensus can be obtained in spite of
our disagreements about notions of perfect justice.26
Minimalism is reasonable, only brawlers and zealots will reject it out-
right. Unfortunately, it has two limitations that make it a less effective
strategy than its proponents seem to believe. The first limitation is that
Minimalism cannot rule out disagreement about the alleged minimum.
Historically, there has always been disagreement about the norms
deemed absolutely necessary for peace and social cooperation. Keep in
mind that the Noachidic laws did not only ban murder, theft and adul-
tery, but also blasphemy and idolatry. There is also disagreement about
what constitutes a gross injustice in our days. Is the chronic underrep-

23 The seven Noachidic Laws are: Prohibitions of idolatry, murder, theft,

adultery, blasphemy, the prohibition to eat the meat of animals that are still
alive and the demand to establish courts of law.
24 Plaut, Gunther W. (2008), Die Tora in jdischer Auslegung, Gtersloh.
25 Rawls, John, supra note 9, 29 n. 31 and 150.
26 Sen, Amartya, supra note 19, 103 ff.
Legitimacy: Where Justice Meets the Law 35

resentation of women in politics part of the persistently grotesque sub-


jugation of women that we must never accept, as Sen would seem to
hold.27 Or is it merely a shortfall from an ideal of gender equality about
which reasonable people may disagree?
A second limitation of Minimalism results from the hermeneutics of
norm application. Two people who recognize a norm as a valid princi-
ple of conduct, may nevertheless give different interpretations of it in
contested cases depending on how they understand the intentions and
reasons behind the norm in the light of their more comprehensive nor-
mative beliefs. If a stable consensus on principles of justice can be ex-
tended to non-paradigm cases of norm application that allow for con-
trary interpretations, it presupposes more than an agreement about iso-
lated principles which in order to secure an agreeable minimum
have been removed from their contested religious or philosophical
background and did not yet face the difficulties of practical political
application.
Minimalism is reasonable but fails to eradicate the possibility of rational
dissent about justice, and one may feel inclined if only for a second
to enjoin Hobbesian authoritarianism as a last resort. We need binding
legal norms and authoritative institutional arrangements to live together
peacefully and to prosper, and if our moral and political disagreements
should prove to be irresolvable, we may want a dictator or monarch to
tell us where to go and what to do. In the authoritarian approach, we
would have to accept the authority of the law irrespective of our per-
sonal judgments about its comparative merits. Waldron does not seem
to be entirely free of Hobbesian insinuations of this kind:
Law ... aspires to justice; but it represents the aspiration to justice
of a community, which ... is made up not of those who think simi-
larly, but of those who think differently about matters of common
concern ... law ... claims authority for its adjudications on principles
which are themselves controversial ... it does so in frank acknowl-
edgement of that controversy ... the peremptory tone of its claim
upon us is not Here is a basis for dispute-resolution which you
should accept if you agree with it. It is rather Here is a basis for dis-
pute-resolution which you are to accept whether you agree with it or
not.28

27 Sen, Amartya, supra note 19, 103.


28 Waldron, Jeremy, supra note 13, 6-7.
36 Hinsch

To some extent Waldron also seems to share Hobbes contempt for


those who take their own reasoning to be the best, if not the only,
source of political authority. The motto of Law and Disagreement is
taken from the Leviathan.
When men that think themselves wiser than all others, clamor and
demand right Reason for judge; yet seek no more, but that things
should be determined, by no other mens reason but their own, it is
as intolerable in society of men, as it is in play after trump is turned,
to use for trump on every occasion, that suit whereof they have
most in their hand.29
Still, the appeal of authoritarianism as a theory of normative authority
is rather limited even if we ignore for a moment that in real life a Hob-
besian Leviathan is a very dangerous being. Firstly, authoritarianism is
incompatible with the value that most of us place on individual auton-
omy and the opportunity to live in accordance with norms that we can
endorse in the light of our well-considered beliefs and value-judgments.
Secondly, anybody who believes in rationality must feel uncomfortable
with the idea that the legitimacy of the law should be entirely unaf-
fected by any possible critique of its content by its subjects, even if this
critique is fully reasonable in terms of substantive considerations. In
any case, I shall not discuss Hobbesian authoritarianism in this article,
and I hasten to add that Waldron does not endorse this view.

IV. Democratic Proceduralism

Minimalism seems to be incapable of securing a reasoned consensus on


basic questions of justice and if Hobbesian authoritarianism is no at-
tractive alternative, we have to consider democratic proceduralism again
a view that Rawls, Waldron, Sen and, indeed, most political philoso-
phers in our days endorse, notwithstanding serious differences between
their views in other respects. The rationale of proceduralism is straight-
forward. The ubiquitous character of rational dissent in matters of basic
justice makes a consensus based on substantive normative reasons look
utopian and we need a non-argumentative procedure to publicly justify
binding social regulations.30 Having reached this point, it is only one
more step to propose democratic decision-making and the majority rule

29 Leviathan, 1651, Chapter 5.


30 Hinsch, Wilfried, supra note 8.
Legitimacy: Where Justice Meets the Law 37

as such a procedure. Disagreements about justice would then be finally


settled not by substantive arguments of moral and political philosophy
but by democratic majorities that decide which way to go.
An essential feature of democratic legislation is that it combines two
elements: a phase of public deliberation and a non-deliberative phase of
collective choice by majority voting. A normative political theory must
account for both phases and explain their respective roles in generating
legitimate norms.
A common understanding of the deliberative phase is that it aims at a
unanimous consensus which, unfortunately, will hardly ever be
reached. Therefore, in practice, a vote is needed to reach a binding col-
lective decision and finally the majority prevails. A problem with this
understanding is that in real life nobody expects the deliberative phase
of democratic legislation to bring about unanimity. Why then, should
we engage in public deliberation and exchange arguments, when, right
from the beginning, it would seem foolish to hope for an agreement?
Simply to win over other voters or legislators and to increase the num-
ber of votes on our own side? Sure enough, as a matter of practical poli-
tics, this is a good reason to engage in public political argument. From
the vantage point of a normative theory, however, winning additional
votes does not make much of a difference as long as we need a vote in
the end anyway. Admittedly, arguments in public deliberations are sup-
posed to be set up in ways that may be expected to convince others and
to establish a consensus between the parties involved. Nevertheless, in
the context of democratic legislation, the point of an open, informed,
and rational political discussion cannot be to bring about a universal
consensus, because this end it almost never achieves. There are other
ends, though, that actually can be achieved by the public exchange of
arguments. Deliberation may help to narrow the range of unreasonable
disagreement and to identify points of agreement and disagreement
among the conflicting parties. It thereby reduces the risk of irrational
collective decisions and the social costs of partisan decision-making that
may engender social strife and conflict. It also helps us to see others as
reasonable fellows who hold intelligible political positions and with
whom we can cooperate on a basis of mutual respect, and all this can be
achieved without actually obtaining a consensus on a reasonably con-
tested political question.
As regarding the second, purely procedural phase of democratic deci-
sion-making, it is well-known that the majority rule, as a decision-rule
for a group of citizens with equal claims of participation, has a number
of important advantages. Unlike the unanimity rule, for instance, it is
38 Hinsch

neutral against all possible alternatives, and it gives equal weight to the
votes of all those involved. In the language of modern decision theory,
the majority rule combines the advantages of neutrality and anonymity:
it is biased neither in favor of any alternative nor in favor of any per-
son.31
I shall not continue with these characterizations of democratic deci-
sion-making. They are only meant to illustrate a more general point
about procedural accounts of legitimacy and authority: We need a
background story which brings together conceptual, empirical and
moral arguments in order to explain why a certain procedure, in virtue
of its general features, has legitimacy generating qualities. Procedural-
ism and majority voting cannot be the last word. It is a question of a
substantive normative theory (like a theory of political justice) to spec-
ify the conditions under which voting procedures do result in legitimate
collective decisions. It is also a matter of a substantive moral argument
about why we should prefer a democratic procedure over others. If lit-
erally all contested questions of justice and legitimacy had to be decided
by voting, we would be caught in an infinite regress: We had to have a
vote, about how to have a vote, about how to have a vote ... about
whether a particular institution, norm, or action is just or not. Every
procedure thus presupposes a substantive understanding of its proce-
dural adequacy, a background story that explains why the procedure
generates legitimate results, and, needless to say, every background
story of this kind may be contested.
Given the need of a substantive and potentially controversial account of
procedural adequacy, it is interesting to see how Waldron in Law and
Disagreement explains the merits of democratic decision-making. 32
Waldrons account of democracy as a source of legitimacy proceeds in
terms of general and plural participation, public deliberation, and ap-
propriate rules of order, and he argues in favor of majority voting by
stressing equality and autonomy. Following Waldron, democratic legis-
lation, contrary to Rawls understanding of legitimacy, does not pre-

31 It is true that lotteries may also have these two attractive features. And a

suitably biased lottery would also be responsive to the number of people who
hold a particular view. Still, it would not determine the outcome of the deci-
sion-making process in accordance with this number and, hence, give every-
body a decisive say in the collective decision. Cf. Waldron, Jeremy, supra note
13, 113, and Ackerman, Bruce A. (1980), Social Justice in the Liberal State, New
Haven, 274-289.
32 Waldron, Jeremy, supra note 13, Chapters 3-5.
Legitimacy: Where Justice Meets the Law 39

suppose an agreed upon conception of political justice. Due to its pro-


cedural requirement of public deliberation, Waldron says, democratic
legislation already incorporates not only substantive claims of justice
(put forth by the conflicting parties) but also the disagreement about
these claims, and, according to Waldron, it is this incorporation of the
disagreement about justice that explains the capacity of democracy to
generate legitimate laws without presupposing a commonly shared con-
ception of justice.
It is apparent, though, that the features of the democratic process that,
according to Waldron, explain the legitimacy-generating quality of de-
mocratic legislation may be easily mapped into Rawls basic rights ac-
count of democratic legitimacy (if you give sufficient leeway for the de-
tails to fit in), or else be seen as an alternative, albeit more general and
less elaborated, account of the same type. Given the need of a back-
ground story for procedural legitimacy this is small wonder. If we think
of political justice as Rawls and many others do as a notion that re-
fers to those very features of political decision-making that purport to
explain the legitimacy generating quality of these procedures, Waldrons
account of democratic legitimacy is (and has to be) based on a substan-
tive (and hence potentially controversial) conception of political justice.
It, therefore, offers no radically different alternative. In any case, there
may be alternative and mutually incompatible background stories
conceptions of political justice that explain democratic legitimacy,
even if Waldrons and Rawls stories should turn out to be very similar
and quite consistent with each other. In order to have a procedure that
yields binding norms with normative authority for everybody, we do
not need an agreement on any particular justice based account of le-
gitimacy. In practice, an overlapping consensus that a given procedure
has legitimacy generating features suffices. In many liberal democracies
there seems to exist such an overlapping consensus with regard to the
procedures of democratic decision-making, and we may not be sur-
prised to find Rawls and Waldron (among many others) on the same
track. Nevertheless, there are clearly discernible limits to what demo-
cratic proceduralism can achieve in terms of resolving reasonable dis-
agreement and generating legitimate norms with normative authority.
Consider the following sketch of a rational dissent: There is a disagree-
ment about the moral permissibility of abortions after, say, the third
month of pregnancy. Each of the parties involved is in a position to
support its own (contested) view on the matter with rationally accept-
able reasons. None of the parties, however, have arguments which are
sufficiently strong to refute all other views. This would be, then, not
40 Hinsch

just a disagreement but a rational dissent that, at the time being, cannot
be resolved by substantive moral or empirical argument. Following the
strategy of proceduralism, one may now have a democratic vote to
reach a just and legitimate decision. As long as all parties either share a
conception of political justice in the Rawlsian sense or agree on the
merits of democratic decision-making in the way Waldron suggests,
there is no problem. A vote is taken, and all parties are willing to treat
the result as legitimate and to ascribe normative authority to the legal
arrangement favored by the majority. The problem of late abortions is
solved. Alas, in our case, this scenario is rather unlikely. The issue of
abortion raises questions of life and death which again raise moral and
constitutional questions concerning the protective function of basic
rights. Do human beings after the third month of pregnancy have a
right not to be killed in an abortion? Let us assume, then, that there is
not only a rational dissent at the substantive level concerning the ques-
tion of abortion but also at the level of the moral requirements for de-
mocratic decision-making. Assuming that the basic right to life extends
to embryos after the third month of pregnancy, even a formally correct
democratic decision to legalize abortions after the third month of preg-
nancy would seem to be illegitimate. On the contrary, assuming that the
constitutional right to life does not extend to embryos after the third
month, such a decision would seem to be legitimate. Again, there are
only two possibilities. Either, in spite of the dissent about the proper
extension of the right to life, the parties are willing to ascribe legitimacy
and normative authority to the results of a democratic vote maybe
those who are against late abortions believe that the values of democ-
ratic decision all-things-considered outweigh the disvalue of the contro-
versial extension of the right to life. In this case, democratic procedural-
ism eventually succeeds. Or there is no such willingness, in which case
at least one party, because of its contested interpretation of the right to
life, will not accept the vote as legitimate and proceduralism fails. In
this case, it seems, there is no way to resolve the remaining conflict ei-
ther by means of moral argument or by a non-argumentative proce-
dural device.
Our conclusion is straightforward: There is no third way! In the case of
reasonable disagreement about basic political justice, we either have
something like a Rawlsian overlapping consensus concerning the essen-
tial features of legitimate law-making or we have no law at all that can
rightfully claim legitimacy and that has moral authority from all rea-
sonable points of view.
Externe und interne Ethisierung des Rechts
Daniel Gruschke

Unter Ethisierung des Rechts wird gemeinhin dreierlei verstanden,


nmlich, erstens, die Verwendung von ffnungsklauseln, die auf auer-
rechtliche normative Mastbe verweisen, zweitens die Etablierung von
sogenannten Ethikkodizes etwa in Forschung und Privatwirtschaft,
sowie, drittens, die Einrichtung von Ethikgremien auf verschiedenen
Ebenen, also von der Ethikkommission der Universittsklinik bis hin
zum Deutschen Ethikrat. Das verbindende Element hinter dieser Trias
besteht in dem Einbezug von Standards, Prozeduren und Institutionen
in das Recht, welche zwar selbst nicht Teil des Rechtssystems sind, je-
doch faktisch eine dem Recht analoge Bindungswirkung entfalten, in-
dem das Recht sie mit seiner Autoritt sozusagen belehnt. Dabei meint
Ethik hier weder die empirische (psychologische, soziologische) Be-
schreibung der gesellschaftlichen de-facto-Moral noch die Reflexion
derselben mit dem Ziel, die blo akzeptierten von den rational gerecht-
fertigten moralischen Normen und Wertmastben zu scheiden, son-
dern ein Korpus als verbindlich gedachter nicht-rechtlicher Normen
und Wertmastbe.
Dieser Ethisierung des Rechts von auen liegt (vermutlich) ein Motiv
zugrunde, das mit Sympathien rechnen darf, nmlich das Bestreben, bei
der rechtlichen Regelung gerade von sensiblen und politisch brisanten
Themen wie Gentechnik, Stammzellenforschung, Primplantationsdi-
agnostik usw. moralische Gesichtspunkte gebhrend zu bercksichti-
gen. Gleichwohl ist diese Art von Ethisierung mit einigen recht grund-
stzlichen Schwierigkeiten verbunden, die es im Blick zu behalten gilt
und die nahelegen, nach einem Korrektiv bzw. einer Ergnzung Aus-
schau zu halten. Deshalb soll ein Vorschlag zu einer gegenlufigen Stra-
tegie unterbreitet werden, d.h. einer Ethisierung des Rechts sozusagen

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 41
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_3, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
42 Gruschke

von innen, die ihre Mastbe auf eine im Folgenden nher zu be-
schreibende Weise der teleologischen Struktur des Rechts entnimmt.1

I. Ethisierung des Rechts von auen

Die Schwierigkeiten mit der Ethisierung des Rechts durch ffnungs-


klauseln, Ethikkodizes und Ethikgremien sind rechtsstaatlicher und
sprachphilosophischer Natur: Ethisierung von auen fhrt zur Entste-
hung einer Art von ethischem Para-Recht, das mit zumindest zwei Ar-
ten von Schwierigkeiten verbunden ist: Erstens sind ffnungsklauseln
und Ethikkodizes aus rechtsstaatlichen Grnden bedenklich, weil sie
auerrechtliche Mastbe und Normen in die Rechtsanwendung durch
Verwaltung und Gerichte einbeziehen und damit in den Rang von Qua-
si-Rechtsnormen erheben, ohne dass diese Quasi-Normen die fr die
Setzung von Recht verfassungsmig vorgesehenen Verfahren durch-
laufen htten, welche ja nicht nur demokratische Legitimation der
Rechtssetzung gewhrleisten, sondern durch ffentlichkeit und Dis-
kussion auch die Einhaltung gewisser Standards sicherstellen sollen,
d.h. vom Aufdecken handwerklicher Fehler bei der Normenformu-
lierung ber die inhaltliche Kritik der angestrebten Regelung bis hin
zur Identifizierung von mglicherweise verfassungsrechtlich problema-
tischen Aspekten. Im Falle von ffnungsklauseln kommt noch hinzu,
dass sich der Bezug auf ethische oder moralische Mastbe, fr die es
keine kanonischen Formulierungen analog zu positiven Rechtsnormen
gibt, schlecht mit dem Grundsatz der Bestimmtheit von Normen ver-
trgt und in die Rechtsanwendung eventuell ein Element der Willkr
einfhrt.
Die Einrichtung von Ethikgremien wiederum ist unter rechtsstaatlichen
Gesichtspunkten fragwrdig, weil von den Entscheidungen etwa der
Zentralen Ethik-Kommission fr Stammzellenforschung zwar nicht de

1 Die Betonung liegt auf Mastbe. Natrlich kann man sagen, dass ge-
wissermaen alles von auen in das Recht kommt, insofern gesetzgeberisches
Handeln fr gewhnlich durch das Erfordernis ausgelst wird, bestimmte Ge-
genstandsbereiche zu regeln, welche selbst (zumeist) nicht rechtlicher Natur
sind. Entsprechendes gelte auch fr die konkreten Flle, mit denen Verwaltung
und Gerichte konfrontiert werden. Das ist richtig, aber fr die Zwecke dieses
Aufsatzes irrelevant, da es hier nicht um die Frage geht, woher die zu regelnden
Materien kommen, sondern um die Frage, woher man die Mastbe fr ihre
rechtliche Beurteilung nimmt.
Externe und interne Ethisierung des Rechts 43

jure, wohl aber de facto die Genehmigung eines Forschungsvorhabens


durch die zustndige Behrde, das Robert Koch-Institut ( 1 Abs. 1
ZES-Verordnung), nach 6 Abs. 5 Stammzellen-Gesetz abhngt: Zwar
ist die Behrde an die Stellungnahme der Kommission nicht gebunden;
sie hat diese jedoch bei ihrer Entscheidung zu bercksichtigen ( 6 Abs.
5 Satz 2 StZG) und in dem Fall, dass sie von der Stellungnahme der
Kommission abweichen mchte, ihre Grnde hierfr schriftlich darzu-
legen ( 6 Abs. 5 Satz 3 StZG).2 Das rechtsstaatlich Problematische liegt
nun darin, dass durch die Stellungnahme der Ethik-Kommission jeden-
falls mittelbar in das Grundrecht auf Wissenschaftsfreiheit eines For-
schers eingegriffen werden kann, diese Stellungnahme jedoch verwal-
tungsgerichtlich isoliert nicht berprfbar ist, da es sich bei ihr um ei-
nen bloen Teil- bzw. Zwischenakt handelt.
Von diesen rechtsstaatlichen Bedenken abgesehen ist es berdies auch
fraglich, ob die Einbeziehung auerrechtlicher moralischer und ethi-
scher Standards ihre Aufgabe erfllen kann, die moralische Gestaltung
des Rechts dadurch sicherzustellen, dass sich die rechtsexternen norma-
tiven Mastbe rechtsintern als ethische Korrektive auswirken. Das
Recht verwandelt nmlich diejenigen Begriffe, die es inkorporiert, und
damit auch die Mastbe, in denen sie verwendet werden: So konnte
etwa ein New Yorker Gericht entscheiden, dass Wale unter den Begriff
des Fisches im Sinne eines Gesetzes fallen, das die Kontrolle von Fischl
regelt, obwohl man wusste, dass Wale keine Fische, sondern Sugetiere
sind.3 Der Begriff des Fisches hatte nach seiner bernahme aus der Bio-
logie in das Recht sowohl seine Extension als auch seine Intension ge-
ndert, die man nun etwa mit (Jedes) Meerestier, aus dem sich l ge-
winnen lsst wiedergeben kann, und war damit aus einem biologischen
zu einem rechtlichen Begriff geworden. Diese bemerkenswerte Eigen-
schaft des Rechts wird auch seine Midas-Natur genannt.4 Sie ist mit

2 Hinzu kommt vermutlich, dass diese Konstruktion angesichts des in der


Kommission versammelten medizinischen, biologischen und ethischen Sach-
verstandes in der Praxis selbst auf das RKI eine gewisse abschreckende Wir-
kung entfalten drfte. Die Stellungnahme der ZES nur als Entscheidungshilfe
fr die Genehmigungsbehrde anzusehen, wie dies R. Mller-Terpitz, in A.
Spickhoff, Medizinrecht, 2011, StZG 6, Rn. 12, tut, ist vermutlich zu liberal.
3 Vgl. D. G. Burnett, Trying Leviathan: The Nineteenth-Century New
York Court Case That Put the Whale on Trial and Challenged the Order of Na-
ture, 2007. Diskussion bei Poscher (Fn. 4).
4 Vgl. R. Poscher, The Hand of Midas: When Concepts Turn Legal, or De-
flating the Hart-Dworkin Debate, in J. C. Hage/D. von der Pfordten (Hrsg.),
Concepts in Law, 2009, 99.
44 Gruschke

der Natur der Rechtsfrage, d.h. der Frage, wie ein bestimmter Sachver-
halt rechtlich zu bewerten ist, verbunden. Diese Rechtsfrage lautet, um
im Beispiel zu bleiben, nicht, ob Wale wirklich Fische sind, sondern ob
es mit Blick auf den mglichen Wortsinn der einschlgigen Rechts-
normen, die Regelungsabsichten des Gesetzgebers, die bisher gebte
Rechtsprechung, Gesichtspunkte der Billigkeit und Zumutbarkeit, ver-
fassungsrechtliche Gebote wie das der Gleichbehandlung, tangierte
Grundrechte der Betroffenen wie das auf Freiheit der Berufsausbung,
bereits ergangene hchstrichterliche Entscheidungen etc. zulssig oder
sogar geboten wre, Wale als Fische anzusehen. Fr das Gericht im Bei-
spiel war es daher wichtiger, sich eine zutreffende Vorstellung von die-
sem Kontext des betreffenden Gesetzes zu bilden, als einen aus biologi-
scher Sicht adquaten Begriff des Fisches zu verwenden. Allerdings
kommen in der Auslegung und Anwendung von Rechtsnormen be-
kanntlich noch weit mehr Faktoren zum Tragen, was den Vorgang er-
heblich verkompliziert: Es soll nicht nur entschieden werden, sondern
es soll auch begrndet entschieden werden, wobei nicht jeder gute
Grund fr eine Entscheidung auch ein rechtlich zulssiger Grund ist,
und es soll nicht nur begrndet entschieden werden, sondern die Ent-
scheidung soll als Ergebnis am Ende eines rechtlich detailliert geregel-
ten Verfahrens stehen und Grundstzen der Rationalitt ebenso Rech-
nung tragen wie dem Bedrfnis nach Rechtssicherheit und Prinzipien
der Rechtsstaatlichkeit.
Man knnte dies auch so zusammenfassen, dass das Recht ein eigenes
Sprachspiel (oder vielleicht auch ein Komplex von ineinandergreifenden
Sprachspielen) ist, das verstanden (bzw. gemeistert) worden sein muss,
um angeben zu knnen, was die Ausdrcke Wal, Fisch, gute Sit-
ten oder auch ethisch vertretbar bedeuten, wenn sie in diesem Spiel
gebraucht werden. Die Midas-Natur des Rechts ist im Grunde also gar
nichts Geheimnisvolles, sondern blo ein weiteres Beispiel dafr, dass
die Bedeutung vieler Ausdrcke in ihrem Gebrauch in der Sprache be-
steht. Verndert sich der Gebrauch eines Prdikates wie ist ein Fisch,
so ndert sich auch die Intension des dadurch ausgedrckten Begriffes
Fisch. Prdikate (und Begriffe) erhalten sozusagen einen Index ,
wenn sie in das Recht einwandern.
Die Midas-Natur des Rechts bewirkt, dass sich auerrechtliche Begriffe
und damit auch Mastbe, welche diese Begriffe verwenden in
rechtliche Begriffe verwandeln, wenn sie durch Verwendung ins Recht
inkorporiert und im Laufe der Zeit rechtsdogmatisch inventarisiert
Externe und interne Ethisierung des Rechts 45

werden.5 Das Auseinanderfallen von auerrechtlicher und rechtlicher


Bedeutung ist vielleicht nicht berall sofort ersichtlich und vielleicht
auch selten so spektakulr wie im Falle des Strafrechtsbegriffs der Ur-
kunde, welcher auch den Bierdeckel umfasst, auf dem die Anzahl der
ausgeschenkten Getrnke in Form einer Strichliste eingetragen wurde.
Entscheidend ist jedoch nicht die Offensichtlichkeit des Auseinander-
fallens, sondern das Angelegtsein in der Natur des Rechts: Ein auer-
rechtlicher Begriff, der in Moral oder Ethik eine Rolle spielt, kann nicht
zugleich im Recht als (ethisches) Korrektiv verwendet werden und
trotzdem das bleiben, was er vor seiner bernahme ins Recht gewesen
ist.6 Auf dieser Annahme beruht jedoch die Strategie, die moralische
Gte des Rechts dadurch zu sichern, dass man auerrechtliche Stan-
dards ins Recht transplantiert. Wer das tut, muss sich darauf einstellen,
dass die Berhrung durch die Midas-Hand des Rechts den Gehalt der
betreffenden Begriffe verndern und so in der Rechtsanwendung mg-
licherweise Ergebnisse zeitigen wird, die er nicht beabsichtigt hat.

II. Ethisierung des Rechts von innen

Eine Ethisierung des Rechts von auen ist somit unter verschiedenen
Aspekten nicht unproblematisch. Den Beweggrund fr sie, nmlich die
moralische Qualitt des Rechts gerade in sensiblen Bereichen zu ge-
whrleisten, wird man wohl aber nur ungern preisgeben wollen. Die
Aufgabe wre dann, dem ethischen Anliegen auf eine Weise Rechnung
zu tragen, die unter rechtsstaatlichen Gesichtspunkten weniger bedenk-

5 Vgl. dazu auch B. Fateh-Moghadam und G. Atzeni, Ethisch vertretbar im


Sinne des Gesetzes Zum Verhltnis von Ethik und Recht am Beispiel der Pra-
xis von Forschungs-Ethikkommissionen, in S. Vneky/C. Hagedorn/M. Cla-
dos/J. v. Achenbach (Hrsg.), Legitimation ethischer Entscheidungen im Recht.
Interdisziplinre Untersuchungen, 2009, 115, 126: Im Kontext rechtlicher
Rechtfertigung, in dem gesetzliche Ethikkommissionen immer schon situiert
sind, gelten die besonderen Anforderungen, die sich aus dem Rechtssystem
selbst ergeben. Alle vorgebrachten Argumente nehmen damit zwangslufig den
Status rechtlicher Argumente ein bzw. mssen sich als rechtliche bewhren und
zwar auch dann, wenn sie begrifflich als ethische ausgewiesen werden. Als
ethisch bezeichnete Entscheidungsmastbe lsen sich mithin im praktischen
Vollzug der Rechtsanwendung notwendig in rechtliche Kriterien auf.
6 Das bedeutet aber auch, dass sich die Grenze zwischen Recht und Moral
bzw. reflektierter Moral (Ethik) zumindest nicht auf dem Wege der Begriffs-
transplantation verwischen lsst.
46 Gruschke

lich und aus sprachphilosophischer Perspektive weniger fragwrdig ist


als diejenige Strategie, die auf eine Ethisierung des Rechts durch ff-
nungsklauseln, Ethikkodizes oder Ethikgremien setzt. Mein Vorschlag
bestnde darin zu prfen, ob sich das Anliegen einer ethischen Gestal-
tung des Rechts nicht vielleicht zumindest in Teilen dadurch retten lie-
e, dass man bei dem ansetzt, was L. Fuller in seiner Kontroverse mit
H.L.A. Hart the inner morality of law genannt hat.7

1. Fullers inner morality of law

Das systematische Zentrum von Fullers Konzeption bildet der Gedan-


ke, dass die Teilnehmer an einer gesellschaftlichen Praxis wie dem Recht
hinsichtlich dieser Praxis wie auch hinsichtlich des Verhaltens der ande-
ren Teilnehmer bestimmte Erwartungen hegen, die mit der bernahme
einer bestimmten Rolle durch den jeweiligen Teilnehmer verbunden
sind. Diese Gesamtheit wechselseitiger und insofern ineinander grei-
fender Erwartungen nennt Fuller das Intendment einer Praxis oder
Institution. Fr das Recht unterscheidet Fuller zwei primre Teilneh-
merrollen, nmlich die Rolle der Gesetzgeber, d.h. derjenigen, die
Rechtsnormen erlassen und anwenden, und die Rolle der Adressaten.
Dass man hier feiner differenzieren knnte und ein Teilnehmer auch
mehrere Rollen ausben kann, ist richtig, soll aber aus Grnden der
Einfachheit an dieser Stelle auer Betracht bleiben.8 Die Gesetzgeber
nun erwarten, dass die Adressaten den Rechtsnormen Folge leisten. Die
Adressaten wiederum erwarten, dass man ihnen diejenigen Rechtsnor-
men, an die sie sich halten sollen, auch bekannt gemacht hat, so dass sie
Kenntnis von diesen Normen erlangen konnten oder zumindest ht-
ten erlangen knnen, etwa durch Hinzuziehung juristischer Experten
und dass es sich bei diesen Normen zumindest in Teilen um generelle
Normen handelt, nicht blo um ad hoc ausgesprochene Befehle; sie er-
warten ferner, dass diese Normen auch verstndlich sind, dass sie wi-
derspruchsfrei sind, dass ihre Befolgung mglich ist, insofern sie nicht
rckwirkend bereits abgeschlossene Vorgnge nachtrglich sanktionie-
ren, sondern prospektiv gelten, und nichts fordern, was zu tun Men-
schen unmglich oder unzumutbar ist; sie erwarten, dass diese Normen
zeitlich so stabil sind, dass die Ausrichtung des eigenen Handelns daran

7 L. Fuller, The Morality of Law, 1969, 42 et passim. Gelegentlich ist bei


ihm auch von the internal morality of law die Rede (173).
8 Fuller hat diesen Punkt sehr wohl gesehen, vgl. id., 217.
Externe und interne Ethisierung des Rechts 47

mglich wird; und sie erwarten, dass das Verhalten von Amtstrgern
und Organen, die mit der Anwendung und Durchsetzung des Rechts
betraut sind, den Rechtsnormen, die als geltend verkndet wurden,
auch tatschlich kongruent ist.9
Wichtig an diesen Erwartungen sind vier Punkte: Erstens setzt das
Funktionieren der betreffenden Praxis die Erfllung dieser Erwartun-
gen voraus. Unbekannte oder Unmgliches verlangende Normen kann
niemand befolgen; dann kann aber auch das Recht seine Aufgabe der
Handlungsleitung nicht erfllen. Zweitens sind es keine bloen Erwar-
tungen hinsichtlich dessen, was statistisch wahrscheinlich ist; es sind
normative Erwartungen. Werden sie enttuscht, wird dies nicht nur
zum Anlass fr Missbilligung und Tadel genommen, sondern auch zum
Anlass, die jeweilige Erwartung als Forderung zu erheben. Formuliert
man diese Erwartungen, drittens, als Grundstze, also beispielsweise als
Rechtsnormen sollen prospektiv sein oder Rechtsnormen sollen
verstndlich und widerspruchsfrei sein oder Amtstrger sollen in
Ausbung ihres Amtes an geltendes Recht gebunden sein, dann erhlt
man eine Menge an Prinzipien, die Fuller principles of legal morality
nennt und die zugleich Grundstze der Rule of Law bzw. Rechts-
staatlichkeit sind.10 Viertens kann, so Fuller, nur in einem Rechtssystem,
in dem diese Grundstze eingehalten und die relevanten Erwartungen
nicht enttuscht werden, von Recht in einem nicht-trivialen Sinne ge-
sprochen werden, weil und insofern nur in einem solchen Rechtssystem
Rechtstreue gefordert werden kann. Bei dieser geht es nicht um
respect for constituted authority, d.h. die Verbindlichkeit des Poli-
zeiknppels, sondern um die legitime Forderung nach fidelity to law.
Diese geraffte Skizze wirft eine Reihe von Fragen auf, die meines Er-
achtens in der Debatte zwischen Fuller und Vertretern der Schule

9 Id., 39.
10 Das, was wir im Deutschen Rechtsstaat nennen, wird in der englisch-
sprachigen Diskussion als substantive conception der Rule of Law angesehen,
also als eine formale Konzeption der Rule of Law zzgl. Gewaltenteilung, De-
mokratie und Grundrechten (einschl. sozialer Grundrechte). Rechtsstaat als ei-
nen Spezialfall der Rule of Law anzusehen hat den Vorzug, die deutsche Kon-
zeption von Rechtsstaat in eine umfassende Systematik von verwandten Kon-
zeptionen einzugliedern, die von Aristoteles Diktum, es sei besser, dass das
Gesetz herrsche (Rhet. I.1 1453a, Pol III.16 1287a), bis hin zu zeitgenssischen
Forderungen an politische Systeme reichen. Dadurch treten auch begriffliche
Zusammenhnge deutlicher hervor. Zur Unterscheidung substanzieller und
formaler Konzeptionen der Rule of Law vgl. B. Tamanaha, On the Rule of Law.
History, Politics, Theory, 2004.
48 Gruschke

H.L.A. Harts nicht wirklich geklrt worden sind. Was soll es heien,
dass die als Grundstze formulierten Erwartungen eine morality, und
noch dazu eine inner morality of law, konstituieren und nicht blo
eine Menge an Maximen fr effektives Regieren? Warum sollten die das
Intendment bildenden Erwartungen gerechtfertigte Erwartungen sein?
Man knnte doch sagen, dass, wer in einer Diktatur so etwas wie Ge-
setzesbindung erwartet, naiv sei. Mehr noch: Wre es dann nicht nahe-
liegend zu behaupten, dass zu einem totalitren Regime eben andere
Erwartungen gehren, damit aber ein anderes Intendment, und daher
andere principles of legality? Htte das Recht eines solchen Staates
dann Anspruch auf fidelity to law und wrden wir wirklich, auer
in einem sehr schiefen Sinne, von der morality etwa des NS-Rechts
sprechen wollen?
Ich mchte diese Fragen angehen, indem ich mit einer Randbemerkung
Fullers beginne, nmlich mit seiner Bemerkung, wenn die das Intend-
ment bildenden Erwartungen nicht mehr erfllt werden, wrde die
betreffende Praxis ihren Witz verlieren und die Teilnahme an ihr sinnlos
werden.11 Man kann diese These weit strker und weit interessanter ma-
chen als Fuller dies getan hat, wenn man sie im Lichte von Wittgen-
steins Einsicht versteht, dass Sprachspiele nicht nur Regeln haben, son-
dern auch einen Witz.12

11 I have been emphasizing that obedience to rules loses its point if the man

subject to them knows that the rulemaker will not himself pay any attention to
his own enactments. The converse of this proposition must also be kept in
mind, namely, that the rulemaker will lack any incentive to accept for himself
the restraints of the Rule of Law if he knows that his subjects have no disposi-
tion, or lack the capacity, to abide by his rules; it would serve little purpose, for
example, to attempt a juristic ordering of relations among the inmates of a luna-
tic asylum. (Fn. 7), 219. Andeutungen hnlichen Inhaltes finden sich verstreut
an mehreren Stellen in The Morality of Law.
12 Das Spiel, mchte man sagen, hat nicht nur Regeln, sondern auch einen

Witz. Philosophische Untersuchungen (PU), 564. Eine hervorragende Un-


tersuchung dazu, der ich viel verdanke, stammt von T.-P. Ertz, Regel und Witz.
Wittgensteinsche Perspektiven auf Mathematik, Sprache und Moral, 2008, des-
sen Rede von der Teleologie einer Praxis ich bernehme.
Externe und interne Ethisierung des Rechts 49

2. Die Teleologie einer Praxis

Beginnen mchte ich mit einer berlegung zur Teleologie einer Praxis:
Nehmen wir die Praxis des Schachspielens. Sie umfasst nicht nur eine
Menge an Regeln, anhand derer sich korrekte von inkorrekten Spielz-
gen unterscheiden, sondern auch eine Pointe, ein worum es geht:
Jemandem, der mit dem Schachspielen nicht vertraut ist und zum ersten
Mal eine Partie verfolgt, knnten wir auf seine Frage, worum es dabei
gehe, antworten, das Ziel beim Schachspielen bestehe darin, den gegne-
rischen Knig matt zu setzen. Angenommen nun, der Fragende htte
eine genaue Kenntnis der Schachregeln sowie der Schachfiguren, htte
aber noch nie etwas davon gehrt, dass es so etwas gibt wie Spiele. Es
wre dann denkbar, dass er auf unsere Antwort erwidert, das habe er
nicht gemeint, denn dass das Hin und Her auf dem Schachbrett auf das
Mattsetzen hinauslaufe, sei ihm bekannt; vielmehr wolle er wissen, wa-
rum sich zwei Spieler berhaupt darauf einlieen, stundenlang an einem
uninteressant gestalteten Brett zu sitzen und Figrchen hin- und herzu-
schieben. Wir knnten ihm antworten, Schach werde wie andere Spiele
auch zum Zweck des Zeitvertreibs gespielt oder es werde zu dem
Zweck gespielt, das logisch-strategische Denkvermgen zu schulen,
oder es werde zu dem Zweck gespielt, sich mit dem Gegner zu messen
und dadurch etwas ber die eigenen Fhigkeiten zu erfahren usw.
Ein anderes von L. Wittgenstein verwendetes Beispiel wre die Praxis,
im Lebensmittelgeschft ein Stck Kse auf die Waage zu legen:13 Diese
Praxis wird wie auch das Schachspielen von Regeln geleitet.14 Sie hat
aber darber hinaus eine teleologische Struktur: Sie wird ausgebt mit
dem Ziel, das Gewicht des gewhlten Ksestckes zu bestimmen und
dadurch den Betrag zu ermitteln, den der Kufer fr dieses Stck zu
bezahlen hat. Der Zweck dieser Praxis wiederum besteht darin, Gter-
tausch (Handel) nach einem bestimmten Verhltnis zu ermglichen.
Ziel und Zweck einer Praxis bilden zusammen ihre Teleologie. Die Un-
terscheidung zwischen Ziel und Zweck mag knstlich erscheinen, zu-
mal im Deutschen beide Ausdrcke oft synonym gebraucht werden; sie
bildet jedoch einen realen Unterschied ab: Ziel einer Praxis ist das, was

13 PU 142.
14 Der Kunde whle ein Stck Kse und gebe an, wie viel er davon kaufen
mchte, Der Verkufer lege das vom Kunden ausgesuchte Stck Kse auf die
Waage; warte, bis das Gewicht angezeigt wird; schlage den Preis je Kilogramm
der gewhlten Ksesorte in der Preistabelle nach; multipliziere das Gewicht des
Stcks in Kilogramm mit diesem Preis etc.
50 Gruschke

erreicht werden muss, damit eine Partie (ein Durchlauf dieser Praxis,
eine ihrer Instanziierungen) als erfolgreich abgeschlossen betrachtet
wird. Zweck einer Praxis hingegen ist das, dem ihr Vollzug dient, also
das, was man ihre funktionale Einbettung in unser Leben nennen
knnte:15 Man spielt Schach nicht um des Mattsetzens willen, sondern
wegen des angenehmen Zeitvertreibes oder wegen der (erhofften) Schu-
lung des logisch-strategischen Denkvermgens. Man legt im Lebens-
mittelgeschft die Ksestcke nicht auf die Waage, um immerfort neue
Zahlen ausrechnen zu knnen (wrde uns der Verkufer an der Theke
erzhlen, dass er den Kse nur deswegen abwiegt, dann fnden wir dies
befremdlich), sondern um den Preis zu ermitteln, den man fr den Kse
von seinem Kunden verlangt. Erreicht man das Ziel der jeweiligen Pra-
xis nicht, dann ist das vielleicht rgerlich, aber kein Grund, die Praxis
aufzugeben.16 Hrt die Praxis hingegen auf, zweckdienlich zu sein, etwa
weil aufgrund von pltzlich vernderten Naturgesetzen Schachfiguren
immer in dem Augenblick verschwinden, wenn sie gezogen werden sol-
len, oder Ksestcke im Moment des Wiegens unaufhrlich ihr Ge-
wicht verndern, dann wrde die Praxis des Schachspielens oder Kse-
wiegens nicht einfach nur fr die Dauer dieser Anomalie undurchfhr-
bar, sondern witzlos, und nicht nur verlre die Teilnahme daran ihren
Sinn; dass die Praxis witzlos geworden ist, wre ein guter Grund dafr,
sie aufzugeben.
Die Teleologie einer Praxis ist nun aus drei Grnden wichtig: Erstens
muss man sie kennen, um die Praxis zu meistern. Zweitens wird eine
Praxis nicht oder zumindest nicht allein durch ihre Regeln konstitu-
iert, sondern durch ihre Teleologie. Drittens haben wir in Abhngigkeit
davon, als was wir die jeweilige Praxis identifiziert haben, bestimmte
Erwartungen etwa an das Verhalten der Teilnehmer, wobei diese Erwar-
tungen normativ sind.

15 Auch diesen Ausdruck bernehme ich von T.-P. Ertz (Fn. 12).
16 Eine Praxis wie Schach ist ein abstrakter Gegenstand und damit weder
rumlich noch zeitlich lokalisiert. Lokalisiert, und damit ein konkreter Gegens-
tand, ist nur diese oder jene Schachpartie. Der Ausdruck Praxis kann jedoch
fr beide Flle gebraucht werden. In diesem Aufsatz werde ich darauf verzich-
ten, jedes Mal darauf hinzuweisen, in welchem Sinne ich den Ausdruck gebrau-
che. Der Kontext sollte dies jeweils deutlich machen. Nur so viel: Wenn hier
und im Folgenden die Rede von eine Praxis aufgeben ist, dann ist damit ge-
meint, auf weitere Instanziierungen von ihr zu verzichten etwa, weil diese
unmglich geworden sind. Wenn gesagt wird, eine Praxis habe dieses Ziel oder
jenen Zweck, dann ist damit gemeint, ihr Vollzug habe dieses Ziel oder jenen
Zweck.
Externe und interne Ethisierung des Rechts 51

Erstens: Wenn wir jemanden in der Praxis des Schachspielens unterwei-


sen mchten, gengt es offenkundig nicht, ihm lediglich die Schachre-
geln darzulegen. Von jemandem, der nicht wei, dass das Ziel des Spie-
les im Mattsetzen besteht, kann man nicht sagen, er spiele eine Partie
Schach, und zwar auch dann nicht, wenn alle seine Zge regelkonform
sind. Entsprechendes gilt fr den Zweck des Spiels: Jemand, der glaubt,
Schach msse man als tdlichen Ernst betreiben oder spielen, um seine
Schachpartner zu demtigen, von dem wrden wir sagen, er habe nicht
begriffen, was es heit, ein Spiel zu spielen.17
Vielleicht wrden wir uns aber, zweitens, auch fragen, ob das, was wir
fr seine seltsame Weise Schach zu spielen hielten, nicht etwas ganz an-
deres ist. Angenommen, es gbe eine Gesellschaft, in der eine Praxis
ausgebt wird, die unserem Schachspielen genau gleicht, was das Spiel-
brett, die Figuren und Spielregeln angeht. Allerdings wird sie aus-
schlielich am letzten Tag des Jahres ausgebt und dann auch nicht von
jedem, sondern von zwei Personen, die durch Los dazu erwhlt werden
und sich ein Jahr lang durch eine mnchische Lebensweise in einer Art
Kloster vorbereiten mssen. Die Partie findet in einem feierlichen
Rahmen vor festlich gekleidetem Publikum statt. Mnner sitzen von der
Position der Teilnehmer aus gesehen auf der linken, Frauen auf der
rechten Seite. Die Teilnehmer sind immer wei bzw. schwarz gekleidet.
Die Partie beginnt immer genau um Mitternacht. Gewinnt Schwarz, so
gilt dies als bses Omen fr das nchste Jahr. Gewinnt hingegen Wei,
so gilt das als glckliches Vorzeichen. Schwarz wird am folgenden Tag
feierlich verbrannt, zu Wei dagegen bringt man Kranke, damit er ih-
nen die Hand auflegt usw. Wrden wir sagen, dass diese Gesellschaft
eine seltsame Weise entwickelt hat, Schach zu spielen? Oder wrden
wir nicht vielmehr sagen, dass es sich dabei allen hnlichkeiten zum
Trotz nicht um ein Spiel handelt, sondern um eine religise Zeremonie?
Vermutlich Letzteres. Daran sieht man, dass, wie T.-P. Ertz schreibt,
Regeln zwar ein Spiel als Schach konstituieren knnen, also im Unter-
schied zu Dame oder Tennis, nicht jedoch Schach als Spiel im Unter-
schied zu Schach als religisem Ritus.18 Dennoch ist der Charakter des
Spielseins, also unterhaltend zu sein, nur ein Spiel zu sein, dem

17 Jede Praxis, insofern ihr Sinn bzw. ihr Witz durch eine funktionale Ein-
bettung in unser Leben bestimmt ist, weist diese teleologische Struktur auf. Da-
her gehrt der Witz der Praxis nicht nur zu ihrer Beschreibung, sondern viel-
mehr ist die Orientierung am Witz auch zentral fr das Handeln innerhalb einer
Praxis. T.-P. Ertz (Fn. 12), 69.
18 Id., 10.
52 Gruschke

Schach ja nicht unwesentlich auch wenn es keine Schachregel gibt, die


festlegt, Schach msse als Spiel betrieben werden und habe unterhaltend
zu sein. Das ergibt sich erst aus seiner Teleologie.
Drittens: Angenommen nun, wir haben das Geschehen zwischen zwei
Personen nicht als religise Zeremonie, sondern als Schachpartie identi-
fiziert. Wir erwarten dann, oder gehen besser gesagt ganz selbstver-
stndlich davon aus, dass sich die Spieler auf eine bestimmte Weise ver-
halten. So erwarten wir etwa, dass die Spieler konzentriert und mit dem
ntigen Ernst spielen, dass sie regelkonforme Zge machen, dass sie da-
von absehen, in unbeobachteten Momenten die Figuren umzustellen
oder die Partie mit der Begrndung abzubrechen, sie htten jetzt keine
Lust mehr. Bemerkenswert an diesen Erwartungen ist, dass es sich bei
ihnen nicht um Erwartungen darber handelt, was in der Regel ge-
schieht, also nicht um statistische Generalisierungen bzw. Wahrschein-
lichkeiten. Angenommen, einer der Spieler sabotiert das Spiel durch al-
bernes Verhalten, fhrt stndig inkorrekte Zge aus oder nutzt jede sich
bietende Gelegenheit, die Figurenanordnung zu manipulieren. In all
diesen Fllen wrden wir nicht mit einem bloen Tja, da hat der ande-
re Spieler eben Pech gehabt; so etwas kommt manchmal vor reagieren,
wie wenn wir in der Straenbahn pltzlich feststellen, dass wir unsere
Fahrkarte zu Hause vergessen haben und ausgerechnet jetzt eine der
ansonsten eher seltenen Kontrollen stattfindet. Wir wren stattdessen
berrascht und befremdet, vielleicht auch verrgert und fr den Fall,
dass wir Grnde zu der Annahme haben, der Spieler tte das, was er
tut, mit Absicht, dann wrden wir sein Verhalten missbilligen oder w-
ren vielleicht sogar emprt. Emprung und Missbilligung sind nun sehr
spezifische Reaktionen: Man kann nicht darber emprt sein, dass das
Wetter schlecht ist, dass man sich eine Erkltung zugezogen hat oder
von der Nachbarskatze gekratzt wurde. Missbilligung und Emprung
als Reaktionen sind nur dann angebracht, wenn wir es mit vernnftigen
Wesen zu tun haben, die nicht so gehandelt haben wie sie uns oder an-
deren gegenber htten handeln sollen. Wie aber kommt das Sollen in
diese Praxis bzw. woher wird der Mastab genommen, anhand dessen
das Verhalten des Schachspielers als Fehlverhalten beurteilt wird, und
inwiefern wird hier die Teleologie des Schachspielens relevant?
Ich denke, die Antwort ist folgende: Wer mit der Praxis des Schachspie-
lens vertraut ist, der kennt ihre Regeln und ihre Teleologie und kann ei-
ne Reihe von wahren Aussagen ber diese Praxis formulieren, also etwa
Schach spielt man nach diesen und jenen Regeln oder Schach spielt
man mit Konzentration, Ernsthaftigkeit und Respekt vor seinem Geg-
ner oder Schach spielt man zur Unterhaltung. Bei diesen Stzen
Externe und interne Ethisierung des Rechts 53

handelt es sich um einen Typ, der sich analog zu den Stzen verhlt, die
Michael Thompson als Aristotelische Kategoriale bezeichnet hat.19
Nehmen wir Stze wie Wlfe leben in Rudeln, Katzen haben vier
Beine, Meerschweinchen sind Pflanzenfresser oder Eulen habe gu-
te Nachtsicht. Diese Stze drcken keine empirischen Generalisierun-
gen oder Wahrscheinlichkeitsaussagen aus. Sie sagen nicht, dass etwas
hufig der Fall ist, sondern, dass etwas die Norm, dass diese oder jene
Eigenschaft zu haben fr Eulen und Meerschweinchen natrlich,
normal ist. Das zeigt sich auch daran, dass wir eine nachtblinde Eule
als krank oder defekt ansehen wrden und die Ftterung von
Meerschweinchen mit Fleisch als nicht artgerecht. Jedes zoologische
Handbuch, das die Lebensform einer Spezies adquat beschreiben
mchte, muss auf diesen Satztyp zurckgreifen. Bloe Generalisierun-
gen von Verhaltensbeobachtungen reichen dazu nicht aus, da immer die
Mglichkeit besteht, dass die Menge an Verhaltensbeobachtungen ent-
weder nicht reprsentativ ist oder die Individuen der Spezies durch
bspw. anthropogene Umweltschden schwer beeintrchtigt wurden.
Aristotelische Kategoriale haben wie viele Stze eine interessante Dop-
pelfunktion: Man kann sie verwenden, um informative Aussagen ber
die Welt zu machen. Wer von Eulen bislang nur wusste, dass es sich bei
ihnen um Vgel handelt, lernt durch das Aristotelische Kategorial Eu-
len haben gute Nachtsicht etwas (Wahres) ber die Individuen dieser
Spezies. Man kann Aristotelische Kategoriale aber auch als grammati-
sche Stze verwenden: Man sagt dann, dass der Zusammenhang zwi-
schen eine Eule sein und gute Nachtsicht haben ein begrifflicher
ist. Analog verhlt es sich auch mit Praxisbeschreibungen, also Stzen
wie Spiele sind unterhaltend:
Der Unterhaltungswert von Spielen ist nicht nur ein empirisches
Faktum, sondern mit dem Begriff des Spiels verbunden. Ein nicht
unterhaltendes Spiel hat einen Defekt und zwar eine Art von De-
fekt, die dem Spiel immanent ist. D.h. ein langweiliges, witzloses,
uninteressantes Spiel erfllt seinen ihm eigenen Zweck nicht.20
Zwischen Lebensform- und Praxisbeschreibungen gibt es nun mindes-
tens einen wichtigen Unterschied: Man kann sich nicht auf dieselbe
Weise dafr entscheiden, ein Wolf zu sein, wie man sich dafr entschei-

19 M. Thompson, The Representation of Life, in R. Hursthouse/G. Law-


rence/W. Quinn (Hrsg.), Virtues and Reasons, 1995, 247. Ph. Foot hat Thomp-
sons Intuition dann zu einer ethischen Theorie der Natural Goodness ausge-
baut: Natural Goodness, 2001.
20 T.-P. Ertz (Fn. 12), 69.
54 Gruschke

den kann, die Rolle des Schachspielers zu bernehmen. Weil ein Wolf
zu sein nicht darin besteht, auf eine bestimmte Weise zu handeln, das
Schachspielersein hingegen schon, kann man aus dem, was fr Wlfe
oder Eulen richtig ist, also gemeinsam im Rudel zu heulen oder gute
Nachtsicht zu haben, nicht eine Forderung an die Adresse von diesem
Wolf oder jener Eule machen. Bei Praxisbeschreibungen geht das
durchaus: Man spielt ja kein Schach, sondern Tim oder Tom. Zu
sagen Schach spielt man nach diesen und jenen Regeln heit zu sagen
Schachspieler spielen nach diesen und jenen Regeln, und das heit zu
sagen, dass Tim und Tom als Schachspieler nach diesen oder jenen
Regeln zu spielen haben, so dass man und das ist wichtig aus dieser
Aussage Forderungen an die Adresse von Tim oder Tom ableiten kann,
also etwa: Was wir hier spielen, ist eine Partie Schach; darum lass bitte
Deine Phantasiezge und spiel geflligst nach den Schachregeln!
Man kann diese berlegungen folgendermaen zusammenfassen: Ers-
tens gehrt zum adquaten Begriff einer Praxis ihre Teleologie. Zwei-
tens geht die Teleologie einer Praxis mit Erwartungen sowohl bezglich
der Welt als auch bezglich des Verhaltens der anderen Teilnehmer ein-
her; erweisen sich diese Annahmen dauerhaft als falsch bzw. werden
diese Erwartungen permanent frustriert, dann wird die Praxis witzlos
und die Teilnahme an ihr sinnlos. Drittens knnen die Erwartungen
hinsichtlich des Verhaltens der anderen Teilnehmer als (berechtigte)
Forderungen explizit gemacht werden, gegen die zu verstoen vor-
werfbar ist und die fr (vorstzliche) Verste gegen Normatives typi-
schen Reaktionen (Missbilligung, Emprung) hervorruft. Die Gesamt-
heit dieser Forderungen ergibt eine Moral der jeweiligen Praxis und
kann, da sie begrifflich mit dem verbunden ist, was die betreffende Pra-
xis ist und soll, innere Moral der betreffenden Praxis genannt werden.
Externe und interne Ethisierung des Rechts 55

3. Die Teleologie des Rechts

Um diesen Gedankengang auf das Recht zu bertragen21, beginnt man


sinnvollerweise mit der Betrachtung von dessen Teleologie.22 Dazu bie-
tet es sich an, eine Idee von R. Summers aufzugreifen, der fnf basale
Arbeitstechniken (basic operational techniques) identifiziert hat, mit
denen bzw. durch die jedes Rechtssystem operiert:23 Es sind dies die
poenale, remediale, administrativ-regulative, benefiziale und arrangie-
rende Technik24, wobei jede dieser Techniken (von Summers auch mo-
des genannt) als linear progression analysiert werden kann, die mit
dem Erlass einer Rechtsnorm beginnt und ber deren Verkndung, ihre
Verankerung im Verhalten von Brgern, ihre Umsetzung durch die
Verwaltung sowie ihre Anwendung durch Gerichte schlielich in die
Durchsetzung behrdlich und gerichtlich angeordneter Rechtsfolgen
einmndet.25 Die fnf Modi unterscheiden sich voneinander zunchst

21 Man sollte dabei im Blick behalten, dass die positiven Rechtsnormen ei-
nes Rechtssystems, etwa die Bestimmungen des BGB oder StGB, sich zur Pra-
xis Recht nicht so verhalten wie die Schachregeln zu der Praxis des Schachspie-
lens, sondern eher so wie Schachzge zum Schachspielen. Das Recht ist nmlich
anders als Schach eine Praxis, in der die Erzeugung von Normen ein mglicher
Spielzug ist, fr den aber selbst wiederum Spielregeln gelten (wie auch fr die
Anwendung dieser Normen etwa im Gerichtssaal). Diese Spielregeln wiederum
sind selbst (zumindest teilweise) als positive Rechtsnormen niedergelegt, zum
Beispiel in der Verfassung oder fr gerichtliche Rechtsanwendung in den
verschiedenen Prozessordnungen.
22 Um ein naheliegendes Missverstndnis zu vermeiden sei vorausgeschickt,
dass den Witz der Praxis Recht bestimmen zu wollen nicht darauf festlegt zu
behaupten, die Teleologie des Rechts sei etwas historisch und kulturell Invari-
antes, sondern lediglich darauf, das Recht habe so etwas wie eine Teleologie.
Worin man jeweils das Telos des Rechts gesehen bzw. worin es bestanden hat,
sind davon verschiedene Fragen. In diesem Aufsatz soll es darum gehen, die
normativen Implikationen, die innere Moral der heute bei uns etablierten und
akzeptierten Rechtspraxis zu bestimmen.
23 R. Summers, The Principles of the Rule of Law, 74 Notre Dame Law Re-
view 1691 (1998-1999), 1697; The Technique Element in Law, 59 California
Law Review 733 (1971).
24 Die gewhlten Ausdrcke sind zwar unschn, halten sich jedoch sehr eng
an Summers Terminologie, der von penal, grievance-remedial, administra-
tive-regulatory, public-benefit conferral und private-arrangement techni-
que spricht.
25 Die Bercksichtigung dieser linearen Progression ist auch deshalb wich-

tig, weil in jedem Stadium bestimmte Prinzipien der Rule of Law eingreifen.
56 Gruschke

einmal durch das, was Summers primary thrust nennt, also ihre pri-
mr verbietende (prohibitive), wiederherstellende (reparative), re-
gulierende (regulative), verteilende (distributive) oder ermgli-
chende (facilitative) Wirkungsweise, sowie durch den unmittelbaren
Ertrag, den sie liefern, nmlich Verbrechensbekmpfung, Kompensati-
on fr Schden, bereinstimmung zwischen Regeln und Adressaten-
verhalten (regulatory compliance), ffentliche Wohlfahrt und indivi-
duelle Selbstverwirklichung durch rechtliche Privatautonomie. Hinzu
kommen als weitere Unterscheidungskriterien die jeweilige Rolle von
Brgern und Amtstrgern im Rahmen der jeweiligen Technik, Art und
Umfang des jeweils ausgebten staatlichen Zwangs sowie die differen-
ces in the collaborative roles of adjudicative and legislative bodies.26
Trotz ihrer Verschiedenheit greifen die einzelnen Modi in der Praxis
hufig ineinander: Zu einer vollstndigen Beschreibung der gesetzlichen
Regulierung des Straenverkehrs etwa gehrt die Definition bestimm-
ter Straftaten wie Fahrerflucht (poenal) ebenso wie die Einfhrung des
Fhrerscheins mit Fahrprfung (administrativ-regulatorisch) oder auch
die Verkehrserziehung an staatlichen Schulen (benefizial).27
Betrachten wir die fnf Operationsmodi etwas genauer: Zum Arsenal
der poenalen Technik gehrt, dass legislatures prohibit criminal con-
duct; police, prosecutors, courts, and punitive and correctional officials
deter would-be criminals; and actual criminals are caught and punis-
hed.28 Ihre primre Wirkung ist prohibitiv und zielt auf Verbrechens-
bekmpfung ab. Neben der remedialen Technik ist sie wohl diejenige,
an die man fr gewhnlich als erstes denkt, wenn man danach gefragt
wird, was das Recht tut.
Die remediale Technik dient dazu, Schden rckgngig zu machen oder
zumindest zu kompensieren. Sie kommt dadurch zum Einsatz, dass

Nach Summers erfasst die Rule of Law das Recht nicht nur in seiner ganzen
Breite (den fnf Operationsweisen), sondern auch in seiner ganzen Lnge (line-
are Progression jeder Operationsweise).
26 The Technique Element in Law, 745.
27 Die Grenzen zwischen den verschiedenen Operationsweisen sind natr-
lich flieend. So knnen etwa Bestimmungen ber den Ersatz, den man einem
anderen fr die ihm im Straenverkehr zugefgten Schden zu leisten hat, ge-
nauso von bestimmten unerwnschten Verhaltensweisen abschrecken wie straf-
rechtliche Sanktionen oder in der Praxis von juristischen Laien auch als Teil
der durch die Justiz verhngten Strafe fr Fehlverhalten angesehen werden. Auf
diese Details kommt es hier aber nicht an.
28 The Principles of the Rule of Law, 1697.
Externe und interne Ethisierung des Rechts 57

courts and legislatures define remediable grievances such as harm due


to negligence and intentional torts, and courts provide reparation for
grievances, thereby also influencing people not to cause such grievances
in the first place.29
Die administrativ-regulative Technik unterscheidet sich, so Summers,
von der remedialen durch ihren prventiven Charakter, d.h. sie kommt
zum Einsatz, bevor Schden eintreten (deren Behebung bzw. Kompen-
sation dann in den Bereich des remedialen Modus fallen), und sie unter-
scheidet sich von der poenalen dadurch, that it regulates wholesome
activity rather than prohibits antisocial forms of behavior altogether.30
Sie besteht darin, that administrators will take precautionary steps to
assure that parties subject to regulation comply with specified regulato-
ry standards so nothing untoward will occur.31 Genauer gesagt ist sie
der Operationsmodus des Rechts, in which administrative officials (a)
lay down standards in advance regulating conduct such as television
programming, food manufacturing, building construction, public
transportation, etc., (b) take other regulatory steps such as licensing and
periodic inspections which are designed to secure compliance with tho-
se standards, and (c) impose sanctions on actual violators (which may
require judicial action, too).32
Die benefiziale Technik besteht in der rechtlich geregelten Definition
und Verteilung von substantive governmental benefits33 sowie der Si-
cherstellung dazu erforderlicher Mittel wie etwa Steuern. Zu den go-
vernmental benefits gehren bspw. staatliche Gesundheitsfrsorge, so-
ziale Transferzahlungen (Renten, Pensionen), Bildung, aber auch Steu-
erbegnstigungen oder ffentliche Verkehrsinfrastruktur.
Die arrangierende Technik schlielich besteht darin, dass das Recht fr
Private die Mglichkeit erffnet, in rechtlich bindende bzw. mit rechtli-
chen Pflichten und Rechten verbundene Verhltnisse einzutreten, also
z.B. die Ehe einzugehen, Vertrge zu schlieen, testamentarische Verf-
gungen zu treffen, Vereine zu grnden usw. Diese Technik nennt Sum-
mers facilitative, wobei die Mehrdeutigkeit dieses Ausdruckes auf-
schlussreich ist: Das Recht ermglicht Privatpersonen, durch rechtliche
Institute die staatlichen Aufsichts-, Dokumentations- und Zwangsin-

29 Id.
30 The Technique Element in Law, 737.
31 Id.
32 The Principles of the Rule of Law, 1697.
33 Id., 1698.
58 Gruschke

strumente fr eigene Anliegen in Anspruch zu nehmen, wodurch


zugleich die Erreichung der damit verbundenen Ziele erleichtert wird.
Sptestens hier zeigt sich, dass man die Einteilung von Summers nicht
als Differenzierung nach Rechtsgebieten (Zivilrecht, Strafrecht, ffent-
liches Recht) missverstehen darf, denn unter diesem Gesichtspunkt fie-
len arrangierende und remediale Technik beide in das Gebiet des Zivil-
rechts und die interessanten Unterschiede zwischen ihnen wrden ver-
wischt.34
Natrlich knnte man diskutieren, inwiefern etwa die Charakterisie-
rung der administrativen Technik ber ihre Prventivitt oder den Be-
zug auf wholesome activity sinnvoll ist und ob es nicht treffender
wre, das Spezifische an ihr mit Blick auf die beteiligten Institutionen
(Behrden) oder die Rolle der Brger herauszuarbeiten, die in der ar-
rangierenden Technik wesentlich aktiver und gestaltender ausfllt als
hier. Allerdings knnen wir darauf im Rahmen dieses Aufsatzes nicht
weiter eingehen. Interessant wre ferner die Frage, ob es noch weitere
basale Operationsweisen des Rechts gibt. An Summers Liste fllt nm-
lich auf, dass die gerichtliche Kontrolle des Verwaltungshandelns oder
auch die berprfung der gesetzgeberischen Aktivitt in Gestalt einer
verfassungsgerichtlichen Kontrolle der erlassenen Rechtsnormen nicht
abgedeckt ist. Die Antwort wird davon abhngen, was man als basale
Arbeitsweise des Rechts ansieht oder ansehen sollte. Dass die Kon-
trolle des Handelns staatlicher Amtstrger jedenfalls kein bloes Desi-
deratum ist, sondern einen intimeren Zusammenhang mit dem Begriff
des Rechts aufweist, wird spter deutlich werden.
Zunchst aber noch einmal zur Teleologie des Rechts: Wenn der jewei-
lige Modus ein Spiel wie Schach wre, wann wrden wir sagen, dass ein
Spieler die Partie gewonnen hat? Bei der poenalen Technik wre dies
wohl dann der Fall, wenn es der Polizei gelungen ist, ein Verbrechen
aufzuklren und den (wirklich) Schuldigen zu prsentieren, wenn fer-
ner die Staatsanwaltschaft seine gerichtliche Verurteilung durchsetzen

34 Summers Einteilung unterscheidet sich auch von solchen entlang der Ge-
waltenteilung, und zwar aus zwei Grnden: First, to represent laws tech-
niques in terms of separate legal institutions judicial, legislative, and executive
is to distort the actual operation of law, for laws techniques are really combi-
nations of legal resources in which courts, legislatures, administrators, and pri-
vate citizens function collaboratively rather than singly. Second, an analysis
based on separation of powers theory focuses on public institutions and ne-
glects the significant roles of private citizens in a legal system, whereas an
analysis of the kind offered here explicitly accounts for these roles. The Tech-
nique Element in Law, 747.
Externe und interne Ethisierung des Rechts 59

und die verhngte Strafe vollzogen werden kann. Fr die remediale


Technik wrde man sagen, dass sie ihr Ziel erreicht hat, wenn der dem
O durch T zugefgte Schaden durch Verurteilung des T zu einem an-
gemessen Schadenersatz und die Durchsetzung der Zahlung kompen-
siert werden konnte usw. Entsprechendes gilt fr die anderen Techni-
ken.
Wenn man sich nun berlegt, worin der Zweck der jeweiligen Technik
des Rechts besteht, dann fllt auf, dass eine abschlieende Antwort auf
die Frage Wozu dient ... ? darin besteht, die Sicherung eines Gutes zu
nennen. So knnte man die Frage, was der Zweck der poenalen Technik
sei, mit Verbrechensbekmpfung beantworten. Diese Antwort ist
aber nicht abschlieend, denn man knnte daraufhin fragen, was denn
deren Zweck sei usw., bis man schlielich zur Antwort erhlt Um Ge-
sundheit, Leben, Freiheit, Besitz, persnliche Ehre etc. der Brger zu
schtzen. Hier noch einmal zu fragen, worin denn deren Zweck be-
stehe, wre nicht nur seltsam, sondern absurd und wrde Zweifel nahe-
legen, ob der Fragende verstanden hat, was mit den Ausdrcken Ge-
sundheit, Leben etc. gemeint ist, bzw. ob er wei, was es bedeutet,
dass etwas ein Gut fr den Menschen ist. Falls mit dieser Frage aber le-
diglich eine Verdeutlichung bzw. die Einordnung der gegebenen Ant-
wort in einen greren Zusammenhang erbeten wird, dann knnte man
sagen, dass es bei dem Schutz dieser Gter letztlich um das fr Men-
schen gute Leben geht. Es wre aber seltsam zu sagen, diese Gter be-
zweckten das gute Leben in dem gleichen Sinne wie die Strafverfol-
gung den Schutz einiger dieser Gter bezweckt, denn offenkundig ist
jedes dieser Gter Selbstzweck und ihr Verhltnis ist kein instrumentel-
les, sondern eher das von Momenten an einem Ganzen, nmlich
menschlichem Glck, eudaimonia oder human flourishing.35
Zwei Klarstellungen sind hier erforderlich: Erstens ist die Rede von
Gtern nicht zu verwechseln mit der Rede davon, dass etwas aus je-
mandes Sicht ein Gut fr ihn ist oder ein Gut, auf dessen Erlangung
es ihm ankommt. Leben, Gesundheit usw. sind nicht fr den einen G-
ter und den anderen nicht, etwa weil sie den einen interessieren und
den anderen nicht; sie sind menschliche Gter. Ein junger Raucher, dem
es darauf ankommt, mit 40 noch gut angezogen zu sein, aber nicht dar-
auf, mit 40 noch gesund zu sein, verhlt sich irrational: Wenn er sagt

35 Ich folge hier J. Finnis, Natural Law and Natural Rights, 1980.
60 Gruschke

Mode interessiert mich, Gesundheit hingegen kmmert mich nicht,


dann wrden wir ihm entgegnen Das sollte sie aber.36
Zweitens ist die Sicherung von Gtern nicht etwas, was das Recht sozu-
sagen unter anderem und neben dem tut, was es sonst noch leistet, nm-
lich Handeln anzuleiten und zu koordinieren: Das Recht sichert diese
Gter, indem es, insofern es und solange es das Handeln seiner Adressa-
ten anleitet sei es durch direkte Normenbefehle, sei es durch die Zu-
weisung von Rechten und Pflichten, die Bereitstellung von Instituten
fr bestimmte Zwecke, das Aussprechen von Sanktionen etc. Den
Zweck des Rechts im Schutz bestimmter Gter zu sehen ist vereinbar
damit, seine vorrangige Aufgabe mit Handlungsleitung, guidance of
action, zu beschreiben, wie dies L. Fuller, H.L.A. Hart und J. Raz ge-
tan haben vorausgesetzt, man behlt das Spezifische rechtlicher
Handlungsleitung im Blick:
Angenommen, die Politiker eines Staates kmen unter dem Eindruck
vermeintlich gesicherter neurowissenschaftlicher Erkenntnisse auf die
Idee, man knne die Zwecke des Strafrechts viel effektiver dadurch er-
reichen, dass man den Brgern bestimmte Implantate in den Neokortex
einsetzt, um sie so durch leistungsfhige Supercomputer rund um die
Uhr berwachen zu lassen und um ggf. steuernd eingreifen zu knnen,
bevor sie eine gefasste kriminelle Absicht in die Tat umsetzen. Wrden
wir ein solches System noch als Rechtssystem ansehen? Wohl nicht.
Warum aber nicht? Weil, so wrden wir sagen, hier vielleicht noch von
Handlungssteuerung die Rede sein kann, nicht jedoch von Handlungs-
leitung vermittels Normen. Das Recht soll ja seine Zwecke nicht auf je-
de erdenkliche Weise zu erreichen suchen, sondern eben auf eine be-
stimmte, und wo diese nicht mehr zur Anwendung kommt, da ist das
Recht durch eine vielleicht effektivere, gleichwohl aber nicht mehr als
Recht zu bezeichnende Herrschaftsweise ersetzt worden. Es gehrt
zum Witz des Schachspielens, dass man mit regelkonformen Zgen zu
gewinnen sucht, es gehrt zum Witz der Medizin, dass sie sich um indi-
viduelle Heilung bemht (statt um den Zustand echter oder eingebilde-
ter Kollektive unter dem Titel der Volksgesundheit, Rassenhygiene
und dergleichen mehr) und es gehrt zum Witz des Rechts, die Siche-
rung von Gesundheit, Leben, Besitz etc. dadurch zu gewhrleisten, dass
von der autorisierten Instanz Normen erlassen und angewendet wer-
den.

36 Das Beispiel stammt von Ph. Foot; The Grammar of Goodness. An Inter-
view with Philippa Foot, XI The Harvard Review of Philosophy 32 (2003), 41.
Externe und interne Ethisierung des Rechts 61

Wie man sich aber an anderen sozialen Ordnungsarten, die gleichfalls


normenbasiert sind, verdeutlichen kann, bspw. Fahrplnen der Eisen-
bahn, militrischen Formationen oder auch der Fhrung eines Unter-
nehmens durch das Management, ist diese Bestimmung noch zu weit.
Es geht im Recht nicht blo um Handlungsleitung, und auch nicht ein-
fach um Handlungsleitung vermittels Normen. Es geht um die nor-
menbasierte Handlungsleitung von Personen, d.h. von vernnftigen
Wesen, die autonom und mithin fhig sind, sich in ihrem Handeln aus
Vernunft zu bestimmen, d.h. Normen zu verstehen, ihnen zu folgen
oder ihnen zuwider zu handeln und sich dafr zu verantworten:
To embark on the enterprise of subjecting human conduct to the
governance of rules involves of necessity a commitment to the view
that man is, or can become, a responsible agent, capable of under-
standing and following rules, and answerable for his defaults. Every
departure from the principles of the laws inner morality is an af-
front to mans dignity as a responsible agent. To judge his actions by
unpublished or retrospective laws, or to order him to do an act that
is impossible, is to convey to him your indifference to his powers of
self-determination. Conversely, when the view is accepted that man
is incapable of responsible action, legal morality loses its reason for
being. To judge his actions by unpublished or retrospective laws is
no longer an affront, for there is nothing left to affront indeed,
even the verb to judge becomes itself incongruous in this context;
we no longer judge a man, we act upon him.37

37 L. Fuller (Fn. 7), 162f. Interessanterweise ist sich hierin der Naturrecht-
ler Fuller mit dem marxistischen Rechtstheoretiker E. Pashukanis und dem
Rechtspositivisten Raz einig gewesen. Pashukanis: Die Rechtsordnung unter-
scheidet sich gerade dadurch von jeder anderen sozialen Ordnungsart, da sie
mit privaten isolierten Subjekten rechnet. Die Rechtsnorm erhlt ihre differen-
tia specifica, die sie aus der allgemeinen Masse der sittlichen, sthetischen, utili-
tren usw. Regeln hervorhebt, gerade dadurch, da sie eine mit Rechten ausge-
stattete und dabei aktiv Ansprche erhebende Person voraussetzt. [] Man
kann unschwer beweisen, da die Idee der unbedingten Unterwerfung unter ei-
ne uere normsetzende Autoritt mit der Rechtsform nicht das geringste zu
tun hat. Man braucht dazu nur Beispiele einer solchen Struktur zu nehmen [].
So etwa die in Reih und Glied aufgestellte Truppe, wo viele Menschen in ihren
Bewegungen einer ihnen gemeinsamen Ordnung untergeordnet sind, wobei das
einzige aktive und autonome Prinzip der Wille des Befehlsfhrers ist. [] Man
braucht sich nur in diese Beispiele zu vertiefen, um zum Schlu zu kommen,
da je konsequenter das Prinzip der autoritren, jeden Hinweis auf einen ge-
sonderten autonomen Willen ausschlieenden Regelung durchgefhrt ist, desto
weniger Boden fr die Anwendung der Kategorie des Rechts bleibt. Allge-
62 Gruschke

4. Die innere Moral des Rechts

Vor dem Hintergrund der vorangegangenen berlegungen ist nun


deutlicher zu sehen, was Fuller mit seiner Rede von laws inner mora-
lity (vermutlich) sagen wollte:
Recht ist eine gesellschaftliche Praxis mit eigener Teleologie, die man
grob etwa so charakterisieren knnte: Handlungsleitung der Rechtsad-
ressaten durch Normen zu dem Zweck, Gter zu schtzen, die Gter
fr alle Mitglieder einer Gemeinschaft sind, also etwa Leben, Gesund-
heit, Freiheit, persnliche Ehre, die Mglichkeit, gesicherte Beziehun-
gen zu anderen Menschen eingehen zu knnen, eine eigene Konzeption
des guten Lebens oder der Persnlichkeit, die man sein mchte, zu
verwirklichen, oder berhaupt mit anderen Menschen in Frieden und
Gerechtigkeit zusammenleben zu knnen. Diese Liste ist natrlich
nicht abschlieend. Allerdings erfordert sie eine wichtige Qualifikation:
Handlungsleitung durch Rechtsnormen bedeutet, Grnde zum Han-
deln zu geben, also die Adressaten prinzipiell als zur rationalen Selbst-
bestimmung fhige, d.h. autonome, Wesen ernst zu nehmen. Das ist et-
was anderes als Abrichtung, Manipulation durch zerebrale Implantate
oder militrische Kommandos.
Man kann dann vor dem Hintergrund der Teleologie der Praxis Recht
eine Reihe von Praxisbeschreibungen bilden, die sich analog zu M.
Thompsons Aristotelischen Kategorialen verhalten, also zum Beispiel
Rechtsnormen leiten das Handeln ihrer Adressaten an, Rechtliche
Handlungsleitung dient dem Schutz von universalen Gtern, Recht-
liche Handlungsleitung operiert im Medium der Grnde, Normad-
ressaten orientieren ihr Handeln an Rechtsnormen usw. Diese Stze
bersetzen sich entweder selbst unmittelbar in Forderungen an die
Teilnehmer dieser Praxis oder erlauben die Ableitung solcher mithilfe
weiterer Prmissen, dass also zum Beispiel Handlungsleitung durch
Normen Verstndlichkeit, Widerspruchsfreiheit, Kennenknnen, Er-
fllbarkeit usw. voraussetzt.

meine Rechtslehre und Marxismus, 1970, 77f., fr J. Raz vgl. The Rule of Law
and Its Virtue, in ders., The Authority of Law, Oxford 1979, 210, 221f. In jng-
ster Zeit hat J. Waldron diesen Gedanken, dass das Recht seine Adressaten als
vernnftige Wesen anspricht und respektiert, aufgegriffen, um damit begriff-
liche Zusammenhnge zwischen dem Begriff des Rechts und dem Begriff der
Rule of Law herauszuarbeiten: The Concept and the Rule of Law, 43 Georgia
Law Review 3 (2008).
Externe und interne Ethisierung des Rechts 63

Die Gesamtheit dieser Stze ergibt nicht bloe Wahrscheinlichkeitsaus-


sagen oder Klugheitsregeln fr effektives Regieren, sondern ein System
normativer Forderungen an die Teilnehmer dieser Praxis (in Abhngig-
keit von ihrer jeweiligen Rolle). Deshalb kann Fuller hier von einer
morality sprechen. Sie ergibt ferner eine inner morality of law, in-
sofern sie mit dem Begriff des Rechts selbst verbunden ist, da zu diesem
Begriff auch die Teleologie des Rechts gehrt: Ein Spiel, das nicht un-
terhaltend ist, ist defekt, und zwar auf eine Weise, die mit dem Begriff
des Spiels selbst zu tun hat. Recht, das durch einen Wust aus unver-
stndlichen, widersprchlichen, rckwirkenden Geheimgesetzen oder
durch Schauprozesse deutlich macht, dass es sich fr seine Adressaten
nicht als vernnftige Personen interessiert, oder das den Charakter ei-
nes Instruments fr die Durchsetzung ideologischer Kapricen hat, ist
nicht einfach, wie H.L.A Hart einmal gesagt hat, law, wenn auch
evil38; es ist Recht, aber es ist intrinsisch defekt wie ein per se lang-
weiliges Spiel, eine nachtblinde Eule oder ein nicht schlssiger Beweis.
Ein Gesetz als Geheimgesetz zu brandmarken bedeutet natrlich auch
zu sagen, es sei unvereinbar mit einem elementaren Respekt vor der
Autonomie seiner Adressaten. Es bedeutet aber ebenfalls zu sagen, ein
solches Gesetz sei defekt, und zwar auf eine Weise, die mit dem Begriff
des Rechts zusammenhngt. Stze wie Gesetze drfen nicht rckwir-
kend sein oder Amtstrger mssen sich an das Recht halten sind
Stze desselben Typs wie Der eigene Knig darf nicht im Angriff ste-
hen bleiben oder Patience muss man alleine spielen. Es sind Stze
ber die Grammatik des Sprachspiels Recht.39 Der Zusammenhang zwi-
schen Rechtsstaatlichkeit und Recht ist ein begrifflicher; die Prinzipien
des Rechtsstaates gehren zur Grammatik des Rechts.
Es wird jetzt auch klar, warum defektes Recht keinen Anspruch auf
fidelity hat. Eine Schachpartie, in der ein Spieler alles tut, um das
Schachspielen zu sabotieren, ist nicht blo defekt, sondern witzlos und
faktisch zusammengebrochen. Mit ihrem Ende erlschen aber auch die
Verpflichtungen des anderen Spielers, die er eingegangen ist, als er sich
auf diese Partie einlie. Analoges gilt fr das Recht: Die Fragen Was ist

38 [L]aws may be law but too evil to be obeyed. H.L.A. Hart, Positivism

and the Separation of Law and Morals, 71 Harvard Law Review 593 (1958),
620.
39 Zwar kann man Aristotelische Kategoriale wie gesagt auch verwenden,

um informative Aussagen ber die Welt zu machen. Da Philosophie aber vor-


nehmlich an der Entdeckung begrifflicher Zusammenhnge interessiert ist, inte-
ressiert sie vorrangig der Gebrauch dieser Stze als grammatischer Stze.
64 Gruschke

Recht? und Hat es Anspruch auf Gehorsam? hngen bei Fuller zu-
sammen.40 Das Band der Wechselseitigkeit zwischen Gesetzgebern und
Gesetzesadressaten, das Fuller ausgemacht hat, besteht nicht einfach
nur aus ineinander verschrnkten Erwartungen, sondern aus Erwartun-
gen, die vor dem Hintergrund der Teilnahme an einer gemeinsamen
Praxis und den damit eingegangenen Verpflichtungen berechtigte Er-
wartungen sind. Wenn etwa die Gesetzgeber oder andere staatliche
Amtstrger in einem Ausma gegen ihre Verpflichtungen aus ihren je-
weiligen Rollen in der gemeinsamen Praxis des Rechts verstoen also
etwa durch den Erlass von Rechtsnormen, die auf weiter Flur mit den
Prinzipien der Rule of Law unvereinbar sind, oder durch Korruption
und Parteilichkeit , welches die Praxis witzlos macht und diese da-
durch zusammenbricht, dann sind die Rechtsadressaten keine Teilneh-
mer mehr an einer gemeinsamen Praxis und unterliegen folglich auch
nicht mehr den mit ihrer Teilnehmerrolle verbundenen Verpflichtun-
gen. Da Entsprechendes auch fr die Amtstrger gilt, verlieren diese ih-
ren Anspruch auf Befolgung der von ihnen erlassenen und angewende-
ten Regeln. Wann der Punkt dieses Zusammenbruches der Praxis er-
reicht wird, ist pauschal nicht zu sagen. Eine Schwalbe macht noch kei-
nen Sommer. Auerdem ist ein schlechtes Rechtssystem unter vielen
Umstnden immer noch besser als gar keines (Anarchie), und es steht
nicht oder zumindest nicht ausschlielich im Urteil des Einzelnen, dar-
ber zu befinden, wann man von der Pflicht zur Rechtstreue dispen-
siert wird. Da man als Brger auch der Pflicht unterliegt, darauf zu ach-
ten, dass man seinen Mitbrgern durch das eigene Verhalten keinen
Schaden zufgt, kann es unter Umstnden sogar geboten sein, sich trotz
der eigenen Zweifel weiterhin rechtstreu zu verhalten, um, wie Thomas
von Aquin sagt, Ansto (scandalum) oder Aufruhr (turbationem) zu
vermeiden.41 Diese Details sind wichtig, berhren jedoch nicht den
Kern der Sache, dass es keinen unbedingten Anspruch auf, und keine
unbedingte Pflicht zum Rechtsgehorsam gibt. In einem grtenteils de-
fekten Rechtssystem gibt es keine Verpflichtungen und keine legitimen
Ansprche mehr, die aus der Teilnahme an dieser Praxis resultieren
wrden.

40 Dabei ist zu bercksichtigen, dass Was ist Recht? nicht danach fragt,
was fr die gerichtliche oder administrative Entscheidung dieses oder jenes Fal-
les die korrekte rechtliche Beurteilung wre, sondern danach, was der adquate
Begriff des Rechts ist.
41 Summa theologiae, I-II, q. 96 a. 4.
Externe und interne Ethisierung des Rechts 65

Was ist nun der Ertrag dieser berlegungen fr die Frage nach der
Ethisierung des Rechts? Wie mir scheint ein zweifacher: Zum einen hat
sich gezeigt, dass Ethisierung nicht zwangslufig darin bestehen muss
(bzw. auch nicht bestehen kann), externe Mastbe an das Recht heran
bzw. in das Recht hinein zu tragen, sondern auch bei der inneren Moral
des Rechts ansetzen knnte. So wre es beispielsweise interessant, etli-
che Manahmen, die im Zuge des War on Terror nicht nur hierzulande
Gesetzesform erhalten haben, daraufhin zu untersuchen, ob es sich bei
ihnen nicht vielleicht um Verletzungen von normativen Forderungen
handelt, welche mit der inneren Moral des Rechts und damit auf be-
griffliche Weise mit dem Recht verbunden sind. Unter Umstnden kann
hier der Ausgang von laws inner morality zustzliche argumentative
Ressourcen fr die Beurteilung gewisser rechtlicher Entwicklungen er-
schlieen. Damit soll nicht gesagt sein, ein solcher Ansatz solle oder
knne deontologische Herangehensweisen ersetzen. Allerdings sind
deontologische Zugnge manchmal zu wenig aussagekrftig und in ge-
wissen Kontexten auch deplaziert, also etwa dann, wenn komplexe ver-
fassungsrechtliche Fragen zu entscheiden sind und es daher auf spezi-
fisch rechtliche Argumentation ankommt.
Zum anderen ist ein Rekurs auf die innere Moral des Rechts hilfreich,
wenn es darum geht, eine Grenze fr die externe Ethisierung des Rechts
zu ziehen. Wenn etwa durch Ethisierung von auen rechtsstaatliche
Probleme aufgeworfen werden, dann wre dies ein Grund dafr, die
angestrebte externe Ethisierung zu berdenken. Bekanntlich heiligt der
Zweck nicht die Mittel und gute Absichten, moralische Besorgnis oder
gar moralisches Pathos sind kein Heilmittel gegen dadurch verursachte
Defekte, die mit dem Begriff des Rechts selbst verbunden und somit
rechtsintrinsisch wren.
Eines leistet der interne Ansatz jedoch nicht: Er schweigt darber, wel-
chen materialen Regelungen wir etwa in Fragen des Embryonenschut-
zes, der Gentechnik oder der weiteren Nutzung der Kernenergie Ge-
setzeskraft verleihen sollten. Das ist fr Vertreter einer externen Ethisie-
rung und ihr Anliegen einer ethisch guten Gestaltung rechtlicher Regu-
lierung natrlich unbefriedigend. Die Frage wre aber, ob es sich hier-
bei um einen Makel des internen Ansatzes und einen Nachteil gegen-
ber der externen Strategie handelt. Dies scheint mir nicht der Fall zu
sein, im Gegenteil: Der interne Ansatz belsst ethische berlegung im
Hinblick auf rechtliche Regelungen dort, wo sie unter Bedingungen
von Demokratie ihren sachlich angemessen und legitimen Ort hat,
nmlich in der gemeinschaftlichen ffentlichen Beratung im Zuge des
Gesetzgebungsverfahrens (wie im Hinblick auf das Gemeinwohl zu
66 Gruschke

verfahren ist) und ggf. auch in der Errterung vor Gericht. Hier ist lei-
der nicht die Gelegenheit, auf Aristoteles Begriff der bouleusis, der
(evtl. gemeinschaftlichen) berlegung, wie zu handeln wre, und die ihr
eigentmliche Tugend einzugehen, nmlich die phronesis politike, dank
der wir gut berlegte, wohl begrndete und insofern praktisch vernnf-
tige Beschlsse in Fragen des ffentlichen Lebens zu treffen vermgen42
obwohl die Darstellung einer internen Ethisierung des Rechts erst da-
durch an Kontur und Tiefe gewinnen wrde. Gleichfalls kann hier nicht
errtert werden, ob es so etwas gibt (oder geben kann) wie Experten fr
die normative Beantwortung ethischer Fragen, auch wenn die Beurtei-
lung der beiden Strategien mindestens zum Teil von der Ansicht abhn-
gen wird, die man sich zu diesem Punkt bildet. Stattdessen will ich mit
einer polemischen Bemerkung schlieen: Der groe Vorzug der inter-
nen gegenber der externen Strategie scheint mir gerade darin zu beste-
hen, dass die interne Strategie nicht den Eindruck erweckt, als knnten
Fragen der Ethisierung des Rechts durch Auslagerung in Kommissio-
nen von (vermeintlichen?) Experten oder durch Rekurs auf private
Ethikkodizes u.. gelst oder auch nur angemessen behandelt werden.
Zwar trifft es zu, dass die interne Strategie weniger verspricht als die
Befrworter einer Ethisierung von auen. Dafr steht jedoch zu erwar-
ten, dass sie das Versprochene auch halten kann.

42 Vgl. Nikomachische Ethik, 3. Buch, 1112a20ff und 1112b sowie 6. Buch,


1141a und b.
Law, Marching with Medicine but in the Rear
and Limping a Little: Ethics as First Aid for
Law
Margaret Somerville

I. Interactions of Law, Medicine and Ethics in Courts

The quotation in the title of this paper, Law, marching with medicine
but in the rear and limping a little, comes from a judgment of Justice
Windeyer of the High Court of Australia in the case Mount Isa Mines v
Pusey1. Its an early case 1970 in which it was recognized by a judge
that the law was clearly not keeping up with advances in medical sci-
ence. With hindsight, we can see in this case ethics coming to the laws
aid, informing and supplementing it, when it was having difficulty cop-
ing in the sense of justice prevailing although ethics would not have
been perceived as playing that role at the time.
The case involved an engineer, the plaintiff, who was employed in a
powerhouse at Mount Isa mine, in Queensland, Australia. Two electri-
cians working in the powerhouse negligently caused an explosion that
generated an electric arc of intense heat. The two electricians were hor-
ribly burnt. The engineer came to the rescue of one of the electricians.
He saw him with his clothes burnt off; his skin peeling; obviously
grievously hurt. The plaintiff was intensely distressed. After some days
the shock of the event, with the added knowledge that both men had
died, began to tell. He became depressed and suffered a severe schizo-
phrenic reaction, with acute depression and an acute anxiety state. He
was unable to work for considerable periods and was under psychiatric
treatment.

1 Mount Isa Mines v Pusey, (1970) 125 CLR 383, per Windeyer, at 395.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 67
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_4, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
68 Somerville

The legal issue for the court was whether the plaintiff could recover
damages for negligently inflicted pure nervous shock, that is, mental
injury unaccompanied by physical injury. Historically, the Anglo-
Australian Common Law did not allow recovery for such damages. At
the time of the High Courts hearing of this case, however, the issue of
whether such damages were legally recoverable was being inconsis-
tently handled in case law and much debated in doctrine. The fears of
allowing compensation were that once this happened, there would be a
flood of cases overwhelming the courts and that fraudulent claims
would be presented.
Justice Windeyer first took note of the many then relatively recent psy-
chiatric advances in recognizing and diagnosing mental illness. Its a
truism in ethics, but no less important for being so, that good facts are
necessary for good ethics. That means as the facts, especially medical
and scientific facts, change, so do the ethics change. And, we can add, so
sometimes should the law. I also want to note here, in view of what I
will argue later in this text with respect to courts incorporating ethics
into law in order to deal with unprecedented advances in medical sci-
ence, that medical advances played an important role as a justification
that allowed Justice Windeyer to reconsider the established approach of
the law and for his decision which changed the law.
In arriving at his conclusions, Justice Windeyer cited Lord Wright in
Bourhill v. Young2 when the latter said:
The lawyer likes to draw fixed and definite lines and is apt to ask
where the thing is to stop. I should reply it should stop where in the
particular case the good sense of the jury or of the judge decides.3
Justice Windeyer went on to add, [t]hat perhaps does not reckon with
courts of appeal, and varying judicial opinions of where in good sense
the proper stopping-place is.
I suggest that the good sense to which Lord Wright and Justice Wind-
eyer refer is moral intuition, which guides our sense of what is and is
not ethical and which, as the judge recognizes, can vary from person to
person. But that is not a valid reason to exclude it as an important hu-
man way of knowing or, likewise, our emotional response to a situa-
tion; its sometimes said we ignore our feelings at our ethical peril.4

2 Bourhill v. Young, [1943] AC, at 110.


3 Supra note 1, at 402.
4 Somerville, The Ethical Imagination: Journeys of the Human Spirit, 2006,
29-31, 70-71, 166, 205.
Law, Marching with Medicine but in the Rear and Limping a Little 69

Rather, it means the use of these ways of knowing needs to be safe-


guarded, in particular, by using reason as a secondary, but essential,
verification mechanism, to check if weve been led astray by these other
ways.5 It might also be that these other ways function to bring ethics
to bear in our decision making. Because that would be no less true of
judges than other people, it might be another way in which ethics is
brought into law.
And Justice Windeyers statement that the law was in the rear and
limping is an articulation of a disconnect that he perceived between, on
the one hand, what ethics required in terms of compensating the plain-
tiff for his psychological injuries, and, on the other hand, what the law
would allow in this regard, if it were interpreted to the effect that the
plaintiff should not be compensated.
I propose that its not a coincidence that this judgment was handed
down in 1970. This was the era when the development of the field of
practice, research and scholarship that we now know as applied ethics
was just beginning. Its emergence was being precipitated by unprece-
dented advances in science and medicine with which the law had no ex-
perience and for which it had no precedents, yet physicians, scientists,
politicians, policy makers and the public were turning to the law for
guidance in relation to these advances.

II. Emergence of Applied Ethics and Ethicists

Prior to around 1970, there was a tacit assumption within each society
that we more-or-less agreed on our collective values on which our so-
cieties were based that is, what was and was not moral and ethical
and that the law reflected, implemented and upheld these values. In the
late 1960s, as challenges to traditional shared values emerged and con-
flict erupted as to what they should be became apparent, we realized
that this assumption was no longer valid.
The causes included that people no longer largely shared a Judeo-
Christian religious tradition to which they would turn for guidance on
values. Many were not religious or, if they were, they followed an in-
creasingly wide variety of religious traditions. Another cause was that
we did not agree on the values that should govern the mind- and world-
altering breakthroughs being realized in the new science.

5 Id.
70 Somerville

Science fiction was rapidly being converted to science fact: the previ-
ously impossible, and even unthinkable, was becoming reality and we
had no precedents for the values that should govern these extraordinary
developments. I believe the seminal event in the emergence of what be-
came the new field of applied ethics was the first heart transplant in
1967 by Dr. Christiaan Baarnard in South Africa. A person was walking
around with a beating heart, the primary indicator of life, of a dead per-
son.
The law was confronted with questions such as: Was it murder to have
taken the donors heart? When was a person dead so their organs could
be taken for transplantation?6 Should organ transplants be prohibited?
If not, under what conditions were they acceptable? Today, we regard
organ transplantation as being such a routine medical procedure that we
easily forget how shocked and deeply concerned the world was to learn
of Dr. Barnards feat.
The second seminal event was the birth of the first test-tube baby,
Louise Brown, in 1978. Once more, the world was shocked at a proce-
dure that involved conception other than through sexual intercourse
and outside a womans body that, again, is routine today.
Questions that emerged in this context included: Was it acceptable to
freeze human embryos? What about using them for experimentation?
Should embryo donation be allowed? Should a surrogate mother be al-
lowed to keep the baby to which she gave birth, but was not genetically
related? And so on.
Science was moving too fast for the law and the courts to keep up with
the unprecedented issues it was presenting. And the number of those is-
sues exploded through the 1980s and into the 1990s and, of course,
has continued to do so.
The courts and, indeed, legislatures when faced with such issues
coped by turning to ethics as an add-on to the law. They would first

6 I note that determining when a person is dead is again a current issue as a


result of some hospitals instituting DCD donation after cardiac death
policies, fulfilling the requirements of which, some people believe, do not mean
the organ donor is dead. See Shah, Truog, Miller, Death and legal fictions, J Med
Ethics, DOI:10.1136/jme.2011.045385; see at http://jme.bmj.com/content/early
/2011/08/02/jme.2011.045385.ful. Even more controversially there are recent
proposals to take organs from dying people, who are beyond suffering and
have given their informed consent, but are not yet dead. See Rodrguez-Arias/
Smith/Lazar, Donation After Circulatory Death: Burying the Dead Donor
Rule, 11(8) The American Journal of Bioethics (2011), 36-43.
Law, Marching with Medicine but in the Rear and Limping a Little 71

look to the law and if this did not provide a clear or satisfactory answer,
they would turn to ethics.
Moreover, increasingly, they called upon ethicists, in particular, bio-
ethicists, who were, at the time, starting to be recognized as profession-
als in applied ethics.7 Bioethicists became involved as expert witnesses
before official enquiries8, courts or parliamentary committees. The
question of what credentials should be required in order to be regarded
as such an expert remains to this day a contentious one.
Chief Justice Robert French of the High Court of Australia discusses
this question in an interesting article, published in 2003.9 He begins by
recognizing the, by then, well-established interaction of law and applied
ethics in relation to issues raised by scientific and medical advances and
notes an increasing reliance on ethicists as public policy life coaches to
guide us on our way.10
He proposes that those ethicists must be, at the least, honest, objective,
independent, competent and diligent in providing transactional advice
in the formulation of administrative practice and public policy and in
the development of the law.11
In other words, the Chief Justice clearly contemplates a valid role for
ethics and ethicists in the laws future. He rightly warns, however,
that
[a]ny tendency to commercialization or commodification of ethics
as a product is damaging to the whole of society. So too is the cor-
ruption of ethics to a form of politically convenient certification of
proposed actions, practices or laws.12

7 Its said that in 1970 there were seven articles published in the world in
English in the field we would now call applied ethics. In 1980 there were four-
teen specialty journals in the field. And by 1990 there were over two hundred
ethics centres, many of them in universities, undertaking teaching and research
in the field.
8 For a description of a coroners enquiry that relied heavily on ethicists as
expert witnesses, see Somerville, The Ethical Canary: Science, Society and the
Human Spirit, 2000, at 152-174.
9 See Justice French (as he then was), Ethics at the beginning and ending of
life, 5 University of Notre Dame Australia Law Review (2003), 1-13.
10 Id., at 2.
11 Id., at 6.
12 Id., at 12.
72 Somerville

He goes on to note that [t]here may be a need to develop ethics13,


a sentiment with which Im sure all ethicists would concur.
To return to the history of the development of applied ethics, I believe
that in the early 1990s the order of analysis changed from analyzing
from law to ethics, to first looking at the ethics and then assessing
whether the law accorded with the ethics.14
This change might seem of little importance and largely irrelevant, but
its effect was far from neutral on the outcome of decisions that involved
both ethical and legal analysis. Law informing ethics does not necessar-
ily result in the same outcome, as when ethics informs law. We can see
this easily in relation to physicians decisions about offering adequate
and effective pain management treatment to patients in pain.
In the past, many physicians interpreted the criminal law as prohibiting
them from giving necessary pain relief treatment, if they believed there
was any chance it might shorten the patients life (or in the case of some
physicians, that it might cause addiction) and they would withhold such
treatment. Yet, it is unethical for a physician to unreasonably leave a
person in serious pain; ethics requires that all reasonably necessary pain
relief treatment be offered to a patient.
When the order of analysis was changed from law informing ethics (law
first, ethics second), to ethics informing law (ethics first, law second),
the law was correctly seen by physicians and others as not prohibiting
the provision of such treatment. Indeed, we now recognize it is a breach
of human rights to leave a person in serious pain and I would argue
there is a legal duty to offer adequate pain management to patients who
need it.
This approach is articulated and implemented in the recent Declaration
of Montreal.

13 Id.
14 Somerville, note 8, at 266-267.
Law, Marching with Medicine but in the Rear and Limping a Little 73

III. The Relation of Ethics and Law

1. Ethics Informing Law: A Human Right to Reasonable Access to


Pain Management: The Declaration of Montreal

The Declaration of Montreal establishes that access to pain management


is a fundamental human right. I had the privilege of being involved in
the development of this Declaration. The story of my involvement is
both personal and professional.
In 1983, my father, who lived in Australia, was terminally ill with pros-
tate cancer that had metastasized to his bones. I was telephoned in
Montreal and told he was about to die, so I jumped on a plane to Aus-
tralia.
I found my father in a university teaching hospital in horrible pain. I
created a huge fuss and managed to get a pain specialist to see him. My
fathers pain was brought under control and, as it turned out, he lived
another nine months receiving excellent pain management.
Dad said to me,
I want to live as long as I can Margo, but I dont want to live if it
means such terrible pain. Its great what you did for me, but not eve-
ryone has a daughter who can go berserk to get them the pain relief
they need. You have to do something to help other people in pain.
That was the start of my research on ethical and legal aspects of access
to pain relief treatment. Publication of that research15 led to an invita-
tion to give an opening keynote speech at the International Association
for the Study of Pains meeting in Paris in 1993.
I decided to consider whether we might be able to use ethics and law to
improve access to pain relief treatment. I called the speech Death of
Pain meaning to convey the double entendre message that we could
kill the person with the pain or we could kill the pain.16 Im adamantly

15 See, for example, Somerville, Pain and Suffering at Interfaces of Medicine

and Law, in Proceedings of the 6th World Congress on Medical Law, Ghent,
Belgium, August 1982, Vol. I, 246-256; 10 Jus Medicum (1984), 133-142; ex-
panded text published in 36 University of Toronto Law Journal (1986), 286-
317. (Selected for referencing in Sociological Abstracts, 1986).
16 Somerville, Death of pain: pain, suffering, and ethics, in Gebhart/
Hammond/Jensen (eds.), Proceedings of the 7th World Congress on Pain. Pro-
gress in Pain Research and Management, Vol. 2. 1994, at 41-58; also published in
74 Somerville

against killing the person with the pain, that is, euthanasia,17 and pas-
sionately in favour of killing the pain.
So, I argued that to implement that latter goal in practice, we should
recognize that people in pain have a fundamental human right to
have reasonable access to pain management and that unreasonable fail-
ure to provide such access was a breach of their human rights. And that
is precisely what the Declaration of Montreal now establishes.

a) Why Turn to Human Rights?


The language of human rights is very persuasive and, I suggest, is a lan-
guage common to ethics and to law; as such, it can bridge gaps between
them. Its difficult to imagine any reasonable person saying, I dont
care about human rights or if they are breached.18
Recognition of human rights, whether in domestic or international law
or, indeed, in ethics, tries to ensure the rightness or ethics of our inter-
actions with each other at the most basic level of our humanness, at the
level of its essence, that which makes us human which is not easy to
define.
As the French philosopher Helene Boussard writes, both human
rights law and bioethics aim to protect human dignity, from which hu-
man rights values stem.19
I believe intentionally leaving someone in serious pain is a complete
failure to respect their human dignity and, therefore, it is appropriate to
bring both human rights law and bioethics to bear to try to prevent

Somerville, Death Talk: The case against euthanasia and physician-assisted sui-
cide, 2002, at 218-230.
17 Somerville, Death Talk, note 16, id.
18 Very recently, I have decided to use human rights language, again, in a
very similar way to my use of it in relation to trying to ensure peoples access to
pain management, this time in the context of the need for ethics to inform the
law governing reproductive technologies. I argue that for every person the most
fundamental human right of all is to be born from natural human biological
origins and this right should be legally recognized. I will discuss this proposal
shortly.
19 Boussard, An Ambiguous Relationship between Ethics and Law: Study of

the Future Declaration on Universal Norms on Bioethics, in Sanati (ed.), Pro-


ceedings of the International Congress of Bioethics 2005: Tehran, Iran, 26-28
March, 2005, 3-16, at 3.
Law, Marching with Medicine but in the Rear and Limping a Little 75

such situations from occurring.20 That also is exactly what the Declara-
tion of Montreal does.21

b) The Nature of Human Rights


To understand why I believe we needed this Declaration I would like to
explain how I perceive the nature of human rights.
First, I believe we do not create human rights; rather, they exist inde-
pendently of being recognized by any human agency. That is why no
one can opt out of respecting them. What we do is articulate human
rights. And thats why statements of them are called declarations.
This non-contingent feature of human rights also means that private ac-
tors can proclaim them, as is true in regard to the Declaration of Mont-
real.
In speaking of other declarations dealing with ethics in scientific and
medical contexts, such as UNESCOs Declaration on Universal Norms
on Bioethics, Boussard explains well the nature of declarations. Her
words apply equally to the Declaration of Montreal.
She says the declarations
are legal instruments but they are not legally binding. Their origi-
nality lies in their aim, which is to translate ethical standards into le-
gal terms in order to protect human rights in scientific research and
medical interventions.22 [B]ioethics and law strengthen each other
to give teeth to fundamental human rights values.23 [T]hey are
ethically-inspired legal instruments.24
I very much like this last sentence.
Second, I believe that what we call human rights is shorthand for a
tri-partite concept that consists of human rights; human responsibilities
(or obligations); and human ethics. Sometimes we need to focus on one
of these limbs, sometimes on another, and sometimes on all of them. I

20 For a discussion of the concept of human dignity see Somerville, Is Dig-


nity a Useful, Useless, or Dangerous Concept?, Brian, Jr. Family Lecture, 2010
Baylor Symposium on Faith and Culture, Baylor University, Waco, Texas (un-
published manuscript).
21 The Declaration of Montreal is attached as Appendix A.
22 Boussard, note 19, at 3-4.
23 Id, at 5.
24 Id, at 8.
76 Somerville

am attaching a chart in which I explain this tripartite concept diagram-


matically.25 As this shows, human rights, human responsibilities, and
human ethics can be seen as three different entry points into the same
reality, situation or issue. It also shows why I believe we can speak of
human ethics, which can later be translated into legally recognized hu-
man rights, before that legal recognition occurs.
An advantage of such an approach is that recognizing the
interdependence between human rights law and bioethics leads us
to move from a static image of existing or positive law in favour of a
more dynamic concept in which views on law as it is and views on
law as it should be are continually merging into views on law as it is
becoming.26
So, recognizing a human right to reasonable access to pain management
means, for instance, that healthcare professionals and healthcare institu-
tions have ethical and sometimes legal obligations to offer patients such
management.

c) The Nature and Impact of the Declaration


But if, as I said, we dont create these obligations, they exist whether or
not we declare them, why declare them? The answer is to help ensure
that they are honoured and not breached. Formally recognizing them
makes it much more likely that they will be respected.
The Declaration of Montreal is not just a piece of paper; its what we
call a verbal act, that is, its words will change reality, just as a judges
verdict is not just words, but changes reality.
The hope is that the Declaration will help to change the horrible reality
of people being left in pain.
The Declaration will also be an ethics guide in relation to pain manage-
ment; and an educational tool for healthcare professionals and trainees.
Sometimes, it will function as evidence to justify giving necessary pain
relief treatment, when others would prevent that. In particular, it will
help to overcome the harmful beliefs of some healthcare professionals
who, as I explained above, withhold pain management because they fear
legal liability or that patients will become addicted. It will deliver a

25 See Appendix B which shows diagrammatically how I see these three

limbs as interacting.
26 Boussard, note 19, at 15.
Law, Marching with Medicine but in the Rear and Limping a Little 77

strong message that its wrong not to provide pain management, not
wrong to provide it.
Provisions in the Declaration could be adopted as case law by courts, in
which case failure to live up to its requirements could constitute medi-
cal malpractice (medical negligence) or unprofessional conduct, which
can be cause to revoke a physicians license to practice medicine.
And the Declaration will inform and one hopes guide institutions and
governments in formulating health policy and law with respect to pain
management. It will help Governments to understand that they have
both domestic and international obligations, at the very least, not to un-
reasonably hinder either their own citizens or other peoples access to
pain management.
It is an outrage and a human tragedy that, in developing countries,
many people in serious pain do not have access to opioids, including as
a result of the conditions relating to narcotic drugs some countries at-
tach to their foreign aid to these developing countries. An egregious ex-
ample of a lack of access to pain management in a developing country is
documented in a report from Human Rights Watch. The vast majority
of children dying from HIV/ AIDS in Kenya die with no pain relief
treatment.27
We need to apply one of the most ancient and universally accepted
maxims in making sure that everyone who needs pain management re-
ceives it: Do unto others as you would that they would do unto you
the Golden Rule. The Declaration of Montreal spells out what those
others have a human right to expect when they are in pain.
There is a beautiful Sanskrit salutation Namaste. It can be roughly
translated as, The Light in me recognizes the Light in you. It affirms
our common humanity across all barriers and borders. One very im-
portant application of it could be rendered as The pain in me recog-
nizes the pain in you and that recognition causes me to respond to re-
lieve your pain which is another way to express the insight communi-
cated in the concept of the wounded healer.
The Declaration of Montreal is a very important step forward in mak-
ing sure as many of us as possible, and especially healthcare profession-
als, do recognize others pain and see it as our privilege and obligation
to do what we can to assuage it.

27 Human Rights Watch, Needless Pain: Government Failure to Provide


Palliative Care for Children in Kenya, see at http://www.hrw.org/en/news/20
10/09/02/kenya-provide-treatment-children-pain.
78 Somerville

d) Wider Impact of the Declaration of Montreal on Human Rights


And, finally, the Declaration of Montreal could raise our sensitivity to
the horror of breaches of human rights, in general.
Fortunately, most of us dont experience breaches of our human rights
in our everyday lives and, consequently, we dont personally identify
with many of these breaches, much as we might abhor them. But be-
cause pain is a universal human experience which we all want to avoid,
wrongful failure to manage it is one of the rare breaches of human
rights with which we can all personally identify and, as a result, better
understand what breaches of human rights, in general, feel like. That is
a lesson we should all heed carefully.

2. Ethics Informing Law: Assisted Human Reproduction


Technologies

Assisted human reproduction technologies (ARTs) is another context


in which both ethics and law have important roles to play and it can
make a difference to our decisions whether we consider the law first
and ethics second or vice versa. It is also a context in which the lan-
guage of human rights can function as a bridge between ethics and law.
And it is an area that gives rise to situations in which we need to con-
sider the ethics of our decisions at levels other than just the individual
one; the cumulative impact of decisions by individuals; and what the
law that governs these decisions should be. I will discuss each aspect in
turn.

a) The Interaction of Ethics and Law in Relation to Reproductive


Technologies
Ethics requires that decisions about the development and use of repro-
ductive technologies must be child-centred, not adult-centred as they
most often are at present. Indeed, the law, itself, can result in adult-
centred decision-making in this context, for instance, when it is inter-
preted to require that in order to avoid discrimination against adults, or
to respect their rights to autonomy and self-determination or privacy,
access to these technologies or particular uses of them that are not in
the best interests of the resulting children must be allowed.
On the other hand, the law could also help to incorporate ethics into
judicial decisions. For instance, the extent to which the courts view the
Law, Marching with Medicine but in the Rear and Limping a Little 79

Canadian Charter of Rights and Freedoms28 as a legal articulation and


embedding of fundamental ethical norms and principles in our Cana-
dian Constitution could affect the extent to which they are willing to
interpret constitutional rights either broadly or restrictively with the
goal of ensuring ethical outcomes.
The more the Charter is seen by judges as intended to ensure that state
actions are ethical, not just legal, the more likely it is that its provisions
will be interpreted by courts so as to incorporate ethics into their judg-
ments in the interests of ensuring justice.
In the same vein, it should come as no surprise that the Charter is being
enlisted by litigants, whose perceptions are that their claims have a
strong ethical component, to promote their claims.
I mentioned previously that I believe that in the 1970s we realized that
we could no longer simply assume that we all bought into the same
shared societal values or that the law reflected, implemented and upheld
shared values and this realization gave rise to the emergence of applied
ethics as a way to supplement the law. I suggest that the Canadian
Charter, which was enacted in 1982, is yet another outcome of this same
phenomenon insofar as it resulted from seeing a need to articulate in a
legal document our shared values and ethics. It merits noting that, as in
all statements of principle on which a wide societal consensus is sought,
the Charter is couched in broad and general language. Variance and dis-
agreement enter at the level of the interpretation and application of its
provisions.
One of the criticisms of seeing the Charter as legally enacted shared
ethics is that its the proper function of the courts to implement the
law, not ethics, and that undertaking the latter task confuses and harms
the law. But that is to forget a major historical feature of at least the
courts in jurisdictions, such as Canada, that have their origins in the
British Common Law system. The Courts of Equity applied a gloss on
the common law, when strict application of that law by the Kings
common law courts caused unconscionable outcomes for unsuccessful
litigants. They were the courts of conscience and acted in personam
to prohibit victorious parties from enforcing such a judgment. Al-
though operating in a very different way legally, the Charter can be
viewed as allowing 21st Century judges to realize goals of the same na-
ture.

28 Canadian Charter of Rights and Freedoms, being Part I of the Constitu-


tion Act, 1982.
80 Somerville

The recent Olivia Pratten case29 shows, in my opinion, a court the


British Columbia Supreme Court squeezing ethics into its decision
through the funnel of constitutional law, but nevertheless using a con-
ventional approach to Charter interpretation and application to do so.
The latter is arguably not true of the use of the Charter by the Supreme
Court of Canada in an even more recent decision, the Insite case,30
which I will discuss shortly.
Olivia Pratten, a young woman who was conceived by anonymous
sperm donation, wanted to know who her biological father was. The
physician who carried out the artificial insemination of her mother that
resulted in her birth refused to release the medical records on the
grounds of respecting the sperm donors privacy.
The British Columbia Adoption Act gives adopted children, when they
turn 19, rights to have access to information about their birth parents.
Ms. Pratten challenged these provisions as being discriminatory, and,
therefore, unconstitutional under the Canadian Charter of Rights and
Freedoms, because they did not give children conceived from sperm or
ova donations the same legal rights of access to such information as
adopted children. Justice Elaine Adair of the British Columbia Supreme
Court agreed.
The judge suspended her ruling striking down the offending provisions
in the Adoption Act for 15 months to give the British Columbia Legis-
lature time to amend the law to give donor-conceived people the same
rights as adopted ones. The British Columbia government has since ap-
pealed the ruling arguing that the trial judge erred in law in her finding.
The British Columbia Attorney General, Barry Penner, explained: The
B.C. government is appealing the Pratten decision because it raises im-
portant constitutional principles that extend beyond this particular
case.
The governments concern is that they could be limited in their ability
to provide programs that respond in tailored ways to particular groups
of individuals.

29 Pratten v. British Columbia (Attorney General), 2011 BCSC 656.


30Canada (Attorney General) v. PHS Community Services Society, [2011]
SCC 44 (30 September 2011, Supreme Court of Canada).
Law, Marching with Medicine but in the Rear and Limping a Little 81

He continued, Governments need the flexibility to develop programs


that respond to the needs of British Columbians, such as programs that
support seniors, social assistance, and other programs. 31
One possible interpretation of the Attorney Generals statement is that
he is concerned that affirmative action positive content discrimination
to assist historically disadvantaged groups could be limited by Justice
Adairs ruling, because governments could take it to mean that if they
cant provide everyone who can claim equivalence to the disadvantaged
group with the same benefits as the latter receive, their only legal option
is not to provide anybody with these benefits, as to do otherwise would
constitute discrimination. Certainly, in many cases, at least, ethics
would not endorse that outcome.
Justice Adairs ruling is the right result, but, from a wider social and
public policy and precedent point of view, as the British Columbia
Government has recognized, the fact its based on discrimination is
worrisome although, I believe, not legally incorrect.
The only way the difference between adopted childrens rights of access
to their biological identities and donor conceived childrens rights to the
same information would be legally valid under Canadian constitutional
law would be to prove the different treatment was not discrimination
within section 15(1) of the Canadian Charter of Rights and Freedoms,
or was justified affirmative action within the exemption in section 15(2)
allowing for that, or, if it were found to be discrimination, it was justi-
fied state action within the requirements of section 1. Establishing the
latter would require the British Columbia government to show that the
breach of Ms. Prattens constitutional rights resulting from the under-
inclusivity of the Adoption Act are reasonable limits prescribed by law
[such] as can be demonstrably justified in a free and democratic soci-
ety.32
It remains to be seen how the courts might rule in these respects on ap-
peal.
Ms. Pratten also argued that she was deprived of her constitutional
right to life, liberty and security of the person33

31 Hall, B.C. government appeals landmark sperm donor ruling, Vancouver


Sun, June 17, 2011; see at http://www.vancouversun.com/health/government+a
ppeals+landmark+sperm+donor+ruling/4966861/story.html#ixzz1VImvMa5D.
32 Supra note 28, section 1.
33 Id., section 7.
82 Somerville

under section 7 of the Charter. She claimed that the failure of the legis-
lature to pass laws requiring that medical records of her biological par-
entage be kept was such a deprivation and was not in accordance with
the principles of fundamental justice, compliance with which section 7
allows as a justification for contravening the rights it establishes. The
court rejected this argument on the basis that it was a claim to a posi-
tive-content right (a right to something) and, without deciding conclu-
sively on the limits of the protection section 7 of the Charter could
provide, ruled that section 7s primary function was to protect peoples
negative-content rights (rights against something) to life, liberty and se-
curity of the person against infringement by the state. It also ruled there
was no state or governmental action infringing section 7 rights as re-
quired for the protection provided by section 7 to apply: a failure to
pass legislation requiring that records be kept was not such action.
As explained previously, if a state action were present in any given
situation, the way in which section 7 rights to life, liberty and security
of the person will be interpreted by the courts, with respect to imple-
menting ethics in their decisions, could depend on the extent to which
they view the Canadian Charter of Rights and Freedoms as a legal ar-
ticulation and embedding of fundamental ethical norms and principles
in our Canadian Constitution and as intended to ensure that state ac-
tions are ethical. If they see the Charter as intended to promote ethics,
they might be more likely to interpret section 7 rights accordingly, and,
similarly, what is required to protect and respect those rights. In con-
trast, if they view the Charter strictly legalistically, their interpretation
of what section 7 requires, could be quite different.
Like many people, I welcomed the outcome of the Pratten decision, al-
though I was concerned about its basis in discrimination law for yet
another reason. If adoptees hadnt had a legal right of access to their re-
cords, as they did not until quite recently, donor offspring might not
have acquired the right either, at least not on the basis of finding a
breach of a constitutional protection against discrimination by way of
comparison with a similarly situated group of people.
This possibility shows the difference between using law and using eth-
ics, and between judge-made law (case law) and legislation, to deal with
a social or public policy issue. An ethical analysis can take into account
a much wider range of considerations than can an analysis based just on
the existing law, and the same is true for politicians in enacting new leg-
islation, as compared with judges in creating case law.
Law, Marching with Medicine but in the Rear and Limping a Little 83

Judges must find a legal basis for their decisions, but they can and do
take into account the morality and ethics of deciding one way or an-
other. Legislators can and I believe should first look at the morality
and ethics of the laws they could pass and then decide on what should
be the content of those laws in light of the relevant ethics.
The judgment of the British Columbia Supreme Court is an example of
law being used to inform implement ethics; when the British Co-
lumbia legislature deals with this issue, ethics should inform law. The
proper question in the Pratten case is an ethical one is it ethically
wrong to intentionally prevent anyone from knowing through whom
life travelled to them? I believe that it is.34
There is rapidly increasing recognition internationally that intentionally
making those who are adopted or donor conceived genetic orphans,
by not giving them access to identifying information about their bio-
logical parents, is ethically wrong and ought to be legally prohibited.
Assuming, for the sake of exploring the issue, that gamete donation is
ethically acceptable (which is debatable in the eyes of some, including a
growing number of donor offspring), then, as was argued in the Pratten
case, donor anonymity is wrong because people born from gamete do-
nation need to know their medical histories for health reasons and their
social histories in order to properly form their sense of identity.
It remains to be seen whether the British Columbia government will
pass a law on its own initiative to end donor anonymity. If past experi-
ence is predictive, they will be heavily lobbied not to do so by the ART
industry (the fertility industry), and groups claiming to represent
would-be parents, who fear that ending anonymity will lead to a drop
in the number of donors and, thereby, limit their ability to have a child.
On the contrary, the United Kingdom which banned donor anonymity
in 2005 has in fact seen an increase in the number of donors.
As we can see in the Pratten case, the issues raised in such social-
ethical-legal values cases, can be as much about the proper interaction
of ethics and law in relation to forming social and public policy, and
about the legitimate respective roles of the courts and legislatures with
respect to that task, as they are about the issue that is the immediate fo-
cus of the case, in this instance, gamete donor anonymity.

34 See Somerville, Childrens Human Rights to Natural Biological Origins


and Family Structure, International Journal of the Jurisprudence of the Family
1 (2011), 35.
84 Somerville

The Insite case35 raises these same kinds of more general issues. It in-
volved a medically supervised clean needle exchange and medically su-
pervised safe injection site in Vancouvers Downtown Eastside, which
has high rates of illegal drug use and drug addiction, HIV and Hepatitis
C infections, homelessness and prostitution, which constituted a public
health crisis. The Insite clinic was one response to this crisis. In order to
grant the professionals operating the clinic immunity from prosecution
for breach of the federal Controlled Drugs and Substances Act (CDSA)
provisions prohibiting drug possession and trafficking, in 2003, the
Federal Minister for Health had given the clinic an exemption under
section 56 of the Act, which allowed for an exemption for a medical or
scientific purpose or [which] is otherwise in the public interest.
In 2008, however, the Minister decided the exemption should no longer
apply and revoked it, which meant the clinic would have to close. The
claimants, who included drug users, challenged the revocation of the
exemption as unconstitutional and ended up on appeal to the Supreme
Court of Canada.
The Supreme Court, in a unanimous judgment, ruled that the CDSA
provisions on possession and trafficking were constitutionally valid. It
held, however, that the Ministers exercise of his discretion under the act
must comply with Charter requirements. The court ruled that the Min-
isters failure to grant an exemption under section 56 CDSA was a
breach of the claimants section 7 Charter rights to life, liberty and se-
curity of the person, because it put drug users health and life at risk
and was not in accordance with the principles of fundamental justice.
The court reached this conclusion on the grounds that the failure was
arbitrary because it undermined the purposes of the CDSA, the pro-
tection of health and public safety.
It was also grossly disproportionate as the clinic was proven to save
lives with no discernible negative impact on the public health and safety
objectives of Canada.
The harm of the refusal to the people Insite served was found to far
outweigh any benefits it would engender. Therefore, the Ministers re-
fusal did not comply with the Charter requirement that any deprivation
of a section 7 right must be in accordance with the the principles of
fundamental justice and was, therefore, unconstitutional. I suggest that
this is an example of the Supreme Court using the Charter to imple-

35Canada (Attorney General) v. PHS Community Services Society, [2011]


SCC 44 (30 September 2011, Supreme Court of Canada).
Law, Marching with Medicine but in the Rear and Limping a Little 85

ment ethics at an individual case level, while keeping the law intact at
the general level.
The judgment has been met with a very mixed reaction. Its seen by
some as a court overriding the governments policy decision and inter-
fering in the exercise of executive discretion, and introducing uncer-
tainty into the application of the law. As opening up possible Charter
challenges to a wide range of executive decision making and, perhaps, a
wider range of bases, such as social and economic considerations, on
which to rule legislation is in breach of the Charter. And as bad ethics.
Just because a court considers ethics doesnt mean what it decides is
necessarily ethically correct. And, as we know, we dont all agree on
ethics.
On the other hand, it can be seen, as I suggested previously was possi-
ble, as the court using the Charter in a legally complex and sophisti-
cated way to reach an ethically acceptable outcome, when the law is
used in a manner that prevents that from happening.36

b) Human Rights as a Bridge between Ethics and Law to Implement


Child-centred Assisted Reproduction Decision Making
I have already discussed how the language of people having a human
right to have reasonable access to pain management helped to make
such access a reality. Most recently, I have argued that we should recog-
nize a human right to be born from natural human biological origins.
This means that in passing laws to govern the use of reproductive tech-
nologies, we should work from a basic presumption that, ethically, chil-
dren have an absolute right to be conceived from, an untampered-with
ovum from one, identified, living, adult woman and an untampered-
with sperm from one, identified, living, adult man. This, I propose, is
the most fundamental human right of all.
Each of the words in the human right articulated above is included for a
reason. Requiring a sperm and ovum means transmission of human life
must be through sexual reproduction, as compared, for example, to
asexual replication (cloning).
The words man and woman rather than referring just to a sperm
and an ovum are intentional. They preclude creating an embryo with
the genetic heritage of two women or two men. And one man and

36 See also Somerville, Is the Charter applied ethics in laws clothing?,


Globe and Mail, 14 November 2011, A11.
86 Somerville

one woman prohibits making an embryo with multiple genetic par-


ents.
Untampered-with means an artificially constructed sperm or ovum
must not be used and also excludes same-sex reproduction, for instance,
the future possibility of making a sperm from one womans stem cell
and using it to fertilize another womans ovum. The word natural ex-
cludes an opposite-sex couple using technology to make an artificial
sperm from an infertile man or artificial ovum from an infertile woman.
Requiring adult gametes preempts using gametes from aborted fe-
tuses. It prevents children being born whose biological parent was
never born. And requiring living donors excludes using gametes for
postmortem conception. Children have a right to a chance, when being
conceived, of meeting their biological parents.
And identified means, as already discussed, that offspring can trace
their biological parentage and through them other close biological rela-
tives.37
I believe that children also have valid claims, if at all possible, to be
reared by their own biological parents within their natural family,
unless an exception can be justified as in the best interests of a par-
ticular child, as in adoption, and to have both a mother and a father.38
And society should not be complicit in intentionally depriving children
of any of these rights. We must consider the ethics of deliberately creat-
ing any situation that is otherwise and, I propose, this is an important
context in which using the language of human rights can help us to en-
sure that, as it should, ethics informs the law.
These proposals have been the source of enormous controversy and
conflict, especially with advocates of same-sex marriage.39 Marriage is a
compound right the right to marry and to found a family. Giving
same-sex couples the right to found a family necessarily abrogates these
rights of children and the dangers of same-sex marriage to childrens
human rights with respect to their biological origins and family struc-
ture are amplified by reprogenetic technoscience. Consequently, I op-
pose legalizing it.

37 Pratten case, note 29; Somerville, note 34.


38 Somerville, id.
39 Somerville, Brave New Ethicists, in Wiseman (ed.), The Public Intellec-
tual in Canada, University of Toronto Press (forthcoming 2012).
Law, Marching with Medicine but in the Rear and Limping a Little 87

If we believe that, ethically, there should be limits on the use of repro-


ductive technologies, we now need the respect-for-natural-procreation
symbolism established by opposite-sex marriage more than in the past.
To recognize same-sex marriage (which is to be distinguished from
same-sex partnerships that do not raise this problem, because they do
not entail the right to found a family) unavoidably eliminates this func-
tion of marriage.
I would also note here in relation to the ethics and law that should gov-
ern reproductive technologies that, quite apart from same-sex marriage,
we need much more in-depth discussion of childrens human rights in
this context. As I mentioned previously, our decision-making with re-
spect to the law that should govern these technologies usually makes
only a token bow to childrens needs and rights and, in practice it has
been almost entirely adult-centred, not child-centred. Using an ethical
analysis to inform the law we enact can help us to understand why a
child-centred approach is necessary and to implement it.40

c) Levels of Doing Ethics


The case for unrestricted access to all reproductive technologies, some-
times referred to as rights to absolute reproductive freedom, is made
almost entirely at the individual level the right of individuals to decide
how and when they will or will not reproduce. This stance focuses on
individual persons rights to autonomy and self-determination and
rights to decide for themselves. While there are also strong arguments at
this level against such unlimited freedom to decide, especially from the
perspective of resulting children, strong arguments against it exist at the
institutional and societal levels, which, so far, have not been given the
consideration they deserve.
In short, almost all the justifications for unrestricted access to repro-
ductive technologies focus primarily on the infertile people who want
to use them, whether their problem in founding a family is medical or
social infertility. The harmful impacts of such use on society and its val-
ues and institutions are ignored. We need, however, to look at their im-
pact, not only, at the micro or individual level, but also, at the meso or
institutional level, the macro or societal level and the mega or global
level. There can be conflict among what is ethical at the different levels
and individual decisions can have a cumulative impact at these other

40 Somerville, note 34.


88 Somerville

levels, factors which both need to be taken into account in decision


making about ethics. Lets look at an example, prenatal diagnosis of
Down syndrome in order to eliminate those affected. This is yet an-
other context in which ethics must inform law.

d) Cumulative Impact of Reproductive Technology Decisions by


Individuals: Deselecting and Selecting our Children
A recent headline from Denmark boldly announced,
Plans to make Denmark a Down syndrome-free perfect society.41
Denmark has decided not to listen to people who may complain of
human selection and have put their foot on the ground to promote
increased abortion of foetuses suspected of having Down syndrome.
As such, if progress [sic] continues at this rate, the last case to be
born with the illness will be around the year 2030, according to the
Danish newspaper Berlingske.42
Aarhus University bioethicist, Niels Uldbjerg, describes it as a fantas-
tic achievement that the number of newborns with Down syndrome is
approaching zero.
The article continues: Whats next? Is the child born with diabe-
tes[to] be discarded? asks Ulla Brendstrup, the mother of a child
with Down syndrome.43
Lillian Bondo, a member of the Denmark Ethics Committee, who is
also chair of the Danish association of midwives, told Berlingske she
wants to help as many people as possible to discuss how society
should draw the line. I do not want a society in which sorting by [test-
ing] is the norm.44
Whatever our views on this issue, at least the Danes are bringing it into
the open and are being more honest about it than we are in Canada.
Current estimates are that in North America around 85 percent of un-
born babies with Down syndrome are aborted. Importantly, the Danes

41 Scancomark.se Team, 17.07.2011, see at http://www.scancomark.se/Comp

etitiveness/Plans-on-the-way-to-make-Denmark-a-Down-syndrome-free-perf
ect-society.html; and at http://www.cphpost.dk/news/scitech/92-technology/5
1921-downs-syndrome-dwindling.html.
42 Id.
43 Id.
44 Id.
Law, Marching with Medicine but in the Rear and Limping a Little 89

are also recognizing that deselecting Down syndrome children or


any other group who, likewise, are chosen for elimination raises issues
for society and is not just a matter of private decision-making by indi-
viduals.
The ethics issues prenatal screening raises will only become more preva-
lent as the range of tests expands, they become safer for the pregnant
woman and cheaper and easier to use, and many are presented as just
routine precautions in medically managing a pregnancy.
The latest announcement concerning a prenatal test is identification of a
babys sex at seven weeks of pregnancy.45 This raises fears of sex selec-
tion, which many people regard as unethical, at least when not carried
out for serious medical reasons.
As we can see in India and China, where sex selection through abortion
and infanticide has resulted in over 100 million missing girls, the deci-
sions of individuals have a cumulative effect on society, itself. Many
young men in those countries cannot find a wife and, for instance, pros-
titution increases, and physical, emotional and sexual abuse of women is
augmented.
Riots, for example, those in England and France in recent times, that
involved a very large number of people, also provide an analogy: one
person acting aggressively or a small group of people rioting is different
in kind, not just degree, from a very large number doing so, although
both situations may raise many of the same ethical and legal issues. The
same is true of individuals choosing their children. So what limits
should we place on their doing so in the interests of society and the
harmful impact it would have on our shared values? Should there be
any legally imposed limits?
Widespread, publicly endorsed and paid for pre-natal screening to
eliminate people with certain conditions, for instance, Down syndrome,
implicates, among other values, those of respect for both individual
human life and human life in general; and respect for disabled (differ-
ently abled) people, both as individuals and as a group.
The implementation of negative eugenics with respect to disabled peo-
ple is the unavoidable collective impact of these screening-based deci-
sions. As harsh as the language is, we can describe it as a search and
destroy mission to wipe out certain groups of people.

45 Devaney/Palomaki/Scott/Bianchi, Noninvasive Fetal Sex Determination


Using Cell-Free Fetal DNA: A Systematic Review and Meta-analysis, 306 (6)
Journal of the American Medical Association (2011), 627-636.
90 Somerville

And where might society supporting such screening lead? For instance,
what would endorsing a belief that a society without disabled people
can be considered perfect say about us? What kind of society might it
result in?
We have unprecedented new technoscience powers and history teaches
us that the use of science in the search for human perfection has been at
the root of some of the greatest atrocities in terms of respect for human
life, individual humans and human rights.
Offering prenatal screening as a routine procedure communicates a
message that a woman is conditionally pregnant, until she is told there
is nothing wrong with the baby until the fetus is certified as nor-
mal or it is the right sex. This approach contravenes our concept of
parental love that it is unconditional that we love our children just
because they are our children.
The societal level message we will unavoidably be delivering is that
We dont want you in our society unless you measure up to a cer-
tain genetic or other standard. You are only a potential member, un-
til youve passed the admission test that we are willing to pay for
with our tax dollars and implement.
And what about the everyday ethics involved in screening? Far from
all physicians are competent to obtain informed consent to these tests
and carry out follow up genetic counseling.
For many reasons, physicians tend to be very pessimistic in predicting
the impact, for instance, of Down syndrome on the child and usually
see no possible benefits from having such a child they can be aston-
ished to learn of the joy, bonding and love such a child can bring to a
family.
One cause of their ignorance is that the people who could inform them
otherwise are silenced. As Audrey Cole, a remarkable Canadian who
advocates for the rights of disabled people and the mother of a 47 year
old man with Down syndrome, wrote to me,
Our voice [against eliminating people with Down syndrome] will,
inevitably, be dismissed as the whinings of a special interest group.
I have never been able to understand why my feelings as a parent of
a wonderful, caring, gentle man can be so easily dismissed as special
interest. I am frightened of the times that seem to be coming.
And, how will women who refuse screening be regarded? What will be
the impact on families who choose not to abort when abnormalities
are discovered? Will they be seen as socially irresponsible? That belief,
Law, Marching with Medicine but in the Rear and Limping a Little 91

in itself, creates a climate of coercion not to proceed with the preg-


nancy.
Perhaps, in deciding about the ethics of prenatal screening and then the
law that should govern it, we should recall its true for all of us that the
well are only the undiagnosed sick and we are thankful that no one
deselected us.

IV. Why Ethics in Medicine and Science matter more


generally, especially to the Law

A while ago I gave a speech entitled Construction of New Realities in


Medicine: Medicine as a Societal Forum for Creating, Affirming, Chal-
lenging and Destroying Shared Values. I argued that what our shared
societal values should be is currently a source of conflict in North
America some call it culture wars and explored how medicine,
medical science and healthcare are, collectively, the forum in which
many of the public square debates, which will determine the values that
govern us as a society, are taking place. That is occurring because many
of the issues to which the competing values are relevant are raised di-
rectly in that context or have a connection with medicine or healthcare.
If you read the newspapers, listen to documentaries on radio or watch
the news on TV youll see numerous reports on topics, some of which
Ive mentioned already in this article, that lie at the intersections of sci-
ence, medicine, ethics and law.46 These issues involve some of our most

46 These topics include euthanasia and physician-assisted suicide; with-

drawal of life-support treatment; treatment of seriously disabled new-born ba-


bies; access to health care, especially expensive new treatments; abortion; prena-
tal genetic screening; new reproductive technologies; designer babies; cloning;
human embryo stem cell research; artificial sperm and ova (making embryos
from two same-sex adults); same-sex marriage; polygamy; sex education of
children; the use of animals in research; manimals embryos with both hu-
man and animal genes; synthetic biology; xenotransplantation the use of ani-
mal organs in humans; transplant tourism; being soft/hard on crime and drugs;
needle exchange clinics; safe injecting sites; capital punishment (should physi-
cians give lethal injections?); law and ethics governing armed conflict, including
healthcare professionals involvement in extreme questioning (query torture),
treatment of wounded enemy combatants, and so on; the ethics of robotic war-
fare; business ethics the pharmaceutical industry; corruption fraud in medi-
cal science; environmental ethics the impact of environmental damage on
health; population health; aid to developing countries (does everyone have a
92 Somerville

important individual and collective social-ethical-legal values. That is


true, in part, because many of these issues are connected with respect
for life, and with birth or death, the two events around which we have
always formed our most important individual and collective values.
Medicine has taken increasing control, if not over birth and death,
themselves, then over their attributes and the context and circumstances
in which they occur; that is, life and death have been medicalized. This
means that medicine has become an important societal forum for creat-
ing, affirming, challenging and destroying shared values. These values,
together with our principles, attitudes, beliefs, myths and so on, make
up the societal-cultural paradigm on which our secular, democratic
Western societies are based that is, the shared story that we tell each
other and buy into in order to form the glue that binds us as a society.
Religion used to be the context in which we explored moral and ethical
issues, and in which we created and communicated our shared values.
Importantly, it was also the context in which we handed on those values
to future generations. It is not possible to use religion in that way in
multi-cultural, multi-religious, multi-ethnic, post-modern, secular, de-
mocratic societies, such as we are in the West. Medicine, medical science
and healthcare are among the forums we are using as substitutes. And,
arguably, in light of the unprecedented scientific developments that face
us with socio-ethical values issues no humans before us have ever had to
address, they form, as a collective, the most prominent and important
context for values formation.
That means that what we decide with respect to the values that are hon-
oured or breached in this context which values we choose to respect,
create or destroy matters well beyond that context. In short, ethics in
medicine, medical science and healthcare matter with respect to our so-
cietal values and its the role of law to uphold our most important
shared values, so ethics in these areas matters to law.
As Ive pointed out in this article, extraordinary advances in medical
technoscience in the last twenty-five years have opened up possibilities
that were unimaginable in the past. We are no longer limited by Nature
or to repairing Nature when it fails; we can do what is impossible in
Nature.
I have spoken already about the ethical and legal issues raised by as-
sisted human reproduction technologies. Ethics and law in this area are

right to some minimal level of healthcare?); bioterrorism and scientific research


the dual use dilemma; and so on. See, in general, Somerville, note 8.
Law, Marching with Medicine but in the Rear and Limping a Little 93

important for many reasons, not least because the huge fertility indus-
try that has developed with assisted reproductive technologies is now
around a $(US)5 billion per year business in the United States alone and
is rapidly expanding globally.47 The law needs to be informed by ethics
in regulating that industry, especially because it often involves exploita-
tion of poor, vulnerable women in developing countries; because of the
very large amount of money involved its estimated that the global in-
dustry is worth around $(US)12 billion annually; and because of the re-
ality that infertile people are often desperate to have a child, which can
generate very strong pressures not to restrict the industry on ethical
grounds.
Ethical questions the industry raises are very broad and diverse. They
include: should we prohibit young women from selling their eggs to
pay their way through university? Is egg donation ethically acceptable?
As discussed above in relation to the Olivia Pratten case, what are our
obligations to donor conceived children with respect to knowing
their genetic heritage and biological parents? Should women be able to
freeze ovarian tissue when they are young and most fertile to use when
they want to have a child at 55 or 60 years of age, when they retire?
Should parents be allowed to choose the sex of their child or design the
childs characteristics or genetically match it to a sibling in order to treat
a disease from which that sibling suffers? Is it ethically acceptable to
create human embryos in order to set up human embryo manufactur-
ing plants that will produce therapeutic materials to be used to benefit
the rest of us?
In short, there has been an exponential increase in the power of medical
science and its practitioners. In the past, all a physician could do was
hold a persons hand, wipe their fevered brow and give them an aspirin
or narcotic. Today medical scientists can redesign life itself. With such
powers come enormous responsibilities, and not just towards present
generations, but also to future ones.
The debate on whether to legalize euthanasia and physician-assisted
suicide is taking place in many of our societies, including in our courts

47 Andrew Purvis, IVF: the business of making babies, Management Today,


1 February 2011, see at http://www.managementtoday.co.uk/news/1050516/
IVF-business-making-babies/?DCMP=ILC-SEARCH: The fertility game is
truly global. In India, this lucrative surrogacy industry is expected to be worth
$2.3bn (1.9bn) a year by 2012. Note, this amount is just for surrogacy
services in only one country.
94 Somerville

and legislatures in Canada our secular cathedrals.48 In the case of


physician-assisted suicide, it is clear from judgments rendered up to the
present that courts are likely to rule that the law prohibiting it is dis-
criminatory with respect to those unable to commit suicide without as-
sistance, and, depending on the judges views on the ethics of allowing
assisted suicide, the legal prohibition will be either struck down as un-
constitutional or upheld, even though considered discriminatory in the
way alleged, as being a necessary protection a reasonable limit that
can be demonstrably justified in a free and democratic society49 of
vulnerable people. I believe that both ethics and law need to uphold the
value of respect for human life, in general, and for each individual hu-
man life, and that requires that we do not abrogate the rule that we do
not intentionally kill each other, as euthanasia and assisted suicide
would necessarily do, no matter how compassionate are the motives of
those carrying out these interventions.
The euthanasia debate can also help us to see the kinds of questions we
need to ask when deciding on issues in medicine that will affect social-
ethical-legal values. Some of the most important of these questions
might not be immediately obvious. For instance, in relation to euthana-
sia three such questions are: Would legalization be most likely to help
us or hinder us in our search for meaning in our individual and collec-
tive lives? In relation to human death, what values do we want to pass
on to future generations? And how do we want our grandchildren and
great-grandchildren to die? In short, we must also consider our obliga-
tions to hold not only our physical world, but also, our metaphysical
world our shared values, attitudes, principles, beliefs, stories, and so
on on trust for future generations.
The issues raised by the above questions and an unlimited number of
others that could be asked require us to go well beyond considering
how they should be answered taking the impact just on individuals into
account. We must also consider the impact of what we decide on insti-
tutions, in particular, law and medicine; our society, as a whole, espe-
cially its values; and, in our 21st century world, our global reality. In
short, we need comprehensive and sophisticated analysis at all the levels
I mentioned previously the micro (individual), meso (institutional),

48 For a much more extensive discussion of the issues raised here see Somer-

ville, note 16, Legalizing Euthanasia: Why Now?, 105-118, from which some
material in this section has been taken.
49 Canadian Charter of Rights and Freedoms, note 28, Article 1.
Law, Marching with Medicine but in the Rear and Limping a Little 95

macro (societal) and mega (global) levels, and in the interfaces among
these levels.
In undertaking that analysis in order to find the ethics we need to guide
us and to inform our law, we must be conscious of at least three dan-
gers. The first is that of false certainty; in other words, we have to build
into our decision making structures an ethics of uncertainty. The second
is the danger of being simplistic; avoiding that requires us to also build
in an ethics of complexity. And, third, we must be conscious of the dan-
gers of not considering the impact our decisions will have in the future
and on future generations; in other words, in addition, we have to build
in an ethics of potentiality. But what building in those elements will re-
quire is beyond the scope of this paper.
I would also suggest that medicine, medical science and healthcare are
particularly important to societal bonding and finding some shared eth-
ics50 in secular democracies with very diverse populations, such as Can-
ada, because they are the societal institutions to which everyone per-
sonally relates. Indeed, medicine might be functioning as what my col-
leagues, Religious Studies scholars, Katherine Young and Paul Nathan-
son, have called a secular religion51. We humans seem to have a need
for some form of powerful belief (or disbelief) that we share with oth-
ers, in order to bond and to find meaning in life.
One of the major current divisions in ethics and law is whether there is
a Natural Law or Natural Morality that should inform our decisions
about what is right and wrong or whether those decisions are simply up
to us, that is, concepts of legal positivism, utilitarianism and moral rela-
tivism should be used. An overwhelming impression that I had at the
Freiburg symposium was that a large majority of participants did not
accept any concept of natural law or natural rights.
The starkest expression of this stance was a question from a member of
the audience in response to my suggestion that everyone has a funda-
mental human right to come into being from natural human origins.
The questioner asked, with an air of incredulity, How can a non-
existent human, an unborn child, have a right? There is no one to be the
holder of the right and one cant have a duty to a non-existent entity.
This seems to be a very legalistic approach based in positivist legal phi-
losophy and doctrine, which is used to deny any such right. Applied

50 Somerville, note 4.
51 Nathanson/Young, Spreading Misandry: The Teaching of Contempt for
Men in Popular Culture, 2001, at 209-210.
96 Somerville

generally, it would mean that we cannot have legal obligations to future


generations, a stance that would contradict, for example, current ap-
proaches in environmental law and ethics.
In the past, we did not need to contemplate recognizing a right to come
into being from natural human origins, because there was no possibility
of coming into being in any other way. That, of course, is no longer
true, which is the reason we need such a law based on deep ethical
analysis.
Some people see Natural Law as having a Divine source and such a
view is probably the reason some others reject it. But it can also be seen
just as innate to being human and as upholding and protecting that
which is of the essence of being human that which manifests the kind
of entity we are. These characteristics might even have some genetic
substrate. Philosopher Jrgen Habermas concept of an ethics of the
[human] species seems to reflect such a view.52

V. Conclusion

As we can see with trying to ensure that people are not wrongfully left
in pain, bringing ethics and human rights considerations to bear on a
situation can influence the law which should govern that situation for
the good. The same is true with respect to the law that should govern
assisted human reproduction.
More generally, the new science has opened up unprecedented powers
and we need ethics to help us to answer questions such as what those
powers could mean for individuals and societies and what limits, if any,
the law should place on their use. This science faces us with questions
that go to the very essence of what it means to be human, that no hu-
mans before us have ever faced. We must constantly ask ourselves, espe-
cially as jurists and lawyers, what does acting ethically, wisely and cou-
rageously with respect to these immense powers require of us in terms
of the law that we choose to govern them.
Ethics must inform our choices; science, ethics and law must march
forward together. My hope is that I have been able to convince you that
ethics is, not only, necessary, but also, beneficial to law, and that law
needs to march with it as an equal partner and not be in the rear and

52 Habermas, The Future of Human Nature, 2003, at Chapter III, The Em-
bedding of Morality in an Ethics of the Species.
Law, Marching with Medicine but in the Rear and Limping a Little 97

limping. Ethics can function as first aid for law enabling it to achieve
that equality, especially in novel situations where the law is most likely
to have difficulty keeping up.
And that, in turn, means that people responsible for making, applying
or teaching law need to have at least some basic education in ethics.
What that requires I leave as a topic for a future exploration.
98 Somerville

APPENDIX A

DECLARATION OF MONTREAL

Declaration that Access to Pain Management Is a Fundamental


Human Right

We, as delegates to the International Pain Summit (IPS) of the Interna-


tional Association for the Study of Pain (IASP) (comprising IASP rep-
resentatives from Chapters in 64 countries plus members in 129 coun-
tries, as well as members of the community), have given in-depth atten-
tion to the unrelieved pain in the world,

Finding that pain management is inadequate in most of the world be-


cause:

There is inadequate access to treatment for acute pain caused by trauma,


disease, and terminal illness and failure to recognize that chronic pain is
a serious chronic health problem requiring access to management akin
to other chronic diseases such as diabetes or chronic heart disease.

There are major deficits in knowledge of health care professionals re-


garding the mechanisms and management of pain.

Chronic pain with or without diagnosis is highly stigmatized.

Most countries have no national policy at all or very inadequate policies


regarding the management of pain as a health problem, including an in-
adequate level of research and education.

Pain Medicine is not recognized as a distinct specialty with a unique


body of knowledge and defined scope of practice founded on research
and comprehensive training programs.

The World Health Organization (WHO) estimates that 5 billion people


live in countries with low or no access to controlled medicines and have
no or insufficient access to treatment for moderate to severe pain.

There are severe restrictions on the availability of opioids and other es-
sential medications, critical to the management of pain.
Appendix 99

And, recognizing the intrinsic dignity of all persons and that withhold-
ing of pain treatment is profoundly wrong, leading to unnecessary suf-
fering which is harmful; we declare that the following human rights
must be recognized throughout the world:

Article 1. The right of all people to have access to pain management


without discrimination.1234

Article 2. The right of people in pain to acknowledgment of their pain


and to be informed about how it can be assessed and managed.5

Article 3. The right of all people with pain to have access to appropriate
assessment and treatment of the pain by adequately trained health care
professionals.6789

1 This includes, but is not limited to, discrimination on the basis of age, sex,
gender, medical diagnosis, race or ethnicity, religion, culture, marital, civil or
socioeconomic status, sexual orientation, and political or other opinion.
2 International Covenant on Economic, Social and Cultural Rights
(ICESCR) (1966). The State parties of the ICESCR recognize the right of eve-
ryone to the highest attainable standard of physical and mental health (Art.
12), creating the conditions which would assure to all medical service and
medical attention in the event of sickness.
3 Universal Declaration of Human Rights (1948): Rights to Health (Article
25); Convention on the Rights of a Child (Article 24); Convention on the
Elimination of All Forms of Discrimination Against Women (Article 12); Con-
vention on the Elimination of All Forms of Racial Discrimination (Article 5(e)
(iv)).
4 The Committee on Economic, Social and Cultural Rights. General
Comment No.14, 22nd Session, April-May 2000 E/C12/2000/4. Core obliga-
tions of all signatory nations included an obligation to ensure access to health
facilities, goods, and services without discrimination, to provide essential drugs
as defined by WHO, and to adopt and implement a national health strategy.
5 Committee on Economic, Social and Cultural Rights. General Comment
No.14, 22nd Session, April-May 2000, E/C 12/2000/4, para. 12. General
Comment No. 14 stated that health accessibility includes the right to seek, re-
ceive and impart information and ideas concerning health issues.
6 Appropriate assessment includes recording the results of assessment (e.g.,
pain as the 5th vital sign, can focus attention on unrelieved pain, triggering
appropriate treatment interventions and adjustments). Appropriate treatment
includes access to pain medications, including opioids and other essential medi-
cations for pain, and best-practice interdisciplinary and integrative nonpharma-
cological therapies, with access to professionals skilled in the safe and effective
100 Somerville

In order to assure these rights, we recognize the following obligations:

1. The obligation of governments and all health care institutions, within


the scope of the legal limits of their authority and taking into account
the health care resources reasonably available, to establish laws, policies,
and systems that will help to promote, and will certainly not inhibit, the
access of people in pain to fully adequate pain management. Failure to
establish such laws, policies, and systems is unethical and a breach of
the human rights of people harmed as a result.

2. The obligation of all health care professionals in a treatment relation-


ship with a patient, within the scope of the legal limits of their profes-
sional practice and taking into account the treatment resources reasona-
bly available, to offer to a patient in pain the management that would be
offered by a reasonably careful and competent health care professional
in that field of practice. Failure to offer such management is a breach of
the patient's human rights.

use of these medicines and treatments and supported by health policies, legal
frameworks, and procedures to assure such access and prevent inappropriate
use. Given the lack of adequately trained health professionals, this will require
providing educational programs regarding pain assessment and treatment in all
of the health care professions and programs within the community for commu-
nity care workers delivering pain care. It also includes establishment of pro-
grams in pain medicine for the education of specialist physicians in pain medi-
cine and palliative medicine. Accreditation policies to assure appropriate stan-
dards of training and care should also be established.
7 Failure to provide access to pain management violates the United Nations
1961 Single Convention on Narcotic Drugs declaring the medical use of nar-
cotic drugs indispensable for the relief of pain and mandating adequate provi-
sion of narcotic drugs for medical use.
8 The UN Universal Declaration of Human Rights (1948) (Article 5) states:
No one shall be subjected to torture or to cruel, inhuman or degrading treat-
ment Comment: Deliberately ignoring a patients need for pain management
or failing to call for specialized help if unable to achieve pain relief may repre-
sent a violation of Article 5.
9 The UN Special Rapporteur on the Right to Health and the UN Special
Rapporteur on the question of torture and other cruel, inhuman, and degrading
treatment stated: The failure to ensure access to controlled medicines for the
relief of pain and suffering threatens fundamental rights to health and to protec-
tion against cruel, inhuman and degrading treatment.
Appendix 101

Note: This Declaration has been prepared having due regard to current
general circumstances and modes of health care delivery in the devel-
oped and developing world. Nevertheless, it is the responsibility of:
governments, of those involved at every level of health care administra-
tion, and of health professionals to update the modes of implementation
of the Articles of this Declaration as new frameworks for pain man-
agement are developed.

References

ANZCA. Statement on patients rights to pain management. ANZCA


PS 45; 2001. Available at: www.anzca.edu.au.

Brennan F, Carr DB, Cousins MJ. Pain management: a fundamental


human right. Anesth Analg 2007;105:20521.

Cousins MJ, Brennan F, Carr DB. Pain relief: a universal human right.
Pain 2004:112:14.

FEDELAT. Proclamation of pain treatment and the application of pal-


liative care as human rights, May 22, 2008.

IAHPC. Joint declaration and statement of commitment on palliative


care and pain treatment as human rights. Available at www.Hospice
care.com

Scholten W, Nygren-Krug H, Zucker HA. The World Health Organi-


zation paves the way for action to free people from the shackles of pain.
Anesth Analg 2007;105:14.

Somerville M. Death of pain: pain, suffering, and ethics. In Gebhart GF,


Hammond DL, Jensen TS, editors. Proceedings of the 7th World Con-
gress on Pain. Progress in Pain Research and Management, Vol. 2. Seat-
tle: IASP Press; 1994. p. 4158.
102

The Relationship of Human Rights, Human Responsibilities and Human Ethics

A. CONCEPTS:
APPENDIX B

B. PRACTICE -
IMPLEMENTATION
THROUGH:

APPLIED ETHICS LAW

C. GENERAL AREA OF
ETHICS/LAW:
environ- business professional social public consti- civil family environ-
mental ethics ethics welfare intl tutional liberties law mental
ethics ethics law law law

D. SPECIFIC AREA
OF ETHICS / LAW:

E. SPECIFIC ISSUE medical health health & constit-


INVOLVES e.g.: ethics care human utional
ethics rights protection
Somerville
Reflections on Theorizing About the Moral
Foundations of the Law: Using the Laws
Governing Detention as a Case Study
Alec Walen

It is a piece of legal common sense that lawyers and judges consult the
law, not morality. Among the reasons for this are (a) that judges are
given authority by the law to rule with reference to the law, not with
reference to morality;1 and (b) that the law, even though often vague
and ambiguous, is more straightforwardly knowable, and less subject to
radical disagreement, than morality.2 Nonetheless, I believe this com-
mon sense overlooks at least two things. First, there is good reason to
think that the law is always moved, if not explicitly then under the sur-
face, by the sense that it must, as much as possible, hew to norms of jus-
tice.3 Second, judicial review of legislation under a constitutional regime
often makes reference to norms of justice.

1 This principle, the principle of legality, is particularly important in the


context of criminal law, where people have a right to fair notice of what exactly
they will be punished for.
2 This was among the reasons theorists such as Thomas Aquinas and John
Locke thought that the state was needed. See St. Thomas Aquinas, The Summa
Theologica, Question 95, First Article (Whether it was Useful for Laws to Be
Framed by Men); John Locke, The Second Treatise of Government, Chapter IX
(Of the Ends of Political Society and Government), 124-126.
3 See generally R. Dworkin, Laws Empire, 1986. See also R. Hyland, The
Case for the Common Law, in M. Hublein (ed.), Rechtsgeschft, Methoden-
lehre und darber hinaus. Liber Amicorum fr Detlef Leenen (2012).

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 103
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_5, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
104 Walen

My concern here will be to illustrate how judicial review can and


should make use of basic moral notions by examining the constitution-
ality, under the U.S. Constitution, of subjecting a legally resident alien,
captured in the United States, to long-term military detention as an
enemy combatant. The point of this is not simply to add to the list of
moral issues that the U.S. Constitution and presumably other consti-
tutions4 have to come to terms with. It is also to demonstrate that so-
phisticated moral theorizing should be relevant to the practice of law. I
do so by showing that in the absence of such careful inquiry, the consti-
tutional discussion regarding the military detention cannot reach a sat-
isfying resolution.
I proceed, then, to argue in part I that judicial review provides an open-
ing for bringing moral reasoning, and in particular sophisticated reason-
ing about aspects of justice, into the law. The rest of the paper turns to
the topic of detention law to illustrate the need for sophisticated moral
reasoning in constitutional law. In part II, I give an overview of my uni-
fied moral theory of detention, which I will argue further on must be
appealed to in order to arrive at a defensible constitutional theory of
military detention. In part III, I discuss the decision in al-Marri v. Puc-
ciarelli,5 which split on the issue of whether a legally resident alien in
the United States, who was not a combatant under the traditional law of
war, could nonetheless be held as an enemy combatant in long-term
military detention. I argue there that neither side of the issue took a de-
fensible position because neither side understood what the underlying
moral issues are. In part IV, I argue that to make sense of the constitu-
tional significance of being a combatant, we need to understand how
that concept arises in a larger moral framework, and give a summary of
how the framework I sketched in part II fits that bill.

4 See, for example, the German Basic Law, Chapter 1 (Basic Rights). But as
I am fairly well versed in U.S. constitutional law, and not German or other con-
stitutional laws outside of the United States, I restrict my attention to U.S. law.
5 534 F.3d 213 (4th Cir. 2008) (en banc), vacated and remanded sub nom, al-
Marri v. Spagone, 129 S.Ct. 1545 (2009) (vacated as moot because the appellant
was no longer being held in military detention).
Reflections on Theorizing About the Moral Foundations of the Law 105

I. Judicial Review and Moral Reasoning

Judicial review is the process by which courts examine statutes or acts


of the executive branch to determine whether they are constitutional.
Obviously, the starting point for judicial review is the text of the rele-
vant constitution. In the United States, that text contains language that
clearly has moral significance. The Fourteenth Amendment, for exam-
ple, bars states from depriving anyone of equal protection of the
laws. To determine whether a state law does that, a court must decide
what sorts of distinctions are legitimate, and what illegitimate. It would
do so as a matter of law, but given that there is no higher law, it must
also do so by recourse to the relevant moral principles. Or, to offer an-
other example, the Fourteenth Amendment also bars states from de-
priving people of their life, liberty or property without due process of
law. That sounds like a call to provide civil and criminal litigants with
due process, but it has been interpreted to reach much more broadly, to
protect the substantive liberties.6 The liberties protected include both
most of the substantive liberties protected by the Bill of Rights (the first
ten Amendments), as well as other unenumerated liberties held to be of
constitutional significance.7 Again, it seems natural to say that these
judgments must be made with reference to moral principles which
would allow one to judge that certain liberties are of particular moral
importance.
Despite the appeal of treating such constitutional texts as appealing to
moral notions, that idea remains controversial. One reason certainly has
to do with the idea, expressed above, that judges should rule with refer-
ence to the law, not with reference to morality. But another reason has
to do with American history. During the Lochner era, which ran from
the 1890s until the late 1930s, the Supreme Court stymied many legisla-
tive efforts to promote the general welfare by citing the constitutional

6 This broader interpretation was arguably necessitated after the Supreme


Court misread another clause from the Fourteenth Amendment, one which
protected U.S. citizens privileges and immunities, to mean essentially noth-
ing. See in re Slaughter-House Cases, 83 U.S. 36 (1872).
7 These other liberties have included the freedom of association (see
NAACP v. Claiborne Hardware Co., 458 U.S. 886) (1928)), the right to send
ones children to a private school (see Pierce v. Society of Sisters, 268 U.S. 510
(1925)), and the right of a married couple to use birth control (see Griswold v.
Connecticut, 381 U.S. 479 (1965)).
106 Walen

protection of the right to contract.8 After that era ended, the Court and
most academic commentators searched for a means of practicing judi-
cial review without engaging in controversial moral judgments, such as
the one that gave primacy to the right of contract.
Yet even from the beginning of the post-Lochner era, the Court could
not avoid making moral judgments about, for example, what sorts of
speech deserved protection,9 what sorts of protection women deserved
under the equal protection clause,10 whether affirmative action was con-
stitutional,11 whether the constitution would protect the privacy in-
terests involved in contraceptive use12 and abortion,13 and so on. At its
recent high-water mark, the Court found a constitutionally protected
liberty interest in consensual, non-commercial, adult sexual relations,
even among same-sex partners.14 And it did so by finding that certain
intimate behavior deserved protection on a par with freedom of con-
science, thought and religion.15
In many of these cases the more liberal members of the Court have
been willing to admit that they are not simply relying on sociological

8 The era takes its name from Lochner v. New York, 198 U.S. 45 (1905) (in-
validating maximum working hours for bakers).
9 See Chaplinsky v. New Hampshire, 315 U.S. 568, 572 (1942) (distinguish-
ing categories of speech unworthy of constitutional protection, including the
lewd and obscene, the profane, the libelous, and the insulting or fighting
words, words whose utterances are no essential part of any exposition of
ideas, and are of such slight social value as a step to truth that any benefit that
may be derived from them is clearly outweighed by the social interest in order
and morality.).
10 See Craig v. Boren, 429 U.S. 190 (1976) (establishing that gender discrimi-
nation is to be subject to intermediate scrutiny).
11 There are too many cases, covering too many types of affirmative action,
to cite them all here. But the one type of racial affirmative action that is still
constitutional occurs in higher education. See Grutter v. Bollinger, 539 U.S. 306
(2003) (upholding Regents of the University of California v. Bakke, 438 U.S.
265 (1978)).
12 See Griswold v. Connecticut, 381 U.S. 479 (1965) (affirming the right of

married couples to use contraception).


13 See Roe v. Wade, 410 U.S. 113 (1973) (finding a right to abortion in the
first two trimesters of pregnancy).
14 Lawrence v. Texas, 539 U.S. 558 (2003).
15 Id., at 558.
Reflections on Theorizing About the Moral Foundations of the Law 107

judgments about the evolving moral views of the American public, but
also on their own independent moral judgment about the relevant is-
sues.16 Conservative members of the Court have consistently railed
against relying on such moral judgments. The dominant theory they
have offered for rejecting such moralized judging is originalism, the
thesis that constitutional texts should be interpreted as they would have
been understood presumably by a majority of legally trained inter-
preters at the time there were adopted.17 But their originalism, based
on what critics rightly call law office history, is clearly a fig leaf to
cover their own use of conservative moral values.18 This becomes clear
when one looks at, for example, the position of the conservative mem-
bers of the Court on such issues as affirmative action, on which topic
conservatives pretend that the original understanding of the Fourteenth
Amendment was that we should have a race-blind government.19
One who accepts this point might, as a result, be uncomfortable with
judicial review as a whole. This is not a point I want to take up here,
though I argue elsewhere that judicial review is defensible in light of

16 See Roper v. Simmons, 543 U.S. 551, 563 (2005) (The Constitution con-
templates that in the end our own judgment will be brought to bear on the
question of the acceptability of the death penalty under the Eighth Amend-
ment.) (internal quotation marks and citations omitted).
17 See A. Scalia, A Matter of Interpretation: Federal Courts And The Law,

A. Gutmann (ed.), 1997.


18 See S. Cornell, The Peoples Constitution vs. the Lawyers Constitution:
Popular Constitutionalism and the Original Debate Over Originalism, 23 Yale
Journal of Law & the Humanities (2011), 295, at 301 n. 24 (Originalist scholar-
ship is a paradigmatic example of law office history. In contrast to scholarly
history, law office history is characterized by several recurring problems: it is
typically result-oriented, it shows an appalling lack of familiarity with Found-
ing Era history and historiography, and it approaches historical texts in an
anachronistic manner.).
19 See, e.g., Justice Thomas, who quotes Justice Harland, dissenting in Plessy

v. Ferguson, 163 U.S. 537, 559 (1896) for the proposition that Our Constitu-
tion is color-blind, and neither knows nor tolerates classes among citizens.
Grutter v. Bollinger, 539 U.S. 306, 378 (2003) (Thomas, J., concurring in part
and dissenting in part). In doing so, he suggests that the Constitution has been
color blind since adopting the Fourteenth Amendment. For criticism, see M.
Berman, Originalism is Bunk, 84 New York University Law Review (2009), 1,
at 91-91.
108 Walen

even the strongest contemporary critics.20 I proceed, then, on the as-


sumption that judicial review is a defensible practice, and explain, first,
why judicial review brings considerations of justice into the law more
than would otherwise be the case, and second, why it is also an appro-
priate forum for sustained theorizing about moral issues that enter the
legal discussion.
It might seem that the first point has been fully made already, insofar as
I have argued that judicial review involves making reference to provi-
sions with obvious moral content. But it is important to see how these
terms become relevant. It need not be simply through striking down
laws that are held to violate the Constitution, including whatever moral
notions the Constitution embodies. It can also be relevant for the inter-
pretation of statutes. In that way, the moral content of constitutional
law has a broader reach than that of any individual statute. For unlike
individual statutes that might also make use of morally loaded terms
such as a reasonable standard of care, constitutional law often brings
a moral dimension to bear on the interpretation of a wide range of laws
that do not obviously have moral content. It does so in accordance with
the rule of constitutional interpretation known as constitutional
avoidance, that holds that a statute is to be interpreted, if possible, to
be constitutional.21
Consider, for the purposes of illustration, the distinction that will oc-
cupy the rest of the paper, that between civilians and combatants. It is a
distinction found in the law of war, including treaty law, such as the
Geneva Conventions. If that distinction has to work in conjunction
with, that is to say in such a way as to be consistent with, the Due Pro-
cess clause protection of liberty, then it must be used in a way that re-
flects the limits of just detention policy. In other words, once due pro-
cess is added to the discussion, the interpretation of legal concepts will
be guided by, and the application of legal concepts will be limited by,
basic principles of justice, as worked out by the courts.

20 A. Walen, Judicial Review in Review: A Four-Part Defense of Legal Con-

stitutionalism. A Review Essay on Political Constitutionalism, by Richard


Bellamy, 7 International Journal of Constitutional Law (2009), 329.
21 See Boumediene v. Bush, 553 U.S. 723, 787 (We are obligated to construe

the statute to avoid constitutional problems if it is fairly possible to do so.) (in-


ternal quotation marks and square brackets omitted).
Reflections on Theorizing About the Moral Foundations of the Law 109

Of course, insofar as a legal concept or a distinction is up for interpreta-


tion, even outside of the context of judicial review, it should be inter-
preted in a way that is morally defensible, if such a way is available.22
But the need to meet constitutional muster provides a court a more ex-
plicit reason to think about the moral dimensions of interpretation,
rather than seeking to reason simply by analogy or by looking uncriti-
cally at history and economics. Thus judicial review matters in a posi-
tive way for bringing moral thought into the law.
This brings me to the second point, which is that sophisticated theoriz-
ing about moral issues has a legitimate role to play in litigation helping
to guide courts in making morally informed interpretation of the law.
There is precedent for such theorizing being offered to courts, at least
in the U.S. When the Supreme Court considered the right to die in
Washington v. Glucksberg,23 one of the briefs was the so called Phi-
losophers Brief, written by Ronald Dworkin, and signed by six of the
most prominent moral and political theorists in the United States.24 The
brief had no obvious impact on the Courts decision in that case, and it
should perhaps be worrisome that it is so easy to cite one particular
philosophical brief, when briefs by economists and historians are so
common no one brief now stands out.25 Nevertheless, even if briefs that
are fundamentally exercises in moral philosophy are destined to remain
a rarity, it is important that the work of moral theorists is being pub-
lished in scholarly law journals, helping thereby to shift the terms of the
debate, for litigators and judges as well as for academics, to those which
are more morally defensible.
In what follows I offer my own attempt to engage in such argument,
hoping to establish not only that it would be better if courts were to
pay attention to the issues that I raise, but also that they cannot come to
an even marginally defensible position if they do not do so.

22 See supra note 3.


23 521 U.S. 702 (1997).
24 Brief for Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls,
Thomas Scanlon, and Judith Jarvis Thomson as Amici Curiae In Support Of
Respondents, Washington v. Glucksberg, 521 U.S. 702 (1997) (Nos. 95-1858,
96-110).
25 Certainly the Philosophers Brief did not create a paradigm shift like the

famous Brandeis Brief, Brief for Defendant in Error, Muller v. Oregon, 208 U.S.
412 (1908).
110 Walen

II. An Overview of My Theory of Detention

The core of my work on detention is captured in a piece called a Uni-


fied Theory of Detention.26 The purpose of this piece is to fill in a gap
I perceived on the part of even progressive legal theorists who discussed
detention in the context of the so-called war on terror. Conservatives
were all too ready, in my opinion, to trade off the liberty of some for
the security of the rest that was a familiar progressive criticism. But
progressives too seemed to have no principled basis for deciding who
can be detained, and when. There were simply more reluctant to de-
prive some of their liberty for the safety of others.
My conviction has been that a simple weighing of liberty and security
does not do justice to moral terrain, especially if one wants to have law
that can be justified in the liberal tradition as respecting people as fun-
damentally free and equal beings, possessed of dignity. I wanted to see
if I could bring the detention of enemy combatants in the time of war
into the same dignity-respecting framework that we think operates in
times of peace. My thought was that only by describing a single, coher-
ent framework could we get morally sound guidance on what to do
with suspected terrorists, who in some ways are like criminals and in
other ways like combatants.
I call the theory that I think can unify the treatment of detention both
in war and in peace the autonomy respecting (AR) model of detention.
Generally put, it holds that individuals who can be adequately policed
and held criminally liable for their illegal choices, as normal autono-
mous actors, and who can choose whether their interactions with others
will be impermissibly harmful or not, can be subjected to long-term de-
tention only if they have been convicted of a crime for which (a) long-
term punitive detention, and/or (b) the loss of the right not to be sub-
ject to long-term preventive detention is a fitting punishment.
This can be broken down into its constituent parts as follows: Punitive
detention, as long as it is in response to the violation of a just criminal
law and proportional to the convicted criminals culpability for his or
her crimes, respects autonomy because it is based on the convicted
criminals autonomous choice to commit a crime. Preventive detention
is not in the same way backwards looking. It looks backwards for evi-

26 A. Walen, A Unified Theory of Detention, with Application to Preven-


tive Detention for Suspected Terrorists, 70 Maryland Law Review (2011), 871.
Reflections on Theorizing About the Moral Foundations of the Law 111

dence of a persons dangerousness, but it is fundamentally concerned


with the persons dangerousness in the future, rather than with punish-
ment for a crime committed in the past. This makes it much harder to
justify in a way that respects the autonomy of the actor.
To see when it can be justified, we need to start by distinguishing short-
term preventive detention (STPD) from long-term preventive detention
(LTPD). STPD is justifiable with less process, including, most impor-
tantly, a lower burden of proof on the state, than the criminal law pro-
vides for.27 This is because even innocent people can be expected to
make small sacrifices for the sake of the greater welfare, and thus there
is less need to be certain that innocent (i.e. non-threatening) people are
not subjected to STPD than to LTPD. LTPD, by contrast, is a signifi-
cant burden on the detainee. How to draw the line between STPD and
LTPD is, naturally, a matter that cannot be settled with any definitive
clarity. These are inherently vague notions. But they are meant to dis-
tinguish qualitatively different impositions on the detainee, and general
practice indicates that six months provides a reasonable marker.28
The question that I take to be more important than how one draws the
line between STPD and LTPD is how LTPD can be justified. As far as I
can see, it is justifiable in only four conditions, namely when:
1. People lack the normal autonomous capacity to govern their
own choices;29
2. They have, in virtue of one or more criminal convictions, lost
their right to be treated as autonomous and accountable;30

27 I do not mean to be cavalier about the process required for short-term de-

tention. Even short-term detention can be onerous. Therefore procedures


should be used which minimize the chances of abuse while allowing important
government ends to be met. See, e.g., United States v. Salerno, 481 U.S. 739
(1987) (upholding the federal Bail Reform Act, allowing for the pre-trial deten-
tion of criminal defendants judged to be dangerous).
28 See A. Walen (note 26), at 915-916.
29 See Addington v. Texas, 441 U.S. 418, 426 (1979) (noting the states power
to protect the community from those who are mentally ill and a danger to
themselves or others).
30 This is certainly the most controversial of the four prongs. It matches the

practice in the United States and elsewhere, but many theorists consider it
clearly unjustifiable for a person to be subject to preventive detention as a result
of a past criminal action. I argue, however, that we can see loss of the normal
112 Walen

3. They have an independent duty to avoid contact with others,


because such contact would be impermissibly harmful (e.g.,
those with contagious and deadly diseases), and LTPD simply
reinforces this duty; or
4. They are incapable of being adequately policed and held ac-
countable for their choices.
The fourth of these is the one that is relevant to the treatment of sus-
pected enemy combatants. It is essentially the complement to the first.
While the first concerns those who are intrinsically incapable of being
held accountable for their actions, the fourth concerns those who are
extrinsically incapable of being held accountable for their actions. In
both cases, the argument goes, they can be treated differently from the
paradigm case of the autonomous and accountable person, who must
not be subjected to LTPD, but who must if he or she is not convicted
of a crime for which punitive detention or loss of the right not to be
subject to LTPD is a fitting punishment simply be released and po-
liced to ensure that he or she respects the rights of others.
I will return to discuss how this fourth prong works in more detail in
part IV below. First, I want to explain why it is necessary to bring this
view to bear on the law by discussing the problems that arise in the law
of detention if it is not.

III. The Problematic Reasoning in al-Marri v. Pucciarelli

I argue here that neither conservatives nor progressives can achieve a le-
gally defensible and morally coherent position if they continue to dis-
cuss the concept of a combatant, understood as one who can be subject
to the military version of LTPD, without a better understanding of the
larger moral context in which such detention is justified. I make this
point by examining the case of al-Marri v. Pucciarelli.31 Given that both
sides are making constitutional arguments, I think this case serves as a
prime example of how lawyers and judges need to transcend the tradi-

right not to be subject to LTPD as an element of punishment that can comple-


ment the more standard use of prison terms and fines. See A. Walen, A Punitive
Precondition for Preventive Detention: Lost Status as an Element of a Just Pun-
ishment, 63 San Diego Law Review (2011), 1229.
31 534 F.3d 213 (4th Cir. 2008).
Reflections on Theorizing About the Moral Foundations of the Law 113

tional distinction, and seek a deeper moral understanding of why the


distinction is important, if they are to arrive at a legally defensible posi-
tion.32 And it is the job, I think, of moral theorists to try to provide
them with that understanding.

1. Background of the Case

Ali Saleh Kahlah al-Marri is a citizen of Qatar who legally entered the
United States, with his family, on September 10, 2001.33 Three months
later, he was arrested as a material witness in the U.S. governments in-
vestigation of the 9/11 attacks.34 In February 2002, he was charged with
possession of unauthorized or counterfeit credit card numbers with
the intent to defraud.35 In January 2003, he was charged with other
crimes in a second indictment.36 He pleaded not guilty and a trial date
was set for July 2003.37 Less than a month before the trial was to begin,
after having been detained already for more than eighteen months, the
United States moved ex parte to dismiss the indictment.38 The Gov-
ernments motion was based on an order by President Bush stating that
he had determined that al-Marri is an enemy combatant [] closely
associated with al Qaeda.39 He was then transferred to military cus-
tody and placed in the Naval Brig in South Carolina.40
Council for al-Marri quickly filed a habeas petition challenging his cap-
tivity.41 The habeas petition was initially dismissed, but that ruling was

32 The rest of this part of the paper is drawn, with the permission of the

Rutgers Law Review, more or less directly from an earlier paper, A. Walen,
Transcending, but Not Abandoning, the Combatant-Civilian Distinction: A
Case Study, 63 Rutgers Law Review (2011), 1149.
33 534 F.3d at 219.
34 Id.
35 Id.
36 Id.
37 Id.
38 Id.
39 Id.
40 Id.
41 He was not, however, allowed to meet with his counsel for 14 months.
114 Walen

overturned on appeal. The opinion I consider resulted from the recon-


sideration of that initial appellate decision by the whole of the Fourth
Circuit Court of Appeals. The issues upon reconsideration included the
one which is relevant here: assuming the Governments allegations
about al-Marri are true, whether Congress has empowered the Presi-
dent to detain al-Marri as an enemy combatant.42

2. Conflicting Legal Opinions

Judge Motz, writing for a minority of four, relying on the traditional


law of war, answered the question regarding the Presidents power to
detain al-Marri as an enemy combatant in the negative.43 Her argument,
in brief, went like this. First, Motz established a baseline constitutional
framework limiting long-term preventive detention: there is a general
rule, reflecting the due process protection of the liberty of both citizens
and lawfully admitted aliens, that the government may not detain a
person prior to a judgment of guilt in a criminal trial.44 The Supreme
Court has permitted [only] a limited number of specific exceptions to
that rule.45 Those who do not fall into the limited number of exceptions
may not constitutionally be deprived of their liberty for the sake of
protecting the community. The relevant exception for the purposes of
people like al-Marri is that Congress may constitutionally authorize
the President to order the military detention, without criminal process,
of persons who qualify as enemy combatants.46 As a result, it is at
least constitutionally problematic, if not outright unconstitutional, to
subject people like al-Marri to military detention if they are not legally
enemy combatants.
The issue, therefore, turns on whether people like al-Marri can be con-
sidered enemy combatants. One might argue that Congress gave the
President the authority to hold suspected terrorists as enemy combat-
ants when it passed the Authorization for the Use of Military Force

42 Id., at 216.
43 Id., at 249-50.
44 Id., at 223 (quoting United States v. Salerno, 481 U.S. 739, 749 (1987)).
45 Id.
46 Id. (quoting Hamdi v. Rumsfeld, 542 U.S. 507, 516 (2004)).
Reflections on Theorizing About the Moral Foundations of the Law 115

(AUMF),47 and that Congress can define the concept enemy combat-
ant as it likes in that statute. But Congress is not free to define con-
cepts at will; if it were, it would be free to make any process due
process of law, by its mere will.48 The proper legal framework for in-
terpreting the concept comes from the law of war treaty obligations
[binding on the United States] including the Hague and Geneva Con-
ventions and customary principles developed alongside them.49 This
framework, as interpreted by the Supreme Court, rests enemy com-
batant status on [an individuals] affiliation with the military arm of an
enemy nation.50 Moreover, this connection between combatant status
and fighting for the opposing side in an international armed conflict is
not without rationale.51
The law of war does not classify persons affiliated with terrorist or-
ganizations as enemy combatants for fear that doing so would immu-
nize them from prosecution and punishment by civilian authorities in
the capturing country.52 Al-Marri was not accused of having fought
for an enemy nation. Therefore he must be treated as a civilian.53
In contrast to Judge Motz, the majority took a more functionalist view
of the combatant-civilian distinction. The five judges who made up the
majority all accepted that the AUMF granted the President the power
to treat people who used or planned to use force in association with al-

47 See Authorization for use of Military Force, Pub. L. No. 107-40, 115 Stat.
224 (2001) [hereinafter AUMF].
48 Al-Marri v. Pucciarelli, 534 F.3d 213, 226 (4th Cir. 2008) (quoting Murray
v. Hoboken Land & Improvement Co., 59 U.S. 272, 276-7 (1855)).
49 Id., at 227.
50 Id., at 231.
51 Id., at 235 n.18.
52 Id. For further support of this view, see K. Ipsen, Combatants and Non-
Combatants, in The Handbook of Humanitarian Law in Armed Conflicts 65,
67 (Dieter Fleck ed., 1995) ([O]n the basis of the ordinary meaning, a combat-
ant is a person who fights. As an international legal term, the combatant is a
person who is authorized by international law to fight in accordance with in-
ternational law applicable in international armed conflict.).
53 Judge Motz added another condition as well for being a combatant: hav-

ing taken up arms in a traditional war zone. I take this up below, as it arises
naturally in my criticism of the pluralitys position.
116 Walen

Qaeda as enemy combatants.54 The three different opinions constituting


the majority differed, however, on how to understand the relationship
between the AUMF and the law of war. All accepted the pluralitys
premise that civilians cannot constitutionally be subject to long-term
military detention as enemy combatants.55 But they took different
routes to the conclusion that the AUMF, in allowing the detention of
members of al-Qaeda, does not violate that restriction. All were moved
by the functionalist idea that members of al-Qaeda operate like mem-
bers of traditional militaries. But some thought that fact suffices by it-
self; others thought more is needed: either congressional action to sup-
plant the traditional law of war or a new definition of enemy combat-
ants to reflect an evolving law of war.
Judge Traxler thought that the fact that al-Qaeda poses a threat more
like that of a military force than a criminal organization is itself suffi-
cient to show that the traditional law of war must be understood to al-
low military detention against its members. He was unpersuaded by
the claim that because al Qaeda itself is an international terrorist or-
ganization instead of a nation state or enemy government, the
AUMF cannot apply, consistent with the laws of war and our constitu-
tional guarantees, to such persons.56 He rejected what he took to be
the premise behind that claim, namely that al-Qaeda cannot be consid-
ered as anything other than a criminal organization whose members are
entitled to all the protections and procedures granted by our constitu-
tion.57 Rather, he believed that al Qaeda is much more and much
worse than a criminal organization. And while it may be an unconven-

54 See 534 F.3d at 253 (Traxler, J., concurring) (joined by Niemeyer, J.); id., at

293 (Wilkinson, J., concurring); id., at 284 (Williams, J., concurring) (joined by
Duncan, J.).
55 For example, Judge Williams said, if al-Marri is an enemy combatant

who falls within the scope of the AUMF, he may be detained; if, however, he is
not an enemy combatant, and therefore a mere civilian, the Constitution forbids
such detention; id., at 285. And Judge Wilkinson said, The text of the AUMF
clearly authorizes al-Marris detention. Our inquiry cannot end here, however.
There are constitutional limits on what Congress can authorize the executive to
do; id., at 312.
56 Id., at 260.
57 Id.
Reflections on Theorizing About the Moral Foundations of the Law 117

tional enemy force in a historical context, it is an enemy force nonethe-


less.58
Judge Williams put extra weight on congressional action, within a
framework that, in his view, the Supreme Court had approved. He was
ready to concede that [t]he plurality opinion may very well be correct
that, under the traditional law of war, persons not affiliated with the
military of a nation-state may not be considered enemy combatants.59
But he thought that the traditional law of war has been supplanted by
the AUMF. As a specific and targeted congressional directive, the
AUMF controls the question of who may be detained, for purposes of
domestic law at least with respect to those individuals that fall within
its scope.60 This was, for him, not an unlimited power. Rather, he
thought that what Congress did with the AUMF fell within the bounds
set by Supreme Court precedent.
Finally, Judge Wilkinson thought the law of war needs to evolve to
handle the new kind of threat. In his view,
[t]he classical model is just that: a classical model. War changes. So too
the law of war has not remained static.
[...] To that end, the recent past has witnessed dramatic changes in the
manner in which wars are conducted. War is less a state-based enter-
prise: the greatest threats to our nations security now include those
from stateless actors intent on unleashing weapons of mass destruction
against civilian populations. Thus, while the principle of discrimination
and the category of enemy combatant surely remain a vital part of the
law of war, they most definitely must accommodate the new threats to
the security of nations. The pluralitys perspective, by contrast, is mired
in the models of the past, and completely fails to accommodate the
changing nature of warfare.61
To meet the changing nature of warfare, he suggested a new definition
of enemy combatant:
[T]he person must (1) be a member of (2) an organization or nation
against whom Congress has declared war or authorized the use of mili-
tary force, and (3) knowingly plans [sic] or engages [sic] in conduct that

58 Id.
59 Id., at 286.
60 Id.
61 Id., at 319.
118 Walen

harms or aims to harm persons or property for the purpose of further-


ing the military goals of the enemy nation or organization.62
Crucial to all three views was cutting the tie between having the privi-
lege to engage in combat and having combatant status. For all three, the
distinct threat posed by al-Qaeda shows that its members or those who
fight on its behalf must be subject to being held in long-term military
detention without being charged with any crime.

3. Problems with Both Sides

Close scrutiny reveals that both the minoritys and the majoritys views
are fatally flawed. The problem with the functionalists in the majority is
that their view threatens to strip the protections of the criminal law and
its highly protective due process framework from people whom any
civil libertarian would think deserve to benefit from them. The implica-
tions of the majority opinion are that a U.S. citizen suspected of being a
member of al-Qaeda could be detained indefinitely, without trial. He or
she would have a right to a habeas hearing, but that would fall far short
of the protections of a criminal trial. Thus, even if the basis for suspi-
cion were the kind of activity normally handled by the criminal justice
system such as conspiring to commit a terrorist act63 a citizen could
simply be put in a military brig until the end of the War on Terror, or
until the government decides it no longer considers him or her a threat.
Despite the worries expressed by Judge Wilkinson concerning the abil-
ity to prosecute suspected terrorists,64 there is currently no need to
adopt such a policy.65 Indeed, adopting such a policy would strike any

62 Id., at 325.
63 See 18 U.S.C. 2332b(b)(2) (2006) (listing conspiracy to commit any of
the named terrorist acts as under the purview of the United States jurisdiction
to prosecute).
64 See al-Marri, 534 F.3d at 307 ([T]he plurality fails to realize that some of

the significant difficulties associated with criminal prosecution are equally pre-
sent when a suspected terrorist has never been on a foreign battlefield.).
65 See R. B. Zabel/J. J. Benjamin, Jr., In Pursuit of Justice: Prosecuting Ter-

rorism Cases in the Federal Courts, Hum. Rights First White Paper (2008),
available at http://www.law.yale.edu/documents/pdf/Alumni-Affairs/USLS-
pursuit-justice.pdf.
Reflections on Theorizing About the Moral Foundations of the Law 119

civil libertarian as riding roughshod over the basic right to liberty, as


protected by such basic and morally fundamental procedural guarantees
as proof beyond a reasonable doubt, and the right to confront the wit-
nesses against one.
Judge Wilkinson has the most well-developed account of why his posi-
tion would not lead to unjustifiable detentions, and he could reply as
follows: On his proposed view, there is the significant political check
of congressional authorization. Specifically, absent some limited inher-
ent authority needed during times of emergency, the executive may
only detain those persons against whom Congress has authorized the
use of force.66 Moreover, he would not allow someone to be detained
as an enemy combatant merely upon a showing of affiliating with al-
Qaeda. He stated, the person in question must have taken steps to fur-
ther the military goals of the organization. Thus, McCarthy-like accu-
sations of mere group membership would not suffice as a basis for de-
tention.67
The problem with these reassurances is that Congress may, if there are
significant terrorist attacks in the future, authorize the use of military
force rather broadly indeed, the AUMF itself has arguably been
stretched to allow the United States to go after groups that affiliated
with al-Qaeda only fairly loosely.68 And Wilkinsons further steps test is
inadequate protection for two reasons. First, it covers things like harm
to property, which would allow military detention for acts as unworthy

66 534 F.3d at 325.


67 Id.
68 As Matthew Waxman pointed out, [r]ecently al Qaeda has tended to
rely on affiliate organizations dispersed across several continents al Qaeda in
the Arabian Peninsula, Lashkar-e-Taiba in Pakistan, al-Shabab in Somalia to
provide financial, technical and other forms of support to local franchises.
Matthew C. Waxman, The Structure of Terrorism Threats and the Laws of War,
20 Duke J. Comp. & Intl L. 429, 436 (2010). Insofar as the U.S. use force
against these groups, they are likely to rely on the AUMF. See, e.g., R. J. Vogel,
Drone Warfare and the Law of Armed Conflict, 39 Denv. J. Intl L. & Poly 101
(2010) (considering a hypothetical U.S. attack on al-Shabab leaders, justified by
the AUMF). But it is not clear that these al-Qaeda affiliates count as organi-
zations that planned, authorized, committed, or aided the terrorist attacks
that occurred on September 11, 2001, or harbored such organizations.
AUMF (note 47), at 6. Al-Qaeda affiliates may harbor those organizations
now, but they may not have even existed as of September 11, 2001.
120 Walen

of it as certain acts of civil disobedience on behalf of groups affiliated


with al-Qaeda. Second, the burden of proof and procedural protections
would still be substantially lower than those found in the criminal jus-
tice system.
Thus, in the end, the majoritys position is a recipe for political abuse.
Moreover, there is simply no call for such a loss of basic procedural
protections when the conditions for normal law enforcement are fully
intact.
Nevertheless, even if the majority position in al-Marri provides inade-
quate protection to liberty, the plurality position provides inadequate
protection for security. Most obviously, it would not allow the United
States to use the normal tools of war detaining or killing fighters on
the other side against an insurgency or in a civil war. Those who fight
in civil wars are not privileged to engage in combat under the Geneva
Convention relative to the Treatment of Prisoners of War. Common
Article 3 of this Convention,69 which concerns non-international armed
conflict, provides them with basic protections, but it does not provide
them with combatant status. True, the Protocol Additional to the Ge-
neva Conventions of 12 August 1949 (Protocol 1) does provide com-
batant status to those fighting in civil wars and insurgent campaigns
who adhere to certain basic rules regarding operating under a command
structure which ensures compliance with the rules of international law
applicable in armed conflict.70 But the United States has not signed
Protocol 1. And even if it had, Protocol 1 helps few to none of the
fighters in a modern civil war or insurgency campaign.
Naturally, the plurality would not embrace the position that the United
States has to use the criminal law when dealing with suspected members
of al-Qaeda detained in Afghanistan or other war zones. They tried to
avoid that implication by saying that a person could also be held as an
enemy combatant if picked up in, or even if he or she had ever fought
in, a traditional battlefield. As a result, the pluralitys test is really a
two-part test: one can be held as an enemy combatant if one is either a
combatant under the traditional law of war, or if one was captured in,

69 See Geneva Convention Relative to the Treatment of Prisoners of War


Art. 3, Aug. 12, 1949, 6 U.S.T. 3316, 75 U.N.T.S. 135.
70 Protocol Additional to the Geneva Conventions of 12 August 1949, and

Relating to the Protection of Victims of International Armed Conflicts Art. 43,


June 8, 1977, 1125 U.N.T.S. 3.
Reflections on Theorizing About the Moral Foundations of the Law 121

or at least was supposed to have fought against the United State in, a
traditional battlefield.
This dichotomy creates a real problem for the plurality, however.71 If
they give up the principled high ground and acknowledge that the
United States may detain people as enemy combatants simply because
they are thought to have fought at one time on a battlefield against the
United States, then a number of questions arise: How do we conceive of
the battlefield? How do we conceive of fighting the United States?
And what is the burden of proof on those issues? Little to none of the
fighting in modern wars occurs in a truly traditional field of battle, with
opposing forces lined up against each other. There is surely no such tra-
ditional battlefield in Afghanistan. Rather, what the United States en-
counters in Afghanistan is a country beset by insurgent fighters using
mostly guerrilla tactics. If suspected members of the Taliban or al-
Qaeda captured in that context can be detained as enemy combatants,
then why not detain as enemy combatants suspected members of al-
Qaeda or related groups with which the United States, according to the
AUMF, is at war wherever they are captured? And given that one is
unlikely to have been caught firing a weapon, what does it mean to have
fought the United States? Would simply having aligned oneself with an
enemy organization suffice? And what level of proof will be required?
Certainly less than that for the analogous crime of providing material
support for designated terrorist organizations.72 The plurality seems to
have no basis for responding to this challenge. But that means they have
no basis for objecting to the long-term military detention of suspected
members of al-Qaeda who are U.S. citizens living in the United States,
who are capable of being policed and charged for any past or future ter-
rorist activities in which they might have engaged or might yet choose
to engage.73
In sum, neither side in the debate has a defensible view. The majority
would allow too much detention for the sake of security; the minority

71 This is a problem, as well, for other civil libertarians who think that the

criminal law should not displace military detentions in places like Afghanistan.
See, e.g., R. B. Zabel/J.J. Benjamin (note 65).
72 See 18 U.S.C. 2339B.
73 This is not just a logical inference about the pluralitys position. It is ex-
plicitly the position they take with regard to Jose Padilla, who was captured in
the United States. See al-Marri, 534 F.3d at 229.
122 Walen

would either allow too little detention for the sake of security, or would
adopt an unprincipled position that having once supposedly fought the
United States in a (more or less) traditional battlefield, ones normal due
process rights are forfeit. Nor can the gap between the majoritys posi-
tion and the principled part of the minoritys position be filled by
somehow numerically splitting the difference. The problem arises be-
cause neither side thought well about why detention is justified in the
first place.74

IV. How the AR Model of Detention Can Help Provide a


Better Analysis of When Suspected Terrorists May Be
Treated as Enemy Combatants

According to the AR Model, as sketched in part II, combatants, as tra-


ditionally understood, may be subjected to LTPD because they are ex-
trinsically incapable of being held accountable for their actions. That is
true because they are, and will remain until the relevant war is over or
they are released from military service, privileged to engage in combat
with the detaining power.75 If a combatant is released or escapes, he or
she has the right to take up arms again.76 Therefore, the detaining power
not only cannot hold him or her criminally responsible for his past vio-
lent actions at least as long as those acts do not violate the laws of war
it also may not hold him or her criminally responsible for any future
acts of violence that conform to the law of war. The state is not re-
quired, however, to allow itself to be attacked. Therefore, it can subject
combatants to LTPD to prevent them from attacking. And it can do so

74 A case from another circuit split the difference between the legal positions
taken by the minority and the majority in al-Marri, arguing that the traditional
law of war provides for the military detention of civilians who are members of
armed forces. Gherebi v. Obama, 609 F. Supp. 2d 43, 66 (D.D.C. 2009). The
problem with this view is that it still leaves unaddressed the civil libertarians
worries, that U.S. citizens, suspected of being members of al-Qaeda, could be
subjected to unlimited military detention, without charges.
75 The possibility of giving parole provides an interesting complication to

this picture. I discuss it at length in A. Walen (note 26), at 927-30.


76 See K. Ipsen (note 52), at 361 (explaining the end to traditional notions of
capture of prisoners of war upon their escape).
Reflections on Theorizing About the Moral Foundations of the Law 123

without disrespecting them as autonomous people because their legal


status makes them unaccountable.
Some STs can also be justifiably subject to LTPD under this same head-
ing, that is because they are extrinsically, given their legal rights, unac-
countable. To see this, start with the assumption that the United States
has no obligation to release and police alien STs in its own territory. The
question then is, would they be adequately policed if released to their
home country or to some other country willing to take them? The an-
swer in some cases for example, Yemen77 is no. It is not that they
have the legal status of being beyond criminal prosecution for future
acts of terror. The problem is (a) that they do not have the legal status
to claim that the United States release them in U.S. territory and police
them there, and (b) where they do have a legal claim to be taken in,
there is too large a chance that they would not be held accountable for
any future acts of terror. As a result, they would be effectively unac-
countable for any future violent acts. Therefore, they can be subject to
LTPD, without disrespecting them as autonomous people, if they are
deemed, after process falling far short of a criminal trial, sufficiently
likely to commit future violent acts.78
What about LTPD for U.S. citizens who are STs? In their cases, the ar-
gument regarding the states obligation to police is different. The state
exists to serve its citizens, so it cannot say to a citizen, as it can to an
alien, that it will not accept the responsibility of policing him or her.
Thus, the question for a U.S. citizen is whether the conditions domesti-
cally are so insecure that effective policing becomes impossible. If they
are not as no one now asserts they are79 then U.S. citizen STs must
be either tried for criminal acts, or released and policed to ensure that
they do not commit such acts in the future. Thus, I believe the AR
Model vindicates the view of Justices Scalia and Stevens in Hamdi, that

77 See Guantanamo Review Task Force, Final Report 18 (2010), available at

http://www.justice.gov/ag/guantanamo-review-final-report.pdf (discussing the


security problems in Yemen and the way they interfere with releasing Yemeni
detainees from Guantnamo).
78 In this regard, it makes sense that roughly forty percent of the detainees

left in Guantnamo are from Yemen. Id. at 14. It is also worth adding that de-
taining aliens from certain regimes who are found likely to be terrorists may of-
ten be more humane than deporting them to a country where, if they are not re-
leased, they are instead likely to face torture.
79 Hamdi, 542 U.S. 507, 554 (2004) (Scalia, J., dissenting).
124 Walen

when it comes to dealing with U.S. citizens suspected of waging war on


the United States, the only constitutional alternatives are to charge
[them with a] crime or suspend the writ [of habeas corpus].80 This pre-
supposes that the United States would not allow its own citizens the
status of privileged combatants fighting for an enemy. But this seems a
fair assumption, one that is central to the concept of loyalty, which un-
derlies the crime of treason. And given this assumption, I would then
add that these two options charging with a crime or suspending ha-
beas if conditions warrant are the only two just alternatives as well.
It is important to be clear about two points related to this way of han-
dling STs. First, there may be cases in which the United States cannot
introduce into a criminal trial whether in a civilian or a military forum
all of the relevant evidence that a U.S. citizen was involved in illegal
terrorist activities. Judge Wilkinson was probably right when he wrote
that [t]he fog of war creates confusion, and, in active combat zones
such as Afghanistan and Iraq, it is often difficult to respect the eviden-
tiary standards, such as an unbroken chain of custody, that are the
hallmarks of criminal trials.81 And he was also probably correct in
writing that some of the significant difficulties associated with criminal
prosecution are equally present when a suspected terrorist has never
been on a foreign battlefield.82 But that simply means that it may be
difficult in some cases to get a conviction of a U.S. citizen involved in
international terrorism. Failing to get a conviction, however, is not a
reason to panic. It does not require that we then lock up the non-
convict in military detention, until either al-Qaeda and other terrorist
organizations no longer pose a threat to U.S. security, or the individual
himself seems no longer to be a threat. The alternative is the same as
with any person suspected of being a dangerous criminal who has not
been convicted: release him or her and police him or her. The options
for policing are surely up to the task of ensuring that non-convicted STs
do not commit future crimes, as is demonstrated by the fact that the
United States at this very moment is monitoring the activities of count-
less STs, waiting to find the best time in terms of information gather-
ing as well as prosecution to make an arrest.

80 Id., at 564.
81 Al-Marri v. Pucciarelli, 534 F.3d 213, 306 (4th Cir. 2008).
82 Id., at 307.
Reflections on Theorizing About the Moral Foundations of the Law 125

Second, the general assumption made by the court in al-Marri, that if a


legal resident alien may be subject to military detention, then so may a
U.S. citizen,83 is invalid. While it is true that resident aliens benefit from
almost all of the same constitutional protections as citizens, they do not
benefit from all of the same protections. In particular, their status as
aliens allows them to be deported if they have done something inconsis-
tent with their having an ongoing right to stay in the country.84 More-
over, the standard for determining whether an alien may have commit-
ted a deportable act is not proof beyond a reasonable doubt, it is clear
and convincing evidence that . . . [he] is deportable.85 That means, in
essence, that the United States is not obliged to release and police an
alien that it has good reason to believe is involved in terrorist activities
but for whom it is either unable or unwilling to obtain a criminal con-
viction. It can deport him. And if there is no country that is willing to
take him or her and police him or her adequately, then the United States
can justifiably subject him or her to LTPD as an ST. One should not be
glib about the processes that would be due such a person before sub-
jecting him or her to LTPD. But alien STs do not have the same right to
be released into the United States that citizens have, and thus they may
be subject to LTPD as citizens may not.
In sum, according to the AR Model, which provides a principled ac-
count of when detention is consistent with our core liberal values, alien
enemy combatants, as that term is traditionally understood, may be
subjected to long-term military detention because they would be unac-
countable for any future use of force against the United States should
they be released or escape. Likewise, alien STs may be subject to LTPD
if the United States chooses not to try them and they cannot be released
to a country willing to police them to ensure that they commit no fu-
ture terrorist acts. U.S. citizens, however, may not be subjected to mili-
tary detention. If they cannot be convicted of a crime, they must be re-
leased and policed. Ultimately the most important questions, as I have
argued elsewhere,86 are not limited to whether an individual is a com-
batant or whether he or she poses a large threat; they also include (a)
whether he or she can be held accountable for any future use of force

83 Id., at 249.
84 See generally 8 U.S.C. 1227 (2006).
85 8 U.S.C. 1229a(c)(3)(A) (2006).
86 A. Walen (note 26), at 938.
126 Walen

against the state, and (b) whether the detaining state has an obligation to
release and police him or her if it cannot or chooses not to try to con-
vict him or her for a past crime.

V. Conclusion

I have argued that both sides in the decision in al-Marri were funda-
mentally unsound because they failed to understand what the deeper
moral issues are in the detention of enemy combatants. I have tried to
sketch an account of how one could get a better understanding of those
issues by using what I call the AR Model of detention. I do not want to
claim that this brief sketch of the AR Model of detention should be
taken as the new paradigm for all thought, moral and legal, in the area
of detention. But I do hope it can provoke more intelligent discussion
of how to construct a unified moral framework for detention one that
recognizes that detention in times of national insecurity still must re-
spect the dignity of the individual.
Finally, it is worth noting how things stand legally on this issue. The al-
Marri case did not make it in front of the Supreme Court. The Court
agreed to hear the al-Marri case but then remanded the case when al-
Marri was released from military detention and pleaded guilty to con-
spiracy to provide material support to al Qaeda.87 But sooner or later
the Court will have to shift from discussions of the threshold proce-
dural rights of detainees to their substantive rights including their
rights to such richer procedural protections as are found in the criminal
law.88 And then one can at least hope (a) that a larger vision of a morally
coherent detention policy will influence how they frame this issue, and
(b) that it will lead them to provide some appropriately principled
checks to the states power to detain dangerous individuals, including
those it is inclined to label combatants.

87 J. Schwartz, Plea Agreement Reached with Agent for al Qaeda, N.Y.

Times, May 1, 2009, at A16.


88 Cases like Hamdi v. Rumsfeld, 542 U.S. 507 (2004) and Boumediene v.
Bush, 553 U.S. 723 (2008) dealt only with threshold procedural rights of detain-
ees, such as whether they have a right to a meaningful hearing to determine if
they are enemy combatants, and whether they have the constitutional right to
petition for a writ of habeas corpus.
B. Ethisierung in internationaler
Perspektive
Grundlagen und Grenzen der Ethisierung des
Vlkerrechts
Silja Vneky

I. Einleitung Ethisierung des Vlkerrechts und


Ethisierung durch Vlkerrecht1

Der Begriff der Ethisierung des Rechts ist in der rechtswissenschaftli-


chen und rechtsphilosophischen Debatte noch neu.2 Meines Erachtens
kann unter einer Ethisierung des Rechts sinnvoll die zunehmende und
verstrkte Ergnzung rechtlicher Normen durch ethische, auerrechtli-
che Standards verstanden werden. Eine so verstandene Ethisierung des
Rechts zeigt sich in den nationalen Rechtsordnungen und im Europa-
recht,3 aber auch im Vlkerrecht. Dieser letzte Teilbereich der Ethisie-
rung des Rechts, mithin die Ethisierung des Vlkerrechts, wird im Fol-
genden untersucht. Konkret geht es dabei darum, die folgenden Ent-
wicklungen zu erfassen:

1 Dieser Beitrag ist eine leicht abgenderte und gekrzte Fassung meines
Beitrages Vlkerrecht und Ethik, Ethisierung des Vlkerrechts, in: Ancilla Iu-
ris, Spezialausgabe: Internationales Recht und Ethik/ Special Issue: Internatio-
nal Law and Ethics, 2012, 1 ff.
2 Vgl. aber zu diesem Themenkomplex die Arbeiten und Dissertationen
meiner Forschungsgruppe zur Demokratischen Legitimation ethischer Ent-
scheidungen (20062011). Zu dem davon zu unterscheidenden Begriff der
Rechtsethik, der den Begriff des Naturrechts ersetzt, vgl. von der Pfordten,
Rechtsethik, 2. Aufl. 2011, insbesondere 39 ff.
3 Vgl. dazu nher fr den Bereich des Wissenschaftsrechts: Vneky, Ethi-
sche Standards im Wissenschaftsrecht, in Lwer u.a. (Hrsg.), Wissenschaft und
Ethik, Beiheft Wissenschaftsrecht, Heft 21, 2012, S. 68 ff.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 129
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_6, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
130 Vneky

Erstens finden sich auch im Vlkerrecht ffnungsklauseln in rechtli-


chen Normen, die ethischen Standards normative Relevanz in der in-
ternationalen Rechtsordnung einrumen.4
Der zweite Bereich einer Ethisierung des Vlkerrechts findet sich in
grundstzlich unverbindlichen und damit nicht-rechtlichen Kodi-
zes, die Akteure verpflichten, ethisch zu handeln, beispielsweise ethi-
sche Forschung nach den Magaben der Deklarationen des Weltrzte-
bundes (World Medical Association, WMA) zu betreiben.
Die Ethisierung des Vlkerrechts zeigt sich drittens an der immer
noch weitergehenden und rechtlich verankerten Institutionalisierung
der Ethik durch Ethikgremien (Ethikrte5 oder Ethikkommissionen6):
Der Einsatz eines Ethikgremiums ist seit einigen Jahren nicht nur in In-
ternationalen Organisationen wie der UNESCO vorgesehen, er wird
auch sonst vlkerrechtlich gefordert; auch faktisch wird der Aufbau

4 Vgl. zu solchen ffnungsklauseln im Kriegsvlkerrecht bspw. den Beitrag


von Mehring, The Ethicalization of International Humanitarian Law: Clarify-
ing the Boundaries for Physicians, in diesem Band.
5 Dies sind Gremien, die insbesondere bei der Suche nach oder bei der Ge-
nerierung von abstrakt-generellen Regelungen in ethisch-moralisch umstritte-
nen Bereichen Hilfe leisten sollen. Sie sind in der Regel unabhngig und plura-
listisch (auch) mit Experten besetzt und eng an Organe der Rechtsetzung im
weitesten Sinn angebunden.
6 Dies sind Gremien, die in spezifischen, ethisch umstrittenen Einzelfllen,
also konkret und individuell, beraten und/oder entscheiden sollen. Sie sind
ebenfalls in der Regel unabhngig und pluralistisch (auch) mit Experten be-
setzt. Ein Einsatzbereich fr diesen Typus von Ethikgremien ist der Bereich der
Arzneimittelforschung am Menschen; dafr ist bspw. nach deutschem Arz-
neimittelrecht fr jedes einzelne Forschungsprojekt das positive Votum einer
Ethikkommission erforderlich (vgl. 40, 42 Arzneimittelgesetz (AMG) in der
Fassung der Bekanntmachung vom 12.12.2005, BGBl. I, 3394). Dazu nher die
Beitrge in diesem Band von Dederer, Gerechtfertigter Einsatz von Ethikkom-
missionen Grundlagen und Grenzen, Poscher, Was Juristen besser knnen als
Ethiker, und Siep, Sinn und Grenzen von Ethik-Kommissionen aus philosophi-
scher Sicht. Insgesamt sind heute von den ber 50 bestehenden ffentlich-
rechtlichen Ethikkommissionen in der Bundesrepublik Deutschland ein Drittel
bei den rztekammern und zwei Drittel bei den medizinischen Fakultten der
Hochschulen errichtet worden, hinzu kommen drei bei den jeweiligen Landes-
verwaltungen, vgl. Delhey/Hoffmann, Die Struktur der ffentlich-rechtlichen
Ethik-Kommissionen in der Bundesrepublik Deutschland, in Vneky (Hrsg.),
Informationspapiere der Max-Planck-Forschungsgruppe Demokratische Legi-
timation ethischer Entscheidungen, 9/2009, abrufbar unter fiponline.de.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 131

und Einsatz von Ethikgremien in einzelnen Staaten durch die UNES-


CO vorangetrieben.7

Alle drei Entwicklungen berlappen und verstrken sich dabei: Rechts-


normen, die ffnungsklauseln enthalten, verweisen auf Ethikkodizes
oder knnen so verstanden werden, dass sie diese in das Recht inkorpo-
rieren; in Ethikkodizes ist oftmals der Einsatz eines Ethikgremiums
vorgesehen, das im konkreten Anwendungsfall bestimmen soll, was
ethisches oder unethisches Handeln ist.

II. Begriffsbestimmungen und theoretisches Verhltnis von


Ethik und Recht

Bevor im Folgenden untersucht wird, ob die in der letzten Fallgruppe


genannten Ethikgremien gerechtfertigt in der Vlkerrechtsordnung ein-
gesetzt werden knnen, soll zunchst das theoretische Verhltnis von
Ethik und Recht dargelegt werden und eine Klrung der hier verwende-
ten Begriffe erfolgen:

1. Ethische Standards, Vlkerrecht und internationales Soft Law

a. Formale Unterscheidung
Wenn ethische Standards formal begrifflich von rechtlichen Normen
unterschieden werden, so ist dies zunchst nur sinnvoll, wenn damit all
diejenigen Standards bezeichnet werden, die nicht Vlkerrecht im Sinne
von Art. 38 Abs. 1 IGH-Statut8 darstellen, also kein vlkerrechtlicher

7 Auch wenn dies im Vorliegenden nicht weiter vertieft werden kann, ist
doch zu bemerken, dass dieser letzte Aspekt im Bereich der nationalen Rechts-
ordnung wiederum zu einer Ethisierung (des nationalen Rechts) durch Vl-
kerrecht fhrt, da vlkerrechtliche Normen bedingen, dass Ethikgremien im
nationalen Recht faktisch Relevanz eingerumt wird und werden muss. Dazu
insgesamt Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-
kratischer Legitimation fr Ethikgremien, 2010, 359 ff., 382 ff.
8 Statut des Internationalen Gerichtshofes, BGBl. 1973 II, 505. Art. 38
IGH- Statut [Anzuwendende Rechtsstze] lautet:
(1.) Der Gerichtshof, dessen Aufgabe es ist, die ihm unterbreiteten Streitig-
keiten nach dem Vlkerrecht zu entscheiden, wendet an
132 Vneky

Vertrag, kein Vlkergewohnheitsrecht und keine allgemeinen Rechts-


grundstze sind. Von nur ethischen und damit nicht-rechtlichen Stan-
dards kann sinnvoll gesprochen werden, wenn diese nicht durch ein
grundstzlich dazu befugtes Rechtssetzungsorgan (also im Vlkerrecht:
durch kein Vlkerrechtssubjekt)9 gesetzt werden, sondern beispielswei-
se durch eine private Wissenschaftsorganisation, einen privaten Verband
etc. verfasst werden. Die internationalen Menschenrechte, wie sie in
vlkerrechtlichen Vertrgen und im Gewohnheitsrecht als Teil der Vl-
kerrechtsordnung heute verrechtlicht sind,10 stellen daher keine (nur)
ethischen Standards im oben genannten Sinne dar, sondern sind Vlker-
recht im engen Sinn.11
Mit diesem letzten Kriterium lassen sich (nur) ethische Standards auch
von sogenanntem unverbindlichem bzw. weichem Recht (Soft Law)
abgrenzen: Als internationales Soft Law werden sinnvoller Weise und
im Folgenden Verhaltensregeln bezeichnet, die keiner formellen Vl-
kerrechtsquelle zuzuordnen sind und damit unmittelbar nicht verbind-
lich sind, die aber von einem Rechtssubjekt geschaffen wurden, das
grundstzlich auch verbindliches Recht (mit)kreieren knnte.12 Interna-
tionales oder vlkerrechtliches Soft Law sind daher beispielsweise Re-

(a) internationale bereinknfte allgemeiner oder besonderer Natur, in de-


nen von den streitenden Staaten ausdrcklich anerkannte Regeln festgelegt
sind;
(b) das internationale Gewohnheitsrecht als Ausdruck einer allgemeinen,
als Recht anerkannten bung;
(c) die von den Kulturvlkern anerkannten allgemeinen Rechtsgrundstze;
(d) vorbehaltlich des Artikels 59 richterliche Entscheidungen und die
Lehrmeinung der fhigsten Vlkerrechtler der verschiedenen Nationen als
Hilfsmittel zur Feststellung von Rechtsnormen. ()..
9 Zu den verschiedenen Vlkerrechtssubjekten wie insbesondere Staaten,
aber auch Internationalen Organisationen, vgl. statt anderer Brownlie, Interna-
tional Law, 7. Aufl. 2008, Kapitel 3.
10 Hailbronner/Kau, Der Staat und der Einzelne im Vlkerrecht, in Graf
Vitzthum (Hrsg.), Vlkerrecht, 5. Aufl. 2010, Rn. 229 f.
11 Dies ist eine begriffliche Przisierung; dies bedeutet aber nicht, dass ver-
rechtlichte Menschenrechte sich nicht inhaltlich mit nicht-rechtlichen, ethi-
schen Menschenrechten decken; berlappungen und bereinstimmungen
sind hier sogar die Regel.
12 Vgl. nur Graf Vitzthum, Begriff, Geschichte und Rechtsquellen des Vl-
kerrechts, in ders. (Hrsg.), Vlkerrecht, 5. Aufl. 2010, Rn. 14, 68, 152.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 133

solutionen internationaler Staatenkonferenzen oder Internationaler Or-


ganisationen.13
Wichtige Beispiele fr internationales Soft Law in diesem Sinne finden
sich insbesondere auch im menschenrechtlichen, biomedizinischen und
umweltvlkerrechtlichen Bereich: Die Allgemeine Erklrung der Men-
schenrechte, geschaffen durch die Generalversammlung der Vereinten
Nationen, vom 10.12.1948, die aus 30 Artikeln besteht, ist eines der be-
deutsamsten Soft Law Dokumente unmittelbar nach dem Zweiten
Weltkrieg;14 gleiches gilt fr die Stockholmer Deklaration und die Rio-
Deklaration von 1972 und 1992, die jeweils einen Katalog von 26 bzw.
27 wichtigen umweltrechtlichen Prinzipien enthalten.15 Im Bereich des
internationalen Biomedizinrechts im weitesten Sinn sind wichtige Bei-
spiele fr Soft Law die UNESCO Deklarationen ber das menschliche
Genom (1997), zum Schutz genetischer Daten (2003) und zu Bioethik
und Menschenrechten (2005).16 Auch die Resolution der Generalver-
sammlung der Vereinten Nationen ber das Klonen von Menschen von
2005 stellt internationales Soft Law im oben genannten Sinn dar.17
Alle diese Resolutionen und Deklarationen Internationaler Organisati-
onen und Staatenkonferenzen haben keine unmittelbare Rechtsverbind-

13Dazu auch Vneky, Recht, Moral und Ethik Grundlagen und Grenzen
demokratischer Legitimation fr Ethikgremien, 2010, 283.
14 UN Doc. A/RES/217 A (III). Der entsprechende verbindliche Menschen-

rechtsvertrag, der Internationale Pakt ber brgerliche und politische Rechte


(BGBl. 1973 II, 1534), wurde erst im Jahre 1966, also beinahe zwei Jahrzehnte
spter, vereinbart.
15 UN Doc. A/Conf.48/14 (1972), ILM 11 (1972), 1416; UN Doc.
A/CONF.151/Rev. 1 (1992), ILM 31 (1992), 880; in der Rio-Deklaration etwa
ist das Vorsorgeprinzip (Prinzip 15) niedergelegt, wonach der Mangel an wis-
senschaftlicher Sicherheit kein Grund sein kann, um Vorsorgemanahmen zum
Schutz der Umwelt zu unterlassen; vgl. Beyerlin, Umweltvlkerrecht, 2000, 19.
16 Allgemeine Erklrung ber das menschliche Genom und die Menschen-

wrde vom 11.11.1997; Allgemeine Erklrung zum Schutz genetischer Daten


vom 16.10.2003 und Allgemeine Erklrung ber Bioethik und Menschenrechte
vom 19.10.2005, abgedruckt in Mller-Terpitz, Das Recht der Biomedizin,
2006, 213 ff.
17 Erklrung der Vereinten Nationen ber das Klonen von Menschen vom
08.03.2005, UN Doc. A/RES/59/280, abgedruckt in Mller-Terpitz, Das Recht
der Biomedizin, 2006, 243 f.
134 Vneky

lichkeit und sind dennoch kein Nicht-Recht.18 Soft Law sind Verhal-
tensregeln, die auerhalb der genannten Vlkerrechtsquellen entstehen,
die aber doch, wie Rechtsnormen im engen Sinne, gesetzte Normen, al-
so Verhaltensregeln abstrakt-genereller Art sind, die faktisch das staatli-
che Verhalten genauso (gut oder schlecht) steuern, wie Vlkerrecht im
engen Sinne.19 Soft Law besitzt daher trotz der fehlenden unmittelba-
ren, vollen Rechtsverbindlichkeit faktische normative Kraft.
Es gibt zudem Durchsetzungsmechanismen fr Soft Law im Bereich
des Vlkerrechts: Verletzungen des vlkerrechtlichen Soft Laws knnen
unfreundliche Akte anderer Staaten und Retorsionen zur Folge haben,
also alle Gegenmanahmen, die selbst nicht das Vlkerrecht verletzen.20
In jedem Fall gibt es bei Verletzungen von Soft Law eine mobilisation of
shame, die auf den verletzenden Staat Druck ausbt.21 Zudem kann Soft
Law als Mglichkeit zum Nachweis der Bildung von Vlkergewohn-
heitsrecht dienen.22 Die teilweise anzutreffende Ansicht, Soft Law sei
ein Oxymoron und Recht sei entweder unmittelbar verbindlich oder
rechtlich

18 Dies ist jedoch umstritten; wie hier beispielsweise Neuhold, The Inade-
quacy of Law Making by International Treaties, in Wolfrum/Rben (Hrsg.),
Developments of International Law in Treaty Making, 2005, 39 ff. Anderer An-
sicht von Heinegg, Die weiteren Quellen des Vlkerrechts, in Ipsen (Hrsg.),
Vlkerrecht, 5. Auflage 2004, 250 ff.; Graf Vitzthum, Begriff, Geschichte und
Rechtsquellen des Vlkerrechts, in ders. (Hrsg.), Vlkerrecht, 5. Aufl. 2010, Rn.
152.
19 Soft Law wirkt dabei auch auf innerstaatliches Recht ein, wenn es durch
nationale Gesetze umgesetzt wird, wenn nationale Gesetze auf es verweisen
oder wenn es ohne ausdrckliche Inkorporation angewandt oder bercksichtigt
wird, vgl. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-
kratischer Legitimation fr Ethikgremien, 2010, 283 ff.
20 Neuhold, The Inadequacy of Law Making by International Treaties, in

Wolfrum/Rben (Hrsg.), Developments of International Law in Treaty Mak-


ing, 2005, 39 ff., 49.
21 Neuhold, ibid., 39, 51.
22 Dies hngt ab von dem Inhalt der Resolution und den Umstnden ihrer
Annahme, vgl. Vneky, Die Fortgeltung des Umweltvlkerrechts in internatio-
nalen bewaffneten Konflikten, 2001, 164 f. mit weiteren Nachweisen.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 135

rechtlich irrelevant, ist daher nicht berzeugend.23 Vielmehr kann Soft


Law mehr normative Kraft besitzen als Vlkerrecht im engen Sinne.24
Wenn im Folgenden von (nur) ethischen Standards nur dann gespro-
chen wird, wenn kein Vlkerrechtssubjekt diese gesetzt hat, und damit
fr die vorliegende Untersuchung ethische Standards von Soft Law un-
terschieden werden, zeigt sich deutlich, dass die Debatte ber die Ethi-
sierung des Vlkerrechts von der Debatte der Frage der Zulssigkeit
und Bedeutung des internationalen Soft Laws getrennt werden kann
und nicht in dieser aufgeht.25 Damit soll nicht verneint werden, dass
man Soft Law im Grenzbereich zwischen Recht und ethischen Normen
verorten kann. Fr die begriffliche Klarheit scheint es aber aus den ge-
nannten Grnden (den Vlkerrechtssubjekten als Setzer dieser Regeln)
berzeugender, wie es auch die Terminologie Soft Law nahelegt, diese
Regeln dem Vlkerrecht im weiteren Sinn zuzurechnen.
Ein Beispiel fr ethische Standards, die gerade kein internationales Soft
Law im oben genannten Sinn darstellen, sind die Deklarationen des
Weltrztebundes (World Medical Association, WMA),26 wie die Dekla-
ration zu ethischen Grundstzen fr die medizinische Forschung am

23 Weil, Towards Relative Normativity in International Law?, American


Journal of International Law 77 (1983), 413 ff. Dagegen Neuhold, The Inade-
quacy of Law Making by International Treaties, in Wolfrum/Rben (Hrsg.),
Developments of International Law in Treaty Making, 2005, 39, 47.
24 Neuhold, The Inadequacy of Law Making by International Treaties, in

Wolfrum/Rben (Hrsg.), Developments of International Law in Treaty Mak-


ing, 2005, 39, 47. Dies ist der Fall, weil ber den Inhalt einer Norm sich eher
Konsens erzielen lsst, wenn sie zunchst rechtlich unverbindlich ist und da-
durch dilatorische Formelkompromisse seltener werden. Hinzu kommt, dass
Soft Law sofort wirksam wird, also nicht erst durch eine bestimmte Anzahl von
Staaten umgesetzt werden muss, bevor es in Kraft tritt. Schlielich kann Soft
Law leichter neuen Umstnden angepasst werden. Wie schnell sich die normati-
ve Kraft von Soft Law entfaltet, zeigt sich an einer Entscheidung des Europi-
schen Menschenrechtsgerichtshofes (EGMR) vom 07.03.2006 (Evans v. UK).
Diese Entscheidung von 2006 zitiert Art. 6 der Bioethik Deklaration der
UNESCO von 2005 als relevant international texts, European Court of Hu-
man Rights, Case of Evans v. The United Kingdom, Judgement, 07.03.2006, Rn.
23 ff., 41, 42.
25 Nher zu der allgemeinen Unterscheidung von Recht und Ethik auf der
Grundlage der positivistischen Rechtstheorie H.L.A. Harts, vgl. Vneky, Recht,
Moral und Ethik Grundlagen und Grenzen demokratischer Legitimation fr
Ethikgremien, 2010, die Kapitel 1 und 2, 24 ff., 39 ff.
26 Vgl. unter www.wma.net.
136 Vneky

Menschen (sog. Helsinki-Deklaration).27 Die WMA selbst als der


normsetzende Akteur ist ein 1947 gegrndeter Zusammenschluss na-
tionaler rzteverbnde, der 101 nationale Berufsvereinigungen repr-
sentiert;28 das deutsche Mitglied ist die Bundesrztekammer. Die WMA
ist mithin ein privater Verband und kein Vlkerrechtssubjekt und hat
keine Kompetenz Vlkerrecht zu setzen. Darin unterscheidet die WMA
sich von Internationalen Organisationen, wie den Vereinten Nationen
oder der UNESCO.29 Der Weltrztebund ist zudem nicht reprsentativ
zusammengesetzt:30 Es fehlt einerseits an einer ausgewogenen geogra-
phischen Reprsentation der Mitglieder, da ein klares bergewicht der
dem westlichen Kulturkreis zuzurechnenden rztevertreter gegeben
ist. Zudem gilt bei Abstimmungen wie bei Beschlussfassungen ber die
HelsinkiDeklaration das Mehrheitsprinzip, so dass Minderheitenan-

27 Zum ersten Mal wurde sie vom Weltrztebund in Helsinki 1964 verab-

schiedet; sie wurde bisher mehrfach insgesamt sechs Mal revidiert in den
Jahren 1975, 1983, 1989, 1996, 2000 und 2008. Vgl. Declaration of Helsinki, in
WMA (Hrsg.), Handbook of WMA Policies, 2010, abrufbar unter http://www.
wma.net/en/30publications/10policies/HB_E_Print_s.pdf. Die 2000er Deklara-
tion von Edinburgh wurde beispielsweise wegen der zu weitgehenden Zulas-
sung zur Verwendung von placebo-kontrollierten Versuchen berarbeitet. Vgl.
auch Taupitz, Die neue Deklaration von Helsinki, Deutsches rzteblatt 98
(2001), A 2413 ff. Die Helsinki Deklaration ist die bekannteste Deklaration der
WMA; eine Vielzahl weiterer Deklarationen werden jedoch bei den jhrlichen
Mitgliederversammlungen beschlossen und berarbeitet: Bei der letzten WMA
General Assembly in Montevideo/Uruguay im Oktober 2011 waren dies
beispielsweise die Declaration of Montevideo on Disaster Preparedness and
Medical Response, die Declaration on End-of-Life Medical Care, die Declara-
tion on Leprosy Control around the World and Elimination of Discrimination
against persons affected by Leprosy und die Declaration of Edinburgh on
Prison Conditions and the Spread of Tuberculosis and Other Communicable
Diseases (revised), vgl. http://www.wma.net/en/30publications/10policies/inde
x.html und fr eine bersicht aller 23 Deklarationen der WMA im Jahr 2010,
vgl. WMA (Hrsg.), Handbook of WMA Policies, 2010.
28 Stand November 2011; vgl. unter http://www.wma.net/en/60about/10me
mbers/index.html.
29 Die UNESCO ist Sonderorganisation der Vereinten Nationen und besitzt

eigene Rechtspersnlichkeit, vgl. nur Epping, in Ipsen (Hrsg.), Vlkerrecht, 5.


Auflage 2004, 32, Rn. 84 ff.
30 Vgl. dazu ausfhrlich die Untersuchungen von Chang, Ethische und

rechtliche Herausforderungen einer globalisierten Arzneimittelprfung Die


Problematik klinischer Versuche an Menschen in Entwicklungslndern, Kap. 4.
E., 2012, (Dissertation), erscheint demnchst.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 137

sichten leicht berstimmt werden knnen und in der endgltigen Fas-


sung der Deklaration nicht ihren Niederschlag finden.31

b. Materiale Unterscheidung
Zustzlich zu dieser formalen Abgrenzung zum Recht sind ethische
Standards auch inhaltlich zu qualifizieren: Ethik liefert als normative
Ethik, als Reflektionswissenschaft, die Grnde fr die Rechtfertigung
und Legitimation von Handlungsweisen; sie ist, wie Dietmar von der
Pfordten in seinem Buch Rechtsethik schreibt, Rechtfertigungsdiszip-
lin.32 Ethische Standards als normative Standards sind daher solche, die
die zwei ethischen Grundfragen (Wie soll ich handeln? und Warum
ist diese Handlung richtig beziehungsweise falsch?) mit Blick auf das
Richtige prinzipiell unabhngig von der herrschenden Moral und von
dem positiven Recht beantworten wollen.33 Ethisch sind damit Hand-
lungen, die durch berpositive Gerechtigkeits- oder Gltigkeitsmast-
be gerechtfertigt werden knnen.34 Hier zeigt sich unabhngig von
der Frage, ob und inwieweit berpositive Gerechtigkeitsmastbe be-
grndbar sind und begrndet werden mssen (dazu unter 2. unten)
bereits ein erster inhaltlicher Konfliktbereich mit bestehenden vlker-
rechtlichen Normen: Da ethisch nur, aber eben auch alle Handlungen
sind, die durch (zu begrndende) berpositive Gerechtigkeits- oder
Gltigkeitsmastbe gerechtfertigt werden knnen, mssen ethische
Normen, die ethisches Handeln in diesem Sinne vorschreiben, nicht
notwendig mit den bestehenden internationalen Menschenrechten, wie
sie im Vertrags- und Gewohnheitsrecht verrechtlicht sind, berein-
stimmen. Da es auch in der wissenschaftlichen Ethik, anders als in den
Naturwissenschaften,35 eine Vielzahl gut begrndeter Theorien und

31 Ausfhrlich Chang, ibid.


32 Von der Pfordten, Rechtsethik, 1. Aufl. 2001, 54.
33 Vgl. auch Quante, Einfhrung in die Allgemeine Ethik, 2003, 11 f.
34 Zu den deontischen Grundbegriffen ethisch geboten und ethisch rich-
tig, vgl. grundlegend Ross, The Right and The Good, 1930; zu dessen intuitio-
nistischer Theorie vgl. Alexy, Theorie der juristischen Argumentation, 6. Aufla-
ge 2008.
35 Dazu auch unten bei Fn. 47. Betont werden soll hier jedoch, dass es nur

auf den ersten Blick ein kategorialer Unterschied zwischen Naturwissenschaf-


ten und Ethik ist, dass Naturwissenschaften sich mit Tatsachen beschftigen,
Ethik aber mit Werten und Werturteilen. Wenn Max Weber die These der abso-
luten Dichotomie von Tatsachenaussage oder Werturteil vertrat, bedeutet
138 Vneky

Kriterien gibt, aber keinen geteilten paradigmatischen Kern, ist das de-
ontologische und individualrechtliche Paradigma, das in den internatio-
nalen Menschenrechten verrechtlicht wurde, nur eines unter vielen
grundstzlich gleich anerkannten Paradigmen, wie beispielsweise das
utilitaristische, das kontraktualistische und das tugendethische Para-
digma.36 Es ist nicht schwer sich vorzustellen, dass utilitaristisch37 ge-
prgte ethische Standards leicht mit Menschenrechten (d.h. einem ver-
rechtlichtem deontologischen und individualrechtlichen Standard) in
Konflikt gelangen knnen. Will man also inhaltlich (nur) ethische Stan-
dards von verrechtlichten ethischen Standards und dies sind primr
die internationalen menschenrechtlichen Standards unterscheiden, so

dies im Kern, dass nicht von Fakten abhngt, ob etwas gut oder schlecht ist. So
verbreitet diese Auffassung heute immer noch ist, so berzeugend wurde sie in
den letzten Jahren widerlegt. Eindrcklich hat bspw. der Philosoph Hilary Put-
nam belegt, dass Tatsachenaussagen selbst Werte voraussetzen und auch die
Praktiken der wissenschaftlichen Forschung, auf die wir uns bei der Entschei-
dung, ob etwas eine Tatsache ist oder nicht, sttzen, Werte voraussetzen (Put-
nam, Vernunft, Wahrheit und Geschichte, 1990, 173 ff.). Es gibt danach keine
absolute Dichotomie, sondern es muss davon ausgegangen werden, dass Tatsa-
chen wertgeladen sind (vgl. allgemein zu den Kritikern der Wert/Tatsache Tren-
nungsthese, Schaber, Stichwort: Wert/Tatsache, in Gosepath/Hinsch/Rssler
(Hrsg.), Handbuch der politischen Philosophie und Sozialphilosophie, Band 2,
2008, 1469 ff., 1470 f.). Deutlich wird dies, wenn nochmals der Wissenschafts-
begriff nher untersucht wird. Es geht in der Wissenschaft zwar formal um
Wahrheit. Was aber Wahrheit ist, ist unklar, solange nicht klar ist, welche
Kriterien rationaler Akzeptierbarkeit entscheidend sein sollen. Ziel der Wissen-
schaft ist der Versuch, eine Reprsentation der Welt zu konstruieren, die
Kennzeichen der instrumentellen Leistungsfhigkeit, der Kohrenz, der Voll-
stndigkeit und funktionalen Einfachheit besitzt. Diese Mastbe der rationa-
len Akzeptierbarkeit (oder Rationalitt in einem engen Sinn) sind aber gleich-
zeitig (kognitive) Werte. Die empirische Welt hngt daher von unseren Werten
ab (so dezidiert Putnam, Vernunft, Wahrheit und Geschichte, 1990, 181 ff.; n-
her Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demokrati-
scher Legitimation fr Ethikgremien, 2010, 81 f.).
36 Nher insgesamt Nida-Rmelin, Theoretische und angewandte Ethik: Pa-
radigmen, Begrndungen, Bereiche, in ders. (Hrsg.), Angewandte Ethik Die
Bereichsethiken und ihre theoretische Fundierung, 2. Auflage 2005, 2 ff.
37 Utilitarism can most generally be described as the doctrine which states
that the rightness or wrongness of actions is determined by the goodness and
badness of their consequences., vgl. Smart, Utilitarism, in Edwards (Hrsg.),
The Encyclopedia of Philosophy, Bd. 8, 1967, 206; dazu auch Nida-Rmelin,
Theoretische und angewandte Ethik: Paradigmen, Begrndungen, Bereiche,
aaO, 2, 8 ff.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 139

wird es immer dann Konfliktpotential und Gefahren fr das bestehende


Vlkerrecht geben, wenn diese ethischen Standards nicht mit den inter-
nationalen Menschenrechten oder zwingendem Vlkerrecht (ius co-
gens)38 bereinstimmen.
Dass dieses Konfliktpotential in der internationalen Debatte zumindest
im Biomedizinrecht gesehen wird, zeigt beispielsweise das Entstehen
und der Wortlaut der UNESCO-Erklrung ber Bioethik und Men-
schenrechte (Universal Declaration on Bioethics and Human Rights).39
Schon der Titel der Erklrung, der Bioethik und Menschenrechte
unterscheidet, zeigt, dass eine inhaltliche Differenz zwischen beiden be-
steht oder doch zumindest von den Verfassern zu denen auch der Bio-
ethikrat (Internationaler Ausschuss fr Bioethik: International Bi-
oethics Committee, IBC) der UNESCO gehrte vorausgesetzt wird.40
Auch inhaltlich zeigt sich an einigen Bestimmungen der Deklaration,
wie utilitaristische (bioethische) Prinzipien von Menschenrechten ein-
gehegt werden sollen. So heit es in Art. 3 lit. b dieser UNESCO-
Erklrung:
The interest and welfare of the individual should have priority over
the sole interest of science or society.
Aus menschenrechtlichem Blickwinkel betrachtet scheint erstaunlich,
dass dieser Grundsatz berhaupt niedergelegt werden muss. Zudem
scheint damit das menschenrechtliche Regel-Ausnahme Verhltnis ver-
kehrt worden zu sein: menschenrechtlich ist der Grundsatz das Beste-
hen der individuellen Rechte, wie das Recht auf Leben und krperliche
Unversehrtheit, und in diese darf auch zum Wohle der Gesellschaft
ausnahmsweise nur eingegriffen werden, wenn dieser Eingriff gerecht-
fertigt werden kann, das heit verhltnismig mit Blick auf ein be-
stimmtes legitimes Ziel ist. Zudem erscheint schwer verstndlich, wie
abgeschwcht nach dem Wortlaut des Art. 3 (1) UNESCO-Erklrung
der Vorrang des Wohlergehens des einzelnen Menschen nur verankert
wird: Es wird nur niedergelegt, dass die Interessen (nicht die Rechte)
des Individuums Vorrang haben sollten (nicht sollen: should und

38 Zu diesem Begriff allgemein, statt anderer nur Verdross/Simma, Univer-

selles Vlkerrecht, 3. Aufl. 1984, 1263.


39 Vgl. oben Fn. 16.
40 Zur Entstehungsgeschichte der Deklaration und dem mageblichen Ein-
fluss des Ethikrates der UNESCO (IBC) im Unterschied zu den Staatenvertre-
tern, vgl. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-
kratischer Legitimation fr Ethikgremien, 2010, 370 ff.
140 Vneky

nicht shall), und dies auch nur gegenber den reinen (sole) Interes-
sen von Wissenschaft und Gesellschaft.

2. Notwendigkeit und Grenzen der Begrndetheit und


Begrndbarkeit berpositiver ethischer Standards

Wird im Folgenden von berpositiven ethischen Standards gesprochen,


muss jedoch vor einer weiteren inhaltlichen Debatte zunchst die hier
vertretene metaethische Position benannt werden: Es stellt sich die Fra-
ge, ob heute, vor dem Hintergrund einer pluralistischen Weltgemein-
schaft, berhaupt sinnvoll von berpositiven ethischen Standards ge-
sprochen werden kann oder ob jeder Rekurs auf berpositive Hand-
lungsstandards ein Rekurs auf zufllige, relative Werte und Prinzipien
ist. Meine These ist hier eine kognitivistische:41 Ziel ethischer Begrn-
dungen ist es danach, von Meinung zu Wissen zu gelangen.42 Ethische
Begrndungsversuche tragen damit dem Anspruch rationaler Wesen
Rechnung, selbst einsichtig und selbst urteilend, d.h. autonom, ethische
Forderungen als legitim anzunehmen oder abzulehnen.43 Setzt man die-
ses Menschenbild der Aufklrung voraus, sind zur Legitimation ethi-
scher Ansprche gegenber anderen Menschen gute Begrndungen er-
forderlich, d.h. rationale Rechtfertigungen, die keine kausalen Erkl-
rungen sind.44

41 Dazu, warum nonkognitivistische und relativistische Theorien meines Er-

achtens nicht berzeugen, vgl. Vneky, Recht, Moral und Ethik Grundlagen
und Grenzen demokratischer Legitimation fr Ethikgremien, 2010, 72 ff.
42 Hier ist nach meiner Auffassung kein Unterschied zu anderen Wissen-

schaften erkennbar. Anderer Ansicht aber Toulmin, An Examination of the


Place of Reason in Ethics, 1950, 127, der davon ausgeht, dass das Wesen morali-
schen (hier: ethischen) Argumentierens sei, dass die unreflektiert ausgesproche-
nen moralischen Empfindungen modifiziert werden; danach wre die Funktion
von Ethik und (anderen) Wissenschaften unterschiedlich: Ethics is concerned
with the harmonious satisfaction of desires and interests.; ibid., 137, 223. Kri-
tisch und differenzierend zu Toulmins These auch Alexy, Theorie der juristi-
schen Argumentation, 1991, 117 ff.
43 Quante, Einfhrung in die allgemeine Ethik, 2003, 145.
44 Quante, ibid. Zu bedenken ist dabei, dass es ein Sollen-implizierendes
Faktum ist, dass etwas rational ist, vgl. Putnam, Pragmatism and Moral Objec-
tivity, in ders. (Hrsg.), Words and Life, herausgegeben von Conant, 1994, 151
ff., 167 f.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 141

Darzulegen, dass, wie ich vertrete, ethische Aussagen begrndungs-


oder wahrheitsfhige Aussagen sind und nicht nur Scheinaussagen oder
Gefhlsuerungen, Empfehlungen oder Imperative, wrde den hier
vorgegebenen Rahmen sprengen.45 Aus an anderer Stelle gemachten
Ausfhrungen folgt meines Erachtens zudem, dass berzeugende Ma-
stbe rationaler Akzeptierbarkeit auch fr ethische Positionen und
Standards bestehen.46 Dies bedeutet wiederum, dass auf der Grundlage
von Begrndungen bessere von schlechteren ethischen Positionen un-
terschieden werden knnen.47 Die These, alle ethischen Annahmen sei-
en gleich gut oder gleich schlecht begrndet und ethische Einstellungen

45 Vgl. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-

kratischer Legitimation fr Ethikgremien, 2010, Kapitel 2 III.


46 Dies bedeutet nicht, dass es keine Unterschiede zwischen Naturwissen-

schaften und Ethik als Wissenschaft gibt: Naturwissenschaftliche Theorien


besitzen einen von einer Forschergemeinschaft geteilten paradigmatischen Kern
und eine etablierte Methodik bzw. experimentelle Prfungsverfahren. In der
Ethik gibt es hingegen wie oben dargelegt eine Vielzahl von Theorien und
Kriterien, aber gerade keinen geteilten paradigmatischen Kern. Es wird daher in
der philosophischen Ethik, wie auch in der alltglichen Ethik, mehr als in na-
turwissenschaftlichen Fragen, notwendig Flle des Dissenses geben, in denen es
keine Mglichkeit gibt, die Meinungsverschiedenheiten beizulegen (vgl. nur
Posner, The Problematics of Moral and Legal Theory, 1999, 62 f.; Putnam, Ver-
nunft, Wahrheit und Geschichte, 1990, 218). Daraus folgt, dass Expertenrat im
Bereich der Ethik, auch wenn er wissenschaftlich und rational ist, immer andere
Voraussetzungen und auch Folgen haben wird, als Expertenrat im Bereich der
Naturwissenschaften. Kein entscheidender Unterschied gegenber den Natur-
wissenschaften ist jedoch, dass es auf manche ethische Fragen keine bestimmte
Antwort gibt. Ein ethisch (objektiv) unbestimmter Fall liegt beispielsweise vor,
wenn die Alternativen, die fr eine Handlung zur Verfgung stehen, so
schrecklich sind, dass ein rationaler Mensch nicht klar erkennen kann, fr wel-
che er sich entscheiden soll, vgl. Williams, Der Begriff der Moral, Eine Einfh-
rung in die Ethik, 1978. Auch gibt es Flle von Kontextrelativitt, in denen also
ein bestimmtes Handeln gerade durch den speziellen Kontext bestimmt wird.
Gleiches gilt aber auch fr naturwissenschaftliche Fragen und Antworten.
Nicht jede naturwissenschaftliche Frage hat eine bestimmte Antwort; auch hier
gibt es Antworten, die abhngig vom Kontext sind (Putnam, Vernunft, Wahr-
heit und Geschichte, 1990, 199 f.). Nicht berzeugend und vereinfachend dage-
gen Mohr, Wissen Prinzip und Ressource, 1999, 133, der vertritt, dass Wider-
sprche in naturwissenschaftlichen Fragen zwischen Experten nur dann vorlie-
gen knnen, wenn einer der Wissenschaftler mehr behauptet, als er wissen-
schaftlich beweisen kann.
47 Vgl. nur Putnam, Vernunft, Wahrheit und Geschichte, 1990, 280.
142 Vneky

damit eine Sache der Willkr oder des Zufalls, ist danach nicht mehr
haltbar.
Wichtig ist jedoch, dennoch zwischen verschiedenen Graden der Be-
grndetheit von ethischen Positionen zu unterscheiden: Die strkste
Form der Begrndetheit wren nicht gute, sondern unbezweifelbare
Grnde. Wren fr eine ausreichende Begrndung ethischer Positionen
unbezweifelbare Grnde erforderlich, wre das Projekt der Begrn-
dung ethischer Positionen gescheitert. Grundstzlich sind alle Grnde
fr ethische Positionen bezweifelbar, eine unbezweifelbare Letzt-
begrndung ist unmglich.48 Einen solchen unerfllbaren Standard fr
ethische Begrndungen zu fordern, wrde jedoch unserer Alltagserfah-
rung widersprechen, wonach wir, auch wenn es keine Letztbegrndung
gibt, dennoch gute von schlechteren ethischen Theorien und Argumen-
ten auf der Grundlage der allgemeinen Mastbe rationaler Akzeptier-
barkeit, wie instrumentelle Leistungsfhigkeit, Widerspruchsfreiheit,
Kohrenz, Vollstndigkeit und funktionale Einfachheit, unterscheiden.
Dass es dabei nicht die Mglichkeit gibt, alle Meinungsverschiedenhei-
ten in ethischen Fragen beizulegen, also einen Konsens zu erzielen oder
wenn schon kein Konsens erreicht werden kann zumindest eine
Mehrheit zu berzeugen, widerlegt nicht, dass es dennoch bessere und
schlechtere Grnde gibt.49 berzeugend kann daher nicht sein, unbe-
zweifelbare Grnde zu fordern oder weil und wenn dies scheitert
ethische Begrndungen ganz als sinnlos abzulehnen. berzeugend ist
vielmehr, erfllbare und angemessene Standards fr ethische Begrn-
dungen zu entwickeln. Das bedeutet zum einen, dass ethische Wissens-
ansprche nicht deshalb als unbegrndet gelten knnen, weil sie sich im
Prinzip als falsch erweisen knnen.50 Und es bedeutet zum anderen,
dass, wenn es in einer pluralistischen Gesellschaft, auch und gerade in
einer pluralistischen Weltgesellschaft, Dissense ber ethische Prinzipien
und Wertfragen gibt, dieses kein metaphysisches bzw. kein epistemolo-
gisches Problem ist, sondern eine politische Aufgabe.51

48 Birnbacher, Fr was ist der Ethik-Experte Experte?, in Rippe (Hrsg.),


Angewandte Ethik in der pluralistischen Gesellschaft, 1999, 267 ff., 273; Put-
nam, Pragmatism and Moral Objectivity, in ders. (Hrsg.), Words and Life, he-
rausgegeben von Conant, 1994, 151 ff., 152.
49 Putnam, Vernunft, Wahrheit und Geschichte, 1990, 218, 236.
50 Quante, Einfhrung in die allgemeine Ethik, 2003, 159.
51 So deutlich John Dewey, vgl. Putnam, Pragmatism and Moral Objectivity,
in ders. (Hrsg.), Words and Life, herausgegeben von Conant, 1994, 155. Auch
Richard Rorty betont, dass es nicht ausreiche, die Idee eines truth forcing con-
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 143

III. Ethikgremien im Vlkerrecht

Das komplexe Zusammenspiel von Ethik und Vlkerrecht soll im Fol-


genden anhand eines Beispiels nher dargelegt werden: Hier geht es um
die Zulssigkeit des Einsatzes von Ethikgremien im Vlkerrecht.
Die Zulssigkeit des Einsatzes von Ethikgremien bei der Generierung
von Vlkerrecht erscheint wesentlich unproblematischer als der Einbe-
zug von nicht-rechtlichen Ethikkodizes. Praktisches Anschauungsbei-
spiel ist der stndige Ethikrat auf internationaler Ebene der Internatio-
nale Ausschuss fr Bioethik (IBC), der 1993 von der UNESCO einge-
richtet wurde.52 Er ist der einzige vlkerrechtlich verankerte globale
Ethikrat fr bioethische Fragen53 und besteht aus 36 unabhngigen Ex-
perten. Faktisch ist und war dieser Ethikrat einflussreich: Er wirkte we-
sentlich mit an den UNESCO-Deklarationen im Bereich der Lebens-
wissenschaften, etwa an der Erklrung ber das menschliche Genom
(1997), der Erklrung zum Schutz genetischer Daten (2003) und der
Erklrung ber Bioethik und Menschenrechte (2005).54 Diese von ihm
mitverfassten Erklrungen der UNESCO sind, wie oben gesagt, dem

sensus aufzugeben, sondern dass die bloe Tatsache des Bestehens oder Nicht-
Bestehens eines Konsenses sei es ber naturwissenschaftliche oder ber mor-
alische Fragen eher soziologisch als epistemologisch erklrt werden msse:
To explain the absence of consensus by lack of cognitive status is like explain-
ing a substances failure to put you to sleep by its lack of dormitive power, vgl.
Rorty, Dewey and Posner on Pragmatism and Moral Progress, University of
Chicago Law Review 74 (2007), 915 ff., 921. Dagegen Posner, The Problematics
of Moral and Legal Theorie, 1999, 62 f.
52 Zur nheren Ausgestaltung vgl. das Statut des IBCs, Statutes of the Inter-

national Bioethics Committee, adopted by the Executive Board at its 154th Ses-
sion, on 7 May 1998, Art. 1 12; abrufbar unter http://unesdoc.unesco.
org/images/0013/001382/138292e.pdf.
53 Aufgabe des IBCs ist das Verfassen von Stellungnahmen und Empfehlun-

gen (advice and recommendations) ber neue ethische Fragen der Biologie und
Medizin (vgl. Art. 7 iVm Art. 2 IBC-Statut). Entsprechend Art. 24 der UNES-
CO-Erklrung ber das menschliche Genom gehrt dazu auch, dass der IBC
ber das menschliche Genom Empfehlungen fr die Generalversammlung erar-
beitet und beratend hinsichtlich der Folgemanahmen zu dieser Erklrung ttig
wird. Schlielich soll der IBC entsprechend dieses Artikels Praktiken identifi-
zieren, die der Menschenwrde widersprechen. Art. 2 (1) (d) (i) (iii) IBC-
Statut in Verbindung mit Art. 24 UNESCO-Erklrung ber das menschliche
Genom.
54 Vgl. dazu oben Fn. 16.
144 Vneky

vlkerrechtlichen Soft Law zuzurechnen, knnen damit entscheidende


normative Kraft entfalten55 und so wiederum nicht nur die weitere
Entwicklung des Vlkerrechts beeinflussen, sondern auch auf das sup-
ranationale Recht und das nationale Recht der Mitgliedstaaten einwir-
ken.56
Ein solches Ethikgremium kann im Vlkerrecht nach dem Prinzip der
souvernen Gleichheit der Staaten im Rahmen einer Internationalen
Organisation nur eingesetzt werden, wenn sein Einsatz nicht den Statu-
ten dieser Organisation widerspricht und damit letztlich nicht dem Wil-
len der Staaten, die Mitglieder der Organisation sind. Grundstzlich
wird dies bedeuten, dass alle Mitgliedstaaten (unter Umstnden) tur-
nusmig berechtigt sein mssen, die Mitglieder eines Ethikgremiums
vorzuschlagen und diese zu bestimmen und dass zudem die geographi-
sche Reprsentativitt der Mitglieder gewahrt sein muss; zudem wird,
will man es als Expertengremium legitimieren, als ein Element der Out-
put-Legitimation die fachliche Kompetenz der Mitglieder und deren
Unabhngigkeit von dem Willen der Entsendestaaten entscheidend sein.
Vorliegend sind diese Voraussetzungen fr den IBC erfllt: Die 36 Mit-
glieder des IBCs werden auf Vorschlag der Mitgliedstaaten vom Gene-
raldirektor der UNESCO ernannt (Art. 3 (1), (2) IBC-Statut). Die An-
forderungen, die an die Mitgliedstaaten gestellt werden, wenn sie Kan-
didaten fr den IBC vorschlagen, sind dabei wenig bestimmt formu-
liert, um den Staaten weite Einflussmglichkeiten zu belassen. Die Staa-
ten sollen sich nur bemhen (shall endeavour), bei ihren Vorschlgen
hervorragende Personen einzubeziehen, die Experten im Bereich der
Lebens-, Sozial- oder Humanwissenschaften (human sciences) sind,
einschlielich der Rechtswissenschaften und Menschenrechte, Philoso-

55 Zur Normativitt von Soft Law im Vlkerrecht, vgl. oben Fn. 18.
56 Vneky, Rechtsfragen der Totalsequenzierung des menschlichen Genoms
in internationaler und nationaler Perspektive, Freiburger Informationspapiere
zum Vlkerrecht und ffentlichen Recht, FIP 4/2012, 6 ff, abrufbar unter
fiponline.de. Dazu auch Nys, Towards and International Treaty on Human
Rights and Biomedicine?, European Journal of Health Law 13 (2005), 5 ff., 8.
Wegen dieser normativen Kraft hat Deutschland beispielsweise auch eine
Stimmerklrung (explanation of vote) zur Erklrung ber Bioethik und Men-
schenrechte und deren Bestimmung insbesondere der gruppenntzigen For-
schung an nichteinwilligungsfhigen Personen (Art. 4, 7 und 9) abgegeben, in
der Deutschland die besondere Schutzbedrftigkeit nichteinwilligungsfhiger
Personen betont; abgedruckt in Deutsche UNESCO-Kommission (Hrsg.),
Allgemeine Erklrung ber Bioethik und Menschenrechte Wegweiser fr die
Internationalisierung der Bioethik, 2006, 24 ff.
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 145

phie, Erziehungswissenschaften und Kommunikationswissenschaften


(Art. 3 (2) IBC-Statut).57 Sie sollen sich zudem bemhen, Kandida-
ten mit der notwendigen Kompetenz und Autoritt vorzuschlagen.58
Diese weichen Formulierungen zeigen, dass den Staaten ein weiter Be-
urteilungsspielraum bei ihren Vorschlge bleibt und dass wissenschaftli-
che Fachexzellenz zwar gewnscht, aber keine notwendige Bedingung
ist. Zudem zeigt die Aufzhlung der genannten Wissenschaften, dass
Multidisziplinaritt der Mitglieder und damit die Interdisziplinaritt
des Gremiums gewahrt werden soll.
Anders als bei den deutschen nationalen Ethikrten mit Blick auf die
Bundeslnder59 soll die Ernennung der Mitglieder des IBCs jedoch un-
ter Bercksichtigung kultureller Diversivitt und ausgewogener geo-
graphischer Reprsentativitt erfolgen. Zudem soll die Notwendigkeit,
eine angemessene Rotation zwischen den Staaten sicherzustellen in Be-
tracht gezogen werden (Art. 3 (1) 2 IBC-Statut).60 Zu der damit ange-
strebten geographischen und kulturellen Ausgewogenheit gehrt auch,
dass nicht mehr als ein Angehriger eines Staates zur gleichen Zeit er-
nannt werden soll (Art. 3 (3) IBC-Statut). Deutlich wird durch das
IBC-Statut, dass alle der 19661 Mitgliedstaaten der UNESCO in glei-
chem Ma das Recht besitzen, in ausgewogenem Verhltnis Experten in
den IBC zu entsenden; dies gilt auch fr die Lnder, die bisher keine
aktive Forschung im Bereich der Biomedizin oder Bioethik betreiben.
Durch diese Regelung soll verhindert werden, dass die bioethische De-
batte und Normsetzung einseitig durch die Industrielnder und entwi-
ckelten Staaten erfolgt.
Neben der Multidisziplinaritt und kulturellen Pluralitt, die bereits
oben benannt wurden, zeichnet sich der IBC durch seine Unabhngig-

57 When proposing their candidates for the IBC, states shall endeavour to

include eminent persons who are specialists in the life sciences and in the social
and human sciences, including law, human rights, philosophy, education and
communication, with the necessary competence and authority to perform the
IBC`s duties.
58 Ibid.
59 Zum Deutschen Ethikrat und dessen Vorgnger, dem Nationalen Ethik-
rat, Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demokrati-
scher Legitimation fr Ethikgremien, 2010, 240 ff.
60 [] When making his choice, the Director-General shall take into ac-

count cultural diversity, balanced geographical representation and the need to


ensure appropriate rotation. [].
61 Stand: April 2012.
146 Vneky

keit aus. Nach den Vorgaben des Statuts sind die Mitglieder unabhngig
und handeln in ihrer persnlichen Kapazitt (Art. 3 (1) 2 IBC-Statut).62
Die Unabhngigkeit des IBCs als Gremium zeigt sich daran, dass er
sich selbst eine Geschftsordnung (Art. 8 IBC-Statut)63 gibt und seinen
Vorsitzenden whlt.64 Schlielich kann der IBC grundstzlich sein eige-
nes Arbeitsprogramm bestimmen. Diese thematische Unabhngigkeit
ist nur insoweit eingeschrnkt, als Vorschlge des Generaldirektors und
des Exekutivrats aufgenommen werden mssen65 (Art. 2 (2) IBC-
Statut).66
Bemerkenswert ist jedoch, dass sich im IBC-Statut keine ausdrckli-
chen Vorgaben zu dem materiellen normativen Rahmen finden, in dem
der IBC agieren und seine Empfehlungen und Stellungnahmen abfassen
soll. Eine solche inhaltliche Legitimation schien der UNESCO nicht er-
forderlich, zumindest nicht ausdrcklich erwhnenswert. Diese inhalt-
lichen Vorgaben, der rechtliche Bezugsrahmen, muss daher aus der
Aufgabe des IBCs abgeleitet werden:
Seine Aufgabe ist, zur Verbreitung der Prinzipien beizutragen, die in
der von der UNESCO angenommenen Erklrung ber das menschliche

62 Um eine gewisse personelle Kontinuitt ohne eine zu weitgehende Verfes-


tigung der Mitgliederstruktur zu gewhrleisten, werden die Mitglieder des IBCs
fr eine Dauer von vier Jahren berufen mit der Mglichkeit der nur einmaligen
Wiederernennung (Art. 6 (1) (3) IBC-Statut).
63 Das Statut des IBCs selbst kann jedoch durch den UNESCO-Exekutivrat

gendert werden (Art. 12 IBC-Statut).


64 Die Wahl erfolgt alle zwei Jahre.
65 Vorschlge des Intergovernmental Bioethics Committee (IGBC) mssen
dagegen nur in Betracht gezogen werden (shall take into account) (Art. 2 (2) 2
IBC-Statut).
66 Allerdings wird diese Ausrichtung auf die Fachexpertise prozedural wie-

der eingegrenzt: Fr das Verfahren nach der Abfassung der Stellungnahmen


und Empfehlungen gilt, dass seit 1998 durch das IBC-Statut bestimmt wird,
dass dem IBC als unabhngigem, interdisziplinrem Expertengremium ein
ebenfalls auf bioethische Fragen spezialisiertes Gremium bestehend aus Vertre-
tern der Mitgliedstaaten zur Seite gestellt wird (Art. 11 (1) IBC-Statut). Dieser
Zwischenstaatliche Ausschuss fr Bioethik (Intergovernmental Bioethics
Committee, IGBC) besteht aus Reprsentanten von 36 Mitgliedstaaten, die von
der Generalkonferenz gewhlt werden. Auch bei der Wahl der Mitglieder des
IGBCs sollen kulturelle Diversitt, ausgewogene geographische Reprsentation
und die Notwendigkeit angemessener Rotation in Betracht gezogen werden
(Art. 11 (3) IBC-Statut).
Grundlagen und Grenzen der Ethisierung des Vlkerrechts 147

Genom und, wie ergnzt werden muss, in den anderen UNESCO-


Erklrungen zur Bioethik niedergelegt sind (Art. 2 (1) (d) (i) IBC-
Statut).
Durch diese Bindung des IBCs an das Soft Law der UNESCO und da-
durch, dass der IBC als Gremium der UNESCO agiert, folgt meines
Erachtens zwingend, dass der IBC nur im Rahmen der vlkerrechtlich
anerkannten Menschenrechte argumentieren kann und soll.67
Zudem bedeutet die Pflicht zur Verbreitung der in den UNESCO-
Erklrungen niedergelegten Prinzipien eine Bindung des IBCs selbst.
Soll der IBC diese Prinzipien verbreiten, muss notwendig sein eigener
normativer Bezugsrahmen auch durch diese Prinzipien vorgegeben
sein. Durch jede der bestehenden UNESCO-Erklrungen im Bereich
der Bioethik wird der normative Bezugsrahmen des IBCs daher weiter
konkretisiert.

IV. Fazit

Soziologisch verstanden ist typisch fr soziale Kontrolle in modernen


Gesellschaften, dass de facto der ethische Vorwurf also: der Vorwurf:
Du handelst verwerflich! durch den Bezug auf das geltende Recht,
also durch ein: Du handelst rechtswidrig! ersetzt wird.68 Nach Luh-
mann liegt in diesem Bezug auf das geltende Recht gerade ein Freiheits-
gewinn und eine Friedensfunktion des Rechts.69 Es ist fraglich, ob auch

67 Entsprechend findet sich in der Prambel der Erklrung ber das mensch-
liche Genom ausdrcklich u.a. das Bekenntnis zu den allgemeinen Grundstzen
der Menschenrechte, insbesondere der Bezug auf die Allgemeine Erklrung der
Menschenrechte von 1948, die beiden Internationalen Menschenrechtspakte der
Vereinten Nationen von 1966 und weitere internationale Menschenrechtsver-
trge. Dies gilt entsprechend fr die Erklrung zum Schutz genetischer Daten
und die Erklrung ber Bioethik und Menschenrechte. In Artikel 2 der Er-
klrung ber das menschliche Genom wird, wie in Art. 1 der Erklrung zum
Schutz genetischer Daten und Art. 3 der Erklrung ber Bioethik und Men-
schenrechte, ausdrcklich auch im operativen Teil die Achtung der Menschen-
wrde und Menschenrechte anerkannt, vgl. oben Fn. 16.
68 Van den Daele/Mller-Salomon, Die Kontrolle der Forschung am Men-
schen durch Ethikkommissionen, 1990, 43.
69 Luhmann, Soziologie der Moral, in ders./Pfrtner (Hrsg.), Theorietech-
nik und Moral, 1978, 8 ff.; vgl. auch ders., Das Recht der Gesellschaft, 1993,
124 ff.
148 Vneky

fr das Vlkerrecht gilt, was fr die nationalen Rechtsordnungen und


die Europarechtsordnung klarer scheint: Dass diese Friedensfunktion
eingeschrnkt und gefhrdet werden knnte, wenn es zunehmend zu
einer Ethisierung des Rechts kommt und es im Zuge dessen erforderlich
wird, Handlungen auch ethisch zu bewerten bzw. Ethikgremien Ein-
fluss auf die Setzung von Vlkerrecht zuzugestehen.
Eine ffnung des Vlkerrechts fr ethische Wertvorstellungen wider-
spricht nicht per se dem Charakter der Vlkerrechtsordnung, die be-
trachtet man die Charta der Vereinten Nationen als normativ prgend
fr die Vlkerrechtsordnung insgesamt heute Gerechtigkeits- und
Friedensordnung im weitesten Sinne sein will. Das Vlkerrecht stellt
sich trotz seines Beitrages zur Verrechtlichung der Grund- und Men-
schenrechte und der grundstzlichen Trennung des positiven Rechts
nach Art. 38 IGH-Statut von der Ethik als Gerechtigkeitsordnung dar,
die den Anspruch erhebt, Grundpfeiler einer ethischen, positiv-
rechtlichen Ordnung zu sein. Dass dieser Anspruch auch fr eine plura-
listische Ordnung, in der es an einer fr alle offensichtliche Natur-
rechtsordnung fehlt, nicht verfehlt ist, habe ich oben versucht zu be-
grnden. Gerade fr das Vlkerrecht gilt jedoch: In einer durch die
menschenrechtlichen Freiheiten geprgten Ordnung kann eine poten-
tiell auch menschenrechtsbeschrnkende Ethik nur mit Augenma ver-
folgt werden.
Bioethics and Human Rights Wherever the
Twain Shall Meet
Henk ten Have

I. Introduction

Bioethics nowadays is characterized by a growing approximation to in-


ternational human rights law. This is due to the recent globalization of
bioethical discourse, following the internationalization of medical re-
search and healthcare. New global moral problems have emerged that
require a common approach around the world. Potters initial concep-
tion of bioethics is today more and more reality, combining the tradi-
tional medical ethical focus on the individual with a focus on social and
cultural dimensions, as well as with environmental concerns. At the
same time, the efforts of international organizations, such as UNESCO,
have created a universal framework of bioethical principles adopted by
all countries. The interconnections between the rise of global bioethics
and human rights discourse will be explored in this contribution.

II. The Globalization of Bioethics

In 1988, the American cancer researcher Van Rensselaer Potter argued


that we need a global bioethics to broaden the scope of bioethics to real
concerns about the environment and the future of humankind.1 An im-
portant intellectual source of inspiration for Potter, especially in his
early publications, was the work of the French geologist and Jesuit Pi-

1 V.R. Potter, Global Bioethics: Building on the Leopold Legacy, East


Lansing: Michigan State University Press, 1988.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 149
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_7, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
150 ten Have

erre Teilhard de Chardin.2 He recognized that Teilhard like him was in-
terested in the problem of human progress. They shared the view that
human progress is the goal of the universe, that we should try to bring
about the best possible future and that the best way to do this is to
combine the science of biology with human values. At the same time
there are significant differences between the views of Teilhard and Pot-
ter. Although they both have an evolutionary perspective, their objec-
tives are different. Potter is primarily interested in solving problems.
His approach is pragmatic in addressing major issues that endanger the
survival of humankind. Teilhards emphasis is on understanding and de-
veloping a vision. The basic question for him is the place of the human
being in the universe. For Potter, the basic concern is the survival of
humankind, so that we need to direct bioethics on imagining solutions
that can prevent future disaster. Instead of developing a new encom-
passing vision, Potter primarily emphasizes the need for interdiscipli-
nary cooperation on the basis of which new visions may be created.3
Potter was the first to introduce the concept of bioethics in 1970 as a
new interdisciplinary effort to combine scientific knowledge and moral
wisdom.4 But he became increasingly dissatisfied with the development
of contemporary bioethics. As an extension of medical ethics, it is pri-
marily focused on medical issues and medical technology.5 This orienta-
tion of bioethics is at odds with Potters conception. First, it is con-
cerned with the perspective of the individual patient: how can individ-
ual lives be enhanced, maintained, and prolonged through the applica-
tion of medical technologies? Second, it is exclusively interested in the
short-term consequences of medical and technological interventions.
Although Potter concedes that medical bioethics has a broader ap-

2 Potter made a reference to this work in the Preface of his 1971 book, ex-
plaining that he started to study it in 1964. He also mentioned some of Teil-
hards books at the end of his 1970 article. In 1968, Potter published an article
on Teilhard, later included as Chapter 2 in his 1971 book.
3 V.R. Potter, Society and Science: Can Science Aid in the Search for So-
phistication in Dealing with Order and Disorder in Human Affairs?, 146 Sci-
ence 1964, 1018-1022.
4 V.R. Potter, Bioethics, the Science of Survival, 14 Perspectives in Biology
and Medicine 1970, 127-153.
5 V.R. Potter, Aldo Leopolds Land Ethics Revisited: Two Kinds of Bio-
ethics, 30(2) Perspectives in Biology and Medicine 1987, 157-169. According to
Potter, the original term bioethics was restricted to the medical application
by the people at Georgetown University.(O.c., 159).
Bioethics and Human Rights Wherever the Twain Shall Meet 151

proach than traditional medical ethics, it is still too narrow to address


what are, in his view, the basic and urgent ethical problems of human-
kind today: population growth, war and violence, pollution and envi-
ronmental degradation, and poverty. He regards these problems as
threats to the survival of humankind, and their urgency induces a grow-
ing concern regarding the future. In order to adequately address these
problems, according to Potter, a new science of survival is necessary,
namely bioethics. Since contemporary bioethics is not generating new
perspectives and new syntheses, Potter wants to re-emphasize the con-
cern for the future of the human species by qualifying the terminology.
What we currently have is medical bioethics. It needs to be combined
with ecological bioethics. This dichotomy can be transcended in a new
synthetic approach called global bioethics.
Recently, especially since 2000, bioethical discourse is more and more
characterized by a global perspective. Following the global dissemina-
tion of science and technology, bioethics has been internationalized.
Medical research is increasingly multi-centered and international, and
more and more research subjects are being recruited in developing
countries. But although healthcare practices are global, guidelines and
legal contexts differ from country to country and are sometimes absent.
Rules for transplantation and procedures for organ donation, for exam-
ple, vary among countries, and these different approaches have led to
abuses such as organ trafficking and commodification of transplanta-
tion practices. Furthermore, the burdens and benefits of scientific and
technological advances are not equally distributed. Poorer countries
risk being excluded from the benefits of biomedical progress. There also
is a danger that double-standards, or at least different moral standards,
are being applied in different regions of the world.
Potter has argued (referring to environmentalist Aldo Leopold) that
there are three stages in the development of ethics.6 The first stage con-
cerns the relation between individuals, the second stage the relation be-
tween individual and society, and the third stage, which does not yet ex-
ist, deals with the relation of human beings with their environment, i.e.,
the land and the animals and plants growing upon it. The evolution of
ethics in the context of healthcare reflects this pattern: developing from
medical ethics into healthcare ethics and medical bioethics, we are wit-
nessing today the emergence of global bioethics.

6 V.R. Potter, Bioethics: Bridge to the Future, Englewood Cliffs, New Jer-
sey: Prentice-Hall, 1971.
152 ten Have

In Potters vision, global bioethics will unite two meanings of the word
global.7 First, it is a system of ethics with a worldwide scope. Second,
it is unified and comprehensive. Given the growing reality of global
bioethics, the fact that it is a worldwide ethics can again have two mean-
ings: international or planetary. Bioethical issues and concerns tran-
scend national boundaries. But global bioethics goes beyond interna-
tional bioethics; it is not merely a matter of crossing borders, but con-
cerns the planet as a whole. Bioethical discourse is not limited to trans-
national territories (for example, the European Union), but has become
necessarily supra-territorial. Bioethics nowadays is relevant to all coun-
tries and takes into account the concerns of all human beings wherever
they are. While bioethics emerged in Western countries, it has expanded
globally. There is now a new social space, not simply a collection of
countries, regions, and continents that challenges bioethical discourse.
Potters second meaning of global refers to bioethics as more encom-
passing and comprehensive, combining traditional professional (medical
and nursing) ethics with ecological concerns and the larger problems of
society. Indeed, many scholars argue that a clear separation between
bioethics and environmental ethics is no longer tenable.8
Another way of defining the global in global bioethics is through is-
sues and methods. Firstly, todays bioethical problems such as pandem-
ics, organ trade, international clinical trials, climate change, obesity,
malnutrition, and food production are global in nature. Global bio-
ethics is characterized by new issues that affect everybody everywhere.
Of particular relevance is the issue of global health.9 Globalizing the
concerns of bioethics means that more attention is paid to issues rele-
vant to developing countries, in particular, to global inequalities in
health. Global concerns demonstrate the interdependence of people in
the world. If an epidemic disease is breaking out in one country, it will
have consequences for other countries. If rich patients want to buy or-
gans, people in poor countries run the risk of being exploited.

7 V.R. Potter, 1988, 78 (note 1).


8 See: J. Dwyer, How to Connect Bioethics and Environmental Ethics:
Health, Sustainability, and Justice, 23(9) Bioethics 2009, 497-502; P.R. Ehrlich,
Ecoethics: Now Central to All Ethics, 6 Bioethical Inquiry 2009, 417-436; L.
Gruen/W. Ruddick, Biomedical and Environmental Ethics Alliance: Common
Causes and Grounds, 6 Bioethical Inquiry 2009, 457-466.
9 See: L. Garrett, The Challenge of Global Health, 86 Foreign Affairs 2007,
14-38; K. Bozorgmehr, Rethinking the Global in Global Health: A Dialectic
Approach, 6 Globalization and Health 2010, 19.
Bioethics and Human Rights Wherever the Twain Shall Meet 153

Secondly, as Warren Reich has pointed out, global bioethics utilizes a


comprehensive vision of methods.10 The global perspective of bio-
ethics is not a matter of geography, but rather, it refers to phenomena
that have a global dimension i.e., they are no longer dependent on the
specifics of a particular culture or society. This is not the same as argu-
ing that global bioethics is a unified field of inquiry in which bioethi-
cists behave in similar ways everywhere in the world or that there is in-
ternational agreement on fundamental values.11 The global dimension
invites us to rethink our usual approaches and ethical frameworks. It
makes us aware of the locality of our own moral views while, at the
same time, asking us to search for moral views that are shared globally.
In this challenge, bioethics is increasingly connected with international
law, particularly human rights law, which has a similar global vision.
The growing importance of global bioethics has reactivated the signifi-
cance of the concept of community. The development of global bio-
ethics offers a broader interpretive setting.12 Within this setting, the
idea of community has become important for two reasons. One is that
global bioethics necessarily reaches beyond the Western individualist
perspective of traditional bioethics. In a global perspective, the ethical
systems of different cultures need to be examined and moral values
need to be analyzed and applied in specific contexts. For some, global
bioethics is an attempt to universalize a specific set of bioethical princi-
ples and to export or impose them on the rest of the world. Whether or
not global bioethics is considered to be ethical imperialism, it has in-
creased sensitivity regarding the application of basic concepts such as
individual autonomy and informed consent across the globe. In many
non-Western cultures, individuals are not privileged over communities.
Global bioethics, therefore, should recognize that in many countries,
individual rights can be less significant than responsibilities towards
family, community, and society.

10 W.T. Reich, The Word Bioethics: The Struggle over Its Earliest Mea-

nings, 5(1) Kennedy Institute of Ethics Journal 1995, 19-34, 24.


11 S. Holm/B. Williams-Jones, Global Bioethics Myth or Reality?, 7 BMC

Medical Ethics 2006, 10; S.K. Hellsten, Global Bioethics: Utopia or Reality?,
8(2) Developing World Bioethics 2008, 70-81.
12 W.T. Reich, 1995, 29 (note 10).
154 ten Have

Another reason for increased attention to community is the recent pol-


icy emphasis on social determinants of health.13 Ethical discourse has
concentrated on clinical encounters, individual dimensions of disease,
and health. Awareness that individuals are embedded in relationships,
communities, and the wider world is moving contemporary bioethics to
a broader social setting. The significance of social conditions has also
increased awareness that health promotion implies promotion of social
justice, not only locally and nationally, but also globally. In fact, there is
an imbalance in the current moral perspective. Rather than continuing
to focus on individual demands and biomedical solutions, we need to
consider how to promote moral change in society and how to cultivate
community responsibility.14 A global perspective will remedy this im-
balance. This was exactly the perspective that Teilhard proposed in 1947
in a UNESCO publication celebrating the adoption of the Universal
Declaration of Human Rights:
We must no longer seek to organize the world in favor of, and in
terms of, the isolated individual; we must try to combine all things
for the perfection (personalization) of the individual by his well-
ordered integration with the unified group in which Mankind must
eventually culminate, both organically and spiritually.15

III. The Idea of a Global Moral Community

The emergence of global bioethics has not only stimulated the interest
in community, but has at the same time expanded the idea of the moral
community. This is demonstrated in debates on the new principle of
protecting future generations and on intergenerational justice.16 The
UNESCO Declaration on the Responsibilities of the Present Genera-

13 P. Illingworth/W.E. Parmet, The Ethical Implications of the Social De-

terminants of Health: A Global Renaissance for Bioethics, 23(2) Bioethics 2009,


ii-v.
14 S. Sherwin, Looking Backwards, Looking Forward: Hopes for Bioethics

Next Twenty-five Years, 25(2) Bioethics 2011, 72-82.


15 P. Teilhard de Chardin, The Future of Man, New York/London/Toronto/
Sydney/Auckland (original English translation 1964): Doubleday, 2004, 189.
16 H.A.M.J. ten Have/M.S. Jean (eds.), The UNESCO Universal Declara-
tion on Bioethics and Human Rights: Background, Principles, and Application,
Paris: UNESCO Publishing, 2009. See specifically 243-5.
Bioethics and Human Rights Wherever the Twain Shall Meet 155

tions towards Future Generations (adopted in 1997) connects our re-


sponsibilities to posterity with the need to ensure the maintenance and
perpetuation of humankind.17 These are the same concerns advocated
in Potters conception of global bioethics. The notion of community is
furthermore introduced in global bioethics through the principle of
benefit sharing. Application of this novel principle in the context of
bioprospecting requires the identification and construction of com-
munities as coherent wholes of indigenous populations and traditional
knowledge. These new debates in fact refer to a more fundamental dis-
course on global community or world moral community, which
regards humanity itself as a moral community. In this discourse, two in-
terrelated arguments are used.18 One argument is that the global com-
munity includes not only human beings but all of nature. The concept
of community is broadened to include more than humans; nonhuman
species need to be considered members of our community since we all
share dependency and vulnerability.19 In fact, this is Potters view. He
argues, building on the Leopold legacy, that ethics should extend the
idea of community from human community to a community that in-
cludes soils, waters, plants, and animals. Humankind coexists with eco-
systems; together they constitute the entire biological community.20
The second argument is that the earth is not the possession of one par-
ticular generation; each generation inherits it and should not bequeath it
in an irreversibly damaged state to future generations. Due to the inter-
dependence of human life and the fragility of our planet, we need a new
vision of human community that encompasses past, present, and future
generations. The continued existence of the human species can only be
guaranteed if humanity itself is regarded as a global community. This
argument is based on the necessity to regulate the global commons that

17 UNESCO, Declaration on the Responsibilities of the Present Genera-

tions towards Future Generations, Paris, 1997, see at http://www.unesco.org/


cpp/uk/declarations/generations.pdf.
18 E. Agius, Environmental Ethics: Towards an Intergenerational Perspec-

tive, in H.A.M.J. ten Have (ed.), Environmental Ethics and International Policy,
Paris: UNESCO Publishing, 2005, 89-115.
19 B.R. Levine, Toward a Broader Notion of Community, 50(1) Perspectives

in Biology and Medicine 2007, 124-135.


20 V.R. Potter, 1971, 78 (note 6).
156 ten Have

are under the custody of humanity as a whole. They need to be pre-


served to safeguard the survival of humanity.21
The new vision of global community is therefore intrinsically related to
the concept of common heritage.22 For a long time, policy makers and
scholars have identified communities within nations and regions. Glob-
alization of science and bioethics has made us more sensitive to and
aware of the need to respect such communities elsewhere in the world.
The new vision of community however does not only emphasize the in-
terdependence of all nations but also recognizes that every generation is
linked. The implication is that global community has become a mor-
ally relevant notion because it refers no longer merely to extent (a
worldwide scope involving citizens of the world who are increasingly
connected and related), but also to content (the identification of global
values and responsibilities as well as the establishment of traditions and
institutions). This development is the result of an expanded use of the
concept of common heritage of humankind. Introduced in interna-
tional law in the late 1960s to regulate common material resources, such
as the ocean bed and outer space, the concept was expanded in the
1970s to include culture and cultural heritage. This has led to the con-
struction of a new global geography of symbols indicating that human-
ity itself can be regarded as a community. Cultural heritage is no longer
only representative of a particular culture but of human culture in gen-
eral. Labeling some cultural products as a world heritage produces a
global grammar in which disparate and local phenomena receive a uni-
versal significance and require global management. Such heritage is the
expression of human identity at a global level; they are part of the quest
of the citizens of the world; they become indicators of world culture.
Regarding and categorizing cultural property as world heritage implies
a global civilization project that seeks to create a new global community
representing humanity as a whole, enable the identification of world
citizens, and evoke a sense of global solidarity and responsibility. This
process of creating the global community as a moral community was
further promoted through the application of the concept of common
heritage in global bioethics, first in the late 1990s in the field of genet-
ics,23 followed in the 2000s by the adoption of a global framework of

21 E.B. Weiss, Our Rights and Obligations to Future Generations for the

Environment, 84(1) American Journal of International Law 1990, 198-207.


22 E. Agius, 2005 (note 18), see specifically 105 et seq.
23C. Byk, A Map to a New Treasure Island: The Human Genome and the
Concept of Common Heritage, 23(3) Journal of Medicine and Philosophy 1998,
Bioethics and Human Rights Wherever the Twain Shall Meet 157

ethical principles.24 Global bioethics can now claim to represent a global


geography of moral values that enables humanity to regard itself as a
moral community. It implies that citizens of high-income countries can
no longer be indifferent to clinical research practices or organ trade in
low-income countries since the same moral values and standards apply
within the global community, although the application is always modi-
fied according to local circumstances and local communities. Member-
ship in the global community furthermore draws on a growing number
of global institutions and movements (e.g., Doctors without Borders,
Oxfam, fair trade, UNESCO). If there is a global community of shared
values, and if these values are the product of intensive and continuous
negotiation, deliberation, and dialogue, then real cosmopolitan ethics
has emerged.25

IV. UNESCOs Bioethics Program

When the United Nations Educational, Scientific and Cultural Organi-


zation (UNESCO) was established in 1945, its Constitution declared
that peace must be founded upon the intellectual and moral solidarity
of humanity. Julian Huxley, the first Director-General of the Organiza-
tion, pointed out that in order to make science contribute to peace, se-
curity and human welfare, it was necessary to relate the applications of
science to a scale of values. Guiding the development of science for the
benefit of humanity therefore implied the quest for a restatement of
morality in harmony with modern knowledge.26
Since its foundation, UNESCO has been working in four areas: educa-
tion, culture, science and communication. UNESCOs Member States
meet once every two years (nowadays in Paris) during three weeks in
order to discuss all issues pertaining to the functioning of the Organiza-
tion. In this General Conference they also determine the program for

234-246; B.M. Knoppers/Y. Joly, Our Social Genome?, 25(7) Trends in Bio-
technology 2007, 284-288.
24 H.A.M.J. Ten Have/M.S. Jean, 2009 (note 16).
25 N. Dower, World Ethics: The New Agenda, 2nd ed. Edinburgh: Edin-
burgh University Press, 2007.
26 J. Huxley, UNESCO: Its Purpose and Its Philosophy, Paris: Preparatory
Commission of the United Nations Educational, Scientific and Cultural Orga-
nization, 1946. Quotation at 41.
158 ten Have

the next two years, specifying the main activities, their objectives and
budgets. The activities are implemented by the Director-General, who
is elected every four years by the Member States. The Director-General
himself selects and appoints international civil servants with competen-
cies and expertise in the working areas of the Organization. They work
either in the Headquarters in Paris or in Field Offices in regions, sub-
regions or countries. Together, all the civil servants constitute the Secre-
tariat of the Organization. They are recruited from all Member States.
The Secretariat is therefore already a microcosm of cultures, traditions,
languages and experiences.
Being a UN specialized organization brings at least two characteristics
for UNESCO and its work. First, the activities should be focused on
accomplishing goals that are relevant for all Member States. Conse-
quently, its activities in promoting science and international coopera-
tion should serve as a channel to address the basic problems and needs
of the world population. Science is therefore not regarded as an end in
itself, but as a means towards the development of nations and the reso-
lution of global problems such as poverty, environmental degradation
and child mortality. Since 2000, the eight Millennium Development
Goals are the overarching goals for the world community to achieve by
2015.
Second, the activities of the Organization should take into account all
perspectives that are relevant to all Member States. In order to facilitate
this, six official languages are used in the Organization: Arabic, Chi-
nese, English, French, Spanish and Russian, while English and French
are the daily working languages. Respect for cultural diversity is one of
the main concerns of UNESCO. It has put in place programs to pre-
serve and protect cultural accomplishments in, for example, architec-
ture, arts, literature, philosophy and science. These programs have been
implemented in specific historical, religious and cultural settings.
UNESCO, through its efforts to identify such accomplishments in all
regions of the world, is showing that all civilizations and cultures have
contributed to the present condition of humankind. However, in all this
richness and diversity, one can also discover the expression of common
values and shared interests. In fact, UNESCO itself is based on its Con-
stitution, adopted in November 1945, affirming that the purpose of the
Organization is to contribute to peace and security by promoting
collaboration among the nations through education, science and culture
in order to further universal respect for justice, for the rule of law and
Bioethics and Human Rights Wherever the Twain Shall Meet 159

for the human rights and fundamental freedoms 27 The same princi-
ples are affirmed in the Charter of the United Nations, adopted a few
months earlier that same year: fundamental human rights, the dignity
and worth of the human person, and equal rights of men and women
and of nations large and small.28 The tensions between respecting diver-
sity and affirming universality are noticeable in all areas of work but
they are particularly sensible when values, rights and principles are con-
cerned.
Since its foundation, UNESCO has been concerned with moral issues
in relation to science. Within the United Nations system, UNESCO is
the only specialized agency with a mandate in the sciences. From the
1970s onwards, the emergence of the life sciences, in particular, has led
to the international examination of bioethical questions. This global fo-
cus on bioethics was institutionalized in 1993 with the establishment of
the International Bioethics Committee (IBC). This also urged the Se-
cretariat to set up a special unit with a work program and budget for in-
ternational activities in bioethics. The program was expanded in 1998
with the foundation by UNESCO of the World Commission on the
Ethics of Scientific Knowledge and Technology (COMEST), which ad-
dresses other areas of applied ethics such as environmental ethics, sci-
ence ethics and technology ethics. Since nowadays many UN organiza-
tions and other international and regional intergovernmental bodies,
such as the European Commission, the Council of Europe, the African
Union, have activities in the field of bioethics, UNESCOs Director-
General in 2002 took the initiative to establish the Inter-Agency Com-
mittee on Bioethics of the United Nations (with, among others, the
Food and Agriculture Organization FAO, the International Labour
Organization ILO, the World Health Organization WHO and the
World Intellectual Property Organization WIPO) for which
UNESCO provides the permanent secretariat. In the same year, the
Member States decided that ethics of science and technology, in particu-
lar bioethics, should be one of the five priorities of UNESCO.29
One major objective of the work of UNESCO in ethics has been the
development of international normative standards. The United Nations,

27 UNESCO, Constitution, London, 1945, Article 1.1., see at http://unesdo

c.unesco.org/images/0011/001176/117626e.pdf.
28 UN, Charter of the United Nations, San Francisco, 1945, Preamble, see at

http://www.un.org/aboutun/charter/.
29 H.A.M.J. ten Have, The Activities of UNESCO in the Area of Ethics, 16
(4) Kennedy Institute of Ethics Journal 2006, 333-351.
160 ten Have

in fact, provide the only existing platform for all nations to explore and
discuss values and principles that they share, and to negotiate and agree
on normative instruments. Other efforts to determine common stan-
dards have been undertaken at regional levels. The Council of Europe
has done exemplary work in the area of bioethics with the drafting and
adoption of the European Convention on Human Rights and Biomedi-
cine, signed in Oviedo in 1997.30 This Convention demonstrates the ex-
istence of agreement at the regional level. At a global level, the UN or-
ganizations provide the only vehicle for agreement. UNESCO has
stated that in fulfilling its mission it will carry out five functions for the
international community: 1) laboratory of ideas, 2) standard-setter, 3)
clearing house, 4) capacity-builder, and 5) catalyst for international co-
operation.31 Standard setting implies the search for universal agree-
ments. While all countries are confronted with global challenges, a deli-
cate balance needs to be produced between developing universal princi-
ples and norms based on shared values on the one hand, and promoting
pluralism through recognition and enhancement of diversity on the
other hand. Reaching such balance is particularly important for bio-
ethics, since it is a relatively new area with many controversies. Bio-
ethics is also a multidisciplinary field. It has emerged in academic set-
tings and has developed into an established scientific discipline in medi-
cal, legal and science departments. It has also become an area of policy
and decision-making, usually with diverging political approaches. For
many issues there is nowadays a need for regulation and legislation, for
example regarding medical research, genetics and transplantation. But
there are also very controversial issues, such as abortion, euthanasia and
stem cell research, that require policies and guidelines. Furthermore,
bioethics is a domain of public debate and is the subject of many discus-
sions in newspapers, radio, and television. The public is increasingly
aware of its rights and of the difficult choices to be made concerning
bioethics. Due to these characteristics, standard-setting in bioethics re-
quires the involvement of many different stakeholders: scientists, law-
yers, policy-makers, and citizens.

30 Council of Europe, Convention for the Protection of Human Rights and


Dignity of the Human Being with Regard to the Application of Biology and
Medicine: Convention on Human Rights and Biomedicine, Oviedo, 1997, see at
http://conventions.coe.int/Treaty/en/Treaties/html/164.htm.
31 UNESCO, 34C/4 Medium Term Strategy 2008-2013, 2007, see at http://
unesdoc.unesco.org/images/0014/001499/149999e.pdf.
Bioethics and Human Rights Wherever the Twain Shall Meet 161

Within UNESCO, the process of standard-setting aims at the involve-


ment of heterogeneous stakeholders, in order to make sure that the best
conditions exist for the emergence of consensus during the process of
developing normative instruments. UNESCO follows a multi-stage
procedure for the elaboration, examination, adoption and follow-up of
declarations that has been determined by the Member States. Independ-
ent experts (in the International Bioethics Committee as permanent
body) will start to make the first draft whereupon intergovernmental
meetings will enter into negotiations.

V. International Standard-Setting

UNESCOs interest in bioethics dates back to the 1970s. In that same


period of time, bioethical concerns emerged in many countries. In 1970,
the word bioethics was introduced for the first time by Potter, who
then gave a very broad extension to the concept.32 The same era wit-
nessed revolutionary changes and innovations in medical diagnosis and
treatment but also in science and technology. Additionally, scandals,
misuse and injustices came to light and alarmed the public and policy-
makers, leading to the first establishment of bioethics centers, ethics
committees, review boards and efforts to codify patient rights and to
regulate the medical and biomedical research community.33 UNESCO
started to organize symposia and conferences on bioethics in 1970,
mainly related to the development of genetics, life sciences and repro-
ductive technologies, and in cooperation with UNESCOs Scientific
Coordinating Committee for the Human Genome Project.34 Member
states have been particularly concerned about the relation between sci-
entific and technological progress and human rights.35 In June 1992,
Federico Mayor, the Director-General of UNESCO, decided to set up

32 V.R. Potter, 1971 (note 6).


33 D.J. Rothman, Strangers at the Bedside: A History of How Law and Bio-
ethics Transformed Medical Decision Making, New York: Basic Books, 1991.
34 UNESCO, Study Submitted by the Director-General Concerning the

Possibility of Drawing up an International Instrument for the Protection of the


Human Genome (27 C/45), General Conference, 27th Session, 1993, see at
http://unesdoc.unesco.org/images/0009/000954/095428eo.pdf.
35 UNESCO, 24 C/Resolution 13.1, para. 2(b), General Conference, 24th
Session, 1987, see at http://unesdoc.unesco.org/images/0007/000769/076995e.
pdf.
162 ten Have

an International Bioethics Committee, chaired by Nolle Lenoir, a


member of the Constitutional Council of the French Republic. The
most important task of the Committee was to explore how an interna-
tional instrument for the protection of the human genome could be
drafted. The Committee met for the first time in September 1993. In the
meantime, a Scientific and Technical Orientation Group was formed in
December 1992, carrying out preparatory studies. The Group con-
ducted extensive consultations, focusing on five themes: genome re-
search, embryology, neurosciences, gene therapy, and genetic testing.
For each theme various dimensions were studied: the current state of
progress in research at the world level, the application of the results of
this research, and the principal ethical concerns for the present and for
the future. On the basis of these studies, the Group identified the refer-
ence points likely to secure the broadest agreement, proposing princi-
ples most likely to respond to the ethical concerns.
The International Bioethics Committee started its work with the con-
sideration that, in the history of mankind, science has always influenced
the evolution of civilizations throughout the world and in that respect,
genetics would not be different. Like all scientific discoveries, the appli-
cation of genetics will cause concerns, but it will be important to go be-
yond the focus on dangers of deviation and infringements of human
rights. The IBC also took into account cultural diversity (ethical posi-
tions depend on the value systems specific to each society in accordance
with its cultural traditions) and universality (the internationally rec-
ognized idea of universality on which human rights are founded is cru-
cial to ethics).36 At this stage, the Committee proposed a framework of
ethical principles for a possible international instrument for the protec-
tion of the human genome.
In November 1997, the General Conference adopted by acclamation
the Universal Declaration on the Human Genome and Human Rights.37
It was endorsed a year later by the General Assembly of the United
Nations. It therefore became the first normative instrument on bio-
ethics adopted by UNESCO. One of the fundamental principles in the

36 UNESCO, Study Submitted by the Director-General Concerning the

Possibility of Drawing up an International Instrument for the Protection of the


Human Genome (27 C/45), General Conference, 27th Session, 1993, see at
http://unesdoc.unesco.org/images/0009/000954/095428eo.pdf.
37 UNESCO, Universal Declaration on the Human Genome and Human
Rights, Paris, 1997, see at http://portal.unesco.org/en/ev.php-URL_ID=13177
&URL_DO=DO_TOPIC&URL_SECTION=201.html.
Bioethics and Human Rights Wherever the Twain Shall Meet 163

declaration is the principle of respect for human dignity. As a sequel to


the Universal Declaration, the International Declaration on Human
Genetic Data was adopted by the General Conference of UNESCO in
October 2003.38 It states the principles related to the collection, process-
ing, storage and use of human genetic data. It is important to note that
both declarations incorporate follow-up mechanisms in order to pro-
mote the dissemination of, the application of and the respect for the
principles and standards established.39
The scope of standard-setting was expanded significantly in 2003 with
the mandate given by the Member States to develop a universal declara-
tion on bioethics. The previous declarations had focused on the special-
ized area of genomics and genetics. When the new mandate was given,
all topics relevant to bioethics were in principle placed on the table for
negotiation. The Universal Declaration on Bioethics and Human Rights
was adopted by acclamation in 2005.

VI. The UNESCO Bioethics Declaration and Human


Rights

Consensus-building for the Bioethics Declaration through UNESCO


was a laborious task. In practice, it implied broad consultation of many
stakeholders, multiple meetings all over the world, frequent reporting
to Member-States, elaboration and revision of subsequent draft text,
and transparency of the process of drafting and consulting.40 In theory,
two strategies of consensus formation were followed. One was to build
on previous instruments, particularly the Universal Declaration of
Human Rights, but also the Oviedo Convention on Biomedicine.41 The

38 UNESCO, International Declaration on Human Genetic Data, Paris,

2003, see at http://portal.unesco.org/en/ev.php-URL_ID=17720&URL_DO=


DO_TOPIC&URL_SECTION=201.html.
39 A.A. Yusuf, UNESCO Standard-setting Activities on Bioethics: Speak

Softly and Carry a Big Stick, in F. Francioni (ed.), Biotechnologies and Interna-
tional Human Rights, Oxford and Portland, Oregon: Hart Publishing, 2007,
85-96.
40 H.A.M.J. Ten Have/M.S. Jean, 2009 (note 16).
41 Council of Europe, Convention for the Protection of Human Rights and
Dignity of the Human Being with Regard to the Application of Biology and
Medicine: Convention on Human Rights and Biomedicine, Oviedo, 1997, see at
http://conventions.coe.int/Treaty/en/Treaties/html/164.htm.
164 ten Have

specific references to the last document are remarkable since, in UN


normative instruments, references to regional documents are not com-
monly made. The second strategy was to extend the previous consensus
within UNESCO in the area of bioethics. Although the Universal Dec-
laration on the Human Genome and Human Rights (1997) and the In-
ternational Declaration on Human Genetic Data (2003) had articulated
principles in a specialized domain, videlicet human genome research
and use of human genetic data, the principles themselves could easily be
generalized.
There are many international documents in bioethics, sometimes very
well known and influential, such as the Declaration of Helsinki42
adopted by the World Medical Association, but the Universal Declara-
tion on Bioethics and Human Rights is the only one adopted by gov-
ernments. It presents principles and applications of principles to which
governments have committed themselves. It is therefore a relevant
frame of reference for future developments in bioethics, especially since
all governments have unanimously agreed on this text.
One of the new elements of the Universal Declaration on Bioethics and
Human Rights is that it connects bioethics and human rights.43 Interna-
tional documents such as the European Convention on Human Rights
and Biomedicine and the Declaration of Helsinki refer to human rights
(and human dignity). In the same vein, the UNESCO Declaration con-
tinues to invoke human rights in establishing global bioethics princi-
ples. The connection with human rights was already made in the Uni-
versal Declaration on the Human Genome and Human Rights. Some
scholars have recently pointed out that the Declarations grounding of
bioethics in universal human rights will bring international bioethics
into a new phase of involvement with regulation and implementation,
being accepted as part of international law.44 However, the interconnec-

42 World Medical Association: Declaration of Helsinki, Seoul, 2008, see at


http://www.wma.net/en/30publications/10policies/b3/17c.pdf.
43 R. Andorno, Global Bioethics at UNESCO: In Defence of the Universal

Declaration on Bioethics and Human Rights, 33 Journal of Medical Ethics 2007,


150-154.
44 T.A. Faunce, Will International Human Rights Subsume Medical Ethics?

Intersections in the UNESCO Universal Bioethics Declaration, 31 Journal of


Medical Ethics 2005, 173-178; H. Nys, Editorial: Towards an International
Treaty on Human Rights and Biomedicine? Some Reflections Inspired by
UNESCOs Universal Declaration on Bioethics and Human Rights, 13 Euro-
pean Journal of Health Law 2006, 5-8.
Bioethics and Human Rights Wherever the Twain Shall Meet 165

tions between bioethics and human rights in the Bioethics Declaration


are more heterogeneous and complicated. Within the text, three types
of relationships are to be distinguished: (1) human rights as starting
point and context of bioethics, (2) human rights as a basic principle of
bioethics itself, and (3) human rights as constraint and final authority
for bioethics.

1. Human Rights as Starting Point and Context of Bioethics

The bioethical principles presented in the Bioethics Declaration are an-


chored in human rights, as is reflected in the title of the normative in-
strument. The Preamble explicitly refers to human rights as the context
within which bioethics principles are developed: Recognizing that
ethical issues [] should be examined with due respect to the dignity of
the human person and universal respect for, and observance of human
rights and fundamental freedoms.45 The Preamble also includes many
references to human rights instruments, as well as an explicit reference
to the Convention for the Protection of Human Rights and Dignity of
the Human Being with regard to the Application of Biology and Medi-
cine, the Convention on Human Rights and Biomedicine adopted by
the Council of Europe in 1997. The context of international human
rights law is furthermore emphasized in one of the explicit aims of the
Declaration. Article 2.c. states that the aim is:
to promote respect for human dignity and protect human rights,
by ensuring respect for the life of human beings, and fundamental
freedoms, consistent with international human rights law.46

2. Human Rights as Basic Principle of Bioethics

Although the Bioethics Declaration does not present bioethical princi-


ples in a hierarchical order, it is nevertheless striking that the first of the
15 principles refers directly to human dignity and human rights, and

45 UNESCO, Universal Declaration on Bioethics and Human Rights, Pre-

amble, 3, Paris, 2005, see at http://unesdoc.unesco.org/images/0014/001461/146


180e.pdf.
46 Ibid., 6.
166 ten Have

defines this as in fact the most fundamental principle of bioethics. Arti-


cle 3 states:
1. Human dignity, human rights and fundamental freedoms are to
be fully respected.
2. The interests and welfare of the individual should have priority
over the sole interest of science or society.

3. Human Rights as Constraint and Final Authority for Bioethics

In several places, it is reiterated that the bioethical principles in the Bio-


ethics Declaration should be interpreted as well as applied within the
context of international human rights law, and therefore cannot be re-
stricted unless in accordance with this international law. The Preamble
starts to determine these constraints in general:
Recognizing that this Declaration is to be understood in a manner
consistent with domestic and international law in conformity with
human rights law.
More specifically, in the formulation of several principles, it is repeated
that exceptions can only be made if they are consistent with human
rights. Article 6 (Consent) states that exceptions to the principle of con-
sent can only be made in accordance with international human rights
law. The same provision is made in Article 7 (Persons without the ca-
pacity to consent) as well as in Article 9 (Privacy and confidentiality).
Article 11 (Non-discrimination and non-stigmatization) emphasizes
that discrimination and stigmatization violate human rights. The Bio-
ethics Declaration also presents several principles that are relatively new
in global bioethics discourse. One example is the principle of respect
for cultural diversity and pluralism (Article 12). At the same time, this
is the only principle in the Declaration for which a restriction is formu-
lated in the text of the principle: considerations of cultural diversity and
pluralism should not be invoked to infringe upon human rights or upon
the other principles of the Declaration. This restriction makes the prin-
ciple the weakest one within the Bioethics Declaration. Another new
principle is social responsibility and health (Article 14). But this princi-
ple is clearly based on the human right to enjoy the highest attainable
standard of health. Finally, explicit limits of the application of bioethics
principles are formulated in the two final articles of the Declaration.
Article 27 declares that limitations of the principles of the Declaration
can only be made under three connected conditions: by law, for specific
Bioethics and Human Rights Wherever the Twain Shall Meet 167

reasons (public safety, criminal offences, protection of public health and


protection of the rights and freedoms of others), and when the law is
consistent with international human rights law. Article 28 states:
Nothing in this Declaration may be interpreted as implying for any
State, group or person any claim to engage in any activity or to per-
form any act contrary to human rights, fundamental freedoms and
human dignity.47

VII. Relationship between Bioethics and Human Rights

The emergence of global bioethics since 2000 and specifically the adop-
tion of a global framework of bioethics principles have led to increasing
approximation between bioethics and human rights in the last decade. It
is argued that parallels between human rights and bioethics are much
older.48 The development and specification of human rights has been
closely related to the development of medical ethics. The 1947 Nurem-
berg trials and the condemnation of physicians and scientists for
crimes against humanity have clearly impacted the 1948 Universal
Declaration of Human Rights. The human rights framework satisfied
the need to make trans-cultural and transnational normative judgments.
It presented a globally acceptable framework that transcends culture,
nationality and religion. Human rights and bioethics therefore share
several common characteristics: they have the same origin (the horrors
of the Holocaust and the need to prevent future atrocities), the same
goal (never again should individual human beings be used as means to
another end), and the same claim to universality. But there are addi-
tional characteristics of the human rights discourse that have made it
more attractive for bioethics, especially since its transformation towards
global bioethics: (1) normative amplification, (2) the emphasis on appli-
cation and (3) the link to policy.

47 Ibid., 11.
48B. Baker, Bioethics and Human Rights: A Historical Perspective, 10
Cambridge Quarterly of Healthcare Ethics 2001, 241-252.
168 ten Have

1. Normative Amplification

The human rights discourse promotes principles and norms that are not
negotiable and cannot be compromised. For example, the commitment
to the integrity of the human body implies that torture, cruel punish-
ment and organ trafficking are always wrong.49 There might be good
arguments, however, to justify these practices. Torturing one person
might result in information that can save the lives of thousands of other
persons. Trafficking organs might help persons with end-stage renal
disease, who have been on the waiting list for organ transplantation for
years, and who might otherwise die. Particularly in medicine, utilitarian
argumentation is influential since the results of medical intervention
(saving lives, curing diseases, preventing illnesses) are usually predomi-
nant. In the past, result-driven activities have led to the precipitous use
of new technologies and devices without information and consent of
patients. This has been especially clear in the context of medical re-
search where it is commonly argued that the interests of many might
weigh more heavily than the interests of a few persons. Medical history
gives many examples where the interests of science or society have re-
sulted in the sacrifice of individuals.50
Human rights discourse therefore provides a counter-weight to utilitar-
ian arguments. It is a deontological framework of principles and norms
that need to be upheld regardless of the results and consequences, since
humanity itself is at stake. When the effects of medical intervention are
the predominant moral consideration, medical practice itself becomes
normative: what is medically feasible is ethically required. This type of
argumentation has led to a long series of scandals and abuses in medical
research. It has also encouraged the introduction of legislation and
oversight mechanism, emphasizing that research with human beings can
only be done properly if certain basic principles, such as informed con-
sent, can be safeguarded. The utilitarian approach can therefore be ap-
plied only within the deontological framework of certain basic princi-
ples. The human rights discourse has assisted bioethics in constructing
this overriding framework.
Global bioethics nowadays is confronted with similar challenges. It is
argued, for example, that the principles of bioethics are Western princi-
ples that cannot be applied in other cultures. One argument is that the

49 D.J. Rothman/S.M. Rothman, Trust is Not Enough: Bringing Human

Rights to Medicine, New York: The New York Review of Books, 2006.
50 D.J. Rothman, 1999 (note 33).
Bioethics and Human Rights Wherever the Twain Shall Meet 169

principle of informed consent is difficult to implement in populations


that are illiterate or that have a tradition of community or family con-
sent. Another argument underlines that the standard of care in Western
hospitals cannot be used in developing countries. These arguments have
justified medical and research practices with double standards: in devel-
oping countries, lower standards are used than in developed countries
because it makes those practices more feasible. Human rights discourse
can redress such tendencies and arguments, emphasizing that ethical
principles are universal (research that is not ethical in the US is also not
ethical in Nigeria), and that the ends do not justify the means (improv-
ing health care for a population does not justify exploitation of some
citizens, taking advantage of poverty, lack of development or social
misery to advance knowledge).51

2. Application

For a relatively long time, bioethics was primarily regarded as an aca-


demic discourse with limited application. If the discourse could be ap-
plied, then it was only in specific settings and within cultures that share
the same principles, as for example the four principles approach in
North America. Especially in the 1970s and 1980s, there were many de-
bates about the pros and cons of various theoretical approaches in bio-
ethics.52 It was commonly argued that bioethical principles were cul-
ture-related, so that the principles of American bioethics were not the
same as those of European bioethics, but also that the principles domi-
nant in one culture cannot be straightforwardly applied to another.
Similar discussions concerned the universal claims of human rights. But
these concerns were pacified because a separation was made between
theory and practice. Human rights discourse could become practical
because it was separated from the underlying justifications. The right to
healthcare, for example, could be applied in practice by courts and ad-
vocacy groups, although there was a fundamental philosophical debate
about the notion of health and what the right entails.53

51 D.J. Rothman/S.M. Rothman, 2006, 53 et seq. (note 49).


52 E.R. DuBose, R.P. Hamel/L.J. OConnell (eds.), A Matter of Principles?
Ferment in U.S. Bioethics, Valley Forge, Philadelphia: Trinity Press Int., 1994.
53 D.J. Rothman/S.M. Rothman, 2006, 139 et seq. (note 49).
170 ten Have

For a long time, there was not a real implementation of human rights.
Reborn in the 1970s, at the same time as the birth of bioethics, human
rights discourse no longer debated the underlying theories but focused
on the principles on which everybody would agree. By freeing the dis-
course from its underlying philosophical and theological justifications
and from the controversies around these, human rights discourse be-
came a public discourse, just like the bioethics discourse after it was
disconnected from the medical profession that traditionally dominated
medical ethics. This analogous development transformed human rights
as well as bioethics into public discourses that were available for all and
that could be applied in various settings.

3. Policy

Many activities in bioethics today relate to policy-making. Bioethics


committees at various levels are drafting recommendations for policy.
At a national level, they analyze guidelines, propose legislation and as-
sist policy-makers. At a local level, they advise hospital boards or re-
search institutions regarding institutional guidelines and policies. Bio-
ethicists are members of expert committees or participants in public fo-
rums. Human rights discourse is often helpful in these policy efforts
since it emphasizes rights rather than humanitarian concerns. Policy-
making in healthcare is often driven by concerns for vulnerable popula-
tions in need of care and protection. Different values can be implied:
saving human lives, human dignity and justice. As is obvious in hu-
manitarian aid, for example in disaster relief, the ethical drive is so
strong and compelling that it can hardly be criticized; at the same time,
it directs our focus on immediate relief for individual victims so that we
tend to forget that other dimensions are equally important. One dimen-
sion is the social context which is often unjust. Another dimension is
the perspective of the recipient. In many humanitarian operations, the
persons who receive assistance are absent and silent.54 The failure to
give voice to the vulnerable is remarkable since the ethics of humani-
tarianism is based on the notion of human dignity.

54 M. Barnett/T.G. Weiss, Humanitarianism: A Brief History of the Present,


in M. Barnett/T.G. Weiss (eds.), Humanitarianism in Question: Politics, Power,
Ethics, Ithaca and London: Cornell University Press, 2008, 1-48.
Bioethics and Human Rights Wherever the Twain Shall Meet 171

It is therefore argued that humanitarianism should be redefined in


terms of rights.55 Instead of the language of needs and compassion, we
should use the language of human rights and dignity. Within the recent
discourses of the United Nations, the Red Cross and NGOs, more em-
phasis is needed on rights-based humanitarianism. Poverty and devel-
opment have been redefined in terms of human rights.
The advantage of this approach is that humanitarianism will be
grounded on an integrated moral-legal framework of international hu-
man rights law. It will be more than just a moral endeavour, but will
also be anchored in institutions (courts, tribunals, truth commissions),
even if they are not recognized by all states. The second advantage is
that rights dignify rather than victimize. People are no longer regarded
as needy victims, but as citizens of the world with the same claims and
rights as everyone else. Human rights make people equal and more
powerful. They provide a universal and objective standard to assess
human behaviour. This does not ignore the many problems in the
global application of this approach. But the fact is that all states have
and still are participating in the norm-creating process in which these
international standards are articulated. The third advantage of the hu-
man rights approach is that it generates foreign policy imperatives as
expression of international responsibility. Membership of the interna-
tional community entails recognition of the moral urgency of human
rights. Erin Kelly has identified three such moral obligations: non-
engagement, aid, and intervention. The modalities of humanitarianism
are, in his view, guided by the shared concern for human rights.56

VIII. Bioethics and Advocacy

The benefits of interconnecting bioethics and human rights are demon-


strated in the rise of a new type of activity: advocacy. The growth of
bioethics has been associated with an expanding domain of different
categories of activities. Research and teaching as traditional activities
have been supplemented with consultation (particularly clinical ethics

55 H. Slim, Not Philanthropy but Rights: The Proper Politicisation of Hu-


manitarian Philosophy, 6(2) International Journal of Human Rights 2002, 1-22.
56 E. Kelly, Human Rights as Foreign Policy Imperatives, in D.K. Chatterd-
jee (ed.), The Ethics of Assistance: Morality and the Distant Needy, Cambridge,
UK: Cambridge University Press, 2004, 177-192.
172 ten Have

consultation), policy-making and public debate. Bioethics has been


criticized for being nave and irrelevant, for focusing too much on aca-
demic discourse and normative analysis, and therefore neglecting
power, injustice and action.57 It is convenient to have a bioethical analy-
sis outlining the rights and wrongs, but what is the point if it does not
make a difference for the people involved?
Considerations like the above have generated the need for a new type of
activity within bioethics: advocacy. It is not sufficient to write a story,
to analyse a case, or to provide recommendations, but action must be
taken and guidance must be given. Advocacy is well-known in the area
of healthcare and social work. Patient advocacy groups play an impor-
tant role in patient care and clinical research.58 Nurses are taught to be
patient advocates in order to protect patients. Especially for nurses, ad-
vocacy is described as a core responsibility.59 Advocacy organizations
can speak on behalf of homeless people,60 and child advocacy is re-
garded as a core paediatrics task in response to child abuse.61 Also, his-
torians can serve as advocates and agents of change.62 Advocacy work
has become important in other areas, for example in international aid,
recognising that the power of global economic institutions is so strong
that without activism and interventions nothing will change, even if the
causes of poverty and marginalisation are well understood.63 Advocacy

57 C.L. Bosk, Professional Ethicist Available: Logical, Secular, Friendly,

128(4) Daedalus 1999, 47-68; A. Kleinman, Moral Experience and Ethical Re-
flection: Can Ethnography Reconcile Them? A Quandary for the New Bio-
ethics, 128(4) Daedalus 1999, 69-97.
58 R.R. Sharp, M. Yarborough/J.W. Walsh, Responsible Patient Advocacy:
Perspectives from the Alpha-1 Foundation; 146A(22) American Journal of
Medical Genetics 2008, 2845-2850.
59 J. Welchman/G.G. Griener, Patient Advocacy and Professional Associa-

tions: Individual and Collective Responsibilities, 15(3) Nursing Ethics 2005,


296-304.
60 A.B. Hamric, What Is Happening to Advocacy?, 48 Nursing Outlook

2000, 103-104; M.C. Schlairet, Bioethics Mediation: The Role and Importance
of Nursing Advocacy, 57 Nursing Outlook 2009, 185-193.
61 D.C. Bross/R.D. Krugman, Child Maltreatment Law and Policy as a

Foundation for Child Advocacy, 56 Pediatric Clinics of North America 2009,


429-439.
62 D.J. Rothman/S.M. Rothman, 2006, 89 et seq. (note 49).
63 B. Coates/R. David, Learning for Change: The Art of Assessing the Im-
pact of Advocacy Work, 12(3&4) Development in Practice 2002, 530-541.
Bioethics and Human Rights Wherever the Twain Shall Meet 173

has been proposed as a means to reinvigorate civil society and participa-


tory democracy, since it helps fostering critical thinking.64 Recently, it is
also argued that bioethics should advocate for persons with disabili-
ties.65
In the context of global bioethics, advocacy can argue for policy or leg-
islative change, for strengthening civil society through creating collabo-
ration, trust and unity among diverse groups, for enlarging the democ-
ratic space in which civil society can operate, and for direct involvement
of excluded people or groups of people in order to secure their rights.
Now that all countries have adopted a basic universal framework of
bioethical principles (the UNESCO Universal Declaration on Bioethics
and Human Rights) and similar research and healthcare activities are
undertaken in many parts of the world, it has become evident that bio-
ethics infrastructures are very different and that bioethics principles are
not equally applied. Advocacy can help in reinforcing these infrastruc-
tures and better implementing bioethical principles.
Bioethics Beyond Borders (BBB) is a non-profit and non-govern-
mental organization that was incorporated in the Commonwealth of
Pennsylvania, USA, in April 2011.66 The vision of the organization is to
build bioethics capacity around the world for universal application of
bioethical principles. It will do so by bringing together bioethicists,
academics, health professionals and policymakers to volunteer world-
wide to promote the application of a human rights-based approach to
bioethics. The organization will undertake five types of activities: (a)
advice and ethical guidance, (b) practical assistance, (c) advocacy, (d)
education, and (e) public debate.
Since its foundation, BBB is primarily focused on the creation of a
global network of bioethics experts. This network will bring together
two types of experts: associate experts and resource experts. Associate
experts will identify cases, problems and issues that require bioethical
expertise, and will address them. They will evaluate and monitor bio-
ethics development in their countries and bring problematic cases to the
attention of the organisation so that the proper resource experts can be
contacted. Usually, but not necessarily, these experts will be from de-

64 J.P. Zompetti, The Role of Advocacy in Civil Society, 20 Argumentation


2006, 167-183.
65 K.L. Kirschner, Rethinking Anger and Advocacy in Bioethics, 1(3)

American Journal of Bioethics 2001, 60-61.


66 See at www.bioethicsbeyondborders.org.
174 ten Have

veloping countries in need of bioethical expertise. Resource experts will


formulate responses to cases brought forward by associate experts, ide-
ally leading to public debate and potentially, if necessary, remedial ac-
tion as well as appropriate measures and policies. Usually, but not nec-
essarily, these experts are from developed countries with extensive ex-
pertise in various domains of bioethics.
With the growth of the global network, bioethics experts can be con-
sulted by bioethicists or experts with ethical concerns in developing
countries in need of bioethical advice and expertise. This consultative
process will ensure that developing countries can effectively benefit
from the expertise built-up in affluent countries, where bioethics is in
more advanced stages of development and where experiences with vari-
ous models, approaches and structures, are available. By convening a
diversity of experts with different specialties and experiences, BBB will
be able to effectively respond to demands for assistance. The global
network can also enhance the impact of networking and cooperation in
promoting and reinforcing the bioethics infrastructure in countries,
providing expert advice to relatively new and inexperienced scholars
elsewhere, who can learn from the experiences, challenges and mistakes
of resource experts. Through its global network, BBB can effectively
advocate for the universal implementation and application of bioethical
principles within the context of the human rights discourse.

IX. Conclusion

Global bioethics and human rights have become increasingly intercon-


nected. Both discourses share the same historical origin, the same goal
and the same claim to universality. These similarities have facilitated the
adoption of normative instruments within the area of global bioethics.
Human rights discourse has also reinforced the global bioethics dis-
course because of its strong emphasis on the framework of rights and
duties, counterbalancing the tendencies in medicine towards a utilitar-
ian justification of interventions. Through endorsing a deontological
context for utilitarian considerations, the connection with human rights
has amplified the normative force of bioethical discourse. The same is
true for the current emphasis on application and policy in global bio-
ethics. Here again human rights discourse can make the ethical dis-
course more powerful, since it transfers the academic debate on founda-
tions and justifications into a practical enterprise of applying and im-
plementing universally accepted principles. This new discourse will
Bioethics and Human Rights Wherever the Twain Shall Meet 175

complement the current range of activities in bioethics with the new ac-
tivity of advocacy, making sure that we no longer only talk about rights
and principles, but continuously try to apply them in very different
practices and settings around the world.
Bioethics and Human Rights the Legitimacy of
Authoritative Ethical Guidelines Governing
International Clinical Trials
Mira Chang

I. Introduction

Todays welfare at least in most parts of the world would not be


thinkable without the milestones in the development of medical treat-
ments. The enormous efforts of research yielded new drugs, saving and
enhancing numerous lives. The need for further research is undisputed.
Yet, the freedom to research cannot be limitless when ultimately human
subjects are to be tested upon. Therefore, the questions are How to
conduct research? and Who is to decide?. Furthermore, since clini-
cal trials are held in all regions of the world additional questions like
How to conduct research in developing countries? or What limita-
tions apply to western pharmaceutical companies that are performing
clinical studies in developing countries? arise.
In modern times, since the Nuremberg Doctors Trial of 1946-47, the
universality of a minimum ethical standard of subject protection has
been evoked.1 In the 1990s, cases of drug research, which would not
have been conducted in the so called developed world, received com-
prehensive media coverage due to their alleged exploitation of poor
people in developing countries to the benefit of the rich.2 The essence of

1 T. Taylor, Nuremberg Trials War Crimes and International Law, 1949,


280; A. Mitscherlich and F. Mielke, Das Diktat der Menschenverachtung, 1947.
2 Exemplary P. Lurie/S.M. Wolfe, Unethical Trials of Interventions to
Reduce Perinatal Transmission of the Human Immunodeficiency Virus in
developing countries, New England Journal of Medicine, 337 (1997), 853-856;
J.S. Hawkins/E. Emanuel (eds.), Exploitation and Developing Countries the

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 177
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_8, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
178 Chang

the critique was that exploitative clinical trials were unethical due to
the application of different standards of subject protection, including
different study designs and shortcomings in terms of distributive jus-
tice. Aforementioned commentators therefore urged, first of all, to uni-
versally apply the existing ethical standards of subject protection, as
applied in developed regions like the European Union and the United
States, and secondly, to set specific positive obligations to externally
sponsored research in developing countries that is responsive to their
specific needs.
From scattered discourses on the ethics of research involving human
subjects, emerged what prima facie might be seen as a global consensus
on the ethical requirements of clinical trials involving human subjects.
At least most actors especially national regulators refer to such an in-
ternational or global ethical standard.3 This ethical standard is, as it
seems, formed by certain globally acknowledged ethical guidelines of
different origins. From a legal perspective, the task must be to explore
this ethical governance in relation to the law and how to address
these normative phenomena. Though the title of this endeavor is bio-
ethics and human rights in global drug trials, it is not supposed to be
an account of the bioethics as formed by ethical guidelines and the
human rights concerning the matter, but instead an argument why a
human rights paradigm should ultimately prevail. In this paper, two of
the most influential guidelines shall be examined for their nature and
scrutinized on their legitimacy.

Ethics of Clinical Research, 2008; E.J. Mills/S. Singh, Health, Human Rights
and the Conduct of Clinical Research within Oppressed Populations,
Globalization and Health, 3 (2007), 10; R. Yearby, Good Enough to Use for
Research, but not Good Enough to Benefit from the Results of that Research
are the Clinical HIV Vaccine Trials in Africa Unjust?, DePaul Law Review, 53
(2004), 1127-1154.
3 Art. 1 (2) European Directive 2001/20/EC for instance defines good
clinical practice as a set of internationally recognized ethical and scientific
quality requirements which must be observed for designing, conducting, re-
cording and reporting clinical trials that involve the participation of human sub-
jects.
Bioethics and Human Rights 179

II. Ethical Guidelines Globally Governing Clinical Trials

1. Ethical Global Governance

The concept of Global Governance serves to analyze specific modes of


conduct on a global level, since despite the lack of a global government,
there are activities whose regulative mechanisms resemble the exercise
of governmental authority.4 Core to the Global Governance concept is
that it acknowledges the relevance of international organizations, but
also of private actors and actors of hybrid nature, in the steering of
conduct on a global stage.5 Within this concept, governance is not only
performed by public actors. It is thus valuable for the visualization of
the mechanisms underlying the ethical governance of research.6

2. Ethical Guidelines Globally Governing Clinical Trials

It would be an impossible task to enumerate all activities by all actors


which might have a regulative steering effect on the conduct of clinical

4 J.N. Rosenau, Governance, Order, And Change in World Politics, in J.N.


Rosenau (ed.), Governance without Government Order and Change in World
Politics, 1992, 1; the notion of Governance has been borrowed from econom-
ics: O.E. Williamson, The Economics of Governance: Framework and
Implications, Zeitschrift fr die gesamte Staatswissenschaft, 140 (1983), 195-
223; A. Benz, Governance Modebegriff oder ntzliches sozialwissen-
schaftliches Konzept; M. Behrens, Global Governance, both in A. Benz (ed.),
Governance Regieren in komplexen Regelsystemen, 2004, 12, 104.
5 A. v. Bogdandy/P. Dann/M. Goldmann, Developing the Publicness of
Public International Law: Towards a Legal Framework for Global Governance
Activities, in A. v. Bogdandy et al. (eds.), The Exercise of Public Authority by
International Institutions Advancing International Institutional Law, 2010, 3;
B.K. Woodward, Global Civil Society in International Lawmaking and Global
Governance Theory and Practice, 2010; G.F. Schuppert, Governance und
Rechtsetzung Grundfragen einer modernen Regelungswissenschaft, 2011.
6 Fidler emphasizes this approach in his analysis of a globalized theory of
public health law. D.P. Fidler, A Globalized Theory of Public Health Law,
Journal of Law, Medicine & Ethics, 30 (2002), 150-159. See also the European-
Chinese Cooperation bionet concerning the Ethical Governance of Biologi-
cal and Biomedical Research, see at http://www.lse.ac.uk/collections/BIO
NET, or C. Rhodes, International Governance of Biotechnology, 2010.
180 Chang

trials on a global level in the sense of this concept.7 However, one of the
weaknesses of the Global Governance concept from a public law per-
spective lies in the leveling of all actors, public, private or hybrid, for-
mal or informal, in a way that does not allow differentiating between
accountable, authoritative and non-authoritative decisions.8 Above all,
Global Governance is being understood as a continuous process, which
exacerbates the attribution of singular specific acts to certain actors.9
Therefore, the Global Governance concept shall not be applied all-
encompassing to this analysis, though it helps pointing out specific acts
of private and hybrid provenance which govern clinical trials on a
global level. Two main ethical guidelines shall be singled out, as these
guidelines are specifically globally acknowledged and authoritative.10

a) The World Medical Associations Declaration of Helsinki


The World Medical Association (WMA) is an alliance of national asso-
ciations of physicians respectively national medical associations, incor-
porated under New York State law, with currently 101 members.11

7 The International Compilation of Human Research Standard, 2012,


published by the Office of Human Research Protection of the U.S. Department
of Health and Human Services enumerates over 1,000 laws, regulations and
guidelines of 103 countries as well as international organizations and misses
most private and hybrid works. See at http://www.hhs.gov/ohrp/international/
intlcompilation/intlcompil2012.doc.
8 G.F. Schuppert, Governance und Rechtsetzung Grundfragen einer
modernen Regelungswissenschaft, 2011, 137; see the critique by A. v. Bog-
dandy/P. Dann/M. Goldmann, Developing the Publicness of Public Interna-
tional Law: Towards a Legal Framework for Global Governance Activities, in
A. v. Bogdandy et al. (eds.), The Exercise of Public Authority by International
Institutions Advancing International Institutional Law, 2010, 3 (9).
9 Ibid.
10 The CIOMS International Guidelines for Biomedical Research Involving
Human Subjects are especially authoritative regarding research conducted spe-
cifically in developing countries. Yet, they are usually not taken into account
regarding research conducted in western countries. For an examination of these
as well as for human rights assessment see M. Chang, Ungerechtfertigte Ethik
Die Legitimitt ethischer Guidelines und das Menschenrechtsparadigma
globaler Arzneimittelforschung, 2013, Chapter 2, forthcoming dissertation.
11 M. Chang, World Medical Association in R. Wolfrum (ed.), The Max
Planck Encyclopedia of Public International Law, Oxford University Press,
2008, vol. X, 940, see also at www.mepil.com.
Bioethics and Human Rights 181

These are the constituent members, with only one national association
per country.12 Individual physicians may join the WMA as associate
members, but do not have own voting rights.
The WMA was founded in 1947 by representatives of 32 national asso-
ciations, only shortly after the judgment in the Nuremberg Doctors
Trial was passed.13 The first years of the WMA were highly influenced
by the atrocities committed by German Nazi-physicians.14 Against this
background, the WMA started the endeavor of formulating ethical
norms to protect human subjects in scientific experimentations. In
1964, the WMAs 18th General Assembly adopted the Declaration of
Helsinki as the first international set of rules governing experimenta-
tions involving human subjects. It has been revised several times, the
current version being of 2008 (adopted in Seoul).

b) The International Conference on Harmonisation of Technical


Requirements for Registration of Pharmaceuticals for Human Use and
its Good Clinical Practice and other Guidelines
The International Conference on Harmonisation of Technical Require-
ments for Registration of Pharmaceuticals for Human Use (ICH) is
besides European Union law the first sustaining successful endeavor
to harmonize drug laws on an international level.15 The public-private-
partnership kicked off in 1989 and the first International Conference on

12 Though according to Section 1 D of its Articles and Bylaws the WMA de-

fines country as a customs territory in which one regulatory body governs


exclusively the licensure to practice medicine, which is why the associations of
Hong Kong and China are both independent members.
13 S.E. Lederer, Research without Borders, The Origins of the Declaration
of Helsinki, in U. Schmidt/A. Frewer (eds.), History and Theory of Human
Experimentation, 2007, 145.
14 The associations of Germany and Japan were not invited to join the
WMA until they would distance themselves from the atrocities German (and
Japanese) physicians had committed. They both joined in 1951. J. Peter, Der
Nrnberger rzteproze im Spiegel seiner Aufarbeitung anhand der drei
Dokumentensammlungen von Alexander Mitscherlich und Fred Mielke, 2nd ed.,
1998, 229; World Medical Association, World Medical Association, British Me-
dical Journal vol. 2 (1948), 605.
15 K.P. Purnhagen, Kann das europische Arzneimittelzulassungsverfahren
als Modell fr eine internationale Harmonisierung dienen?, EuR, (2010), 438-
453 (446).
182 Chang

Harmonisation, with representatives of the regulatory bodies and min-


istries of the EU, USA and Japan, as well as the main pharmaceutical
industrys lobby associations of the EU, USA and Japan, was held in
1991.16 Representatives of the WHO and the regulatory bodies of Can-
ada and Sweden were observers. Since then, the ICH has been institu-
tionalized, though it is not incorporated.
The ICH has prepared a high number of guidelines to harmonize tech-
nical requirements regarding the quality, safety and efficacy of drugs for
human use.17 Among these, certain guidelines like the Good Clinical
Practice Guideline E6 (GCP-Guideline) of 1996, but also others such as
the Choice of Control Group and Related Issues in Clinical Trials E10
of 2000, have a substantial impact on the design of clinical studies and
therefore on the ethical implications of trials.

III. The Exercise of Public Authority by Private or Hybrid


Institutions Issuing Ethical Guidelines

It has been claimed that the two enumerated guidelines are specifically
authoritative acts, as deviating from these guidelines may deem research
unethical. These are guidelines regularly referred to when the inter-
national or global ethical standard of clinical trials is being discussed
or referenced. The fundamental problem of such ethical governance lies
in the legitimacy of the private or hybrid institutions issuing these
guidelines, which is generally weaker and more dubious than that of
public institutions. This aspect will be elaborated on later; first, it has to
be illuminated why legitimacy should be of concern at all, if these
guidelines are only of ethical nature and formally not legally binding
comprehending legitimacy as a concept of political philosophy and
public law, which justifies public authority.

1. Basic Conceptualization

In order to assess this question, the specific nature of the aforemen-


tioned ethical guidelines needs to be explored. To do so, the conceptu-

16 P.F. DArcy/D.W.G. Harron (eds.), Proceedings of The First International

Conference on Harmonisation Brussels 1991, 1992.


17 See for an overall overview http://www.ich.org/products/guidelines.html.
Bioethics and Human Rights 183

alization of the exercise of public authority as developed by von Bog-


dandy, Dann and Goldmann shall be relied on.18
In a national understanding, public authority encompasses the elements
of norm-setting and their coercive enforcement vis--vis subordinated
citizens.19 For the international realm, aforementioned authors define
authority as the legal capacity to determine others and to reduce their
freedom, i.e. to unilaterally shape their legal or factual situation. An ex-
ercise is the realization of that capacity, in particular by the production
of standard instruments such as decisions and regulations. The determi-
nation may or may not be legally binding. It is binding if an act modi-
fies the legal situation of a different legal subject without its consent. A
modification takes place if a subsequent action, which contravenes that
act, is illegal. Yet, following von Bogdandy, Dann and Goldmann, a
concept of authority which is conceived in a broader way than this
rather traditional definition, shall be relied on. The capacity to deter-
mine another legal subject can also occur through a non-binding act
which only conditions another legal subject. This is the case whenever
that act builds up pressure for another legal subject to follow its impe-
tus. Such exercise of public authority often occurs through the estab-
lishment of non-binding standards, which are followed inter alia be-
cause the benefits of observing them outweigh the disadvantages of ig-
noring them. Such a conditioning effect can also be realized by non-
legal sanctions as reputational or economic losses or penalties.
This broad understanding of the concept of authority rests on the em-
pirical insight that conditioning acts can constrain individual freedom
and [public] self-determination as much as binding acts. Accordingly,
this broad understanding is underlined by the following considerations:
if public law is understood in keeping with the liberal and democratic
tradition as a body of law to protect individual autonomy and to al-

18 The submissions of this section follow A. v. Bogdandy/P. Dann/M. Gold-

mann, Developing the Publicness of Public International Law: Towards a Legal


Framework for Global Governance Activities, in A. v. Bogdandy et al. (eds.),
The Exercise of Public Authority by International Institutions Advancing
International Institutional Law, 2010, 3; also C.A. Feinugle, Hoheitsgewalt im
Vlkerrecht das 1267-Sanktionsregime der UN und seine rechtliche Fassung,
2011, 36.
19 E. Schmidt-Amann in T. Maunz/G. Drig, Grundgesetz Kommentar,

2011, vol. III, Art. 19 (4) GG, para. 45; C.A. Feinugle, Hoheitsgewalt im
Vlkerrecht das 1267-Sanktionsregime der UN und seine rechtliche Fassung,
2011, 30.
184 Chang

low for political self-determination, any act that has an impact on those
values, whether it is legally binding or not, should be included if that
impact is significant enough to give rise to meaningful concerns about
its legitimacy.
However, not every exercise of authority may be qualified as interna-
tional and public. Formalistically speaking, international public author-
ity can be understood as any authority exercised on the basis of compe-
tence instituted by a common international act of public authorities,
mostly states, to further a goal which they define, and are authorized to
define, as a public interest. The publicness of an exercise of authority, as
well as its international character, therefore depends on its legal basis.
However, the Global Governance approach showed, despite the cri-
tique, that there are institutions based on private law and hybrid institu-
tions, which lack any relevant delegation of authority, that nonetheless
carry out activities which are just as much of public interest as those
based on delegations of authority. This is the case when such activity
can be regarded as a functional equivalent to an activity on a public le-
gal basis. Such institutions exercise public authority if they enjoy condi-
tioning capacities.

2. Publicness: Functional Equivalence to the Exercise of Public


Authority

Private acts, which delimit individual freedoms and rights against the
subjects consent pursuing a public good, equivalently to public acts,
need to meet the same legal requirements as acts of public authority,
that is, they need to meet the same requirements of legitimacy.

a) Formal Equivalence: Relation to Law


In order to assess the functional equivalence to public acts, it needs to
be examined if private or hybrid acts fulfill the same functions as legally
non-binding acts of public authority on a public basis. The debate sur-
rounding the notion of soft law identified various functions of soft law,
which may as well be qualified as exercises of public authority. The test
is therefore, if private acts fulfill the same functions as soft law (apply-
ing a formalistic definition of soft law which encompasses only acts of
Bioethics and Human Rights 185

institutions invested with competences by states). In the following sec-


tion, the denominations are borrowed from Peters and Pagotto.20

(1) Pre-Law Function


Soft law often fulfills a preparatory pre-law function by achieving yet
legally non-binding agreements.21 Such agreements are often not purely
demonstrations of a political will, but normative statements, evolving
about to become law.22 Yet, quite often these acts serve as a factual
model for the genesis of law and later legislation is not necessarily in-
tended.23 Either way, the influence of these acts on the development of
law cannot be denied as they are dynamizing factors in the legal or-
der.24 They may even be cloud points25 in the evolution of interna-
tional customary law.

(2) Law-Plus Function


A further function of soft law is to clarify and to further define the con-
tent of effective law.26 In cases in which the legal position is unclear
such acts may advance a consistent application of law by consolidating
and illustrating the attained level of regulation, and hereby contribute

20 A. Peters/I. Pagotto, Soft law as a new mode of governance: a legal


perspective, NewGov New Modes of Governance, see at http://www.eu-ne
wgov.org/database/DELIV/D04D11_Soft_Law_as_a_NMG-Legal_Perspective.
pdf.
21 M. Knauff, Der Regelungsverbund: Recht und Soft Law im Mehr-
ebenensystem, 2010, 378.
22 H. Kremser, Soft Law der UNESCO und Grundgesetz, 1996, 125.
23 M. Knauff, Der Regelungsverbund: Recht und Soft Law im Mehr-
ebenensystem, 2010, 380.
24 A. Peters, Elemente einer Theorie der Verfassung Europas, 2001, 468; A.
Peters/I. Pagotto, Soft law as a new mode of governance: a legal perspective,
NewGov New Modes of Governance, see at http://www.eu-newgov.org/data
base/DELIV/D04D11_Soft_Law_as_a_NMG-Legal_Perspective.pdf, 23.
25 E. Riedel, Standards and Sources. Farewell to the Exclusivity of the
Sources Triad in International Law?, European Journal of International Law, 2
(1991), 58-84 (68); W. Heusel, Weiches Vlkerrecht, 1991, 279.
26 U. Fastenrath, Relative Normativity in International Law, European
Journal of International Law, 4 (1993), 305-340 (315).
186 Chang

to the transparency, clarity and effectiveness of the law.27 The soft-law-


setting institution may formulate these norms with the intent to de-
mand the same observance for these as for the accompanied law.28 Re-
gardless of an explicit intent, addressees may observe such acts nonethe-
less in order not to jeopardize disadvantages in the administrative prax-
is.29

(3) Para-Law Function


Soft law, which has no reference to the effective law it clarifies or sub-
stantiates, but claims to independently regulate an area, may be attrib-
uted a para-law function.30 In international law, such acts often display
an alternative to non-achievable hard law, especially if the only al-
ternative would be anarchy.31 A soft solution is then favored over
no solution. Still, such categorizations are not always clear-cut as
agreed on soft law may not have any reference to effective law from an
ex-ante perspective, but may have a pre-law function in an ex-post per-
spective. Nevertheless, one difference to pre-law soft law is that para-
law acts are often intended to endure as soft regulation, which may
attribute them a character of informal legislation.32

27 M. Knauff, Der Regelungsverbund: Recht und Soft Law im Mehr-


ebenensystem, 2010, 381.
28 For the case of the European Commission see F.G. Snyder, Soft law and

Institutional Practice in the European Community, 1993.


29 For European Competition Law see H.A. Cosma/R. Whish, Soft Law in

the Field of EU Competition Policy, European Business Law Review, 14 (2003),


25-56 (31).
30 A. Peters/I. Pagotto, Soft law as a new mode of governance: a legal

perspective, NewGov New Modes of Governance, see at http://www.eu-ne


wgov.org/database/DELIV/D04D11_Soft_Law_as_a_NMG-Legal_Perspective.
pdf, 23; M. Knauff, Der Regelungsverbund: Recht und Soft Law im Mehr-
ebenensystem, 2010, 384.
31 A. Peters/I. Pagotto, Soft law as a new mode of governance: a legal
perspective, NewGov New Modes of Governance, see at http://www.eu-ne
wgov.org/database/DELIV/D04D11_Soft_Law_as_a_NMG-Legal_Perspective.
pdf, 23.
32 M. Cini, The Soft Law Approach: Commission Rule-Making in the EUs
State Aid Regime, Journal of European Public Policy, 8 (2001), 192-207 (194).
Bioethics and Human Rights 187

b) Substantial equivalence
Substantially, private/hybrid functionally equivalent acts fulfill interna-
tional public tasks in regard to content. The main tasks of international
public law are just to name a few peacekeeping, the administration
of global public goods, the international protection of individuals, the
coordination of global infrastructure and the balancing of socially and
economically disparate regions. The question therefore is, if ethical
guidelines substantially fulfill such functions.

3. Forms of Conditioning

As laid out, private or hybrid institutions may condition other subjects


by reducing their freedom, i.e. unilaterally shaping their factual situa-
tion through non-binding acts, which build up pressure for other legal
subjects to follow their impetus. As this conditioning is not secured by
legal coercion, other forms of extrinsic motivation need to be taken into
consideration. Intrinsic motives can be left out of consideration, as this
conceptualization aims to locate ethical guidelines within a public-law-
framework, which is not concerned with the question of why the rules
are followed by individual subjects.33

a) Reputation
From 1946-1948, US-American researchers conducted experiments in
Guatemala on sex workers, soldiers, prisoners and mentally challenged
persons, without their knowledge or consent, by infecting them with
syphilis in order to test treatments. These experiments had not been un-
covered until 2010 when a historian published her findings.34 This pub-
lication triggered much controversy, causing President Barack Obama,
Secretary of State Hillary Clinton and Secretary of Health and Human
Services Kathleen Sebelius to apologize to the government of Guate-
mala and survivors and descendants of the experiments, as these were

33 See M. Goldmann, Internationale ffentliche Gewalt, 2013, forthcoming


dissertation.
34 S.M. Reverby, Normal Exposure and Inoculation Syphilis: A PHS
Tuskegee Doctor in Guatemala, 1946-48, see at http://www.wellesley.edu/Wo
menSt/Reverby%20Normal%20Exposure.pdf.
188 Chang

clearly unethical.35 Even after decades, clearly unethical experi-


ments may lead to reputational damage.36
Ethical guidelines now claim to set the parameters for ethical research.
In other words, any deviation from these guidelines implies a potential
accusation of unethical conduct. Ethical guidelines can be seen as
constitutions of normative ethics serving the evaluation of moral acting
and judging.37 The function of morals from a sociological, cultural-
anthropological and evolutionary-biological perspective, lies in the sta-
bilization of a group or community by serving as a group-marker (for
example of a scientific community).38 Therefore, a breach of such
norms holds the threat of expulsion from this group through loss of
credibility. Reputation has a signaling function for credibility and dam-
age will often trigger further consequences.
In the subsystem of the scientific community, reputation has become
one of the essential constituting characteristics of a career in science.39
Yet, not only scientists pursuing a career fear a loss of reputation. A
damaged reputation may have severe economic consequences, as it may
for instance have an impact on consumer-demand or access to assign-
ments.40

35 British Medical Journal online, Oct. 4, 2010, doi 10.1136/bmj.c5494 (see

http://dx.doi.org/ to resolve); D.G. McNeil, U.S. Apologizes for Syphilis Tests


in Guatemala, New York Times, Oct. 2, 2010, page A1 New York Print Edi-
tion, see at http://www.nytimes.com/2010/10/02/health/research/02infect.html
online edition.
36 As the Inspector General of the Global Funds to Fight AIDS, Tuberculo-
sis and Malaria found: Unethical conduct can result in considerable reputa-
tional damage. Global organizations must deliver against extremely high stan-
dards. Everyone must conduct themselves as moral actors, responsible agents
who do their work within an ethical framework. J.E. Dubinsky, Ethics and
Reputational Risk Assessment The Global Fund, see at www.theglobal
fund.org/documents/oig/OIG_EthicsAndReputationalRiskAssessment_Report
_en, 2.
37 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-

kratischer Legitimation fr Ethikgremien, 2010, 72.


38 Ibid., 59; M.D. Hauser, Moral Minds, 2006, 97.
39 N. Luhmann, Die Wissenschaft der Gesellschaft, 4th ed., 2002, 244.
40 During the first International Conference on Harmonisation the ethics
of human exposure in clinical trials have been regarded as a substantial respon-
sibility of sponsors whose violation might trigger painful consequences in-
cluding litigation and public condemnation. P.F. DArcy/D.W.G. Harron
Bioethics and Human Rights 189

On a state-level, states and regulatory bodies may not want to be ac-


cused for endorsing unethical research, as this might severely hinder
cooperation in other fields. 41

b) Scientific Standard Setting


The ethics of research are highly intertwined with the scientific va-
lidity of the research. As the accumulation of scientific knowledge is
the aim and justification of research, it also sets the parameters for sci-
entific necessities. In some cases, the need for scientific validity is con-
gruent with the need for research subject protection (for example the
necessity of qualified personnel). In some cases it is not (for example in
study design and the use of placebo-control). In other cases scientific
necessities may not be linked directly to research study protection (for
example statistical validity). In any case, scientifically invalid research
has no public value, and the involvement of human subjects may not be
justified, deeming the research unethical. However, ethical guidelines
do also set scientific standards of methodology for instance, standards
with a strong conditioning effect, since deviations may cause market-
exclusion.42

c) Sanctions
Sanctions in the sense of international public law are not to be expected.
Rather, applying a broad notion, direct or indirect economic sanctions
and sanctions resulting from the loss of reputation may have a condi-
tioning effect. Moreover, even the threat of sanctions may be condition-
ing. As to sanctions resulting from the loss of reputation, the publica-
tion of research results can require the observance of certain ethical

(eds.), Proceedings of The First International Conference on Harmonisation


Brussels 1991, 1992, 357.
41 Rational-choice concepts are based on this notion, A.T. Guzmn, How

International Law Works a Rational Choice Theory, 2008; D.E. Ho,


Compliance and International Soft Law: Why do Countries implement the
Basle Accord?, Journal of International Economic Law, 5 (2002), 647-688, 647.
42 H.C. Rhl, Internationale Standardsetzung; O. Lepsius, Standardsetzung
und Legitimation, both in C. Mllers/A. Vosskuhle/C. Walter (eds.),
Internationales Verwaltungsrecht, 2007, 319, 345.
190 Chang

guidelines. Not being able to publish may stop a career in the sciences
quite quickly.
Sanctions may also occur by reference through national law. Domestic
administrative, civil, professional or even criminal law may directly or
indirectly link consequences to unethical research. Pharmaceutical
companies may not be granted marketing authorization for drugs and
medical products or physicians may lose their approbation. On the
front end, financing and hiring may be linked to the obligation to ob-
serve certain ethical guidelines.
States on the other hand may fear being excluded from markets if they
do not adopt certain ethical requirements. Research could be with-
drawn or conferred to other countries if research conducted in this
country according to this countrys regulatory requirements, raises sus-
picion as being unethical or if home markets will not accept other stan-
dards.43

d) Setting the Agenda


Certain ethical guidelines can furthermore have a rather indirect condi-
tioning effect by setting the agenda of the discourse on how to con-
duct research rightly. They may not only influence the topics and
norms, but also frame the language and be a common point of refer-
ence. Positioned in a specific line of tradition, they may also conjure a
certain tradition of ethical thinking and ethical reasoning, which is dif-
ferent from legal reasoning.

IV. The Exercise of Public Authority via Ethical Guidelines

Having sketched the parameters for private or hybrid acts to be dealt


with as exercises of international public authority, the two specified
ethical guidelines globally governing clinical trials shall be scrutinized.

43 Ibid.
Bioethics and Human Rights 191

1. The World Medical Associations Declaration of Helsinki

a) Publicness: Functional Equivalence


(1) Formal Equivalence
(a) Pre-Law Function
The Declaration of Helsinki has been formulated against the back-
ground of the atrocities committed by German Nazi-physicians, and is
the first authoritative set of regulation on an international level.44 There
had been no other authoritative international regulation, neither bind-
ing nor non-binding. Obviously, the WMA as a private body did not
intend to subsequently replace the Declaration by a binding provision.
However, the Declaration of Helsinki served as a factual model.
As to international conventions: the Convention on Human Rights and
Biomedicine45 and its Additional Protocol concerning Biomedical Re-
search46 were highly influenced by the Helsinki Declaration. Besides the
inclusion of the subject matter, the Helsinki Declaration is concerned
with, in a binding convention substantial principles have been directly
borrowed, partly consciously, in the same wording as enshrined in the
Helsinki Declaration.47
As to international soft law: The UNESCO Declaration on Bioethics
and Human Rights notes the Helsinki Declaration in its preamble as an
international guideline and text in the field of bioethics that it takes into
consideration.48 The Model Law on Protection of Human Rights and

44 Prior to the Declaration of Helsinki in 1947 the so called Nuremberg

Code had seen light. This Code encompasses ten basic ethical principles of re-
search involving human subjects. Nonetheless, this Code had actually only been
part of the judgement in the Nuremberg physician trial. As such the Nurem-
berg Code was highly associated with Nazi-criminals why nobody else felt ad-
dressed by it. Furthermore, as it probably had been drafted by a judge alone it
lacked acquaintance with actual scientific and medical practice, why it was
deemed not to be useful in everyday practice. See H.K. Beecher, Research and
the Individual: Human Studies, 1970.
45 CETS No.: 164.
46 CETS No.: 195.
47Steering Committee on Bioethics, Convention on Human Rights and
Biomedicine CETS No. 164, Preparatory Work on the Convention, CoE Doc.
CDBI/INF (2000) 1, 15.
48See H. ten Have, The UNESCO Universal Decaration on Bioethics and
Human Rights, 2009.
192 Chang

Dignity in Biomedical Researches in the CIS Member States adopted by


the Interparliamentary Assembly of Member Nations of the Common-
wealth of Independent States49 cites the Declaration in its preamble as
one of the international sets of regulations it corresponds to.
The Declaration had further impact on the evolution of specific princi-
ples as informed consent into customary international law.50
Moreover, the Declaration set a major example for national legislation.51
For instance, in European Union law, the European Directive
2001/20/EC on good clinical practice states in recital 2 that
the accepted basis for the conduct of clinical trials in humans is
founded in the protection of human rights and the dignity of the
human being with regard to the application of biology and medi-
cine, as for instance reflected in the 1996 version of the Helsinki
Declaration.
Furthermore, Art. 3 of the Directive 2005/28/EC demands the obser-
vance of the Helsinki Declaration of 1996 in clinical trials, just as para-
graph 8 of the preamble of Annex I of Directive 2001/83/EC as revised
by Directive 2003/63/EC. The Declaration has also had a significant
impact in cases in which national legislation does not cite it explicitly.52
Especially the widely spread installment of ethics committees may be
ascribed to the Helsinki Declaration. In Israel for instance, these com-
mittees are called Helsinki-Committees.53

49 See at http://www.iacis.ru/html/index-eng.php?id=54&pag=596&nid=9.
50 B.D. Parker for the U.S. Court of Appeals, 2nd Circuit, Abdullahi et al. v.
Pfizer, Inc., Jan. 30, 2009, 562 F.3d 163, 181.
51 See for instance the various country reports in E. Deutsch/J. Taupitz

(eds.), Forschungsfreiheit und Forschungskontrolle in der Medizin zur


geplanten Revision der Deklaration von Helsinki, 2000; see also various refer-
ences in U. Schmidt/A. Frewer (eds.), History and Theory of Human
Experimentation, 2007.
52 For example in German legislation, F.v. Freier, Recht und Pflicht in der
medizinischen Humanforschung zu den rechtlichen Grenzen der kontrollier-
ten Studie, 2009, 94; G. Fischer, Medizinische Versuche am Menschen, 1979, 7;
or South African legislation, C. van Wyk, Country Report South Africa, in E.
Deutsch/J. Taupitz (eds.), Forschungsfreiheit und Forschungskontrolle in der
Medizin zur geplanten Revision der Deklaration von Helsinki, 2000, 219.
53 A. Shapira, Country Report Israel, in E. Deutsch/J. Taupitz (eds.),
Forschungsfreiheit und Forschungskontrolle in der Medizin zur geplanten
Revision der Deklaration von Helsinki, 2000, 241.
Bioethics and Human Rights 193

(b) Law-Plus Function


Obviously, the Helsinki Declaration was not issued by a body with
law-making capacity in order to accompany legal provisions by the
same body. Nevertheless, the Declaration serves in an interpretive man-
ner for certain legally binding provisions on an international level. By
applying a dynamic interpretation of human rights conventions, specific
rights, as the right to health in Art. 12 of the ICESCR, are for example
being interpreted with regard to informed consent in a direction to meet
the Helsinki Declaration.54

(2) Substantial Equivalence


The Declaration of Helsinki aspires to protect and therefore regulate the
autonomy, life, health and dignity of test subjects. It is clearly set out to
protect individuals, which had been identified as an international public
task. Furthermore, the Declaration regulates certain aspects of attaining,
endorsing and distributing medical and pharmaceutical knowledge as a
public good55, thereby performing another task of international public
law. Finally, the Declaration aspires to influence the disparity of richer
and poorer regions in the world by taking ethical-regulatory measures.

b) Conditioning Capacity
(1) Reputation
As already laid out, an accusation of performing or endorsing unethi-
cal research may lead to reputational damage, which may be disas-
trous. To give guidance, ethical guidelines claim to set the parameters
for ethical research. The Declaration of Helsinki is one of these.
Breaching the principles enumerated in the Helsinki Declaration may
lead to suspicions about unethical conduct. Therefore, actors financing
or utilizing research very often sanction the breach of ethical princi-
ples as substantiated by the Declaration of Helsinki, because these vio-
lations may have a severe impact on their own reputation, even if the

54 UN Report by A. Grover, Special Rapporteur on the Right of everyone


to the enjoyment of the highest attainable standard of physical and mental
health, Aug. 10, 2009, UN Doc. A/64/272.
55 P.A. Samuelson, The Pure Theory of Public Expenditure, Review of
Economics and Statistics, 36 (1954), 387-389.
194 Chang

violations were committed by third persons that they supported, either


financially or otherwise.56
Besides sanctions, a lot of actors bind themselves prophylactically to
the Declaration of Helsinki in order to not risk their reputation. For ex-
ample, in 2010 the Max Planck Society adopted Guidelines and Rules on
a Responsible Approach to Freedom of Research and Research Risks57 to
set ethical limits to research.58 The introduction explains that the aim is
inter alia to enable scientists to better resolve ethical uncertainties and
prevent accusations of unethical conduct. The rules of the Max Planck
Society are hereby not exclusive but are supplemented by subject-
specific self-regulatory measures such as the Declaration of Helsinki.59
Pharmaceutical companies, which are also dependent on their reputa-
tion, advertise their soundness by an assurance to observe all ethical
standards, especially the Declaration of Helsinki.60 Equally, they de-
fend themselves against accusations of unethical conduct by reference
to their compliance with the Helsinki Declaration.61
As to governments, regulatory bodies and international organizations,
the introductory remark above about the US American syphilis ex-
periments in Guatemala shows the reluctance of states to be associated
with the endorsement of unethical research. This may be one reason for
numerous adoptions of and referencing to the Helsinki Declaration in
domestic legislations, as well as guidelines and handbooks published by
international organizations.62

56 J.E. Dubinsky, Ethics and Reputational Risk Assessment The Global

Fund, see at www.theglobalfund.org/documents/oig/OIG_EthicsAndReputati


onalRiskAssessment_Report_en.
57 See at http://www.mpg.de/232129/researchFreedomRisks.pdf
58 For an assessment under the Geman Basic Law see H.C. Wilms,
Verantwortliche Forschung und Wissenschaftsfreiheit ein Widerspruch?, Wis-
senschaftsrecht, 43 (2010), 386-407.
59 Footnote 5 of the Guidelines and Rules on a Responsible Approach to
Freedom of Research and Research Risks of the Max Planck Society, see intra at
57.
60 For instance see the statement of Pfizer in 2008, see at http://www.pfizer.
com/files/research/Helsinki_statement_5_08.pdf.
61 For example M. Wadman, Pesticide Tests on Humans Cause Concern,

Nature, 394 (1998), 515.


62 Exemplary UNAIDS/WHO Guidance Document, Ethical Considera-

tions in Biomedical HIV Prevention Trials, 2007, see at http://data.unaids.org/


Bioethics and Human Rights 195

(2) Sanctions
Disregards of the Helsinki Declaration may hold sanctions of direct or
indirect economic kind or may result in reputational damage.

(a) Capacity to Publish


As mentioned before, the capacity to publish is constituent for any ca-
reer in the sciences. Most journals and publishers, especially those with
a high reputation, will publish only results of research which has been
conducted in accordance to the Declaration of Helsinki.63 Not being
publishable is a major sanction that motivates actors to adhere to the
Declaration (at least formally).

(b) Financing
The financing of research follows the same conditioning mechanisms as
the capacity to publish. For instance, the Seventh Framework Pro-
gramme for Research, Technological Development and Demonstration
Activities of the European Union conditions financing of research to

pub/manual/2007/jc1349_ethics_2_11_07_en.pdf, 8; UNAIDS, Good Participa-


tory Practice, Guidelines for Biomedical HIV Prevention Trials, 2011, see at
http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspubli
cation/2011/JC1853_GPP_Guidelines_2011_en.pdf, 6, 48, 55; WHO, Hand-
book for Good Clinical Research Practice, 2002, see at http://ori.hhs.gov/
documents/WHOHandbookonGCP04-06.pdf, 3, 18, 21, 27, 35, 42, 43, 44, 48,
59, 66, 68, 72, 81, 98, 103, 104.
63 Decision of the International Committee of Medical Journal Editors,
Uniform Requirements for Manuscripts, Apr. 2010, Ethical Considerations in
the Conduct and Reporting of Research, see at http://www.icmje.org/ethical_6
protection.html; Members of the ICMJE are: Annals of Internal Medicine,
British Medical Journal, Canadian Medical Association Journal, Chinese
Medical Journal, Croatian Medical Journal, Journal of the American Medical
Association, Nederlands Tijdschrift voor Geneeskunde (The Dutch Medical
Journal), New England Journal of Medicine, New Zealand Medical Journal,
The Lancet, The Medical Journal of Australia, Revista Mdica de Chile,
Tidsskrift for Den Norske Lgeforening (The Journal of the Norwegian
Medical Association), Ugeskrift for Laeger (Journal of the Danish Medical
Association), the U.S. NLM, and the World Association of Medical Editors; see
also at http://www.oxfordjournals.org/our_journals/bjaint/for_authors/gen
eral.html.
196 Chang

compliance with fundamental ethical principles.64 Specific decisions


of the Council concretize that the fundamental principles of the Decla-
ration of Helsinki have to be complied with.65

(c) Domestic Legal Consequences


Furthermore, a breach of the Helsinki Declaration may be coercively
sanctioned by domestic professional,66 administrative, labor,67 civil or

64 Art. 6 (1) Decision 1982/2006/EC of the European Parliament and of the


Council concerning the Seventh Framework Programme of the European
Community for research, technological development and demonstration activi-
ties (2007-2013).
65 Council Decision concerning the Specific Programme Cooperation im-

plementing the Seventh Framework Programme 2006/971/EC, Official Journal


EU L 400/86, 108; Council Decision concerning the Specific Programme
Ideas, 2006/972/EC, O.J. EU L 400/242, 266; Council Decision concerning
the Specific Programme People, 2006/973/EC, O.J. EU L 400/270, 285;
Council Decision concerning the Specific Programme Capacities,
2006/974/EC, O.J. EU L 400/299, 314; Council Decision concerning the Spe-
cific Programme implementing the Seventh Framework Programme of the
European Atomic Energy Community (Euratom) for nuclear research and
training activities (2007 to 2011), 2006/976/Euratom, O.J. EU L 400/404, 432;
Council Decision concerning the Specific Programme to be carried out by
means of direct actions by the Joint Research Centre under the Seventh Frame-
work Programme of the European Community for research, technological de-
velopment and demonstration activities (2007 to 2013), 2006/975/EC, O.J. EU
L 400/368, 401; Council Decision concerning the Specific Programme to be car-
ried out by means of direct actions by the Joint Research Centre implementing
the Seventh Framework Programme of the European Atomic Energy Commu-
nity (Euratom) for nuclear research and training activities (2007 to 2011),
2006/977/Euratom, O.J. EU L 400/434, 452.
66 In Germany physicians and psychotherapists need to comply with the

Declaration of Helsinki according to their professional law. 15 (3) federal mo-


del code for physicians of 1997 as revised in 2011 (Musterberufsordnung fr die
in Deutschland ttigen rztinnen und rzte), see at http://www.bundesaerzte
kammer.de/downloads/MBO_08_20111.pdf, and 28 (1) federal model code
for psychotherapists of 2007 (Musterberufsordnung fr die Psychologischen
Psychotherapeutinnen und Psychotherapeuten und Kinder- und Jugendlichen-
psychotherapeutinnen und Kinder- und Jugendlichenpsychotherapeuten), see at
http://www.bptk.de/uploads/media/20060117_musterberufsordnung.pdf. The-
se federal model codes are generally adopted by the competent state chambers
(Landesrztekammern and Landespsychotherapeutenkammern).
Bioethics and Human Rights 197

criminal law. Regarding administrative consequences, it has been


pointed out that non-compliance may lead to a rejection of marketing
approval under European Union law. Furthermore, ethics committees,
whose favorable decision/opinion is essential for the approval of clinical
trials in many countries, often reason on the basis of the Declaration of
Helsinki.68

c) Setting the Agenda


As already mentioned, the Declaration of Helsinki had an essential im-
pact on the agenda of international discussions, simply because it was
the first set of authoritative international regulation with high visibility.
It hereby strengthened the linkage to the bioethical discourse (rather
than legal discourse), perpetuating the perception that this subject mat-
ter needs to be governed primarily by ethical principles. By this linkage,
the language and reasoning of bioethics, which are highly dominated by
so called Principlism (which lacks a coherent moral-theoretical underly-
ing), are predominantly applied to the sensitive matter of research in-
volving human subjects.

2. The Guidelines of the International Conference on


Harmonisation

a) Publicness: Functional Equivalence


(1) Formal Equivalence
(a) Pre-Law Function
The Guidelines of the ICH have been adopted by the participating
states, their regulatory bodies and the industry, with no such expressed
intent (on the part of the states) to subsequently elaborate a legally
binding convention to replace these legally non-binding guidelines.
Nevertheless, from an ex-post perspective, the guidelines may prove to
be preparatory for a treaty, although this may currently seem unlikely.

67 The cited Rules and Guidelines of the Max Planck Society and the cited

profession law for physicians for example give ground for sanctions compliant
with German labor law.
68 I. Klingmann/D. Adam (eds.), Ethik in der klinischen Prfung, 1990, 92.
198 Chang

(b) Para-Law Function


The endeavor undertaken by the ICH is, besides European Union law,
the first successful attempt to harmonize drug regulations. Yet, instead
of a binding convention, the participating countries of the ICH opted
to develop, conjoined with the pharmaceutical industry, guidelines,
which they politically agreed to implement into national regulation.
The harmonization has deliberately been based on legally non-binding
agreements, which nonetheless serve as a form of informal legislation.

(2) Substantial Equivalence


There might be a stronger emphasis of the ICH-guidelines on the scien-
tific side of regulation. Nevertheless, to a substantial degree, these
guidelines perform tasks in the same manner as the Declaration of Hel-
sinki.69

b) Conditioning Capacity
(1) Reputation
As to reputational aspects, the conditioning capacity of the ICH-
guidelines and especially of the Good Clinical Practice Guideline is just
as effective as the capacity of the Declaration of Helsinki. The partici-
pating representatives of the pharmaceutical industry pointed out that
reputation is a concern to be taken seriously. Non-compliance with
ethical principles could have painful consequences such as legal
prosecution, but also such as public condemnation, which might have
further consequences in economic terms.70

(2) Scientific Standard Setting


Most of the guidelines of the ICH are setting scientific standards, for
example for methodology or evaluation. Even a guideline such as the
Good Clinical Practice Guideline, which aspires to give guidance on
fundamental ethical principles, is primarily setting scientific and techni-
cal standards. As such, a breach of the GCP-Guideline is often judged

69 See intra.
70 P.F. DArcy/D.W.G. Harron (eds.), Proceedings of The First International
Conference on Harmonisation Brussels 1991, 1992, 357.
Bioethics and Human Rights 199

as a breach of scientific validity. The GCP-Guideline has been imple-


mented by the legislations of the EU, USA and Japan, in respect to their
regulatory bodies, and is therefore binding on a domestic level.71 Yet,
the ICH-guidelines have a much wider effect as well in terms of matter
as in terms of region. On the one hand, they affect research which is
neither drug research nor intended to support an application for mar-
keting approval. On the other hand, regulatory bodies of other coun-
tries, which are not members of the ICH, feel conditioned to adopt
these guidelines as well.72 The ICH-Standards are even perceived as the
global standard for scientific standards with spillover effects on their
perception from an ethical perspective.73

(3) Sanctions
(a) Capacity to Publish
Most renowned journals and publishers do not explicitly demand that
research, in order to be published, has to be conducted in accordance
with the GCP-Guideline. Yet, the International Committee of Medical
Journal Editors74 decided on a prerequisite for publication, which re-
quires a registration of the methodology (not results) of experiments on
ClinicalTrials.gov in order to prevent the non-publication of disagree-

71 The guideline has on the one hand influenced national legislation, see for
example recital 6 directive 2001/20/EC and recital 8 of directive 2005/28/EC,
on the other hand it has been adopted by the regulatory bodies as a factually
binding guideline. EMEA Doc. CPMP/ICH/135/95/Step5; adoption by the
FDA: 62 Federal Register, 25691-25709 of 9 May 1997; adoption by the Japa-
nese regulatory body: PAB Notification No. 430, MHLW Ordinance No. 28.
The EMEA is invested with competences to issue guidelines on grounds of Art.
57 (1) Regulation (EC) 2004/726.
72 During the first ICH an observer and representative of the Soviet regula-

tory agency remarked that there were 11,000 km and 300,000,000 inhabitants
between the EU and Japan and that it would be sensible to think about a global
process of harmonization as the (former) Soviet countries already began to
harmonize their legislation with the requirements of the EU, USA and Japan.
P.F. DArcy/D.W.G. Harron (eds.), Proceedings of The First International
Conference on Harmonisation Brussels 1991, 1992, 577.
73 D.A. Zarin/T. Tse/N.C. Ide, Trial Registration at ClinicalTrials.gov

between May and October 2005, New England Journal of Medicine, 353 (2005),
2779-2787.
74 Intra at 63.
200 Chang

able results.75 ClinicalTrials.gov is a platform established by the US Na-


tional Institutes of Health in collaboration with the FDA on grounds of
the FDA Modernization Act of 1997. A prerequisite for the registration
on ClinicalTrials.gov is the conformity of research with any applicable
human subject or ethics review regulation as well as with any appli-
cable regulations of the national (or regional) health authority.76 This
prerequisite leads to a de facto requirement for all clinical trials (even
those which are not intended to support an application for marketing
approval) to conform with ICH-GCP in order to avoid complications
in the question of which standard to apply.77

(b) Financing
For the reasons stated above, financing of studies is often also condi-
tioned on the observance of ICH-standards.

(c) Market Exclusion


Regarding the standard setting capacity of the ICH-guidelines, legisla-
tors of other countries are conditioned to match their legislation with
the requirements of the important markets of the ICH-regions, in order
to not be excluded from the relevant research-markets and to partici-
pate in the global scientific community.78 Countries such as China

75 See at http://www.icmje.org/publishing_10register.html; C. De Angelis et


al., Clinical Trial Registration: A Statement from the International Committee
of Medical Journal Editors, The Lancet, 364 (2004), 911-912.
76 See at http://prsinfo.clinicaltrials.gov/.
77 This development is sharply criticized on part of researchers T. Lang/P.Y.
Cheah/N.J. White, Clinical Research: Time for Sensible Global Guidelines, The
Lancet, 377 (2011), 1553-1554; A.D. McMahon et al., The Unintended
Consequences of Clinical Trials Regulations, PLoS Medicine, 6 (2009),
doi:10.1371/journal.pmed.1000131 (see http://dx.doi.org/ to resolve).
78 For example Australia: A. Alston, Country Report Australia, in E.

Deutsch et al. (eds.), Die Implementierung der GCP-Richtlinie und ihre Aus-
strahlungswirkungen, 2011, 203 (210); Israel: A. Shapira, Country Report Israel,
in the same volume, at 241; South-Korea explicitly changed its own good clini-
cal practice requirements to meet the ICH-GCP-Guideline: K.-Y. Yeun, Rege-
lungen fr die klinische Prfung und die Implementierung der GCP-Richtlinie
in der Republik Korea, in the same volume at 275.
Bioethics and Human Rights 201

adopt these guidelines in order to guarantee that Chinese research is


formally FDA compliant.79

c) Setting the Agenda


The ICH-Guidelines are highly influential in terms of setting scientific
standards. Agreements on an ICH level have the effect of setting the
agenda for methodological aspects, which also have high ethical impli-
cations for example, the Choice of Control Group and Related Issues
in Clinical Trials E10.80

V. Legitimacy

The two examined guidelines are globally acknowledged to formulate


the requirements for ethical research. Moreover, they are functional
equivalences to exercises of international public authority with condi-
tioning capacity. The claim is that as such they need to meet certain re-
quirements of legitimacy.

1. An Approach to Legitimacy

Legitimacy as justification for authority and rule is a modern concept


which emerged with secularization and the renunciation of a divinely
determined order.81 The concept has been distinctly founded and de-
fined by various authors over the last two centuries. Basically, a descrip-
tive-empirical and a normative conceptualization may be distinguished.

79 D. Cyranoski, China Rushes through Major Funding System, Nature,

455 (2008), 142.


80 The commentary to Guideline 11 of the CIOMS International Ethical
Guidelines for Biomedical Research Involving Human Subjects cites this guide-
line in order to demonstrate scientifically valid alternatives in study design, see
at http://www.cioms.ch/publications/guidelines/guidelines_nov_2002_blurb.
htm.
81 Even though the term legitimacy could already be found in Roman juris-

prudence and even though since the Enlightment religious and secular justifica-
tions competed against each other. See T. Wrtenberger, Die Legitimitt
staatlicher Herrschaft eine staatsrechtlich-politische Begriffsgeschichte, 1973.
202 Chang

The descriptive-empirical, sociological concept which has been substan-


tially coined by Max Weber and Niklas Luhmann, and later David
Beetham, is based on an account of legitimacy as the factual acceptance
of political power and its decisions.82 Yet, it is not the empirical accep-
tance of rules which is of importance here, but the acceptability of
rules.83 Therefore, in normative terms the claim of an institution to gov-
ern shall be legitimized when it is authorized to govern.84 This authori-
zation is furthermore not to be understood in a pure positivistic-
legalistic sense, but in a political-philosophical one. A claim of author-
ity is legitimized when it meets certain requirements of justice and ra-
tionality.85
This is especially of importance with regard to international govern-
ance-institutions that are not vested with powers by state-consent,
which is still being regarded as the dominant source of legitimacy in in-
ternational law theory. 86

2. Legality

Following a pure legal positivism, any rule which has been set in formal
accordance with higher laws and/or which is secured by coercion is law,

82 M. Weber, die drei reinen Typen der legitimen Herrschaft, posthumous


publication in Preuische Jahrbcher, vol. 187, 1, reprinted in the Annex of J.
Winckelmann/M. Weber, Legitimitt und Legalitt in Max Webers Herrschafts-
soziologie, 1952; N. Luhmann, Legitimation durch Verfahren, 1969, 28; F.
Bourricaud, Esquisse dune Thorie de lAutorit, 1961, 7; D. Beetham, The
Legitimation of Power, 1991.
83 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen

demokratischer Legitimation fr Ethikgremien, 2010, 136.


84 A. Buchanan, The Legitimacy of International Law; J. Tasioulas, The Le-

gitimacy of International Law, both in S. Besson/J. Tasioulas (eds.), The


Philosophy of International Law, 2010, 79, 97.
85 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen

demokratischer Legitimation fr Ethikgremien, 2010, 132.


86 R. Wolfrum, Legitimacy of International Law and the Exercise of Admin-
istrative Functions: The Example of the International Seabed Authority, the In-
ternational Maritime Organization (IMO) and International Fisheries Organi-
zations, in A. v. Bogdandy et al. (eds.), The Exercise of Public Authority by
International Institutions Advancing International Institutional Law, 2010,
917.
Bioethics and Human Rights 203

irrespective of its content.87 Positive law does not need any further
moral, rational or divine justification. Legitimacy is therefore identical
with legality. However, this concept is logically limited by the question
of the validity of the highest laws,88 which can ultimately only be
founded by the extra-legal powers backing them.89 Moreover, besides
the conceptual weaknesses, the conceptualization of legitimacy that is
pursued here, aims at an acceptability of rules, which is also founded
over-positively.90 It aims to encompass acts which are not legal, but
nonetheless have the effect to condition other subjects and unilaterally
affect their freedoms in a comparable manner. Following a pure legalis-
tic approach would not require these claims of authority to meet any
prerequisites. Nevertheless, the legality of a claim of authority may
constitute an assumption that this claim meets certain requirements of
justice and rationality and is therefore legitimized.91 Conversely, this
means that non-legal claims of authority need to be scrutinized even
more.

3. Normative Concepts of Legitimacy

Various normative concepts of legitimacy are based on contractual


theories as formulated by John Locke92, Jean-Jacques Rousseau93, Im-

87 H. Kelsen, Reine Rechtslehre, 2nd ed., 1960, 76.


88 G. Bachmann, Private Ordnung, 2006, 180.
89 A. Peters, Elemente einer Theorie der Verfassung Europas, 2001, 507, ci-
ting Thomas Hobbes: auctoritas, non veritas facit legem.
90 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-

kratischer Legitimation fr Ethikgremien, 2010, 135; A. Peters, Elemente einer


Theorie der Verfassung Europas, 2001, 506.
91 Legality as a necessary but not sufficient condition of public order S.

Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demokratischer


Legitimation fr Ethikgremien, 2010, 138; A. v. Bogdandy/P. Dann/M. Gold-
mann, Developing the Publicness of Public International Law: Towards a Legal
Framework for Global Governance Activities, in A. v. Bogdandy et al. (eds.),
The Exercise of Public Authority by International Institutions Advancing
International Institutional Law, 2010, 3 (20).
92 J. Locke/T.P. Peardon, The Second Treatise of Government, 1952, first

edition of 1690.
93 J.-J. Rousseau/A. Heine, Der Gesellschaftsvertrag, 1997, first edition of
1762.
204 Chang

manuel Kant94 or more recently John Rawls95, whereby free and equal
citizen fictionally agree on fair conditions of social cooperation.96 How-
ever, these theories all take recourse to a collective identity, often identi-
fying the social contract with a constitution, and are consequently ex-
pressed in public democratic institutions. Therefore, the effort to confer
these theories on an international level meets demanding difficulties. In
consequence, requirements shall be adapted from theories of legitimacy
which are not based upon the notion of a collective identity.

a) Discourse-Theoretical Approach
One approach, which is not based upon the need for a collective iden-
tity, is discourse-theoretical, as mainly pursued by Jrgen Habermas.97
Acts of authority are legitimized when their procedures have been de-
liberate and representationally just. On the national level, in a republi-
can understanding, deliberate and representationally just procedures in-
stitutionalized in a constitutionalized state for the democratic forming
of a political will are means to generate legitimacy.98 On the interna-
tional level with no global demos, a discourse-theoretical approach may
generate legitimacy when taking recourse to the exercise of communica-
tive powers which are the actual foundation of this approach.99 The ap-
proach does not depend on a demos, but on a community ruled by law.
And even though there is no global demos, the outlines of an interna-
tional community ruled by law (as a Vlkerrechtsgemeinschaft) are al-
ready positivized.100 The question therefore is if an act can be rationally
accepted by all legal subjects within a discursive formation of will.101

94 I. Kant/K. Vorlnder, Metaphysik der Sitten, 4. ed., 1922, first edition of

1797, 47.
95 J. Rawls, A Theory of Justice, Revised ed., 1999; J. Rawls, Political
Liberalism, 1993, 23.
96 For a feminist critique see A. Peters, Elemente einer Theorie der
Verfassung Europas, 2001, 532.
97 See also M. Goldmann, Internationale ffentliche Gewalt, 2013, forthco-

ming dissertation.
98 J. Habermas, Hat die Konstitutionalisierung des Vlkerrechts noch eine

Chance? in J. Habermas, Der gespaltene Westen, vol. 10, 2004, 113 (138).
99 J. Habermas, Faktizitt und Geltung, 1st ed., 1998, 167, 209.
100 B. Simma/ A. Paulus, The International Community: Facing the

Challenge of Globalization, European Journal of International Law, 9 (1998),


Bioethics and Human Rights 205

Yet, as Habermas understands a rational discourse to be any attempt


of communication on problematic claims of validity under conditions
of communication within a public space constituted by illocutionary
obligations which allows for a free processing of themes and contribu-
tions, information and reasons, this rational discourse ideally neutral-
izes social power structures, giving rise only to arguments that create a
mutual understanding convincing all parties in the same way. Such an
ideal rational discourse is not realizable.102
Alternatively, there are possibilities of negotiations. Clashes of interest
may be balanced rationally, occasionally by bargains of compromises,
which, in principle, must be acceptable to all parties provided that the
negotiations have been fair.103 A compromise may then be acceptable
to the parties for various reasons. The conditions of negotiation must be
founded discursively, as the negotiations aim to coerce or convince one
party to accept the others position.104 The discourse-principle securing
an unconstrained compromise may then be exerted indirectly by creat-
ing procedures which fairly regulate negotiations.105 Negotiations,
which follow procedures that give all interested persons the same
chances to take part in the negotiations and give them the same oppor-
tunities to influence each other and to enforce their interests, bolster the
assumption that the agreements are fair, although these procedures have
to be justified in moral discourses.
Moreover, rationally founded procedures are most important in cases in
which unresolvable differences of opinion persist. If the procedures

266-277; C. Tomuschat, Die internationale Gemeinschaft, Archiv des Vlker-


rechts, 33 (1995), 1-20.
101 J. Habermas, Faktizitt und Geltung, 1st ed., 1998, 169.
102 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-

kratischer Legitimation fr Ethikgremien, 2010, 138.


103 J. Habermas, Faktizitt und Geltung, 1st ed., 1998, 139.
104 Habermans cites J. Elster, Arguing and Bargaining, Manuscript 1991, 3:
To bargain is to engage in communication for the purpose of forcing or induc-
ing the opponent to accept ones claim. To achieve this end, bargainers rely on
threats and promises that will have to be executed outside the assembly itself.
Bargaining power does not derive from the power of the better argument, but
from material resources, manpower and the like. Statements asserted in a pro-
cess of bargaining are made with the claim to being credible, in the sense that
bargainers must try to make their opponents believe, that the threats and prom-
ises would actually be carried out. Ibid., 205.
105 Ibid., 205.
206 Chang

have been drafted and perceived to be fair, the decisions can also be car-
ried by those who failed to assert their interests.106

b) Input/Output Legitimacy
Fritz Scharpf coined the notions of input and output legitimacy in order
to distinguish two perspectives for the justification of authority.107 The
input perspective examines governance by the people and emphasizes
participatory and consensual aspects. The output perspective examines
governance for the people and shifts the legitimizing powers to the ef-
fective solution of collective problems. Scharpfs notion of input legiti-
macy is based on a contractual reasoning, complicating a transfer to the
global level.108 Nevertheless, the abstract concept may be of use.
Nonetheless, the output legitimacy is not based on any collective iden-
tity, but only on the ability to solve problems which need collective so-
lutions, because neither individuals, nor the markets, nor voluntary col-
lective acts of civil society, may solve the problems.109 Legitimacy is
therefore not based on a common identity, but on a common interest,
and is hence a valuable approach on the international level.110 For this
approach, communication is essential, and thus the freedom of commu-
nication as an (enforceable) guarantee is fundamental to this conceptu-
alization.111 Essentially, every person sharing a common interest must
be able to communicate in the same way, in order to find a solution for
a common problem which is effective.

106 S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-
kratischer Legitimation fr Ethikgremien, 2010, 139.
107 F.W. Scharpf, Demokratietheorie zwischen Utopie und Anpassung, 1970;
F.W. Scharpf, Regieren in Europa, 1999.
108 Critical S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen

demokratischer Legitimation fr Ethikgremien, 2010, 158; A. Peters, Elemente


einer Theorie der Verfassung Europas, 2001, 521.
109 F.W. Scharpf, Regieren in Europa, 1999, 20.
110 Ibid., 21.
111 Ibid., 23.
Bioethics and Human Rights 207

4. Practical Requirements of Legitimacy

a) Representational Justice
Every person concerned must have the chance to articulate her inter-
ests.112 Every person or group of persons with an interest must be cor-
respondingly represented. This requirement is not only discourse-
theoretically based, but is also necessary to elaborate effective solutions
in the sense of an output-conception. Acts which claim authority on a
global level should therefore involve representatives of all concerned
regions and groups in their decision-making process in a way that gives
all parties the same chance to articulate and enforce their interest. The
plurality of concerned parties should ultimately be reflected in the deci-
sion-making organ(s) of such an institution.

b) Fairness of Procedures
Compromises as a result of negotiations have to be bargained under fair
conditions.113 These conditions, i.e. procedures, can be assumed to be
fair, if they give all interested parties the same chances in the negotia-
tions and the same potential influence, therefore, giving every interest
the same chance to prevail in the bargaining. Different levels of power
should be balanced as to give all parties equal chances. Bargaining posi-
tions should therefore, for example, not be conditioned to financial
contribution. Moreover, transparency is necessary since information
about the procedures and mechanisms of institutions and its organs
should be accessible to all concerned persons without extensive costs
and be defined and clear.114

c) Effectivity of the Solution


As Scharpf points out, the effectivity of problem-solving as a source of
legitimacy has two sides. First of all, the institution which regulates a

112 st
J. Habermas, Faktizitt und Geltung, 1 ed., 1998, P. 206; also A. Bucha-
nan/R. O. Keohane, The Legitimacy of Global Governance Institutions, in R.
Wolfrum/V. Rben (eds.), Legitimacy in International Law, 2008, 25 (51).
113 J. Habermas, Faktizitt und Geltung, 1st ed., 1998, 139.
114 See also A. Buchanan/R. O. Keohane, The Legitimacy of Global Govern-
ance Institutions, in R. Wolfrum/V. Rben (eds.), Legitimacy in International
Law, 2008, 25 (53).
208 Chang

matter must have a comparative advantage, in the sense that no other


organ, which offers more advantages and fulfills requirements of proce-
dural legitimacy, exists. Second of all, the solution itself must be materi-
ally effective. Regulations should therefore be free of contradictions and
sufficiently defined and clear in order to concretely guide their address-
ees.

VI. Legitimacy of Ethical Guidelines

1. The World Medical Association

a) Representational Justice and Fairness of Procedures


(1) Membership
The WMA currently has 101 members (the United Nations count 193
members).115 The structure shows that there is a predominance of West-
ern states. Although this predominance has decreased and the WMA
currently counts 18 African members, as well as the national associa-
tions of Muslim countries (such as Egypt, Tunisia, Kuwait, Azerbaijan,
Malaysia and especially Indonesia), African and Muslim, but also Asian,
developing countries are still highly underrepresented.

(2) Organs and Decision-Making Process


The under-representation of African and Asian developing countries, as
well as Muslim countries, is being amplified by the organization of the
WMA, which also determines the decision-making procedures. The
central organs of the WMA are the General Assembly, the Council and
the Secretariat.
The General Assembly, which meets annually, decides ultimately upon
the adoption of declarations, resolutions and statements. Each member
may appoint one delegate with voting powers to the General Assembly.
For every 10.000 members of the national association for which all

115According to the online list of members, see at http://www.wma.net/en/


60about/10members/21memberlist/index.html.
Bioethics and Human Rights 209

membership fees have been paid, the national association may appoint
another delegate with voting powers.116
Nevertheless, it is the Council which mainly determines the policies of
the WMA. The Council sets the agenda and submits resolutions, decla-
rations and statements to the General Assembly. It seems as if the Gen-
eral Assembly is merely there to give the nod to the recommendations
of the council, without having much influence on the content.117 Con-
troversial aspects are indeed discussed vehemently, yet, alone the very
short duration of proceedings in the assembly shows the rather weak
influence of the General Assembly on the content of declarations,
statements and resolutions. Deliberation within the Council and the
Committees is of far greater importance.
The national medical associations are assigned to six geographical re-
gions, namely Europe, Asia, Pacific, Latin-America, Africa and North-
America. For every region, there is one seat on the Council for every
50.000 member-physicians in the national associations. Every national
association with more than 50.000 enrolled and paid-for members may
appoint one delegate for every 50.000 members to the Council. The re-
maining seats for a region on the Council are assigned by election,
whereby every national association has as many votes as member-
physicians, if applicable, reduced by 50.000 member-physicians for
which it has already appointed a delegate.
In 2009, the Council had one African (Ethiopian), two Asian (both In-
dian), six European (Danish, two German, Dutch, Norwegian, British),
three Latin-American (Uruguayan, two Brazilian), three North-
American (Canadian, two US American) and four Pacific (Australian,
South-Korean, two Japanese) members.
Additionally, the Council is assisted by three standing committees. Be-
sides the Finance and Planning Committee and the Socio-Medical-
Affairs Committee, the Medical Ethics Committee is the most important
with respect to the guidelines examined here. Its function is to advise
the Council on declarations and statements of primarily ethical na-

116 Chapter III, Section 2 of the Articles and Bylaws of the WMA of 1978 in

the version of Oct. 2006. The Articles and Bylaws as most of the WMAs gov-
erning documents are not generally publicly available, but may possibly be ob-
tained on request at http://www.wma.net/en/contact/index.html. Copies of the
governing documents of the WMA that are cited here have been obtained per-
sonally at the General Assembly 2009.
117 This is at least my personal observation of the General Assembly of 2009.
210 Chang

ture.118 Most of the deliberation takes place within this committee. The
members of the committee are appointed by the Council from among
its own delegates. This means that, from an early stage, a lot of national
medical associations are excluded from the deliberation. A lot of na-
tional medical associations can only step into discussions later in the
negotiations, at which point most of the opinions have already been
formed.

(3) Decision-Making Process


(a) Initiation
A declaration may be initiated by one or more national member asso-
ciation through submission of a proposal to the Secretariat, which ex-
amines the proposal for formalities.119

(b) Consideration by the Competent Committee


According to the content of the proposed declaration, it is forwarded to
the corresponding Committee. The same subject may not be considered
by another declaration for the duration of the procedure. After a pre-
liminary consideration, the Committee may recommend that the docu-
ment be referred to the national member association, postpone consid-
eration, or not approve the document and recommend that it be not ap-
proved by the Council.
Where a proposed declaration is referred to the national member asso-
ciations for comments, the comments received are collated by the Secre-
tariat, and/or an appointed rapporteur, and a new draft document is de-
veloped. A designated workgroup may serve as rapporteur.
Thereafter, the Committee may approve the proposed declaration with-
out change and recommend that it be approved by the Council, amend
the document and approve it and recommend that it be approved by the

118 See Section 3.5.5. of the Procedures and Operating Policies of the WMA

of 2011. The Procedures and Operating Policies as most of the WMAs govern-
ing documents are not generally publicly available, but may be obtained on re-
quest at http://www.wma.net/en/contact/index.html.
119 The following submissions on the procedures are following section 4.4 of
the Procedures and Operating Policies of the WMA of 2010 as amended by the
188th WMA Council Session in April 2011.
Bioethics and Human Rights 211

Council, refer the document back to the rapporteur or the Secretariat


for further revision, postpone consideration, or not approve the docu-
ment and recommend that it be not approved by the Council.

(c) Consideration by the Council


Following consideration and recommendation by the Committee, a
proposed declaration is forwarded to the Council. The Council may ap-
prove the proposed declaration without change, amend the document
and approve it, postpone consideration, direct that the document be re-
ferred to the national member association for comments and/or refer
the document back to the committee for further consideration, or not
approve the document.

(d) Consideration by the General Assembly


Upon approval by the Council, the proposed declaration is submitted
to the General Assembly with a recommendation for adoption.
In the case of non-approval, the Council provides reasons for its deci-
sion to the initiator. The initiator may request that the proposed decla-
ration be submitted to the General Assembly for consideration. Follow-
ing receipt of such request and the consent of four members of the
Council, the document is submitted by the Council to the General As-
sembly with a recommendation that it be not adopted.
Proposed declarations determined by the Council to be ethical in nature
require the affirmative vote of three quarters of the delegates, which are
present and vote for adoption.120

(4) Evaluation
Since regulations only concern matters of professions, it seems to be
reasonable to rely on an exclusive international association of profes-
sionals. Yet, physicians are not the only persons concerned by ethical
guidelines on research. The Declaration of Helsinki has a huge impact
on other actors, especially test-subjects and patients. This is also pur-
posed by the WMA, which claims to speak on behalf of all physicians

120 Chapter III, Section 6 of the Articles and Bylaws of the WMA of 1978 in
the version of Oct. 2006, see intra at 116.
212 Chang

worldwide.121 The purpose of its declarations, like the Declaration of


Helsinki, is to reflect WMA policy on an issue considered to be of sig-
nificance, to be universally applicable and embodying principles that
endure over time.122 Yet, its universal claims are not reflected by uni-
versal representation. Neither are other professions besides physicians
involved in the deliberation, nor are all physicians represented.
The member-structure shows a predominance of Western states, which
is sustained and amplified in all decision-making and deliberating or-
gans of the WMA. Especially developing countries are underrepre-
sented in these bodies.
As already put forward, for every 10,000 member-physicians, a national
medical association may appoint one delegate to the General Assembly,
provided that these member-physicians are enrolled and paid for.123 As a
consequence, in 2009 only seven of the then 16 African national associa-
tions enrolled their member-physicians and paid the fees.124 Of these
seven, not all sent delegates to the assembly. Instead of sending eight
delegates (South-Africa had two delegates), the region was only repre-
sented by four countries and five delegates. In 2008, when the most re-
cent version of the Declaration of Helsinki was adopted, the WMA had
only 12 African members and only South-Africa was represented in the
General Assembly with one delegate.125
China, whose citizens make up a fair share of the worlds population,
had enrolled and paid for only 2,222 member-physicians in 2009, and
hence appointed only one delegate to the General Assembly (India was
represented by ten delegates). The biggest parties in 2009 were of Japan

121 The purpose of the WMA is as it claims to serve humanity by endeavor-


ing to achieve the highest international standards in medical education, medical
science, medical art and medical ethics, and health care for all people of the
world Art. 2 of the Articles and Bylaws of the WMA of 1978 in the version of
Oct. 2006, see intra at 118.
122 Definition M2 of the Schedule of Function and Operating Policies in the

version of May 2006. The Schedule of Function and Operating Policies as most
of the WMAs governing documents is not generally publicly available, but may
possibly be obtained on request at http://www.wma.net/en/contact/index.html.
123 Chapter III, Section 2 of the Articles and Bylaws of the WMA of 1978 in

the version of Oct. 2006, see intra at 116.


124 See internal WMA Document FPL 183/Dues Report/Oct2009 Report on

Membership Dues Payment for 2009, submitted to the Finance and Planning
Committee at the 183th Council Session in 2009.
125 Ibid.
Bioethics and Human Rights 213

with 16 delegates, the USA with 13, Germany with 11, India with 10
and Great Britain and Brazil each with 6 delegates.
The national medical association of countries of the European Eco-
nomic Area, Japan, USA and Canada appointed 72 of the 117 delegates
to the General Assembly in 2009.
Theoretically, national associations with more enrolled member-
physicians may appoint more delegates. Yet, it is not the actual size of a
national association that matters, but the number of physicians the as-
sociation is willing to pay for. This is of even higher importance, as de-
cisions are made by majority and single votes have no vetoing power.
The unequal representation is therefore also caused by the inability or
unwillingness of national medical associations to pay for all their mem-
ber-physicians, even though the WMA differentiates between the eco-
nomic facilities of its members and categorizes them in order to allow
less affluent national associations to pay less.126 The Chinese medical as-
sociation had 500,000 members in 2011, and surely a similar number in
2009, yet only enrolled slightly more than 2,000 members to the WMA
in 2009.127 And even the American Medical Association seems to be un-
willing to pay for all its members. Although it represents ca. one third
of the physicians in the USA, it only enrolled slightly more than half of
them to the WMA. 128
To condition voting capacities to financial contributions may be justi-
fied in cases where decisions that are financially burdensome to coun-
tries/national associations are made. However, decisions like the Hel-

126 In 2009 the WMA had four categories, charging 0,40 EUR for every

member-physician to national associations of category A, 0,90 EUR to associa-


tions of category B, 1,50 EUR to those in category C and 2,00 EUR to those in
category D.
127 See at http://www.cma.org.cn/ensite.
128 According to the AMA Annual Report for 2009 the AMA had 228,000
members. See at http://www.ama-assn.org/resources/doc/about-ama/2009-an
nual-report.pdf, 26. According to the US Department of Labor, Bureau of La-
bor Statistics there were 661.000 physicians and surgeons employed in the USA
in 2008. See at http://www.bls.gov/oco/ocos074.htm (though this number could
as well encompass students and dentists). In 2009 the AMA paid fees for
121,000 member-physicians to the WMA according to the WMA Report on
Membership Dues Payment for 2009. This Report as most of the WMAs gov-
erning documents is not generally publicly available, but may possibly be ob-
tained on request at http://www.wma.net/en/contact/index.html.
214 Chang

sinki Declaration are not of (primarily) financial nature. Moreover, its


purpose is to set ethical guidelines with the claim of universal validity.
Another reason for unequal representation is that the national associa-
tions do not necessarily represent all physicians in one country. In
countries like Germany or Spain, membership is mandatory to physi-
cians, but in countries such as the USA, South-Africa, India or China, it
is voluntary.
Developing countries are also significantly underrepresented in the
most important organ, the Council, and therefore also in the Standing
Committees. One of the essential conditions for fair proceedings,
namely that all parties have the same chances to articulate their posi-
tions, is not fulfilled. Although all national associations may send ob-
servers to the Council, deliberation is mainly entrusted to Council-
members.
To sum up, not only are all persons concerned not being heard in the
deliberation, especially not patients and test-subjects, but also the
WMA does not represent all physicians worldwide. This isolation is
also amplified by a lack of transparency, making it almost impossible to
view or even comment on the protocols of debates, votes, and the like.

b) Effectivity of Solution
As to output legitimacy, one question is whether the Declaration of
Helsinki is materially effective as to solve ethical dilemmas regarding
subject protection and distributive justice of international research.
That is, if it is free of contradictions and sufficiently defined and clear to
concretely guide its addressees. Its addressees are primarily physicians,
but in newer versions also other actors of research, who did not partici-
pate in the drafting process, which is reflected in their lack of perspec-
tive. For an overall regulation of research involving human subjects, in
order to protect test-subjects, the Declaration is unsatisfactory. This is
inter alia because it remains too general to be of concrete guidance,
even though it is designed specifically for research involving human
subjects.
The best example is the lack of addressing the various forms of study
design, which are currently deemed as scientifically valid and actually
used. Except for placebo-control, non-treatment and active-control, the
Declaration fails to address other designs of control and methods of
test-subject allocation, such as randomization, double-blinding, add-on
Bioethics and Human Rights 215

studies, replacement studies, dose-variations, wash out periods etc.129 In


order to find guidance for the practice of these methods, it is question-
able if it is sufficient to turn to the more general principles of the Decla-
ration, which claim to be complete. Another example is the lack of ad-
dressing phase I and phase II/III studies. Phase I studies are conducted
on healthy volunteers in order to get pharmacokinetic data and first in-
formation on pharmacodynamics, which are necessary in assessing the
safety of the drug and first dose information. While phase II and III
studies are conducted involving sick persons in order to assess the effi-
cacy of the drug and an overall risk/benefit ratio. This means that the
risk/benefit ratio is inherently different in studies involving healthy
persons and in studies involving sick patients. Additionally, this also
depends on the study design, that is, there is a difference whether pa-
tients are being treated or not.
These aspects, which the Declaration fails to address satisfactorily, are
commonly known, meaning that unfitting principles of the Declara-
tion have been and are being ignored by actors in order to leave it
workable.130 This in turn questions the material decision guidance.
On the other hand, it may be argued that the principles of the Helsinki
Declaration are of a mere fundamental nature, offering a basic position-
ing and orientation. Yet, it misses a stringent moral-theoretical underly-
ing.131 It also offers a no conflict rule. Although it misses a clear moral-
theoretical underlying, it is surely influenced by the so called Princi-
plism, the leading current in bioethics discourse with its most influen-

129E. Deutsch, Klinische Forschung International: Die Deklaration von


Helsinki des Weltrztebundes in neuem Gewand, NJW, (2001), 857-860 (860).
130 For instance the Helsinki Declaration states in its 1996 version in II.3.

that in any medical study, every patient including those of a control group, if
any should be assured of the best proven diagnostic and therapeutic method.
This is clearly not feasible, as it contradicts the logics of comparing clinical tri-
als. Nevertheless, the European Union explicitly demands in Art. 3 Directive
2005/28/EC that clinical trials have to be conducted in accordance with the
Declaration of Helsinki 1996. Only the later version of 2000 caused controversy
and the EMEA published a statement expressing its concern that forbidding
placebo-controlled trials [] would preclude obtaining reliable scientific evi-
dence. The stricter clause of 1996 seems to have been simply ignored for its
non-viability. EMEA/CPMP Statement on the Use of Placebo in Clinical Trials
with regard to the Revised Declaration of Helsinki EMEA/17424/01.
131 See also W. Schaupp, Der ethische Gehalt der Helsinki Deklaration, 1993,
291.
216 Chang

tial proponents Beauchamp and Childress.132 Yet this Principlism en-


dorses principles of autonomy, beneficence, non-maleficence and justice,
that are theorized to be basically equal with no theoretical guidance on
balancing in conflicts. It is accompanied by encompassing considera-
tions in scripture on how to balance these principles in individual cases.
Yet, the Helsinki Declaration is not accompanied by an annex with con-
siderations for every single case. However, the Declaration is not ex-
plicitly based on Principlism and if it were, the addressee would be left
alone to balance conflicting principles, say autonomy and beneficence,
in almost all concrete cases. Even strong fundamental principles, such as
informed consent, are not clear in accordance with the Helsinki Decla-
ration, as there are, for instance, cases when it is conflicting with benefi-
cence. For concrete guidance it is too vague. For a clear orientation, its
moral-theoretical reasoning is too vague.
Furthermore, the Helsinki Declaration lacks definitions. It works with
concepts, such as vulnerability or capacity to consent, granting vulner-
able persons special protection. These concepts are widely used and
known in bioethical discourse, but they are not undisputed. They are
left open for various interpretations, depending on region and/or
moral-theoretical reasoning or simply interest.
The lack of a consistent underlying moral-theoretical reasoning is also
reflected by a relatively quick succession of changes in regard to con-
tent, each time expressing a completely new positioning. For example,
the current version of 2008 demands that in medical research involving
human subjects, the well-being of the individual research subject must
take precedence over all other interests.133
The version of 2000 stated that in medical research on human subjects,
considerations related to the well-being of the human subject should
take precedence over the interests of science and society while the ver-
sion of 1996 negatively formulated in research on man, the interest of
science and society should never take precedence over considerations
related to the well-being of the subject though the version of 1989 de-
manded that concern for the interests of the subject must always pre-
vail over the interests of science and society.
As the relationship of the individual test-subject to the benefits of soci-
ety is essential in the question of how much may be asked of an indi-

132 T.L. Beauchamp/J.F. Childress, Principles of Biomedical Ethics, 6. ed.,


2009.
133 Emphasis is added to this and the following citations.
Bioethics and Human Rights 217

vidual for the good of society,134 these dramatic changes leave a feeling
of uncertainty about the overall position between research or individual
protection.
The balancing in cases of conflict and the interpretation of vague ex-
pressions are ultimately delegated to ethics committees (or review
boards), whose composition and institutional constitution are mostly
left open.135
However, to sum up, the Declaration of Helsinki is often vague, too
general and in decisive points open to free interpretation and as it
misses a coherent moral-theoretical underlying it lacks in giving a clear
orientation.

2. The International Conference on Harmonisation

a) Representational Justice and Fairness of Procedures


(1) Membership
The first International Conference on Harmonisation of Technical Re-
quirements for Registration of Pharmaceuticals for Human Use (ICH)
in 1991 has been hosted by the International Federation of Pharmaceu-
tical Manufacturers and Associations (IFPMA) with representatives of
the European Commission, the European Federation of Pharmaceutical
Industries and Associations (EFPIA), the Japanese Ministry of Health,
Labor and Welfare, the Japan Pharmaceutical Manufacturers Associa-
tion (JPMA), the US Food and Drug Administration (FDA) and the
Pharmaceutical Research and Manufacturers of America (PhRMA).
These parties were also equally represented in the Steering Committee,
which had been set up in 1990 to prepare the conference.136 Representa-
tives of the WHO and the drug regulatory bodies of Canada and Swe-
den (for the European Free Trade Association) were observers. The ICH

134 Expressed for example in the question when the use of placebo in order to
gain scientifically more valuable data may not be justified as it may harm the
individual test subject.
135 And which bring with them a whole array of subsequent legal problems.
See S. Vneky, Recht, Moral und Ethik Grundlagen und Grenzen demo-
kratischer Legitimation fr Ethikgremien, 2010.
136P.F. DArcy/D.W.G. Harron (eds.), Proceedings of The First International
Conference on Harmonisation Brussels 1991, 1992.
218 Chang

has been supported by further business-interest groups.137 The ICH has


finally been instituted though it is not incorporated and its secre-
tariat is hosted by the IFPMA.

(2) Organs
The Steering Committee is the main regulatory organ of the ICH.
Members with voting power are representatives of the European Com-
mission,138 the Japanese Ministry of Health, Labor and Welfare,139 and
the FDA, as well as their corresponding lobby organizations EFPIA,
JPMA and PhRMA, with two seats each. The European Commission is
supported by the Committee for Medicinal Products for Human Use
(CHMP), which is part of the European Medicine Agency (EMEA), and
the Japanese ministry is supported by the Japanese regulatory body, the
Pharmaceutical and Medical Devises Agency (PMDA), and the Japanese
National Institute of Health Sciences.
As agreements of the three main markets for medicines strongly affect
other actors, there are observers of the WHO, the Canadian regulatory
body, and one of the EFTA to the Steering Committee. They have no
voting powers.
Regulations for harmonization are prepared by the Working Groups,
which are appointed by the Steering Committee. The Working Groups
on Quality, Safety and Efficacy review the differences in the require-
ments between the ICH regions, and develop scientific consensus re-
quired to reconcile those differences.140 There is no formal fixed
membership, but each of the six parties nominates a topic leader as
the contact person for the topic.
There are various working groups, but the most important are the Ex-
pert Working Groups (EWG), which develop harmonized guidelines.
These EWGs can only gather officially when at least one member of

137Such as the US-Japan Business Council, the lobby for biotechnology in


Europe or the Senior Advisory Group on Biotechnology.
138 Currently one representative of the DG Health and Consumers and one

of the Committee for Medicinal Products for Human Use at the EMEA.
139 With one representative of the Ministry and one representative of the

Japanese regulatory agency.


140According to the information provided by ICH, see at http://www.ich.
org/about/organisation-of-ich/working-groups.html.
Bioethics and Human Rights 219

each of the six ICH regions is represented. Representatives of other or-


ganizations may take part in the various working groups as observers.
In 1996, the ICH opened to other interested parties for instance, they
invited representatives of the generic industry to the working groups.141
In 2003, other initiatives to harmonize standards,142 which encompass
all regions of the world, were invited to join a Global Cooperation
Group, subordinated to the Steering Committee, and to attend the tech-
nical working group meetings and discussions of the Steering Commit-
tee.143 In 2007, the ICH decided to invite single regulatory bodies of
countries, which have adopted the ICH guidelines or which generate
much clinical data, to join the Global Cooperation Group.144 The re-
gional harmonization-initiatives can each appoint one expert to the
working groups to take part as other observer-organizations.145
A comprehensive conference takes place biannually and is financed by
the three lobby-parties.146 The costs of the Expert Working Groups are
covered by the parties delegating experts.147 The secretariat is financed
by the industry.

141The subsequent submissions are following J. A. Molzon, presentation


The ICH Process: Evolution of an Idea, at the FDA ICH public meeting of
May 19, 2011, see at http://www.fda.gov/downloads/InternationalPrograms/
HarmonizationInitiatives/UCM258766.pdf.
142 These are the Asia-Pacific Economic Cooperation (APEC), Association

of the Southeast Asian Nations (ASEAN), Gulf Cooperation Council (GCC),


Pan American Network for Drug Regulatory Harmonization (PANDRH) and
Southern Africa Development Community (SADC).
143 M. Ward, presentation The Global Cooperation Group and the Chang-

ing Face of ICH at the ICH public meeting of May 19, 2011, slide 10 seq., see
at http://www.fda.gov/downloads/InternationalPrograms/HarmonizationInitia
tives/UCM258761.pdf.
144 These are Australia, Brazil, China, Taipei, India, South-Korea, Singapore

and Russia.
145 M. Ward, presentation The Global Cooperation Group and the Chang-

ing Face of ICH at the ICH public meeting of May 19, 2011, see intra 143,
slide 19.
146 According to the submissions of C. Meyer of the ICH-Secretariat to an

inquiry, see at http://www.ich.org/contacts.html.


147 According to the submissions of C. Meyer of the ICH-Secretariat to an
inquiry, see at http://www.ich.org/contacts.html.
220 Chang

(3) Decision-Making Process


According to the ICH webpage, the formal harmonizing proceedings
consist of five steps.148 The proceeding is initiated by the Steering
Committee through a concept paper or business plan. The concept pa-
per explains how the EWGs shall be composed.

(a) Step 1: Consensus Building


The EWG prepares a consensus draft of the guideline, based on the ob-
jectives set out in the concept paper. When consensus on the guideline
draft is reached among all six ICH-party EWG members, the EWG
signs the draft, which is then submitted to the Steering Committee.
Members of the Global Cooperation Group and the observers work
equally in the EWGs on the development of the draft,149 though it is
unclear if the consensus has to be found among them as well.

(b) Step 2: Confirmation of Six-Party Consensus


In a second step, the Steering Committee agrees, based on the report of
the EWG, that there is sufficient scientific consensus on the technical is-
sues for the draft guideline to proceed to the next stage of regulatory
consultation. This agreement must be confirmed by at least one of the
Steering Committee members for each of the six ICH parties signing
their assent.

(c) Step 3: Regulatory Consultation and Discussion


This step occurs in two distinct stages. In the first stage, the guideline
embodying the scientific consensus is excluded from the ICH process
and becomes the subject of normal wide-ranging regulatory consulta-
tion in the three regions. In the EU, it is published as a draft CHMP
guideline, in Japan, it is translated and issued by MHLW for internal
and external consultation, and in the USA, it is published as draft guid-
ance in the Federal Register. Regulatory authorities and industry asso-

148 See at http://www.ich.org/about/process-of-harmonisation/formalproc.

html, descriptive parts are taken from the text of this webpage.
149 According to the submissions of C. Meyer of the ICH-Secretariat to an
inquiry. See at http://www.ich.org/contacts.html.
Bioethics and Human Rights 221

ciations in non-ICH regions, as well as anybody interested, are invited


to comment on the draft consultation documents by providing their
comments to the ICH Secretariat by email in an open consultation.
In a second stage, the EWG works to address all comments received
and reach a new consensus. If the rapporteur was from an industry
party, a new rapporteur from a regulatory party is appointed following
Step 2, preferably from the same region as the previous rapporteur. If
both regulatory and industry parties of the EWG are satisfied that the
consensus achieved at Step 2 has not been substantially altered as a re-
sult of the consultation, or consensus is reached on any alterations, the
new document is signed by the EWG regulatory experts.

(d) Step 4: Adoption of an ICH Harmonised Tripartite Guideline


In a fourth step, the final document is signed by the Steering Commit-
tee for the regulatory parties of the ICH as an ICH Harmonised Tri-
partite Guideline. The regulatory parties cannot sign the final document
with major changes of the content. In such a case, step 2 and 3 have to
be repeated.150 This means that without an overall consensus among the
public and private parties, no ICH guideline can be signed.

(e) Step 5: Implementation


In a final step, the guideline is implemented by regulation. The imple-
mentation is carried out according to the same national/regional proce-
dures that apply to other regional regulatory guidelines and require-
ments in the EU, Japan and the US.

(f) Revision
Revision proceedings are initiated when the scientific or technical con-
tent of an ICH guideline is no longer valid, or state of the art, or if new
information shall be added. The proceedings follow step 1 step 5 and
are denominated by R1-Rn.

150 According to the submissions of C. Meyer of the ICH-Secretariat to an


inquiry. See at http://www.ich.org/contacts.html.
222 Chang

(4) Evaluation
The difference between the ICH and the WMA lies in the fact that two
democratically legitimized states151 and the democratically legitimized
European Union152 are regulatory actors in the ICH. Nevertheless, the
guidelines of the ICH strongly affect persons beyond these three re-
gions, who had no means to elect these representatives. Furthermore,
the private industry is predominantly co-regulated by co-drafting and
deciding the guidelines.
The industry is directly involved in the drafting of the guidelines and
decides directly on their adoption. The EFPIA represents 31 national
federations153 and 38 leading pharmaceutical companies154, and claims to
be the voice on the EU scene of 2,000 companies. The PhRMA has 30
major companies as members155 and 18 as associates. The JPMA repre-
sents 67 pharmaceutical companies.156 Noticeably, major companies
such as AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers
Squibb, Eli Lilly, GlaxoSmithKline, Merck, Novartis, Pfizer or Sanofi-
Aventis are represented in two or all three federations (though through
different subsidiaries). These federations also finance the ICH, among
others the Secretariat, which is hosted by the IFPMA. The IFPMA

151Respectively agencies as parts of states: C. Mllers, Transnationale


Behrdenkooperation, ZaRV, 65 (2005), 351-389.
152 The democratic legitimacy of the EU is meanwhile predominantly seen to
be set on two columns in the sense of Art. 10 (2) TEU: directly via the citizens
of the EU who elect the European Parliament and indirectly via the Council.
Before the validity of the Lisbon Treaty: A. Moravcsik, In Defence of the
Democratic Deficit: Reassessing Legitimacy in the European Union, Journal
of Common Market Studies, 40 (2002), 603-624; a latent but justifiable deficit is
seen by the German Constitutional Court BVerfGE 123, 267 Lissabon, para.
276; J.H.H. Weiler, The Transformation of Europe, Yale Law Journal, 100
(1990), 2403-2484.
153 See at http://www.efpia.eu/Content/Default.asp?PageID=353.
154 These are major companies such as Astra Zeneca, Boehringer Ingelheim,
Pfizer, GlaxoSmithKline, Bayer HealthCare, Roche, Novartis, Merck, Sanofi,
Eli Lilly etc. See at http://www.efpia.eu/Content/Default.asp?PageID=353.
155 For example AstraZeneca, Bayer HealthCare, Boehringer Ingelheim,
Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Merck, Novartis, Pfizer,
Sanofi-Aventis etc. See at http://www.phrma.org/about/member-companies.
156 For example AstraZeneca, Bayer Yakuhin, Bristol-Myers, Eli Lilly Japan,
GlaxoSmithKline, Novartis Pharma, Pfizer Japan, Sanofi-Aventis, etc. See at
http://www.jpma.or.jp/english/about_us/member.html.
Bioethics and Human Rights 223

represents 44 national federations157 and 29 single pharmaceutical com-


panies158. Therefore, certain single financially powerful companies are
represented by more votes than public representatives. Besides, multi-
national companies are represented over-proportionately, as small sized
companies and non-commercial institutions are rarely visible.
Other concerned persons, such as test-subjects and patients, are not
represented on their own. It can be argued that ideally they are repre-
sented by the public parties to the ICH, yet there might be conflicts of
interest as four of the six delegates to the Steering Committee are of
regulatory bodies whose function it is to guarantee a high quality and
safety of drugs protecting public health, which might contradict the in-
terests of test-subjects.159 In the EU, questions of drug regulation are
vested with the Directorate-General for Enterprise and Industry (and
not Health and Consumers), which also represented the Commission in
the Steering Committee in the first years.160
As previously mentioned, a lot of other persons outside the ICH re-
gions are affected, either because research by ICH-companies is con-
ducted offshore, or because the regulatory bodies of other regions are
conditioned to adopt the ICH guidelines. As pointed out, other mar-
kets are pressed to conform. Yet, these are not directly involved in the
decisions upon guidelines. Although other regions are engaged via the
Global Cooperation Group, the final consensus and the final adoption
take place in the Steering Committee. Hence, the ICH-guidelines,
which have been substantially co-formulated by the pharmaceutical in-
dustry, have a strong influence on the conduct of research involving
human subjects in other countries, who have not participated in the
adoption.
Decisions cannot be made against the will of single regulatory bodies in
respect to public representatives. Yet, decisions can also not be taken

157 Inter alia the PhRMA und JPMA and those members of the EFPIA.
158 Inter alia AstraZeneca, Bayer HealthCare, Boehringer Ingelheim, Bristol-
Myers Squibb, Eli Lilly, GlaxoSmithKline, Merck, Novartis, Pfizer, Sanofi-
Aventis etc. See at http://www.ifpma.org/about-ifpma/members/companies.
html.
159 See for instance recitals 13, 33 of Regulation (EC) 726/2004.
160 P.F. DArcy/D.W.G. Harron (eds.), Proceedings of The First International
Conference on Harmonisation Brussels 1991, 1992. Though the Commission is
currently represented by a member of the Directorate-General for Health and
Consumer.
224 Chang

against the will of the private industry members. Public representatives


cannot impose guidelines within the ICH process on the private
members against their will.
Other than the Steering Committee, members may articulate their in-
terests in the working groups at an early stage and may also comment
on drafts within the formal regulatory proceedings within the EU, USA
and Japan respectively to the ICH Secretariat in open consultation
though the agenda for topics is exclusively set by the Steering Commit-
tee. Any person concerned may therefore articulate her interest, yet the
chances to enforce are rather low, as the final consensus and final deci-
sion is reached among the ICH-members. Besides, specific concerned
persons, such as uneducated test-subjects in developing countries, will
probably not find a way to articulate their concern in these open con-
sultations.
Certain questions remain, though there are mechanisms to invite any-
body concerned to articulate their interest, the chances of their en-
forcement are rather low. The private industrys enormous influence
remains. Also, questions of transparency persist, as concrete proceed-
ings are unclear and documents such as memoranda of understanding
on the proceedings are not publicly accessible.

b) Effectivity of Solution
The Good Clinical Practice Guideline and the guidelines concerning the
study design are especially in contrast to the Helsinki Declaration
far more encompassing and more detailed. The FDA argued, among
other things, with this greater depth of detail and the enumeration of
specific obligations and responsibilities, when it changed its regulation
requiring non-IND studies conducted abroad to follow a GCP stan-
dard and no longer the Helsinki Declaration (of 1989).161 The guidelines
were, after all, drafted for legislative endeavors. They are thus very re-
search-orientated, which is no surprise as the pharmaceutical industry
co-drafted them. The best examples again are questions on study design
and control groups. The ICH-guidelines follow a scientific paradigm,
while explicating various alternatives in study design depending on the
situation. They are indeed closer to actual research than the Helsinki
Declaration and more guidance than rough orientation. The informed
consent requirement, for instance, is accompanied by a long catalogue of

161 73 F.R. 22800 [22801] Apr. 28, 2008.


Bioethics and Human Rights 225

obligatory information for the test-subject, which may be used as a


checklist. Although, the practicability comes with the price that specific
individual cases may not be adequately addressed by such a checklist.
The practicability is also demonstrated by the glossary, defining every
decisive term for the purpose of the GCP-Guideline.
Nevertheless, the GCP-Guideline also lacks a coherent moral-
theoretical underlying. However, the relative depth of details concern-
ing specific obligations and responsibilities leaves these workable, yet
fundamental principles remain blank.
The ICH-guidelines may be clear and certain regarding organizational,
documentary and managerial aspects of the design of studies, as to ef-
fectively regulate these aspects of research. Yet, they hereby concentrate
primarily on methodological scientific requirements and not on subject
protection or distributive justice. From this perspective ethical consid-
erations seem to be only outer necessities to delimit certain methodo-
logical requirements here and there. By only limiting the ethical parts
to a minimal standard of protection, major aspects and debates in bio-
ethical discourse are being left out. This is especially clear with regard
to research conducted in developing countries.
The ICH guidelines have been primarily drafted for research conducted
in richer ICH-regions. However, research in developing countries is
touched by the ICH guidelines, because the developing country was
conditioned to adhere to them and/or because the research is sponsored
by companies of the ICH-regions. The ICH tries to incorporate all re-
gions of the world within its Global Cooperation Group and to engage
them to participate in early stages of the harmonization process. Yet,
specific ethical considerations regarding research in developing coun-
tries, widely discussed within the ethical discourse,162 have not found
any or only marginal reference in the ICH guidelines. On the contrary,
it is being argued that there was no room for unethical research, be-
cause it would be impossible to find test-subjects that would voluntar-
ily participate.163 Yet, this is exactly what is being criticized as one of the
reasons to outsource research to developing countries.
Other normative specifics of research in developing countries which are
discussed in literature, such as aspects of distributive justice, are also
not addressed. Cases which are often debated under keywords, such as

162 See intra at 2.


163 ICH Harmonised Tripartite Guideline, Choice of Control Group and
Related Issues in Clinical Trials E10.
226 Chang

exploitation when a drug is being tested in a developing country but


not marketed,164 are not mentioned in the guidelines.
To sum up, the ICH-guidelines may be sufficiently clear and certain to
globally govern the methodological, organizational, managerial and
documentary aspects of research with a great emphasis on scientific va-
lidity, yet they are also too vague to give rise to fundamental ethical
principles. Especially with regard to research conducted in developing
countries, the ICH-guidelines fail to take into account and address the
specifics of test-subjects protection and distributive justice.

VII. Conclusion

Ethical guidelines globally govern clinical studies. Certain guidelines


such as the WMAs Declaration of Helsinki or ICHs Good Clinical
Practice Guideline are even functionally equivalent to public acts, and
have conditioning capacities, as they unilaterally reduce the freedoms of
actors by defining ethical research. They may therefore be regarded
as equivalences to exercises of international public authority. As such,
they have to meet certain requirements of legitimacy understanding
legitimacy as justification for claims of public authority. As these guide-
lines are not based on a public legal basis, they cannot claim legality and
therefore have to be scrutinized for normative political-philosophical
requirements of legitimacy all the more.
They fail to meet such requirements in parts. Western interests are pre-
dominantly represented in the WMA and actually exclusively repre-
sented in the ICH (regarding deciding powers). Specific interest groups
prevail. The WMA is an exclusive club of physicians (and barely a rep-
resentation of all physicians), while the ICH is highly dominated by
pharmaceutical companies. The chances for other directly affected
groups, such as patients and test-subjects, to articulate and enforce their
interest are small. The guidelines even materially fail to satisfactorily
solve the various problems on a global stage regarding international re-
search involving human test-subjects. Either because ethical principles
are too vague to be of concrete guidance in individual situations, or be-
cause international concerns, such as research conducted in developing
countries, are not addressed at all. This is reinforced by the reliance on
the bioethical discourse, which is dominated by a moral-theoretical

164 Intra at 2.
Bioethics and Human Rights 227

current that consists of equal principles, which have to be elaborately


balanced in every single case.
These findings are aggravated by the fact that research involving human
test-subjects affects basic human rights. As the life, health and dignity
of human test-subjects are directly affected, care of their human rights
has to be taken. The ethical guidelines are thus not to be dismissed
completely, as they actually do have valuable insights, especially for
technicalities not covered by international law. Yet, they have to be em-
bedded in a strong human rights regime and may only be subsequently
invoked. Even though they may be helpful, they may not undermine
the human rights approach. Specifically, the reliance on ethical guide-
lines, open for a regionally differentiated application as an escape to
ethics, may not undermine the claim for universal validity of human
rights. Although ethical guidelines can be meaningful in solving practi-
cal problems, there are institutions with higher legitimacy which might
address these questions. The perception needs to shift to a human rights
paradigm which legitimately governs international research interfering
with human rights.
The Ethicalization of International
Humanitarian Law: Clarifying the Boundaries
for Physicians
Sigrid Mehring

I. Introduction

Increasingly, the law is opened to ethical standards through opening


clauses, ethics councils, and ethical codes. The benefits, as well as the
possible dangers of this development were outlined by Silja Vneky in
her introductory remarks. Further presentations on ethics and law
formed the basis for the discussions at the Symposium on The Ethical-
ization of Law in Freiburg in September 2011.1 The Symposium ad-
dressed a great number of fundamental questions concerning the inter-
action of ethics and law, ethical points of view that inform discussions,
the disagreement between ethics and law, and ethics commissions.
Contributing to the discussions regarding the practical implication of
an intersection of ethics and law, this article addresses an example of
where the law provides an opening for ethics namely, the reference to
medical ethics in international humanitarian law. Article 16 of the First
Additional Protocol (AP I) and Article 10 of the Second Additional
Protocol (AP II) to the Geneva Conventions (GC) read:
Persons engaged in medical activities shall not be compelled to per-
form acts or to carry out work contrary to the rules of medical eth-
ics []

1 The term ethicalization (Ethisierung) was coined by Silja Vneky, in


id., Recht, Moral und Ethik Grundlagen und Grenzen demokratischer
Legitimation fr Ethikgremien (Mohr Siebeck, 2010).

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 229
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_9, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
230 Mehring

Accordingly, international humanitarian law has a very clear vision of


the role of physicians in armed conflict. Medical treatment during
armed conflict should always be in accordance with medical ethics. The
question is how to interpret this opening to ethics through a reference
to medical ethics in an international treaty.

II. Background

Physicians, whether civilian or military, have always played an essential


role in armed conflicts. Being the first to be in contact with the
wounded and sick, physicians can report violations of international
humanitarian law or human rights abuses. An example of this was the
insider-eyewitness-report by two Norwegian physicians of their ex-
periences carrying out medical work in Gaza during the 2008/2009
Gaza conflict.2 They found violations of the neutral status of the Red
Cross by the conflict parties and raised awareness regarding serious
wounds stemming from white phosphorus and DIME-bombs.3 Physi-
cians are thus in a privileged position to watch over the rights of the
victims of armed conflicts.
Certainly, physicians most often act for the benefit of those in need of
medical care but there may also be some black sheep. Recently, in-
volvement by physicians in ill-treatment and torture during interroga-
tions in United States (U.S.) detention facilities, established in the so-
called war on terror, raised serious criticism.4 The International

2 Mads Gilbert and Erik Fosse, Inside Gazas Al-Shifa Hospital, 373 The
Lancet, 200 (2009).
3 Although so-called focused lethal munition is not prohibited under in-
ternational disarmament agreements, experts have voiced concerns about their
effects. UN Secretary General, Report on the Protection of Civilians in Armed
Conflict, UN Doc. S/2009/277, (29 May 2009), para. 36; see also UN Fact-
Finding Mission Report of the United Nations Fact-Finding Mission on the
Gaza Conflict (Goldstone Report), UN Doc. A/HRC/12/48, (25 September
2009), paras. 907908.
4 The conclusion that the treatment of detainees in US detention facilities
amounted to ill-treatment and at times torture, was reached concerning
Guantnamo Bay by five UN Special Rapporteurs in Leila Zerrougui,
Chairperson of the Working Group on Arbitrary Detention, et al., Economic
and Social Council, Report on the Situation of Detainees at Guantnamo Bay,
UN Doc. E/CN.4/2006/120, (27 February 2006), para. 52. The involvement of
Ethicalization of International Humanitarian Law 231

Committee of the Red Cross (ICRC), in a confidential report to the


U.S. government in February of 2007, addressed the medical treatment
of fourteen high-value detainees of the U.S. Central Intelligence
Agency.5 One chapter of the report is wholly dedicated to a discussion
concerning the medical ethics of the physicians treating the detainees.
The ICRC establishes that:
[t]he alleged participation of health personnel in the interrogation
process and, either directly or indirectly, the infliction of ill-
treatment constituted a gross breach of medical ethics and, in some
cases, amounted in participation in torture and/or cruel, inhuman or
degrading treatment.6 (emphasis added)
The report does not explicitly state whether the ICRC believes that
physicians have committed violations of international humanitarian law
it would have to be ascertained whether international humanitarian
law is/was applicable in the so-called war on terrorism. Nevertheless,
the report demonstrates the relevance of medical ethics in modern
armed conflicts and its interaction with international humanitarian law.

physicians in interrogations and torture was also widely discussed in medical


literature, see Robert J. Lifton, Doctors and Torture, 351:5 New England
Journal of Medicine, 415 (2004); M. Gregg Bloche and Jonathan H. Marks,
Doctors and Interrogators at Guantanamo Bay, 353:1 New England Journal of
Medicine, 6 (2005); id., When Doctors go to War, 352:1 New England Journal
of Medicine, 3 (2005); Susan Okie, Glimpses of Guantanamo Medical Ethics
and the War on Terror, 353:24 New England Journal of Medicine, 2529 (2005);
George J. Annas, Unspeakably Cruel Torture, Medical Ethics, and the Law,
352 New England Journal of Medicine, 2127 (2005); Philippe J. Sands, Torture
Team Deception, Cruelty and the Compromise of Law (Penguin Books,
2008); Nancy Sherman, From Nuremberg to Guantnamo: Medical Ethics
Then and Now, 6 Washington University Global Studies Law Review, 609
(2007); Jonathan H. Marks, Doctors as Pawns? Law and Medical Ethics at
Guantnamo Bay, 37 Seton Hall Law Review, 711 (2007).
5 International Committee of the Red Cross, Regional Delegation for
United States and Canada, ICRC Report on the Treatment of Fourteen High-
Value Detainees in CIA Custody, WAS 07/76, (14 February 2007).
6 Ibid., 2627.
232 Mehring

III. Legal Framework

Since the adoption of the Additional Protocols in 1977, there have been
more detailed rules for the boundaries of medical actions during armed
conflict than those contained in the Geneva Conventions of 1949, even
though the need for boundaries had already been painfully clear after
World War II, during which physicians had been involved in some of
the most gruesome crimes against protected persons.7 Of course, al-
though many of the rules contained in the Additional Protocols are cus-
tomary, it needs to be emphasized that they have not been ratified uni-
versally, lacking ratification by certain states such as Israel, Somalia, In-
dia, Iran, and the USA.8
Articles 11 AP I and 5 (2)(e) AP II establish a protection for detained
persons against unwarranted medical procedures in international and
non-international armed conflicts respectively. They proscribe subject-
ing protected persons who are in the power of an adversary to any
medical procedure which is not indicated by the state of health of the
person concerned, and which is not consistent with generally accepted
medical standards [] applied under similar medical circumstances to
free persons (AP II) or persons who are nationals of the party con-
ducting the procedure and who are in no way deprived of their liberty
(AP I). Medical care should thus always be indicated by the health of a
patient and conform to generally accepted medical standards. Gener-
ally accepted medical standards are difficult to define. Even the ICRCs
official commentary to the Additional Protocols has difficulties in de-
termining what this reference means. It states that there is no doubt
that there are minimum standards though it is certainly necessary to

7 Some interesting cases: Military Court for the Trial of War Criminals,
Trial of Alfons Klein, Adolph Wahlmann, Heinrich Ruoff, Karl Willig, Adolf
Merkle, Irmgard Huber, and Philipp Blum [The Hadamar Trial], Judgment
[1945], Vol. IV; Military Court for the Trial of War Criminals, Trial of Josef
Kramer and Forty-Four Others [The Belsen Trial], Judgment [1945], Vol. II;
Military Court for the Trial of War Criminals, Trial of Heinrich Gerike, Georg
Hessling, Werner Noth, Hermann Mller, Gustav Claus, Richard Dmmerich,
Fritz Flint, and Valentina Bilien [The Velpke Baby Home Trial], Judgment
[1946], Vol. VII; and United States Military Tribunal I, United States of
America v. Karl Brandt, et al. [The Doctors Trial], Judgment [1947] Trials of
War Criminals before the Nuernberg Military Tribunals under Control Council
Law No. 10, Vol. I & II.
8 For a list of ratifications, consult http://www.icrc.org/ihl.nsf/CONVPR
ES?OpenView.
Ethicalization of International Humanitarian Law 233

define these better.9 They are not ethical standards but rather technical
medical standards that are universally accepted, that a mainstream phy-
sician from every corner of the world would agree to, and that can be
applied in all circumstances despite differences in resources and techno-
logical advances. Of course, states with better resources can provide
more than a minimum of medical care, yet with minimum standards,
equal care to all those in need of it can be guaranteed. In armed con-
flicts, medical care will always depend on triage which assigns priority
to certain cases based on medical needs and the distribution of re-
sources. This is a necessary and acceptable aspect of medical care during
armed conflict as long as the main criterion for distribution of medical
care are the medical needs of a person.10
A willful violation of the prohibitions in Article 11 AP I which seri-
ously endangers the physical or mental health or integrity of a pro-
tected person in the power of the adversary party, constitutes a grave
breach and can, in international armed conflicts, be prosecuted as a war
crime (Article 11 (4) AP I). The Rome Statute has criminalized certain
medical crimes in both international and non-international armed con-
flicts in Article 8 (2)(b)(x) and (e), yet few states have adopted special
provisions in their international criminal codes concerning medical war
crimes. Furthermore, the criminalization in the Rome Statute only con-
cerns unwarranted medical experiments and mutilations, whereas pur-
suant to the provision in Additional Protocol I the category of medical
grave breaches is much broader, including all unwarranted medical pro-
cedures that meet the criteria.
Next to the prohibition of unwarranted medical procedures, the Addi-
tional Protocols both also introduce additional safeguards for physi-
cians working in armed conflict. Articles 16 AP I and 10 AP II deter-
mine that no person shall be punished for providing medical care com-
patible with medical ethics. The second paragraph stipulates that medi-
cal personnel may also not be coerced to violate medical ethics, medical
rules designed for the benefit of the wounded and sick, or Geneva Law
in general. Examples of acts contrary to the patients benefit envisaged
by the drafters include the administration of mind-altering drugs for in-

9 Yves Sandoz et al. (eds.), Commentary on the Additional Protocols of 8


June 1977 to the Geneva Conventions of 12 August 1949 (Martinus Nijhoff
Publishers, 1987), para. 476.
10 This can also be found in Arts 12 (3) GC I and II, 16 GC III, 27 (3) GC
IV, 10 (2) AP I and 7 (2) AP II.
234 Mehring

terrogations or medical experiments.11 Moreover, the principle of confi-


dentiality, important for physicians and patients, is given a place in the
last paragraphs of these articles. They were controversial from the start
because, in this respect, national legislators can make rules concerning
the denunciation of patients that may override international humanitar-
ian law.12 As is the case with unwarranted medical procedures, few
states have transposed Articles 16 AP I and 10 AP II into their military
manuals, and overall it is too early to classify the provisions as custom-
ary international humanitarian law because states have generally pro-
vided neither state practice nor opinio juris on this issue.13
Surprisingly, medical ethics as such do not necessarily factor into medi-
cal war crimes as introduced in Articles 11 (4) and 85 AP I, considering
that during some of the trials of physicians after World War II, medical
ethics played a large role. The prosecutor in the famous Doctors Trial
of 1946, for example, stated that
[a]ll of [the accused] violated the Hippocratic commandments
which they had solemnly sworn to uphold and abide by, including

11 Diplomatic Conference on the Reaffirmation and Development of

International Humanitarian Law Applicable in Armed Conflicts 1974 - 1966,


Official Records (O.R.), XI, CDDH/II/SR.27, Statement of the Belgian Rep-
resentative, at 269; Sandoz et al. (eds.), Commentary to the Additional
Protocols, (note 9), para. 4695.
12 Maurice Torrelli, La protection du mdecin dans les conflits arms, in
Christophe Swinarski (ed.), Studies and Essays on International Humanitarian
Law and Red Cross Principles in honour of Jean Pictet (Martinus Nijhoff
Publishers, 1984), 589; Waldemar A. Solf, Development of the Protection of
the Wounded, Sick and Shipwrecked under the Protocols Additional to the
1949 Geneva Conventions, in Christophe Swinarski (ed.), Studies and Essays
on International Humanitarian Law and Red Cross Principles in honour of Jean
Pictet (Martinus Nijhoff Publishers, 1984), 245246. It was already criticized in
the diplomatic conferences: Official Records (O.R.), XI, CDDH/II/SR.16,
151153; CDDH/II/SR.19, 180182.
13 This conclusion contradicts the conclusion by the ICRC in its study on

customary international law, especially Rules 26 and 92. The study comes to the
conclusion that both the prohibition of unwarranted medical procedures that
violate generally accepted medical standards and the provision that physicians
are protected when acting in accordance with medical ethics are customary
rules of international law. Jean-Marie Henckaerts et al. (eds.), Customary
International Humanitarian Law (Cambridge University Press, 2005).
Ethicalization of International Humanitarian Law 235

the fundamental principle never to do harm primum non no-


cere..14
When looking at the prosecutions of medical war crimes following
World War II, it can be surmised that most medical war crimes are also
violations of medical ethics. Vice versa, violations of medical ethics
could often also be prosecuted as medical war crimes.
The question that is interesting for present purposes concerns the open
term we find here, namely medical ethics. In her article, Margaret
Somerville speaks of ethics as an add-on to law. Indeed, the drafters of
the relevant provisions referred to medical ethics as an additional safe-
guard above international humanitarian law,15 although they did not ex-
pand on what this means. Although few physicians carrying out medi-
cal work during armed conflict commit medical war crimes, medical
ethics can nonetheless play an important role in safeguarding the well-
being of protected persons. In addition, clarity on the boundaries of
medical activities in armed conflict can provide legal certainty and
specificity to physicians, protecting them from inadvertently trespass-
ing and enabling them to resist unethical orders, as justified by Articles
16 AP I and 10 AP II.
Reports from recent conflicts have demonstrated again that physicians
play integral roles. Although working on the sidelines, physicians are
often the center of attention, for example in the unrest during the Arab
spring of 2011.16 Yet the above referred to reports by international or

14 Prosecutor Telford Taylor in The Doctors Trial, (note 7), 68.


15 For example, see Official Records (O.R.), XI, CDDH/II/SR.16, delegate
Pictet (ICRC), 146; XI, CDDH/II/SR.19, delegate Bothe (Germany), 183.
16 Especially non-governmental organizations have discussed the role of
physicians in armed conflict, for example in the Gaza conflict: Amnesty Inter-
national, The Conflict in Gaza: A Briefing on applicable Law, Investigations
and Accountability, AI Index: MDE 15/007/2009, (2009) at http://www.am
nesty.org/en/library/info/MDE15/007/2009; Physicians for Human Rights
Israel, Ill Morals: Grave Violations of the Right to Health during the Israeli
Assault on Gaza, (March 2009); in Libya: International Committee of the Red
Cross, Libya: ICRC makes urgent call for access to wounded, (24 March
2011), at http://www.icrc.org/eng/resources/documents/update/2011/libya-up
date-2011-03-24.htm; see also in Bahrain: Amnesty International, Bahrain: A
Human Rights Crisis, AI Index: MDE/11/019/2011, (2011), at http://www.
amnesty.org/en/library/asset/MDE11/019/2011/en/40555429-a803-42da-a68d-
0f016b908580/mde110192011en.pdf; Physicians for Human Rights, Do No
Harm: A Call for Bahrain to end Systematic Attacks on Doctors and Patients,
(April 2011), at http://physiciansforhumanrights.org/issues/persecution-of-
236 Mehring

non-governmental organizations critical of physicians work in armed


conflict can not be ignored. Considering the apparent practical impor-
tance of Articles 16 AP I and 10 AP II in providing guidelines and pro-
tection for physicians and thereby protecting those they treat, the lack
of information on the meaning of the reference to medical ethics in in-
ternational humanitarian law, and the lack of scholarly literature or
state practice concerning medical ethics in armed conflicts, are baffling.
In order for medical ethics to make a valuable contribution to the bene-
fit of those who are not or no longer involved in hostilities, they need
to be more clearly defined. A valuable definition of medical ethics is es-
sential for the practical applicability of the articles and an amelioration
of the protection of victims of armed conflict who are in need of medi-
cal care. As it is, international humanitarian law is left with an open, yet
undefined reference to an extra-legal concept that can be important for
both physicians and those they treat. In order for this ethicalization to
be compatible with the protective character of international humanitar-
ian law, it needs to be determined how the reference can be substanti-
ated sensibly: what are medical ethics, where can such principles be
found, and have they been established on an international level?

IV. Interpretation

Several scholars in this book are of the opinion that it may at times be
better to leave decisions concerning medical care to physicians. This
would mean that ethics and law would remain two separate categories
that would guide physicians on a parallel level. However, firstly, the ex-
plicit references to medical ethics in the Additional Protocols lead to an
intersection of the two normative orders. Secondly, in the reality of
armed conflicts, exceptional situations of chaos, it may serve all in-
volved in medical care better if there are prescribed guidelines than if
medical decisions are left to the conscience of individuals.17 The auton-
omy of the medical profession should be respected in the sense that the

health-workers/bahrain/background.html; in Syria: Amnesty International,


Health Crisis: Syrian Government targets the Wounded and Health Workers,
AI Index: MDE 24/059/2011, (2011), at http://www.amnesty.org/en/library/
info/MDE24/059/2011/en.
17 Here, Somerville argued that law is not necessarily always more certain
than ethics but due to space restrictions, this cannot be further discussed in this
essay.
Ethicalization of International Humanitarian Law 237

most useful interpretation of medical ethics would be one influenced by


the medical profession.
An interpretation of medical ethics in the context of international hu-
manitarian law leads to an examination of several sources that will be
briefly discussed in the subsequent section.

1. General Principles of Medical Ethics

From the traditional ethical discourse, for example by looking at ap-


plied ethics or the Georgetown Principles,18 one can find inspiration for
clarifying the opening to medical ethics. Such principles or sets of prin-
ciples form a very broad ethical framework for physicians. In practice,
they certainly influence most physicians. Yet looking at the possible
ethical and legal dilemmas physicians may face when working in armed
conflict, for example concerning their role in torturous interrogations,
it can be concluded that much depends on a physicians medical ethics.
Principles of medical ethics, as developed in the philosophical dis-
course, have been criticized for being too abstract to be practicable
since they do not provide guidance in specific questions.19 In situations
of stress and chaos, there is neither much time to thoroughly weigh the
different principles against another nor to compare with previous ex-
periences when deciding on a course of action. Although both balanc-
ing and experience naturally play a role, in ethically challenging situa-
tions strict guidelines would serve both the physician and the patient.
This, however, the ethical discourse cannot provide.
With regard to legal certainty in armed conflicts, ethical principles leave
too much room for interpretation and application. As Alec Walen states
in his article, law is more easily discernible, at times more easy to le-
gitimate, and often less prone to change or controversy. In the interest
of the principle of specificity,20 medical ethics should be more specific

18 For the latest edition, see Tom L. Beauchamp and James F. Childress,

Principles of Biomedical Ethics, 6th ed. (Oxford University Press, 2009).


19 Criticism was raised by Clouser and Gert against Beauchamp and Chil-

dress principlism in K. Danner Clouser and Bernard Gert, A Critique of


Principlism, 15 The Journal of Medicine and Philosophy, 219 (1990). A recent
comparison and criticism: Hilde Lindemann, Autonomy, Beneficence and
Gezelligheid, Hastings Center Report, 39 (2009).
20 Antonio Cassese, International Criminal Law, 2nd ed. (Oxford
University Press, 2008), 41 et seq.
238 Mehring

so that physicians have clear guidelines on how to treat persons in ac-


cordance with medical ethics without violating international humanitar-
ian law. In that way, physicians, as possible perpetrators of medical war
crimes, can also foresee the consequences of their actions and courts, as
a last instance, can judge the ethical behavior of physicians in armed
conflict. From the ICRC Commentary, it can be inferred that more
specific rules of medical ethics had also been envisaged. For this reason,
the reference to medical ethics in Articles 16 AP I and 10 AP II should
not be taken as a reference to the ethical discourse.

2. Medical Ethics within International Humanitarian Law

It could be argued that the reference to medical ethics is a reference to


the principles concerning medical care explicated in international hu-
manitarian law itself. Gunn and McCoubrey, in the only extensive essay
on the issue, argue that there is a specific code of medical ethics in in-
ternational armed conflict which is built into the relevant provisions of
1949 Geneva Conventions I and II and of 1977 Additional Protocol I.21
They find the basic principle inherent to the laws of armed conflicts in
Articles 12 GC I and II and 10 AP I. These articles determine that all
those hors de combat due to wounds or sickness are, without distinc-
tion on other than medical grounds, entitled to medical care. Further-
more, the basic principle is supplemented by the code provided by Ar-
ticle 11 AP I, according to which medical procedures on protected per-
sons should be to their benefit and in accordance with generally ac-
cepted medical standards. These generally accepted medical standards,
according to Gunn and McCoubrey, are not the subjective standards of
the treating physician. Rather, they are a minimum safety net, for
matters not covered either by the fundamental general norms or by spe-
cific requirements,22 that is implicit in the provisions of Geneva Law
and they refer to medical standards relevant to the actual medical treat-

21 Michael J. Gunn and Hilaire McCoubrey, Medical Ethics and the Laws

of Armed Conflict, 3:2 Journal of Armed Conflict Law, 133 (1998). Their ar-
gument is in parts supported by Torrelli who notes that les rgles de droit hu-
manitaire qui viennent dtre rappeles font incontestablement partie de la
dontologie mais elles ne couvrent pas tous les aspects de celle-ci. Torrelli, La
protection du mdecin dans les conflits arms, (note 12), 588.
22 Gunn and McCoubrey, Medical Ethics and the Laws of Armed Conflict,
(note 21), 140.
Ethicalization of International Humanitarian Law 239

ment. Physicians should treat patients in accordance with the practices


approved by general, meaning mainstream, professional medical opin-
ion.23 Having established this basis, Gunn and McCoubrey then for-
mulate several further principles of medical ethics that, according to
them, emanate from Geneva Law.
The solution that Gunn and McCoubrey advocate is that the system of
international humanitarian law suffices in and on itself. They contend
that it operates independently of outside influence, hence medical ethics
should also be interpreted within the general framework of Geneva
Law. The argument is convincing in that it foregoes a strenuous search
for outside sources that could be used to give meaning to medical ethics
in the Additional Protocols. As international humanitarian law was de-
veloped specifically to regulate armed conflicts, answers to questions
regarding the treatment of victims of war could logically be sought
within this system. Articles 12 GC I and II, 10 AP I and 7 AP II indeed
provide basic principles for the treatment of all those in need of medical
care: that they be protected, respected, and treated humanely. However,
international humanitarian law alone does not suffice to establish medi-
cal ethics. No article contains clear rules for physicians that concern
medical treatment. Article 11 AP I, for example, only contains clear
prohibitions that rely on the basic premise that a physician should put
the patients interest above all. Beneficence may indeed be a principle of
medical ethics, but it is not a comprehensive code of medical ethics.
Gunn and McCoubrey are caught in a circular argumentation: if medi-
cal ethics are contained in the basic principles of international humani-
tarian law, a reference to such a term would have been futile. The
travaux prparatoires demonstrate that the reference to medical ethics
was deliberately included as an additional safeguard to ensure that phy-
sicians are bound by an external set of rules, namely the rules that are
usually considered to bind the medical profession. Due to its circularity,
Gunn and McCoubreys argument does not solve the question of medi-
cal ethics in armed conflict. A reference to medical ethics should be be-
yond international humanitarian law itself.

23 Ibid., 140.
240 Mehring

3. International Treaties Addressing Medical Ethics

International treaties concerning medical ethics could also be used to


give meaning to the opening to medical ethics in international humani-
tarian law. Treaties and conventions are particularly important as they
are official sources of international law24 and legitimized by their origin
in state consent.25 On an international level, such documents adopted
by states are sparse. There are two exceptions.
One exception that Henk Ten Have discusses in detail is the
UNESCOs Universal Declaration on Bioethics and Human Rights
(UDBHR) adopted in 2005 by UNESCOs General Conference.26 The
UNESCO, one of 17 specialized UN agencies, provides a global plat-
form to identify shared values and to assert universal principles.27 One
of the objectives of UNESCO is to set international normative stan-
dards in the sphere of global ethics.28 The UDBHR proclaims 15 non-
binding principles that form the core of the Declaration. The basis, in
Article 3 UDBHR, forms the principle of respect for human dignity,
human rights and fundamental freedoms. As the only principle solely
addressing medical interventions, Article 6 (1) UDBHR stipulates the
requirements for informed consent. The only provision that addresses
the principle of informed consent in international humanitarian law is
Article 11 (5) AP I which gives patients the right to refuse surgery.
Here, international humanitarian law clearly presents a lacuna where
Article 6 (1) UDBHR could provide guidance.29 As in all emergency

24 Article 38 (1)(a) ICJ Statute lists international conventions, whether gen-

eral or particular, establishing rules expressly recognized by the contesting


states as a source of international law.
25 Allen Buchanan and Robert O. Keohane, The Legitimacy of Global

Governance Institutions, in Rdiger Wolfrum and Volker Rben (eds.),


Legitimacy in International Law (Springer Verlag, 2008), 3640.
26 United Nations Educational Social and Cultural Organization, Universal

Declaration on Bioethics and Human Rights, UNESCO Publ. No


SHS/EST/BIO/06/1, (19 October 2005).
27 Henk A.M.J. ten Have and Michle S. Jean, Introduction, in Henk

A.M.J. ten Have and Michle S. Jean (eds.), The UNESCO Universal
Declaration on Bioethics and Human Rights: Background, Principles and
Application (UNESCO Publishing, 2009), 23.
28 Ibid., 19.
29 Not all states agree on what informed consent entails Belgium, for ex-
ample, in an official explanation of vote, provided its own interpretation of in-
Ethicalization of International Humanitarian Law 241

situations, Article 6 (1) UDBHR would have to be adjusted to the


situation of armed conflict where there is not always the possibility to
attain prior, free and informed consent.
Since the UDBHR addresses bioethics, it encompasses not only ethics
governing the medical practice the classical medical ethics but also
ethics concerning other sciences, especially life sciences. Although there
are certain principles that are relevant for medical treatment, such as the
balance of benefits and harm (Article 4)30 or the principles of consent
for persons without the capacity to consent, of equality and of non-
discrimination (Articles 7, 10 and 11),31 it is clear that this is not the
main aspiration of the UDBHR. Regulating medical practice or finding
solutions for ethical problems in medicine is of secondary importance
to setting standards for science and research.32 This is in line with the
mission of UNESCO: the Social and Human Sciences Department of
the UNESCO is seized with ethical dimensions of the current scientific

formed consent. For the Belgian explanation of vote, see UNESCO, Draft
Report of Commission III - Statements on the Interpretation of specific
Provisions of the Universal Declaration on Bioethics and Human Rights,
Annex II, Doc. No. 33 C/83, (18 October 2005), at http://unesdoc.unesco.org/
images/0014/001415/141500e.pdf, 1.
30 See also the discussion by Pellegrino that is based on the inference that
the article addresses medical treatment and medical research he does not men-
tion life sciences. Edmund D. Pellegrino, Article 4: Benefit and Harm, in
Henk A.M.J. Ten Have and Michle S. Jean (eds.), The UNESCO Universal
Declaration on Bioethics and Human Rights: Background, Principles and
Application (UNESCO Publishing, 2009), 107.
31 Article 7 UDBHR has, like Article 6 UDBHR, also raised concerns.

Germany has stated that it thus reaffirms its position on research on persons
lacking the capacity to consent and approves the Declaration on Bioethics with
the express note that the determination of international minimum standards
that differ from German legislation does not give the Federal Republic of Ger-
many any cause to deviate from the stricter German legal standards.
Statements on the Interpretation UDBHR, (note 29), 2.
32 See also Kollek who only speaks of international akzeptierte Leitlinien

fr das Handeln im Bereich der biomedizinischen Forschung und der Lebens-


wissenschaften leaving aside medical practice altogether. Regine Kollek,
Schritte zur internationalen Verstndigung ber bioethische Prinzipien, in
Deutsche UNESCO Kommission (ed.), Allgemeine Erklrung ber Bioethik
und Menschenrechte: Wegweiser fr die Internationalisierung der Bioethik
(Deutsche UNESCO Kommission, 2006), 42.
242 Mehring

and technological evolution.33 Questions relating to medicine and


health traditionally fall within the ambit of the WHO, whereas only
questions concerning science as such are within the area of responsibil-
ity of UNESCO.34 Not only is the emphasis on science and research
problematic, it is also questionable whether the UDBHR can guide
physicians. Article 1 (2) UDBHR explicitly declares that it is addressed
to states. For individuals, it can only provide guidance when appropri-
ate and relevant.35 Awareness of the UDBHR depends on UNESCO
member states and their efforts to disseminate it among the medical
profession. In the area of medicine as carried out in armed conflicts, the
UDBHR is of little practical value. Only few principles of the UDBHR
are sufficiently general to guide physicians who provide medical treat-
ment in armed conflict. This is also the reason why it plays only a mi-
nor role in interpreting medical ethics in the context of armed conflicts.
Another rare example is the United Nations General Assembly resolu-
tion 37/194, containing, in its annex, the Principles of Medical Ethics.36
Despite their broad title, the Principles are limited to medical ethics
relevant to the role of health personnel, particularly physicians, in the

33 Its mission statement is available at http://www.unesco.org/new/en/socia


l-and-human-sciences/about-us/how-we-work/mission/.
34 This can also be inferred from Article 2 (1) of World Health Organization

Agreement between the United Nations Educational, Scientific and Cultural


Organization and the World Health Organization, Official Records WHO
(1955) 13, 96, 323, (17 July 1948, 1948) which reads: In particular, it is recog-
nized by UNESCO that WHO shall have the primary responsibility for the en-
couragement of research, education, and the organization of science in the fields
of health and medicine, without prejudice to the right of UNESCO to concern
itself with the relations between the pure and applied sciences in all fields, in-
cluding the sciences basic to health. Some argue that UNESCO should have
left questions concerning medical treatment to the WHO. John R. Williams,
UNESCOs proposed Declaration on Bioethics and Human Rights A Bland
Compromise, 5 Developing World Bioethics, 210 (2005).
35 Hlne Boussard, The Normative Spectrum of an ethically-inspired
Legal Instrument: the 2005 Universal Declaration on Bioethics and Human
Rights, in Francesco Francioni (ed.), Biotechnologies and International Human
Rights (Hart Publishing, 2007), 110111.
36 UN General Assembly, Resolution 37/194 Principles of Medical Ethics

relevant to the Role of Health Personnel, particularly Physicians, in the


Protection of Prisoners and Detainees against Torture, and other Cruel,
Inhuman or Degrading Treatment or Punishment, Doc. No. A/RES/37/194,
(18 December 1982).
Ethicalization of International Humanitarian Law 243

protection of prisoners and detainees against torture, and other cruel,


inhuman and degrading treatment or punishment. While international
humanitarian law prohibits torture and inhuman treatment per se, it
does not single out physicians as possible perpetrators.37 The Principles
are more specific. Pursuant to the second principle:
[it] is a gross contravention of medical ethics, as well as an offence
under applicable international instruments, for health personnel,
particularly physicians, to engage, actively or passively, in acts which
constitute participation in, complicity in, incitement to or attempts
to commit torture or other cruel, inhuman or degrading treatment
or punishment.
They furthermore prohibit other forms of participation and are non-
derogable. As the Principles concern the treatment of prisoners and de-
tained persons, they complement Geneva Conventions III and IV and
Article 11 AP I. An explicit prohibition of physicians involvement in
acts or omissions that amount to an active or passive participation in
torture or cruel, inhuman or degrading treatment cannot be found in in-
ternational humanitarian law. Hence, the Principles provide an extra
layer to the protection of detained persons and prisoners of war.38 If
states fail to ameliorate their efforts to prevent or regulate physicians
involvement in interrogations or punishment of prisoners or detainees,
the Principles provide a very general basis for physicians to refer to for
guidance or in their defense in situations where torture is likely, such as
interrogations or punishment.39 In that sense, the Principles are a valu-
able addition to the protection of protected persons receiving medical
care. However, the Principles cannot substantiate the open term medi-
cal ethics in general as they are aimed at a specific situation, namely de-

37 Torture is prohibited, in international armed conflicts, in Arts 12 GC I, 12


GC II, 17 GC III, and 32 GC IV, and in non-international armed conflicts, in
common Article 3 GCs and Article 4 (2)(a) AP II. In general, international hu-
manitarian law only prohibits torture and, when it comes to interrogation of
prisoners of war, any other form of coercion. Cruel, inhuman and/or degrad-
ing treatment is not explicitly prohibited as such, although inhuman treatment
is one of the classic grave breaches pursuant to Arts 50 GC I, 51 GC II, 130
GC III, and 147 GC IV.
38 Namely Arts 7 and 10 ICCPR and the Convention against Torture in
general.
39 Yves Beigbeder, The Role and Status of International Humanitarian
Volunteers and Organizations the Right and Duty to Humanitarian
Assistance, Vol. 12 (Martinus Nijhoff Publishers, 1991), 340.
244 Mehring

tention, and at the subject of torture and cruel, inhuman and degrading
treatment. On issues such as triage or consent, they are silent. This bars
their applicability to all medical activities in armed conflict. They can be
used as guidelines for situations of detention, even in extension of Arti-
cle 11 AP I, but they cannot substantiate medical ethics in the Addi-
tional Protocols.
These rare international documents address specific aspects of medical
ethics, namely science and ill-treatment. As such, they can provide
guidance for physicians who find themselves in a certain situation but
they do not provide a definition of medical ethics or a list of general
principles of medical ethics that could be applicable in armed conflicts
as envisaged in the Additional Protocols.

4. National Medical Ethics

Some scholars support the idea that the reference to medical ethics
should be taken as a reference to national medical ethics as adopted by
national medical associations.40 Others are more hesitant; Gunn and
McCoubrey state in this respect that [very] obviously something more
is intended than the subjective, and possibly abominable, national stan-
dards of any particular power.41 A general comparison of guidelines on
medical ethics by national medical associations demonstrates that there
are common denominators on medical ethics that can be distilled from
all codes and guidelines.42 Although they are defined differently and ex-
plicated to various degrees, the respect for the patient and his human
dignity, the principle of non-discrimination, the principle of informed
consent, and the principle of confidentiality seem to be accepted by
most medical associations. These principles are generally already part of

40 For example Michael Bothe et al., New rules for Victims of Armed

Conflicts - Commentary on the two 1977 Protocols Additional to the Geneva


Conventions of 1949 (Martinus Nijhoff Publishers, 1982), 128; Frits Kalshoven,
International Humanitarian Law and Violation of Medical Neutrality, in Ger
L. Wackers and Clemens T.M. Wennekes (eds.), Violation of Medical Neutrality
(Thesis Publishers, 1992), 1014.
41 Gunn and McCoubrey, Medical Ethics and the Laws of Armed Conflict,
(note 21), 139.
42 The author compared ethics codes by six national medical associations:
the American, Canadian, Dutch, German, Israeli, and South African medical as-
sociation.
Ethicalization of International Humanitarian Law 245

international humanitarian law: the principle of respect for human dig-


nity can be found in the provisions calling for humane treatment of
protected persons43 and the provisions prohibiting outrages upon per-
sonal dignity,44 the principle of non-discrimination is explicitly codified
in Articles 12 GC I and II, 16 GC III, 27 GC IV, 10 (2) AP I, and 7 (2)
AP II, and the principle of confidentiality (though only in the Addi-
tional Protocols and dependent on national legislation) in Articles 16 (3)
AP I and 10 (3 and 4) AP II. The only exception is the principle of in-
formed consent from an ethical and medical point of view, this seems
to be one of the principles that practitioners and ethicists agree on, yet
that, with the exception of a severely circumscribed version in Article
11 (5) AP I, was not included in international humanitarian law. Despite
these convergences, there are also differences, for example regarding the
involvement of physicians in interrogations. This becomes clear when
comparing an extensive opinion on Physician Participation in Interro-
gation adopted by the American Medical Association in 200645 and a
position paper on the same topic, namely on the Prohibition of Physi-
cian Participation in Interrogations and Torture, adopted by the Israeli
Medical Association in 2007.46
Substituting medical ethics with principles and prohibitions as pro-
claimed by national medical associations would lead to pluralistic ap-
proaches to the care of the wounded and sick in armed conflicts. Al-
though this may have benefits in that medical ethics would be inde-

43 Arts 3 GC I, II, III, and IV, 12 GC I and II, 13 and 14 GC III, 27 GC IV,

10 (2) and 75 AP I and 4 and 7 AP II. It should be noted that these are all refer-
ences to humane treatment, not human dignity per se. An explicit reference to
human dignity was neither included in the Geneva Conventions, nor in the Ad-
ditional Protocols. Inhuman treatment also constitutes a grave breach of the
Geneva Conventions.
44 Article 75 (2) AP I and for non-international armed conflicts Article 4
(2)(e) AP II. A violation of the latter, however, does not constitute a grave
breach of the Geneva Conventions.
45 The opinion on physician participation in interrogation is based on a re-
port by the AMA Council on Ethical and Judicial Affairs (CEJA Report 10-A-
06) on physician participation in interrogation (Res. 1, I-05) of June 2006.
American Medical Association, Opinion 2.068 Physician Participation in
Interrogation, (November 2006), at http://www.ama-assn.org/ama/pub/physi
cian-resources/medical-ethics/code-medical-ethics/opinion2068.page.
46 Israeli Medical Association, Position Paper on the Prohibition of
Physician Participation in Interrogations and Torture, (December 2007), at
http://www.ima.org.il/ENG/ViewCategory.aspx?CategoryId=4529.
246 Mehring

pendent of international politics, be determined by the medical profes-


sion of a state or territory, and so be culturally adjusted, pluralism is not
always beneficial. If national medical associations provide very different
guidelines in a matter important in armed conflicts, such as the treat-
ment by physicians of persons detained, a pluralistic approach would
do exactly what international humanitarian law intends to prevent. It
would create different standards of care for different people depending
on who they are being treated by especially if from different parties to
the conflict. The drafters chose open, extra-legal terms that have gained
legal importance through their incorporation in the Additional Proto-
cols for a reason. This reason is equal and efficient protection of the
wounded and sick that is compatible with international humanitarian
and human rights law. The medical treatment of the wounded and sick
is to be independent of national notions the purpose of the reference
to medical ethics is to ensure a universal standard of treatment for all
persons in need of medical care in the precarious situation of an armed
conflict. Medical ethics in the Additional Protocols should thus not be
substantiated using principles of medical ethics as proclaimed by na-
tional medical associations.

5. The World Medical Association

Most scholars, as well as the ICRC, follow the approach that the refer-
ence to medical ethics should be clarified by looking at the relevant
guidelines provided by the World Medical Association (WMA).47 These
would be the Declaration of Geneva, the International Code of Medical

47 Sandoz et al. (eds.), Commentary to the Additional Protocols (note 9),

para. 656. See also the paragraphs in the ICRC Commentary concerning Article
10 AP II. Ibid., paras. 46854691; Alma Baccino-Astrada, Manuel des droits et
devoirs du personnel sanitaire lors des conflits arms (La Croix-Rouge, 1982),
3738; Pierre Perrin, The Right to Health in Armed Conflict, in Andrew
Clapham and Mary Robinson (eds.), Realizing the Right to Health (Rffer &
Rub, 2009), 162; Jann Kleffner, Protection of the Wounded, Sick and
Shipwrecked, in Dieter Fleck (ed.), The Handbook of International
Humanitarian Law (Oxford University Press, 2008), para. 614 (3); Beigbeder,
The Role and Status of International Humanitarian Volunteers and
Organizations - the Right and Duty to Humanitarian Assistance, (note 39),
339340.
Ethicalization of International Humanitarian Law 247

Ethics, and the Regulations in Times of Armed Conflict.48 Attention


should be paid to the fact that these documents are regularly updated
by vote in the WMA General Assembly.
The WMA proclaims that its declarations and statements be universally
applicable.49 It can thus be assumed that the WMAs intention is not
only to bind its members and the physicians who are members of the
national medical associations but also physicians worldwide, states,
governments, authorities, combatants, and the media who are addressed
in the documents relevant to armed conflicts. Unlike UN organs and
international organizations, the WMA is a non-governmental organiza-
tion. This begs the question of whether it can make binding rules for
individuals and states.
Its documents cannot be considered soft law. Non-binding norms by
non-governmental organizations can be categorized as soft law when
such norms have a de facto normative influence, for example on the in-
terpretation of binding, legal rules or on the behavior of states.50 The
soft law status of the Declaration of Geneva, the International Code of
Medical Ethics, and the Regulations in Times of Armed Conflict should
be denied. Even though they meet certain requirements of soft law,
namely that they are not formal sources of law and, as such, lack legal
bindingness, and have a certain proximity to legal rules in that they
produce certain legal effects,51 they lack the most intrinsic aspects of

48 The documents are available online at http://www.wma.net/en/10home/

index.html. The most important documents for the functioning of the WMA
are the World Medical Association, Articles and Bylaws of the World Medical
Association, Inc., (adopted by the 32nd World Medical Assembly, November
1978, last amended by the WMA General Assembly, Pilanesburg, South Africa,
2006) and World Medical Association, Procedures and Operating Policies of
the World Medical Association, (approved by the 186th WMA Council Session
in Vancouver, October 2010 and amended by the 188th WMA Council Session
in Sydney, April 2011).
49 Chapter 4.1.2 of the Procedures and Operating Policies.
50 Helen Keller, Codes of Conduct and their Implementation: the Question
of Legitimacy, in Rdiger Wolfrum and Volker Rben (eds.), Legitimacy in
International Law (Springer Verlag, 2008) 221, 249.
51 Threr identifies four intrinsic aspects of soft law: 1) that they express

common expectations regarding the conduct of subjects of international law in


international relations; 2) that they be created by subjects of international law;
3) that due to their not being from a formal source of international law they
lack legal bindingess; and 4) that they have the capacity to produce certain legal
effects. See Daniel Threr, Soft Law, in Rdiger Wolfrum (ed.), Max Planck
248 Mehring

soft law. To claim influence in the international realm, only rules by


NGOs that seek to influence states and that ultimately de facto also af-
fect state behavior or the behavior of international organizations should
be considered normatively influential enough to be classified as soft
law.52 Such a norm should actually govern international relations.53 This
the WMAs documents do not.
It has then to be considered whether the WMAs documents can give
meaning to the open term medical ethics as easily as is envisaged by
scholars and the ICRC Commentary. For this question to be answered
satisfactorily, it will have to be determined whether the WMA enjoys
legitimacy in international law which would heighten its credibility in
setting normative standards. Legitimacy, beyond purely democratic le-
gitimacy, can be defined as the justification of the authority of an or-
ganization or institution to make binding rules.54
If the WMAs procedures can be considered adequate and fair, this
could provide the organization with procedural legitimacy.55 The WMA
consists of 97 national non-governmental medical associations. Individ-
ual physicians are not voting members, nor are states. As, in interna-
tional law, states cannot be bound against their will,56 the claim to bind
states is a bold assertion that cannot be substantiated. Despite its name
and image, representation within the WMA is not universal. It is heav-
ily dominated by European, the American, and the Israeli Medical As-
sociation, and has only three Arab and comparatively few African

Encyclopedia of Public International Law (Oxford University Press, 2010),


para. 9.
52 Hobe presents an interesting overview of examples yet in all cases there
has been a palpable influence on the behavior of international actors. Stephan
Hobe, The Role of Non-State Actors, in particular of NGOs, in Non-
Contractual Law-Making and the Development of Customary International
Law, in Rdiger Wolfrum and Volker Rben (eds.), Developments of
International Law in Treaty Making (Springer, 2005), 324327.
53 Threr, Soft Law, (note 51), para. 5.
54 This definition is based on a description of legitimacy by Bodansky in id.,
The Legitimacy of International Governance: a Coming Challenge for
International Environmental Law, 93:3 American Journal of International Law,
596 (1999), 601.
55 For this, the two most essential documents to the WMA were considered,

the WMAs Articles and Bylaws and its Procedures and Operating Policies.
56 Permanent Court of International Justice, The S.S. Lotus Case, [1927]
Publications of the PCIJ, Series A, No. 10.
Ethicalization of International Humanitarian Law 249

members. Furthermore, the balance of power within the organization


tips in favor of the WMAs Council which is an elected body responsi-
ble for the WMAs policies and the agenda. The Council has the ulti-
mate say over the policies whereas the representative body, the General
Assembly, has little power. Within both the Assembly and the Council
voting rights are distributed unequally with larger associations, usually
of wealthier, Western nations, having more votes than smaller, less
wealthy associations. In addition, access to the WMA and its transpar-
ency are also inadequate. Although most of its documents are available
online on its website, the WMA does not disclose its statutes or finan-
cial statements. Furthermore, the WMA lacks accountability towards its
accountability-holders and cannot be subject to sanctions for its ac-
tions. There is no mechanism for individual physicians to review the
WMA, to hold it accountable for its policies, or to expose it to legal or
other sanctions. Moreover, between the WMA and its members, there is
not a sufficient amount of distance to enable independent supervision
or review. Hence, most procedures within the WMA are neither ade-
quate nor fair. Due to these deficits in procedural legitimacy, it is ques-
tionable whether the WMA guidelines and codes can be taken as the
principles of medical ethics to be applied in armed conflicts.
Yet while being skeptical of the organization in general, some of its
rules that do not contradict general international humanitarian law can
offer valuable guidance to physicians on medical ethics in armed con-
flict. This could be considered a sort of output legitimacy.57 In sum-
mary, the following rules of medical ethics can be considered reasonable
and valuable additions to international humanitarian law: that medical
ethics are the same in times of peace as in times of armed conflict; that
the health of those in need of medical care should be the primary con-
sideration for physicians who should prioritize their patients and those
they care for even over their military duties; that physicians should re-
spect their patients inherent human dignity and should at all times act
to the benefit of those in need of medical care; that they should, if rea-
sonably possible, require their informed consent before conducting

57 This derivation of legitimacy is based on Scharpfs theory of output (and

input) legitimacy. Scharpfs theory will, however, not be discussed in detail as it


is heavily intertwined with the concept of democracy, a concept that as such has
no relevance concerning the WMA for the above named reasons. Fritz W.
Scharpf, Regieren in Europa: Effektiv und Demokratisch? (Campus Verlag,
1999). See also Bodansky, The Legitimacy of International Governance, (note
54), 612 et seq.
250 Mehring

medical procedures and respect the confidentiality of personal, medical


information, except when the person presents a threat to others. Al-
though implicit in international humanitarian law, it is important to
clarify that physicians should not use medical knowledge to violate
human rights, use medical knowledge to facilitate coercive interroga-
tions or torture, participate in torture, or perform non-therapeutic pro-
cedures or experiments.58 Hence, those provisions in WMA documents
that are reasonable and valuable, can prove the WMAs problem-
solving effectiveness and, thus, give it legitimacy.59

V. Conclusion

As demonstrated, the provisions concerning medical treatment of pro-


tected persons are instrumental to the protection of the victims of
armed conflict in situations of dependency, for example civilians in an
occupied territory, all persons detained, and prisoners of war. The refer-
ence to medical ethics in Articles 16 AP I and 10 AP II has ethicalized
international humanitarian law. It has opened the system of interna-
tional humanitarian law regarding medical care provided to protected
persons and the protection of physicians to medical ethics which should
henceforth govern the actions and provide the limits for important ac-
tors in armed conflict, namely physicians. The reference was expressly
chosen so that their actions may be regulated by the rules of the medical

58 Condoning such practices, as prohibited by the Regulations, does not,


however, fall under the legal prohibition in international humanitarian, crimi-
nal, or human rights law. Most international documents refer to an act of tor-
ture by which it can be inferred they mean active participation. Nowak explic-
itly refers to an active undertaking as a requirement for establishing torture
under Art. 7 ICCPR. Manfred Nowak, U.N. Covenant on Civil and Political
Rights Commentary, 2nd ed. (N.P. Engel Verlag, 2005), 161. Moreover, the
documents neglect to specify which consequences a violation of WMA declara-
tions should have. Here, the UN Principles offered a more valuable contribu-
tion by clarifying that a contravention of medical ethics should entail account-
ability. UN General Assembly, Resolution 37/194 Principles of Medical Ethics
relevant to the Role of Health Personnel, particularly Physicians, in the
Protection of Prisoners and Detainees against Torture, and other Cruel,
Inhuman or Degrading Treatment or Punishment, Doc. No. A/RES/37/194,
(18 December 1982).
59 Bodansky, The Legitimacy of International Governance, (note 54), 622.
Ethicalization of International Humanitarian Law 251

profession which were thought to provide additional protection in the


interaction between physicians and protected persons.
The reference to medical ethics in these international treaties is interest-
ing for its explicitness and its lack of an explanation. An interpretation
of the opening is all the more relevant seeing the importance of medical
ethics for medical treatment. Not only do all wounded and sick depend
on medical treatment, but this treatment should be the same for all and
persons should be able to know what to expect when seeking medical
care. Also, the boundaries for physicians should be clear so that what
the ICRC calls breaches of medical ethics and possible medical war
crimes can be tackled more efficiently and hopefully finally be pre-
vented in the future. Hence, international humanitarian law would
benefit greatly from clear ethical standards as envisaged by the drafters
of the Additional Protocols.
From the cursory examination, it follows that the most convincing in-
terpretation of the reference to medical ethics in the Additional Proto-
cols is a combinational approach. First of all, the humanitarian princi-
ples of international humanitarian law itself provide a guideline on what
aspects of medical care are relevant in armed conflict for example, tri-
age is essential whereas questions regarding the beginning of life are
not. These aspects can be supplemented, where appropriate, by those
WMA principles that correspond to international humanitarian law and
the general ethical discourse. In that way, the opening of international
humanitarian law to ethical standards is reasonable because it only
builds on existing norms. For example, the principle of informed con-
sent is given a prominent spot in the WMA documents, national medi-
cal ethical codes, and the general ethical discourse. However, in interna-
tional humanitarian law it was almost completely omitted. As the prin-
ciple is compatible with international humanitarian law, it should also
be applicable in armed conflicts.
In the future, further guidelines for all physicians in both international
and non-international armed conflicts should add on to the existing
provisions in the Additional Protocols and clarify the reference to
medical ethics to shed light on where the boundaries of physicians ac-
tions lie. More detailed guidance on medical work during armed con-
flict can contribute to clarity, legal specificity, and ultimately protection.
This can be helpful in situations, addressed by the ICRC, where physi-
cians may have violated not only medical ethics but also international
humanitarian law.
Mapping Expansive Uses of Human Dignity in
International Criminal Law
J. Benton Heath*

The label incitement could never fully do justice to the depths of eth-
nic hatred that pervaded Rwandan media during and leading up to the
1994 genocide. There is no doubt that many radio broadcasts amounted
to inciting genocide, as several radio broadcasters threw their support
behind the killing, named targets on the air and offered gentle encour-
agements to leave no grave half full.1 But equally horrifying was the
steady drumbeat of pure hatred, characterizing the Tutsi as vermin, re-
ferring endlessly to Tutsi mendacity and trickery and intimating that
the Hutu must free themselves from Tutsi economic domination. If in-
ternational criminal trials can even begin to redress the horrors of
atrocities like the Rwanda genocide many may have thought at the
time should the law not also be capable of punishing this truly repre-
hensible hate speech?
In 2007, the Appeals Chamber of the International Criminal Tribunal
for Rwanda grappled with this problem. Whereas direct and public in-
citement to genocide was clearly a crime within the tribunals jurisdic-

* The author would like to thank Jos E. Alvarez, Jeremy Waldron, Julian
Arato, Graham F. Dumas, and Carla Greenberg for valuable suggestions on ear-
lier drafts. The author wishes to express tremendous gratitude to Silja Vneky
and the organizers of the 2011 Symposium on the Ethicalization of Law, where
this paper received extremely beneficial comments from Alec D. Walen, James
Fowkes, Michaela Hailbronner, and Sigrid Mehring.
1 Gourevitch, We Wish to Inform You that Tomorrow We Will Be Killed
With Our Families, 1998, at 134.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 253
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_10, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
254 Benton Heath

tion,2 no clear law criminalized the other kind of hate speech that made
the radio broadcasts and newspaper articles so insidious. Dignity pro-
vided the solution: the tribunal noted that hate speech constitutes an af-
front to human dignity and as such it might serve as the basis for a con-
viction for crimes against humanity. Thus the court upheld a persecu-
tion conviction for Ferdinand Nahimana, the head of Radio-Tlvision
Libre des Mille Collines.3
Addressing a different situation, in 1998 the Trial Chamber of the In-
ternational Criminal Tribunal for the former Yugoslavia (ICTY) strug-
gled to determine whether oral penetration constituted the crime of
rape.4 The court stated that this question was undetermined in interna-
tional law and that it was contested across national jurisdictions. How-
ever, the tribunal noted that forced oral penetration constitutes a viola-
tion of human dignity and that dignity, as a general principle of interna-
tional law, requires the court to interpret the crime of rape to apply to
such conduct.
These two cases represent examples of what I term expansive uses of
human dignity in criminal jurisprudence. In these cases, human dignity
is deployed expansively in at least two senses. First, the concept allows
judges to address and punish conduct that was not clearly proscribed
under the positive law of the tribunal, thus expanding the reach of the
court in a practical sense.
Second, the usage here is expansive in that it references a broad concept
of human dignity that is not tied to specific legal doctrines or to any
particular history of jurisprudential elaboration and interpretation. By
contrast, the fundamental protections of the laws of armed conflict have
given rise to a dense body of jurisprudence surrounding the meaning of
outrages against personal dignity, focusing primarily on the issue of
detention and treatment of detainees.5 Even though these provisions

2 The origins of this crime date to the Convention on the Prevention and
Punishment of the Crime of Genocide, 9 December 1948, Art. 3(c), 78 UNTS
277.
3 Prosecutor v. Nahimana, ICTR, Case No. ICTR-99-52-A, Appeal Judg-
ment of 28 November 2007. The defendants were also convicted of direct and
public incitement to genocide, which did not require recourse to the principle
of human dignity.
4 Prosecutor v. Furundija, ICTY, Case No. IT-95-17/1-T, Trial Judgment
of 10 December 1998.
5 Geneva Protocol I Additional to the Geneva Conventions of 12 August
1949, and Relating to the Protection of Victims of International Armed Con-
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 255

reach a broad and ever-increasing array of conduct, I argue that they are
narrow in the sense that they are tied historically and jurispruden-
tially to particular contexts and meanings.6
Expansive uses of dignity, on the other hand, draw on broadly phrased
invocations of the inherent worth of the human person, as elaborated in
the preambles to the major international human rights instruments.7
These uses of human dignity are thus expansive in the sense that they
abstract from context and are capable of transcending boundaries be-
tween doctrines, between legal categories and between legal and moral
lines of reasoning.
Expansive uses of human dignity arise sporadically in international
criminal law, as gap-fillers, as interpretive principles or as tools for
overcoming the principle of legality (nullum crimen sine lege). The phe-
nomenon is rare in the densely juridified environment of todays inter-
national criminal law, but expansive uses of human dignity can be pow-
erful or even transformative when they do arise. This paper begins to
study the expansive concept in isolation from the more particular invo-
cations of dignity found in the Geneva Conventions as well as from the
prohibitions on degradation in international human rights law. As the
paper demonstrates, this methodological choice should yield some use-
ful insights and point to some problems and challenges associated with
the concept of dignity.

flicts, 8 June 1977, Arts. 75, 85, 1125 UNTS 3 (1978) [hereinafter Additional
Protocol I]; Geneva Protocol II Additional to the Geneva Conventions of 12
August 1949, and Relating to the Protection of Victims of Non-International
Armed Conflicts, 8 June 1977, Art. 4, 1125 UNTS 609 (1978) [hereinafter Addi-
tional Protocol II]; Geneva Convention I for the Amelioration of the Condition
of the Wounded and Sick in Armed Forces in the Field, 12 August 1949, Art. 3,
75 UNTS 31 (1950) [hereinafter Common Article 3]. The dignity of prisoners
appeared in the Lieber Code, intended to guide soldiers during the U.S. Civil
War, but it did not appear in the Geneva Conventions or Hague Conventions
until 1949. See General Orders No. 100: Instructions for the Government of
Armies of the United States in the Field, Adjutant Generals Office, 24 April
1863, Art. 75.
6 On interpretive practice relating to personal dignity, see Droege, In
Truth the Leitmotiv: The Prohibition of Torture and Other Forms of Ill-
Treatment in International Humanitarian Law, 89 Intl Rev. Red Cross (2007),
515.
7 The 1948 U.N. declaration, for example, holds that [a]ll human beings
are born free and equal in dignity and rights. Universal Declaration of Human
Rights, G.A. Res. 217A (III) of 10 December 1948.
256 Benton Heath

This contribution should be seen as clearing the ground for an ongoing


conceptual analysis of the role of human dignity in international crimi-
nal jurisprudence. The first section sets out and defends a two-dimen-
sional approach to analyzing judicial uses of dignity in international
criminal law (I). In this approach, depth refers to the form that dignity
takes in judicial reasoning and breadth refers to the context attached to
a particular utterance of dignity. The second section argues that expan-
sive (broad) uses of human dignity can work important effects on the
outcomes of criminal trials by, for example, extending the law, motivat-
ing or demanding expansive interpretations, trumping other rights con-
cerns and overcoming objections based on the principle of legality (II).
The paper concludes by highlighting the need for a serious and cautious
approach to human dignity (III). In this last section, I lay the ground-
work for the argument that viewing dignity as a form of rank (dignitas)
may help explain the importance of expansive uses of dignity in interna-
tional criminal law, while at the same time bringing much-needed con-
ceptual clarity to the area.
Human dignity provides a particularly useful case study for the ethical-
ization of law. First, dignity is the paradigmatic hybrid of a legal and a
moral concept; it suggests a deeply moral understanding of humanity,
even as it seems far more at home in our legal and constitutional texts
than it does in everyday ethical discourse. It stands at the foundation of
modern human rights law as well as undergirding the constitutional
structures of many states, yet it seems to demand that we search outside
the law for its content. Second, because of dignitys pride of place
within modern rights-based systems, it commands attention and au-
thority when used by courts and legal texts. Third, the concepts inde-
terminacy makes it as malleable as it is powerful. Used indiscreetly, the
concept can be totalizing. In international criminal law, the stakes are
clear. Expansive uses of dignity threaten the guarantees of legality and
may even operate as a vehicle for privileging Western notions of justice
and morality over procedural fairness and cultural sensitivity. On the
other hand, dignity may guard against an overly rigid international
criminal law, making sure that the law is capable of adapting to new
atrocities and is not subject to envelope-pushing and gaming by
savvy war criminals.8

8 E.g. Luban, Fairness to Rightness: Jurisdiction, Legality, and the Legiti-


macy of International Criminal Law, in Besson/Tasioulas (eds.), The Philoso-
phy of International Law, 2009, at 569, 586.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 257

I. The Dimensions of Dignity: Depth and Breadth

As a leading currency for moral and legal discourse,9 human dignity


tends to insert itself into nearly every debate surrounding the protec-
tion of persons or communities in the international system.10 This may
make it difficult to hear dignity-talk as anything more than noise,
empty moralizing or the inescapable grammar of international legal ar-
gument. To assess the promise and perils of the concept, one must un-
derstand how human dignity actually affects substantive outcomes in
particular cases. By distinguishing between the various ways in which
human dignity may be invoked, this section takes the first step in clear-
ing the ground for a productive discussion of the concepts potentially
outcome-determinative role in international criminal law.
As this section explains, judicial uses of human dignity in international
criminal law may be usefully mapped along two dimensions. First, hu-
man dignity displays variable depth, in the sense that it may operate di-
rectly on a subject to regulate conduct, or it may serve as a background
justification for a law or legal regime (1.). In other words, dignity takes
a variety of forms: philosophical justification, substantive rule or inter-
pretive principle. Second, dignity may be employed with varying
breadth, as the introductions distinction between expansive and nar-
row uses of dignity makes clear (2.). Breadth is not so much a function
of form but of context, as the concept of dignity may arise either in a
concrete and contextualized way, or it may arise in a manner that is
unmoored from any specific factual, historical, relational, doctrinal or
jurisdictional circumstance. The dimensions being derived from cases
and treaties that employ the concept of human dignity, the goal of this
section is to abstract from the particular legal analyses in each case, to
systematize a way of thinking about human dignity, as it relates to in-
ternational criminal jurisprudence.11
The two-dimensional structure captures something important about the
power and attractiveness of dignity as a normative concept. Certainly,

9 Note the foundational role of dignity in the Charter of the United Na-
tions. See U.N. Charter, preamble (to reaffirm faith in fundamental human
rights, in the dignity of the human person []).
10 See, e.g., Valencia-Ospina, International Law Commission, Third Report
on the Protection of Persons in the Event of Disasters, UN Doc. A/CN.4/629,
paras. 5162 (2010) (canvassing uses of dignity in international law).
11 Further work will conduct in-depth case studies of dignity-based reason-
ing in international criminal law.
258 Benton Heath

dignity-talk derives some of its transformative force from its ability to


evoke the sense that human dignity lies deep at the foundations of mod-
ern international law. In other words, dignitys power is at least in some
sense a function of depth. But broad uses of human dignity are much
more likely to generate new substantive rules, to break from past prece-
dent, or to transform aging legal doctrines than narrow uses. Because
human dignity can be employed in a way that is detached from any par-
ticular factual context, judges and lawyers can mold the concept to de-
velop substantial change in legal doctrines. Dignity becomes all the
more flexible when the concept invoked carries less contextual baggage
a right to human dignity12 may generate more transformative change
than a protection against outrages on personal dignity in the context of
armed conflict.
The two dimensions are connected, as broad uses of human dignity are
more likely to draw on deeper foundational notions. But each dimen-
sion requires consideration. Dignitys power lies in its ability to draw
connections between usages of varying depth and breadth, thus poten-
tially producing a wide array of legal consequences. In the hands of a
creative prosecutor or judge, dignity thereby becomes a useful multi-
purpose tool for expanding existing law.

1. Depth: Foundational, Substantive, and Interpretive Uses of


Human Dignity

In legal discourse, human dignity arises at several levels of abstraction.


The term has justificatory value as a reason (or perhaps the reason) for
the existence of the modern state, of constitutionalism or of human
rights, but dignity also exists as a thing that can be injured by individual
conduct and as something that people have a right to protect.13 The
concept of human dignity often appears as either a foundational notion

12 See German Basic Law, Art. 1 para. 1 (Human dignity shall be inviola-
ble.).
13 McCrudden captures this slippage when he notes that in many jurisdic-
tions dignity is to be found in the preamble, whereas in others it is used to ex-
plicate particular rights. In some, it is referred to as foundational in some sense;
in others not. In some, human dignity is a right in itself (and in some systems, a
particularly privileged right), whilst, in other jurisdictions, it is not a right but a
general principle. McCrudden, Human Dignity and Judicial Interpretation of
Human Rights, 19 EJIL (2008), 655, 675.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 259

in the sense that it justifies the existence of a particular regime or legal


order, or as a substantive notion, prescribing or proscribing specific
forms of conduct.14 This section further proposes that we can identify
an interpretive notion of human dignity, which operates at an interme-
diate level between substance and foundation, and works to convert as-
pects of the foundational concept into substantive law. For international
criminal law, these varying depths are important not in themselves, but
in the way that the foundational, substantive, and interpretive can bleed
together to produce a range of results.

a) Foundational Uses of Human Dignity


Human dignity occupies a conspicuous place at the base of many mod-
ern domestic and international systems for the protection of fundamen-
tal rights, and thus the foundational role of human dignity should be
familiar.15 In international criminal law, dignity has been recognized as
the foundation of the entire regime16 and as the animating notion be-

14 I am extremely grateful to Alec Walen for encouraging me to make this


distinction in terms of foundation and substance, which I have found very help-
ful in revising my arguments. Petersen similarly distinguishes between dignity
as a formal-philosophical concept that justifies the human rights system, and
dignity as a substantive legal guarantee that includes protections against hu-
miliation and discrimination, as well as providing a yardstick for development.
Petersen, International Protection of Human Dignity, in Wolfrum (ed.), The
Max Planck Encyclopedia of Public International Law, 2011.
15 Examples are legion. In human rights, see for example International

Covenant on Civil and Political Rights [ICCPR], 16 December 1966, preamble,


999 UNTS 171 ([r]ecognizing that these rights derive from the inherent dig-
nity of the human person). This foundational notion also appears powerfully
in German constitutional jurisprudence, which holds that dignity is the consti-
tutive principle in the system of basic rights. Klein, Human Dignity in Ger-
man Law, in Kretzmer/Klein (eds.), The Concept of Dignity in Human Rights
Discourse, 2002, 145, at 147. The Red Cross commentary to the Geneva Con-
ventions asserts that the law of armed conflict, even before 1949, was con-
cerned with people as human beings, without regard to their uniform, their al-
legiance, their race or their beliefs. Pictet (ed.), Intl Committee of the Red
Cross [ICRC], Commentary: III Geneva Convention Relative to the Treatment
of Prisoners of War, 1960, 28.
16 The late Antonio Cassese delineates the category of international
crimes, which are limited to, inter alia, those crimes that protect the values
considered important by the whole international community, as laid down in
260 Benton Heath

hind crimes against humanity in particular.17 The ICTY in the Fu-


rundija trial judgment connects this intuition to what it sees as a
broader thread running through international law:
The general principle of respect for human dignity is the basic un-
derpinning and indeed the very raison dtre of international hu-
manitarian law and human rights law; indeed in modern times it has
become of such paramount importance as to permeate the whole
body of international law.18
Other judgments strike a similar tone.19 Despite the broad consensus
that human dignity plays some role in the foundations of international
criminal law, the foundational use lacks any determinative content of its
own. In addition, its role in everyday international criminal law-
application remains unclear.
By referencing human rights law and humanitarian law in their invoca-
tions of human dignity, international criminal law judges do not supply
a great deal of content to the concept of dignity and they arguably in-
troduce the contestation over dignity in human rights law into the cor-
pus juris of international criminal law. McCrudden, tracing the history
of the Universal Declaration of Human Rights (UDHR), notes that the
documents references to human dignity served as a placeholder to
paper over deep philosophical disagreement on the nature of rights.20
Beneath the general consensus that human dignity is somehow relevant
to human rights and the law of war21 lies deep conceptual indetermi-

human rights conventions and the U.N. Charter. Cassese, International Crimi-
nal Law, 2nd ed. 2008, at 11 & 10.
17 See Cassese (note 16), at 98 (crimes against humanity protect against grave

indignities); Luban, A Theory of Crimes Against Humanity, 29 YJIL (2004), 85,


103 (persecution crimes punish the most serious indignities).
18 Furundija, Trial Judgment (note 4), para. 183.
19 See Prosecutor v. Aleksovski, ICTY, Case No. IT-95-14/1-T, Trial Judg-
ment of 25 June 1999, para. 54 (It can be said that the entire edifice of interna-
tional human rights law, and of the evolution of international humanitarian law,
rests on this founding principle [of respect for human dignity and personal-
ity].).
20 McCrudden (note 13), at 678.
21 On this consensus, see Appiah, Comment, in Ignatieff, Human Rights as
Politics and Idolatry, 2001, at 101, 106 (ordinary people almost everywhere
have something like the notion of dignity); Lafrance, International Humani-
tarian Law and Cultural Relativism, in Sassli/Bouvier, How Does Law Protect
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 261

nacy and disagreement. Dignity, for example, may be invoked as the ba-
sis, wellspring or justification for all rights, or it may be viewed by
some legal and moral cultures as wholly unconnected from individual
rights, emphasizing duties, community, or honor.22 In addition, dignity
can be employed either as an individual or a communitarian concept,23
and it is as likely to justify an individuals duties to the state or the
community as it is to privilege individual rights.24 This indeterminacy is
part of its charm:
the abstention from a philosophical decision regarding the source
and cause for rights and duties paves the way for a political consent
concerning the specific rights and duties that ought to be legislated
and enforced in practice without waiving or compromising basic
principles of belief.25
Though a handful of international criminal law cases make reference to
the foundational notion of dignity, few address the content (if any) of
such a notion. The Appeals Chamber of the Rwanda tribunal in the case
against three figures responsible for the debasing hate speech that per-
vaded Rwandan media before and during the 1994 genocide stated in a
footnote that the various aspects of human dignity in international
law are elaborated in the thirty articles of the UDHR.26 The idea that
the UDHR expresses some core content of human dignity in interna-
tional law (or law in general) is shared by some constitutional and in-

in War?, Vol. 1, 2nd ed. 2006, at 86 (noting the broad acceptability of notions of
dignity).
22 See generally Donnelly, Human Rights and Human Dignity: An Analytic
Critique of Non-Western Conceptions of Human Rights, 76 Am. Pol. Sci. Rev.
(1982), 303 (arguing that, while all cultures may agree on the importance of
human dignity, this concept is not necessarily connected to any notion of
rights).
23 McCrudden (note 13), at 699701.
24 In his work on dignity, McCrudden, id. at 666, notes the American Decla-
ration of 1948, which is divided into two chapters: rights and duties. The pre-
amble of that document states: Rights and duties are interrelated in every so-
cial and political activity of man. While rights exalt individual liberty, duties ex-
press the dignity of that liberty. American Declaration of the Rights and Du-
ties of Man, OAS Res. XXX of 1948 (emphasis added).
25 Shultziner, Human Dignity Functions and Meanings, 3 Global Jurist

Topics (2003), at 5.
26 Nahimana, Appeal Judgment (note 3), n.2256.
262 Benton Heath

ternational legal scholars.27 But it is difficult to know what results from


this statement. What does it mean for a provision of the UDHR such
as the right to social security to be an aspect of dignity? This does
not necessarily say anything about the content of dignity itself; it may
simply refer to the commonly held belief that such rights are in some
sense justified by the principle of human dignity. Whether these rights
shed any light on the essential content of human dignity in a founda-
tional sense, and whether the concept of dignity limits or expands the
reach of the particular rights in the UDHR, is an open question.

b) Substantive Uses of Dignity


Substantive uses of dignity attempt to direct or prohibit certain con-
duct. Though used in other areas of human rights law, such as economic
and social rights,28 substantive uses tend to pertain to cruelty, humilia-
tion and the treatment of prisoners.29 The most conspicuous rule is the
prohibition on outrages upon personal dignity in armed conflicts,30
though human dignity may also be mentioned in other cases referring
to inhuman treatment or inhumane conditions of detention. Drafters
have long resisted any precise elaboration of the factors that determine
outrages upon dignity, out of a fear that any effort at codification would
underestimate the ability of abusers to find new ways to torture and
humiliate their victims.31

27 See Carozza, Human Dignity and Judicial Interpretation of Human


Rights: A Reply, 19 EJIL (2008), 931, 937.
28 UDHR (note 7), Arts. 2223.
29 See generally Shultziner (note 25), at 12-16 (on thin meanings of dig-
nity focused on condemning humiliation and cruel treatment).
30 E.g. Rome Statute of the International Criminal Court, 17 July 1998, Art.
8, 2187 UNTS 90.
31 The commentary to the Geneva Conventions is illuminating in this re-
spect:
[I]t is always dangerous to try to go into too much detail especially in this
domain. However great the care taken in drawing up a list of all the various
forms of infliction, it would never be possible to catch up with the imagination
of future torturers who wished to satisfy their bestial instincts; and the more
specific and complete a list tries to be, the more restrictive it becomes. The form
of wording adopted is flexible, and at the same time precise.
Pictet (note 15) at 39 (referring to the prohibitions both against torture and
against outrages upon dignity). In dealing with a case alleging inhumane treat-
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 263

Nevertheless, the case-law of courts that have addressed this protection


makes clear that Common Article 3 and related provisions address se-
vere humiliation, namely the exercise of dominance over another hu-
man being, such that the victim is placed in a position of being unable
to exercise her own will.32 In other words, we have working, generally
stable idea of what Common Article 3 and similar provisions refer to,
which is continually confirmed in the practice of tribunals.33 However,
recent international criminal law cases have employed another substan-
tive use of human dignity which does not share this conceptual clarity.
Outside the confines of the law prohibiting torture and humiliation,
human dignity arises in at least two other areas of international criminal
law: persecution and other inhumane acts. Persecution, a crime
against humanity, requires a showing that the defendant engaged in the
severe deprivation of fundamental rights on discriminatory
grounds.34 While the courts have scrupulously avoided laying down any
list of fundamental rights that may give rise to a persecution charge,35
contemporary decisions often provide some basis in international or re-
gional human rights law for the determination that the defendants con-

ment, the Inter-American Court elaborated on the notion of humiliation: The


degrading aspect is characterized by the fear, anxiety and inferiority induced for
the purpose of humiliating and degrading the victim and breaking his physical
and moral resistance. IACHR, Loazya Tamayo v. Peru, Judgment of Septem-
ber 17, 1997, Series C, No. 33, para. 57.
32 Droege gives a helpful, if chilling, list of examples from court cases, in-

cluding forcing a prisoner to wear soiled clothes, forcing him to relieve himself
in his clothing, using prisoners as human shields, cutting off hair and beards as
punishment, and subjecting people to a constant fear of physical, mental, or
sexual violence. Droege (note 6), at 531; see also Tamayo (note 31), para. 58.
33 It is all the more important to reaffirm the utility of this narrow sense of
human dignity in the face of recent attacks from the Bush administration and
others who wish to create indeterminacy where there was clarity. Carozza (note
27), n. 26 (quoting President Bush on the Geneva Conventions).
34 Rome Statute (note 30), Art. 7(2)(g). The ad hoc tribunals referred to a
gross or blatant denial [] of a fundamental right laid down in international
customary or treaty law. Prosecutor v. Kupreski, ICTY, Case No. IT-95-16-T,
Trial Judgment of 14 January 2000, para. 621. The differences are generally
thought to be immaterial. Fenrick, The Crime Against Humanity of Persecu-
tion in the Jurisprudence of the ICTY, 32 Neth. Yearbook of Intl Law (2001),
81, 9596.
35 See Prosecutor v. Branin, ICTY, Case No. IT-99-36-T, Trial Judgment of
1 September 2004, para. 1031.
264 Benton Heath

duct violated a fundamental right.36 The Rwanda media case held that
hate speech may serve as the ground for a persecution conviction, be-
cause such speech violates the right to respect for human dignity, as laid
out in the preamble to the UDHR.37 Thus, according to at least one
case, violations of human dignity, as it is broadly expressed in the
UDHR, may constitute the basis for a persecution conviction.
An additional role for human dignity arises occasionally in the so-called
residual category of crimes against humanity, which proscribes other
inhumane acts not explicitly covered by the relevant instruments. The
work of the International Law Commission and the ICTY generally de-
fine other inhumane acts as those which caused mental or physical suf-
fering or constituted a serious attack on human dignity.38 In recent
years, formulations have dropped the reference to human dignity, limit-
ing the residual category to acts that cause physical or mental harm.39
One may speculate that, because courts tend to emphasize the need to
read this crime narrowly, the expansive potential of human dignity was
disused, and the reference to dignity came to be seen as redundant or
surplus language.40 Nevertheless, the Iraqi High Tribunal found that the
razing of orchards could constitute an inhumane act within the mean-

36 See, e.g., Prosecutor v. Blagojevi & Joki, ICTY, Case No. IT-02-60-T,
Trial Judgment of 17 January 2005, para. 592 ([T]he Trial Chamber observes
that the exposure to terror is a denial of the fundamental right to security of
person which is recognised in all national systems and is contained in Article 9
of the ICCPR and Article 5 of the ECHR. Accordingly, the Trial Chamber
finds that terrorization violates a fundamental right laid down in international
customary and treaty law.).
37 Nahimana, Appeal Judgment (note 3), para. 986.
38 Prosecutor v. Vasiljevic, ICTY, Case No. IT-98-32-T, Trial Judgment of 29
November 2002, para. 234; see also Draft Code of Crimes against the Peace and
Security of Mankind, Art. 18(k), in Report of the International Law Commis-
sion, UN Doc. A/51/10 (1996) (referring to other inhumane acts which se-
verely damage physical or mental integrity, health or human dignity, such as
mutilation and severe bodily harm).
39 Rome Statute (note 30), Art. 7(1)(k); Prosecutor v. Kordi & Cerkez,
ICTY, Case No. IT-95-14/2-A, Appeal Judgment of 17 December 2004, para.
117.
40 See Boas/Bischoff/Reid, International Criminal Law Practitioner Library,
Vol. 2, 2009, at 10001.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 265

ing of the tribunals statute, in part because it robbed the victims of


their honor, freedom and dignity.41
Contemporary international criminal law thus features at least three
main substantive roles for human dignity. The first is the jurisprudence
associated with inhuman treatment, humiliation and outrages upon per-
sonal dignity. This usage is at one the most common and the most
clearly understood. However, the Rwanda and Iraq tribunals point to
additional substantive roles for human dignity. In the Rwanda case, the
right to human dignity provided the legal basis for stating that hate
speech could constitute a crime against humanity. In the deeply flawed
Iraq judgment, the concept of dignity proved helpful in justifying a
finding that property crimes could constitute inhumane acts. As ex-
plained in Section II, below, these latter invocations amount to expan-
sive uses of human dignity, and demonstrate the malleability and
power of this concept.

c) Interpretive Uses of Human Dignity


The interpretive use of human dignity occupies a middle level between
the foundational and substantive senses discussed above. In being pri-
marily interpretive, human dignity in this sense does not prescribe in
advance any particular rule of conduct or decision, as the substantive
use does. Instead, it provides a consideration that, for whatever reason,
an interpreter of an ambiguous statute must take into account in arriv-
ing at a particular judgment in a given case. For this reason, the inter-
pretive use is different than purely foundational senses of the term.
Courts may invoke the foundational sense of human dignity to justify a
particular decision, or to evoke emotional reactions of anger, pity [or]
compassion.42 without bringing about any specific legal consequence.
Interpretive uses of dignity, by contrast, play a potentially outcome-

41 Iraqi High Tribunal, Judgment of the Dujail Trial, Case No. 1/C 1/2005,
at 218 (unofficial Human Rights Watch translation, available at http://www.
hrw.org/legacy/pub/2007/ij/dujail_judgement_web.pdf); see also Bhuta, Fatal
Errors: The Trial and Appeal Judgments in the Dujail Case, 6 J. Intl Crim. Jus-
tice (2008), 39, 5354 (noting this and other more serious defects in the Saddam
trial).
42 White, Emotions and the Judicial Use of the Concept of Dignity, JSD

Proposal of Study, http://www.law.nyu.edu/ecm_dlv1/groups/public/@nyu_la


w_website__llm_jsd__graduate_admissions/documents/documents/ecm_pro_0
69003.pdf.
266 Benton Heath

determinative role in cases, by influencing interpretations of provisions


that, on their face, do not reference human dignity.
The Furundija trial judgment provides the most salient example of the
interpretive use. In trying to develop a working definition for the crime
of rape in international law,43 the tribunal found no consensus in inter-
national law and divergence among domestic jurisdictions regarding the
question of whether oral penetration alone could constitute the crime of
rape.44 Its search of national laws exhausted, the trial chamber turned to
the general principles of international criminal law and international
law, and subsequently focused on the general principle of respect for
human dignity.45 Noting that human dignity is meant to shield peo-
ple from humiliation and degradation, the chamber held that a defini-
tion of rape that extended to oral penetration is consonant with hu-
man dignity, and that dignity favours an expansive interpretation.46
The court subsequently overrode any lingering concerns about the
principle of legality (nullum crimen sine lege).47 Though few would dis-
agree with the conviction of an individual for the conduct alleged, the
tribunals methodology remains controversial.48
The interpretive mode of human dignity thus acts as a kind of trans-
mission belt between the foundational notion of dignity as essential to
international humanitarian law and human rights, and particular sub-
stantive norms. By noting the foundational role that human dignity

43 The ad hoc tribunals for the former Yugoslavia and Rwanda were estab-
lished by statutes annexed to Security Council resolutions. These statutes de-
fined, inter alia, the subject matter jurisdiction of the tribunals, granting them
authority to try criminals for rape, murder, torture, et cetera. But the statutes
did not provide definitions or elements of the crimes to be charged. Therefore,
many of the tribunals early cases engaged in the laborious process of inducing
definitions of crimes from national and international practice.
44 Furundija, Trial Judgment (note 4), para. 182.
45 Id. paras. 18283; see also text accompanying note 18 for the full quote.
46 Id. paras. 18384.
47 Id. para. 184.
48 Bantekas, Reflections on Some Sources and Methods of International
Criminal and Humanitarian Law, 6 Intl Crim. L. Rev. (2006), 121, 126-128
(International tribunals have in such cases abused their power to ascertain the
law in an objective manner and have made a strenuous effort to distil general
principles from nowhere.); Cassese (note 14), at 21 & 24 (suggesting that the
Kupreskic Trial Chamber took a more compelling approach to applying gen-
eral principles).
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 267

plays in the law of war, in international criminal law, in human rights,


or in international law generally, this mode facilitates the interpretation
of norms in ways that can be viewed as dignity-enhancing.

2. Breadth: Expansive and Narrow Uses of Human Dignity

It is not sufficient, however, to understand dignity only in terms of its


depth. All utterances of human dignity in international law will invoke,
to some extent, both the concepts substantive and foundational layers,
and often the intermediate interpretive layer as well. These uses com-
bine in various ways to produce varying legal effects. To understand the
actual and potential consequences of using human dignity in interna-
tional criminal law cases, we add a second dimension to our schematic:
uses of human dignity have not only depth, but also breadth. In other
words, dignity may be deployed narrowly, so as to leave largely un-
changed the tribunals reach or sphere of competence, or it may be used
expansively, to broaden this competence into heretofore indeterminate
areas.
The paradigm case of a narrow use of human dignity arises in the con-
text of Common Article 3 of the Geneva Conventions and related pro-
visions dealing with humiliating and degrading treatment. International
law attaches criminal sanctions to outrages upon personal dignity
conducted during armed conflicts.49 These provisions come with juris-
dictional restraints: for example, the Rome Statute limits this crime to
situations of international armed conflict, and to any armed conflict
where the victim is a person taking no active part in hostilities.50 Within
this context, national and international courts have engaged in a dec-
ades-long process of concretizing the meaning of outrages upon per-
sonal dignity. These cases provide a reservoir of interpretive authority
when any new dispute arises. Recognizing an outrage upon personal
dignity then becomes an exercise that is clearly within or outside of a
courts competence, and one that essentially requires an application of
law to facts.
This is not to say that the cases will always be easy, that the standard of
personal dignity is not open to interpretation, or that the process of
law-application is a mechanical one that involves no moral or principled

49 See citations supra note 5.


50 Rome Statute (note 30), Art. 8(2)(b)(xxi), (c)(ii).
268 Benton Heath

deliberation.51 However, the law as practiced in the area of Common


Article 3 operates in a limited universe of possibilities, defined by the
conditions of armed conflict, the relationship between the victim and
the perpetrator,52 and the types of conduct that have previously been
deemed to violate the standard.53 When detainees are stuck in small,
dark rooms for days on end, made to relieve themselves in their cloth-
ing, forced to commit incest or used as human shields, we know that
these acts may constitute outrages upon personal dignity in armed con-
flict, and they probably do. These acts have a certain family resem-
blance with one another. By contrast, hate speech campaigns in the me-
dia, failure to set up an adequate social safety net for poor citizens dur-
ing peacetime, and attacks that cause disproportionate damage to civil-
ians do not violate these provisions, even though they may implicate
broader notions of human dignity.
By contrast, expansive uses of human dignity in legal practice draw on
broader references to the concept of dignity that are unfettered by ties
to any particular context, legal doctrine, or relationship between perpe-
trator and victim. A paradigmatic case is the trial of members of the
Rwanda media for hate speech during and before the 1994 genocide, in
which the Appeals Chamber held that hate speech targeting a popula-
tion on the basis of ethnicity, or any other discriminatory ground, vio-
lates the right to respect for the dignity of the members of the targeted
group as human beings.54
For support, the tribunal drew on the UDHR, specifically the pream-
ble, which recognizes the inherent dignity of all human beings.55 Thus,

51 Indeed, to protect victims against innovative forms of torture, the protec-


tions of Common Article 3 must be substantially open-ended. In this connec-
tion, note the commentary of the ICRC to Common Article 3 in note 31; see
also Waldron, Vagueness and the Guidance of Action, NYU Pub. L. & Legal
Theory Research Paper Series No. 10-81 (2010), at 2326 (noting the inherently
open-textured nature of torture laws, and defending this aspect of such rules).
52 The victim is usually a detainee, a prisoner or otherwise under the control

of the perpetrator. See the summary of findings in Boas et al. (note 40), at 275-
78.
53 Droege (note 6) canvasses the case law of the ad hoc tribunals.
54 Nahimana, Appeal Judgment (note 3), para. 986.
55 Id. n.2256. The Universal Declaration states that recognition of the in-
herent dignity and of the equal and inalienable rights of all members of the hu-
man family is the foundation of freedom, justice and peace in the world.
UDHR (note 7), preamble.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 269

the case blends the foundational and substantive meanings of human


dignity in order to expand the tribunals reach and address hate speech
in an unprecedented way.56
The two cases above Common Article 3 jurisprudence and the
Rwanda hate speech case each employ a substantive sense of human
dignity, but they do so in contrasting ways, thus demonstrating the
need for a second dimension to our schematic of dignity. The Common
Article 3 jurisprudence relies on a version of human dignity bounded
by certain jurisdictional and contextual limitations and it draws on a
longstanding practice of interpreting and applying dignity and applying
in such a context. The version of human dignity expressed in the
UDHR, upon which the Rwanda tribunal relies, is not completely un-
bounded it remains focused on the dignity of the human person, as
opposed to the state, the polity, or artificial persons such as corpora-
tions.57 But the substantive meaning of human dignity in the preamble
remains intentionally wide open,58 and the concept can refer to a range
of substantive issues, from economic and social rights59 to democratic
self-government60 to proportionality in criminal punishment61 to bio-
ethical issues62 to free speech.63 Thus, the Rwanda tribunal draws on a

56 For arguments regarding the precedential value of the media-related

judgments of the International Military Tribunal at Nuremberg, see Or-


entlicher, Criminalizing Hate Speech in the Crucible of Trial, 21 Am. Univ. Intl
L. Rev. (2006), 557, 58186.
57 For discussions of these other uses of dignity in U.S. jurisprudence, see
Chisolm v. Georgia, 2 U.S. 419, 455 (1793) (Wilson, J.) (exalting the dignity of
man over the dignity of states); Alden v. Maine, 527 U.S. 706 (1999) (discussing
the dignity of states); cf. Citizens United v. Federal Election Commission, 558
U.S. (2010) (Stevens, J., dissenting) (arguing that corporate expenditures are
distinguishable from individual expenditures because, when corporate expen-
ditures are restricted, no ones autonomy, dignity, or political equality has been
impinged upon in the least).
58 See supra text accompanying notes 2025.
59 E.g., International Covenant on Economic, Social and Cultural Rights
[ICESCR], 16 December 1966, Art. 13, 993 UNTS 3 (1976).
60 Brennan, The Constitution of the United States: Contemporary Ratifica-

tion, 19 UC-Davis L. Rev. (1985), 2, 8.


61 E.g., Trop v. Dulles, 356 U.S. 86, 100 (1958) (The basic concept underly-
ing the Eighth Amendment is nothing less than the dignity of man.).
270 Benton Heath

broader, more expansive, concept which allows the court to tap a deep
reservoir of thinking about the nature of human dignity in a variety of
contexts.
Given the foregoing, we may say that where dignitys depth is a ques-
tion of form,64 its breadth is a function of context and reach. Expansive
uses of dignity are not weighed down or controlled by references to a
particular factual or jurisdictional context or to a certain relationship.
Expansive uses employ this conceptual breadth to substantively in-
crease the reach of the tribunal by broadening definitions of crimes or
criminalizing previously unaddressed conduct. As the Rwanda trial
shows, uses of dignity tend to blend the substantive, foundational, and
interpretive elements in unique ways from case to case; in the hate
speech trial, the tribunal found a rule of conduct (potentially criminal-
izing some hate speech) situated within the broadest and most founda-
tional statement of dignity in international law (the UDHR).
By labelling this use of human dignity an expansive one, we note the
particular way in which foundational and substantive connect to pro-
duce new norms of conduct by capitalizing on the broad array of mean-
ings attributed to human dignity in rights discourse. The category of
expansive uses also helps to distinguish the case from other instances in
which the foundational notion of dignity is invoked, but it has less
transformative legal effect.

3. Interim Conclusion: The Utility of a Two-Dimensional Schematic

The two dimensions of human dignity should provide a useful mecha-


nism for assessing uses of dignity by combining familiar and novel in-
tuitions about the concept. Dignitys depth is a commonly discussed is-
sue, as many writers have drawn distinctions or connections between
dignity as a justification for human rights or law in general, and dignity

62 World Medical Association [WMA], 18th WMA General Assembly, June


1964, WMA Declaration of Helsinki Ethical Principles for Medical Research
Involving Human Subjects, paras. 1130, available at http://www.wma.net/en/
30publications/10policies/b3/index.html.
63 Cohen v. California, 403 U.S. 15, 24 (1971) (free speech respects individ-
ual dignity and choice).
64 The three levels of depth described in Part A.I. constitute three idealized
forms: the justificatory foundation, the substantive rule, and the interpretive
principle.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 271

as a component of specific rules of conduct or prohibitions.65 This re-


mains a particularly helpful distinction, especially when examining a
text to determine whether it presents dignity in a foundational sense or
in a more operative role, such as the substantive or interpretive senses.
But any actual use of dignity in a criminal case (or perhaps in any judi-
cial or quasi-judicial context) is likely to involve a jumble of these
meanings, as any utterance of human dignity might sound in all three
layers of depth. The dimension of breadth uses helps making sense of
actual cases by sorting them according to the extent to which a particu-
lar invocation of dignity remains married to a determined factual or
doctrinal context. The category of expansive uses of human dignity
thus provides an interesting object of study because it tends to capture
what is most powerful, most transformative and most troubling about
the concept.

II. Legal Consequences Flowing from Expansive Uses of


Human Dignity

The above discussion about form and context, depth and breadth only
matters because certain uses of human dignity may produce actual con-
sequences that bear on the fate of criminal defendants. When courts use
dignity expansively, they can produce a range of legal effects, often si-
multaneously. In brief, expansive uses of dignity may give rise to the
following results, arranged roughly in order from most likely to most
speculative: (1.) criminalizing new forms of conduct and filling gaps in
the law; (2.) motivating judicial innovation; (3.) demanding convergence
among previously divergent jurisdictions and trumping other rights
concerns; and (4.) responding to concerns about legality. Each of these
effects produces useful possibilities for international criminal law, but
each also poses certain risks. Specifically, these features of expansive
uses of human dignity create friction with the principle of legality and,
additionally, threaten to undermine the self-understanding of interna-

65 See, e.g., Petersen (note 14) (distinguishing dignity as a legal guarantee


and as a philosophical justification); Shultziner (note 25) (noting that dignity
has at least five functions and normative meanings); Waldron, Dignity and
Rank, 48 Eur. J. Sociology (2007), 201, 20304 (noting the difference between
the Universal Declarations justificatory use and the German Basic Laws guar-
antee of a right to dignity).
272 Benton Heath

tional criminal law as a jurisdictionally limited regime. This section


concludes with a brief assessment of those tensions (5.).

1. Substantive and Gap-Filling Functions

Perhaps the primary motivation for resorting to expansive uses of dig-


nity in international criminal law is to generate new substantive norms
to govern and criminalize odious conduct by criminal defendants. For
the Rwanda tribunal, disrespect for human dignity gave the Appeals
Chamber the necessary justification for finding that hate speech could
be a constitutive act of a crime against humanity.66 For the Extraordi-
nary Chambers in the Courts of Cambodia, human dignity offers a po-
tential basis for punishing forced marriage as a crime against human-
ity.67 The ICTY employed dignity to address what it perceived as a dis-
junction between national laws on rape, and to categorize coerced oral
penetration as rape despite the lack of international consensus on this
point.68 Given these examples, it may be said that dignity proves useful
in justifying a courts decision to extend the reach of international
criminal law into new forms of conduct. It may also help the court rec-
ognize novel forms of cruelty, such as forced marriage or widespread

66 Nahimana, Appeal Judgment (note 3). It should be emphasized that the

tribunal specifically stated that it would not rule on the question of whether
hate speech alone can constitute an underlying act of persecution. Id. para. 987.
The Appeals Chamber nonetheless considers acts of hate speech jointly with
incitement and other acts to establish persecution, and Judge Meron, in dissent,
notes that hate speech was an important and decisive factor in the conviction.
Id., Partly Dissenting Opinion of Judge Meron, para. 13. Moreover, at least one
judge would have explicitly ruled that hate speech alone was sufficient to con-
stitute persecution. Id., Partly Dissenting Opinion of Judge Pocar, para. 3.
Thus, the Nahimana case can be read to support the proposition that hate
speech not rising to the level of incitement can constitute an act of persecution.
Cf. Bassiouni, Crimes Against Humanity: Historical Evolution and Contempo-
rary Application, 2011, at 403 (placing the Nahimana judgment on this point in
context).
67 ECCC, Case 002 (Ieng Sary et al.), Closing Order [Indictment], Office of

Co-Investigating Judges, Case No. 002/19-09-2007-ECCC-OCIJ, paras. 1442


47.
68 Furundija, Trial Judgment (note 4), paras. 18283.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 273

hate speech in the first place, but this second claim should not be taken
too far.69
Where a tribunal adapts vague or limited substantive provisions to
criminalize previously unaddressed conduct, it comes into conflict with
the principle of legality (nullum crimen sine lege).70 The legality objec-
tion is not always fatal, as international criminal law courts generally al-
low some adaptation of the substantive elements of crimes, so long as
the crime is accessible and the conviction foreseeable to the defendant at
the time of the action.71 Thus, legality often will prove no bar to a con-
viction when a defendants conduct was morally outrageous (malum in
se), clearly criminal in some sense, and contrary to the principles of
international criminal law.
Therefore, legality should not protect the defendant who forced a vic-
tim to engage in certain sex acts, simply because those particular acts
were not covered in the domestic rape statutes of some jurisdictions. By
contrast, where a defendant believed he was exercising protected inter-
national human rights as might be argued in a hate speech case the
principle of legality might be undermined by criminalizing his conduct,
however morally outrageous.

69 The Furundija courts use of dignity should lead us to be skeptical of any


claim that the language of dignity forces judges to fully recognize new forms of
cruelty for what they are. Despite its appeals to human dignity, the ICTY Trial
Chamber in Furundija developed a mechanical and arguably regressive defini-
tion of rape, one that focused on technical definitions and body parts. See Id.
para. 185. For a critique of the Furundija definition, see MacKinnon, Are
Women Human?, 2006, at 23941.
70 The principle of legality has taken an increasingly central role in ICL.
Compare Intl Military Tribunal at Nuremberg, Judgment of 30 September
1946, in Trial of the Major War Criminals before the Military Tribunal, Vol. 1,
1947, at 171, 219 [hereinafter IMT Judgment] (legality is only a principle of
justice and not a limitation on sovereignty) with Rome Statute (note 30), Art.
2224 (codifying a strong form of legality).
71 For a recent statement, see ECCC, Case 002 (Ieng Sary et al.), Pre-Trial
Chamber, Decision of 11 April 2011 on Ieng Sarys Appeal against the Closing
Order, Case No. 002/19-09-2007-ECCC/OCIJ (PTC75), paras. 229-240. See
generally Shahabuddeen, Does the Principle of Legality Stand in the Way of
Progressive Development of Law?, 2 J. Intl Crim. Justice (2004), 1007; Van
Schaack, Crimen Sine Lege: Judicial Lawmaking at the Intersection of Law and
Morals, 97 Georgetown L. J. (2008), 119.
274 Benton Heath

2. The Motivating Role

Human dignity not only aids in the creation of new substantive norms;
dignity also urges the tribunal to action, stimulating the juris-generative
process. Dignity motivates the expansion of criminal norms by de-
manding that the law develop to meet perceived indignities. At the same
time, the concept is employed to generate new legal content to cover
the particular case. The ICTY Trial Chamber in Furundija found that
human dignity favored extending the definition of rape to forced oral
sex.72 In another case, the ICTY repeated its insistence that the court
consider the principles and purposes of international humanitarian
law, including respect for human dignity, in interpreting its statute.73
In this way, dignity represents the influence of human rights logic over
international criminal law: in seeking maximum protection for victims,
human rights advocates favor expansive or even unprecedented inter-
pretations of substantive norms.74 This logic stands in tension with the
basic principles of liberal criminal justice systems which emphasize the
narrow interpretation of legal rules of conduct.75 Dignity thus acts as a
prime mover in what Robinson termed international criminal laws
identity crisis in which the protective tendencies of human rights and
the laws of war come into conflict with the liberal principles of legality
and fair labelling associated with modern criminal systems.76

3. Trumps, Conflicts, and National Variations

When dignity pushes international criminal law outward to establish


new rules governing previously unaddressed forms of conduct, interna-

72 Furundija (note 4), para. 184.


73Prosecutor v. Hadihasanovi, ICTY, Trial Chamber, Decision of 12 No-
vember 2002 on Joint Challenge to Jurisdiction, Case No. IT-01-47-PT, para.
64.
74 See e.g. Danner/Martinez, Guilty Associations: Joint Criminal Enterprise,
Command Responsibility, and the Development of International Criminal Law,
93 Calif. L. Rev. (2005), 75, 8690.
75 Id. at 8990. But see Luban (note 8), at 58586 (noting the need for
broader interpretation to avoid gaming in the dangerous areas of torture and
other grave crimes).
76 Robinson, The Identity Crisis of International Criminal Law, 21 Leiden J.
Intl L. (2008), 925.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 275

tional criminal law is not stepping into legally unmapped terrain.


Rather, the legal terrain outside the reach of current international
criminal law is characterized by conflicting approaches to legal prob-
lems within and among jurisdictions.
The Nahimana case regarding hate speech offers a particularly potent
example. The civil or criminal regulation of hate speech continues to be
a matter of deep contestation among national constitutional systems
and leads to bitter debates within individual polities.77 The United
States remains committed to a content-neutral approach to speech
protection that gives wide latitude to hate speech,78 while other systems
are more open to regulation.79 For post-conflict countries like Rwanda
or for emerging democracies, debate continues over the appropriateness
of hate speech regulations. Some insist that hate speech restrictions will
be used to attack political opponents and undermine democracy,80 while
others suggest that robust protections for hate speech would risk new
rounds of ethnic violence or otherwise strain emerging democracies.81
When a court applying international criminal law enters into this terri-
tory, it necessarily passes judgment on these important and contested is-
sues, even if it does so only implicitly.82

77 For a succinct description of the field see Errera, Freedom of Speech in


Europe, in Nolte (ed.), European and US Constitutionalism, 2005, at 23, 3641.
78 See Brandenburg v. Ohio, 395 U.S. 444, 44748 & n. 2 (1969) (per curiam)
(indicating that even hate speech promoting violence will be protected unless it
is directed to inciting or producing imminent lawless action and is likely to in-
cite or produce such action).
79 See Convention on the Elimination of All Forms of Racial Discrimina-
tion, 21 December 1965, Art. 4, 660 UNTS 195 (requiring, inter alia, that states
punish all dissemination of ideas based on racial superiority or hatred). The
United States has entered a reservation to this provision.
80 This point was made forcefully by the Open Society Institute in its

amicus brief to the appellate chamber of the ICTR, and Judge Meron repeated
these concerns in his dissent. Nahimana, Appeal Judgment (note 3), Partly Dis-
senting Opinion of Judge Meron, paras. 1012
81 Lewis appears open to this argument in his otherwise spirited defense of

free speech. See Lewis, Freedom for the Thought that We Hate, 2007, at 166; see
also Assante, Nation Building and Human Rights in Emergent African Nations,
2 Cornell Intl L.J. (1969), 72, 9297 (suggesting that emergent nations cannot
withstand the strain caused by robust speech protections).
82 The Trial Chamber in Nahimana stated clearly that hate speech is not
protected in international law. Prosecutor v. Nahimana, Trial Chamber Judg-
ment of 3 December 2003, Case No. ICTR-99-52- T, paras. 107476. The Ap-
276 Benton Heath

The Nahimana case also indicates how a court might use dignity to re-
solve tension between certain fundamental rights. Both free speech and
human dignity are, on some accounts, fundamental rights essential to
the modern constitutional state,83 and some jurisdictions claim that one
or the other principle must not be balanced against other considera-
tions.84 At the very least, the Nahimana decision suggests that free
speech concerns may indeed be balanced against the dignity of persons
targeted by the speech, a consideration that would likely be anathema in
U.S. courts.
A stronger reading would hold that free speech protections must give
way to strong concerns about human dignity, because, as the Rwanda
tribunal indicates, the right to free expression constitutes but one as-
pect of the right to respect for human dignity, which stands at the basis
of contemporary human rights law.85 In this way, concerns about dig-
nity would trump speech protections. The idea that free speech is an
aspect of human dignity and thus must be limited by that founding
principle is common among rights theorists,86 and the appropriate

peals Chamber found this statement to be irrelevant to the question of criminal


culpability, as the underlying acts in a persecution case need not themselves be
crimes under international law. Nahimana, Appeal Judgment (note 3), para. 985.
Nonetheless, by convicting the defendants for hate speech the court necessarily
implies that hate speech does not enjoy protected status, as the dissent argues.
Id., Partly Dissenting Opinion of Judge Meron.
83 See, e.g., Meiklejohn, Free Speech and Its Relation to Self-Government,
1948, at 2227 (exploring the relationship between free speech and self-
government through the metaphor of the town meeting); Klein (note 15) (on
the principle of dignity in German law).
84 See, e.g., Naske/Nolte, Case Note: Aerial Security Law, 101 AJIL (2007),
466, 470 (discussing this tendency in German constitutional law).
85 Nahimana, Appeal Judgment (note 3), n.2256.
86 See, e.g., Heyman, Free Speech and Human Dignity, 2008, 17779 (argu-
ing that respect for human dignity is a background condition of political dis-
course and that the prohibition of hate speech is an essential rule of order for
a democratic society); Schauer, Speaking of Dignity, in Meyer/Parent (eds.), The
Constitution of Rights: Human Dignity and American Values, 1992, at 178 (ar-
guing that thinking of dignity as the basis for free speech leads inescapably to
the conclusion that much speech should not enjoy the broad range of protec-
tions it currently benefits from in the United States); Carmi, Dignity The En-
emy from Within, 9 Univ. Penn. J. Constitutional L. (2007), 957 (extending
Schauers arguments). But see Dworkin, Foreword, in Hare/Weinstein (eds.),
Extreme Speech and Democracy, 2009, viix (arguing that speech protections
are required to respect the dignity of those who hold these opinions).
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 277

boundaries between speech and dignity require ongoing discussion. But


these issues are arguably properly addressed in fora other than an in-
ternational criminal tribunal that does not clearly possess jurisdiction
over hate speech.87
It may be objected that a court applying international criminal law will
necessarily resolve these important conflicts one way or the other be-
cause an acquittal would be tantamount to permitting the conduct in
question. Such an argument would misunderstand the nature of interna-
tional criminal law. The regime exists not to create a universal criminal
code that reaches all forms of unacceptable conduct, but simply to pun-
ish the most serious crimes of concern to the international commu-
nity.88 This mission statement necessarily leaves a wide range of con-
duct to national criminal courts, regional efforts and civil or administra-
tive measures.
Therefore, a finding that international criminal law provides no appli-
cable law on the question at hand does not amount to a statement that
the defendants activity is permitted.89 Rather, such a finding would
constitute recognition of the natural substantive limits of the regime of
international criminal law. Such limitations prevent international crimi-
nal law from stifling transnational and national legal dialogue on impor-
tant and contentious issues such as the regulation of hate speech, and
they should be preserved.

4. Overcoming Legality

Dignity may also provide an argument for escaping the requirements of


legality that protect defendants from the unbounded application of
criminal sanctions.90 A variety of arguments may be deployed to sug-
gest that, where a defendants conduct offends human dignity, the stric-
tures of legality should be loosened. A court could argue that legality it-
self is rooted in human dignity and, therefore, that the protections of

87 Orentlicher (note 56), at 589 (criticizing the Trial Chamber judgment in

the Nahimana case).


88 Rome Statute (note 30), preamble.
89 The situation is not, therefore, akin to the principle that states are free to
act unless there exists a rule of international law limiting that freedom. See,
e.g., S.S. Lotus (France v. Turkey), PCIJ 1927, Series A, at 21.
90 On legality see notes 7071 and accompanying text.
278 Benton Heath

legality must give way in light of severe threats to the dignity of the vic-
tims in a given conflict. Alternatively, a court might find that human
dignity constitutes a consideration that must be weighed against the de-
fendants claim that he is owed the protections of strict legality when
the threat to dignity is too great or the infringement on legality too
slight, then dignity-based concerns will trump claims based on legality
and militate toward conviction.
The ICTY has suggested the latter approach in the Furundija case. The
tribunal argued that legality posed no bar to classifying forced oral
penetration as rape, because such an act would be criminal sexual as-
sault in any case, the penalty for that crime would be identical to rape
under applicable law, and so the defendants only concern would be
that a greater stigma attaches to being a convicted rapist.91 The court
doubted the legitimacy of such a stigma, but also argued that any such
concern is amply outweighed by the fundamental principle of protect-
ing human dignity, a principle which favours broadening the definition
of rape.92
Exactly what weight should dignity receive in this analysis? The con-
cept had already done so much work in Furundija, both motivating
the courts purported93 expansion of the definition of rape and provid-
ing the content of that expanded definition. When the concept is then
re-used to respond to objections based on legality, dignity begins to ap-
pear as an all-purpose justification for expansive interpretations.

5. Interim Conclusion: The Twin Problems of Legality and


Limitation

The four legal effects described above demonstrate the usefulness of re-
ferring to expansive uses of human dignity and therefore of the two-
dimensional schematic developed in Part I. The transformative effects
discussed here come about through cases that blend the concepts foun-

91 Furundija, Trial Judgment (note 4), para. 184.


92 Id.
93 As mentioned supra at note 69, the Furundija definition may be re-
garded as regressive rather than expansive and I tend to agree with the tribunals
critics in this respect. But that is not at issue here. The critical point for the cur-
rent inquiry is that dignity appears at a moment in the courts reasoning where
expansion seemed necessary and the court then employed the concept expan-
sively.
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 279

dational, substantive, and interpretive modes, drawing at once on dig-


nitys indeterminacy and on its positive instantiation in international
humanitarian law and human rights. In doing so, these expansive uses
create problems both for the principle of legality and for the limits of
international criminal law, which will briefly be synthesized here.
The tension between expansive uses of dignity and the principle of le-
gality runs much deeper than the fact that dignity remains an indeter-
minate and contested concept. Dignity motivates courts to develop new
substantive rules to govern conduct they recognize as outrageous. It
then provides the content of the resulting rule and potentially offers re-
sponses to the defendants attempts to invoke the principle of legality.
Dignity thus becomes a self-justifying force for expanding the law to
the detriment of defendants.
Where the defendant is obviously engaged in a form of sexual assault
and the court is simply fretting over whether to call this rape, the ex-
pansive force of dignity may not be morally problematic.94 But where
the defendant may have thought he was exercising core human rights,
he might deserve the protections of legality even where his conduct was
morally reprehensible. The tension between dignity and legality should
thus spur renewed interest in the contours and demands of legality, and
in the role of human dignity in actually shaping the content of this fun-
damental principle of criminal law.95
The principle of dignity also problematizes the self-understanding of
international criminal law as a substantially limited regime for the worst
crimes facing humanity. Dignity pushes the reach of international
crimes ever outward to criminalize new forms of conduct perceived as a
threat to dignity, potentially disregarding deep national and transna-
tional contestation over those issues. But international criminal law
should take its limits seriously. At some point, acquittal of an admit-
tedly bad person should reflect the regimes self-awareness of its own

94 Cf. Luban (note 8).


95 On the role of dignity in shaping the requirements of legality, see Pufen-
dorf, Of the Law of Nature and Nations, 1672, bk. 2, ch. 1, 5 (Kennett trans.,
3d ed. 1717) (The Dignity of Man, and his excellency above all other Parts of
the Animal World, made it require that his Actions should be squared by some
Rule; without which no Order, no Decorum, no Beauty can be conceived.);
von Liszt, Die deterministischen Gegner der Zweckstrafe [Deterministic Op-
ponents of Purposive Punishment], reprinted in The Rationale for the Nullum
Crimen Principle, 5 Intl J. Crim. Just. (Fraser trans., 2007); Fuller, The Moral-
ity of Law, Rev. ed., 1969, at 162.
280 Benton Heath

natural limitations. In other words, a finding of not guilty is not a


finding of non liquet96 or even recognition of innocence, but rather an
acknowledgement of appropriate boundaries for a regime that is meant
to deal with the worst crimes facing humanity.

III. Conclusion: Toward a Substantive Theory of Dignity?

The foregoing discussion highlights the need to take legality and the
limits of international criminal law seriously but it often abstracts from
the terrifying facts of the cases at issue. Any time spent perusing the
transcripts of Radio-Tlvision Libre des Mille Collines97 makes it pain-
fully clear why the court felt it important to punish the journalists
speech qua speech itself, beyond any role the defendants may have
played in inciting the genocide. Likewise, the practices of forced mar-
riage adjudicated by the Cambodia and Sierra Leone tribunals consti-
tute serious attacks on the dignity of the victims, regardless of whether
they are accompanied by sexual violence or psychological trauma.98
These cases indicate a need to take dignity seriously, to inquire whether
the concept may take on a more determined, stable and well-
understood role in the development of international criminal jurispru-
dence.
An inquiry into the content of expansive uses of human dignity in in-
ternational criminal law should endeavor to develop a workable, appli-
cable conception of dignity that fills a gap in existing substantive crimi-
nal law and may be used predictably from case to case. A full-fledged
investigation is not possible here, but some tentative remarks may be
made. One helpful way of understanding dignity in international crimi-
nal law might be to draw on notions of human dignity as a kind of rank
or social status (dignitas)99 and to understand dignitary injury as a kind

96 On the allergy of courts to findings of non liquet (law is unclear), see

Weil, The Court Cannot Conclude Definitively []: Non Liquet Revisited,
36 Columbia J. Transnatl L. (1997), 109.
97 I have found helpful the papers collected in Thompson (ed.), The Media

and the Rwanda Genocide (2007).


98 See, e.g., Prosecutor v. Brima et al., Appeal Judgment of 22 February

2008, Case No. SCSL-2004-16-A.


99 See generally Waldron, Dignity, Rank, and Rights: The 2009 Tanner Lec-
tures at UC Berkeley, NYU Public Law & Legal Theory Research Paper Series,
No. 09-50 (2009); Whitman, Human Dignity in Europe and the United States:
Mapping Expansive Uses of Human Dignity in Int. Criminal Law 281

of social re-stratification, in which the victim is treated as a member of a


lesser class of society.
This view of dignity as rank helps explain how international criminal
tribunals have thought about dignity, particularly in the context of hate
speech. For example, the Nahimana Trial Chamber addressed hate
speech this way:
Hate speech is a discriminatory form of aggression that destroys
the dignity of those in the group under attack. It creates a lesser
status not only in the eyes of the group members themselves but also
in the eyes of others who perceive and treat them as less than hu-
man. The denigration of persons on the basis of their ethnic identity
or other group membership in and of itself, as well as in its other
consequences, can be an irreversible harm.100
The court explained the mechanics of this denigration by reference101 to
the Streicher judgment of the International Military Tribunal, in which
a newspaper editor was convicted of persecution and executed for hate-
ful and inflammatory writings toward Jews.102 The International Mili-
tary Tribunal noted that Streichers writings acted as a poison injected
into the minds of thousands of Germans which caused them to follow
the National Socialists policy of Jewish persecution and extermina-
tion.103 The Trial Chamber employs this poison metaphor in justify-
ing its conclusion that the Radio-Tlvision Libre des Mille Collines
broadcast accusing all Tutsi of cunning and trickery amounted to perse-
cution.104
It is possible to make several inferences from this line of reasoning.
First, though the Trial Chamber referred simply to hate speech, it
seems to have a more specific idea of the kind of activity or, more accu-
rately, the kind of harm involved. The court does not seem concerned

The Social Foundation, in Nolte (note 77), at 108. For skeptical views see
Hernette-Vauchez, A Human Dignitas: The Contemporary Principle of Hu-
man Dignity as a Mere Reappraisal of an Ancient Legal Concept, European
University Institute Working Paper Series, LAW No. 2008/18.
100 Nahimana, Trial Judgment (note 82), para. 1072 (emphasis added).
101 Id. para. 1073.
102 IMT Judgment, supra note 70, at 30104.
103 Id. at 302.
104 Nahimana, Trial Judgment (note 82), para. 1078 (This is the poison de-
scribed in the Streicher judgment.). But see Orentlicher, supra note 56, at 576
89 (explaining the flaws in the Trial Chambers reliance on Streicher).
282 Benton Heath

with the bilateral relationship of insulter-insulted, in which the speaker


personally assaults the dignity of the subject of his vituperative speech.
Rather, the Trial Chamber here describes a kind of environmental harm
in which the terms of social relations themselves are altered by the per-
vasive hate speech spouted by Rwandan media outlets. This leads to the
second important point about the case, which is that the Trial Chamber
saw the injury as one of social status. Indeed, the striking and disturb-
ing feature of the radio broadcasts was that they worked to create a sec-
ond status in Rwandan society, in which Tutsis and anyone who helped
them were seen as vermin-like, treacherous, dishonorable people who
had no place in Rwandan society.
Thus, the kind of dignitary injury at issue in the Rwanda case and the
related Nuremberg cases is one of re-stratification. In short, the tribu-
nals have been moved to punish actions that worked to re-order society,
to re-define what it meant to be a full-fledged human being, entitled to
the respect of the dominant social order. Because of practices such as
hate speech and forced marriage, the objects of the defendants actions
came to be treated as lower-ranking creatures not worthy of the defer-
ence and respect given to ordinary people in daily life. The idea of re-
stratification draws from the understanding of human dignity as a kind
of rank and status, but it is adapted to the context of international
criminal law. It may be useful to explaining the role of human dignity in
cases like the Rwanda media trials and it may prove a useful basis for
grounding the more unmoored and expansive references to human dig-
nity.
But this or any other substantive approach to human dignity does not
solve all of the problems with expansive uses of the concept. Defining
and elaborating the content of a broader principle of human dignity
may provide for more stable application, but it does not prevent dignity
from being used as a self-justifying concept for overcoming the princi-
ple of legality. Nor does it necessarily enforce reasonable limits on the
reach of substantive international criminal law. If international criminal
institutions are to survive sustained normative scrutiny, they must do
justice not only to the victims of atrocities, but also to the accused per-
petrators and to the broader populations that will be affected and
shaped by the norms generated by international criminal tribunals. Fur-
ther conceptual elaboration of human dignity must, therefore, take
place alongside more open and frank discussions about the role of legal-
ity in contemporary international criminal law, and about the appropri-
ate limits of international criminal law.
C. Ethisierung in europischer Perspektive
Ethisierung des Europarechts Grundrechtliche
Grenzen und politische Praktiken
Hans Christian Wilms

I. Einleitung

Nach den bislang rechtsphilosophischen Betrachtungen einer Ethisie-


rung des Rechts mchte ich eine solche Entwicklung nun aus einer
praktischen Perspektive betrachten, der des Europarechts. Das Europa-
recht bildet mittlerweile ein eigenstndiges und abgeschlossenes System
von Normen, das dogmatisch bereits tief durchdrungen ist. Die Fort-
schritte der Wissenschaft, die das Themenfeld der Bioethik und damit
eine moderne Befassung mit den Gedanken einer Ethisierung des
Rechts erst begrnden konnten, wollten auch die Europischen Organe
im supranationalen Bereich entsprechend der Mglichkeiten der Union
koordinieren und begleiten. Eine Aufgabe, die eher mangelhaft bewl-
tigt wurde, wie ich im Folgenden aufzeigen will.
In einem eher schleichenden Prozess fand die Kompetenz der For-
schungsfrderung und -koordinierung im Jahre 1986 Eingang in die
Einheitliche Europische Akte und damit in die Europischen Vertr-
ge.1 Heute betrgt das Gesamtvolumen des Siebten Forschungsrahmen-
programms der Europischen Union, das den Zeitraum von 2007 bis

1 Den Anfang der Wissenschaftskoordinierung auf Gemeinschaftsebene


bildete die Entschlieung des Rates vom 14. Januar 1974 ber die Koordinie-
rung der einzelstaatlichen Politik und die Definition der Aktionen von gemein-
schaftlichem Interesse im Bereich der Wissenschaft und Technologie, ABl. 1974
C-7/2. Nach weiteren unverbindlichen Entschlieungen zu ersten gemeinsamen
Rahmenprogrammen (bspw. ABl. 1983 C-208/1) wurde die Wissenschaft dann
schlielich durch die Einheitliche Europische Akte als zustzliches Kompe-
tenzfeld in die Vertrge aufgenommen.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 285
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_11, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
286 Wilms

2013 umfasst, 50.5 Milliarden Euro, verteilt auf verschiedenste For-


schungsbereiche. Die Europischen Organe erkannten bereits in den
1980er Jahren, dass mit der Erweiterung ihres Aufgabenbereiches um
die Bereiche Forschung und Technologie auch Probleme einhergehen
wrden. Die Bewltigung der ethischen Konflikte der modernen Wis-
senschaft musste auch bei der Europischen Forschungsfrderung und
-koordinierung gewhrleistet bleiben; ein Unterfangen, das durch den
rechtlichen und ethischen Pluralismus der Mitgliedsstaaten weiter er-
schwert wurde.
Die Lsung dieser Konflikte scheinen die zustndigen Europischen
Organe, allen voran die Kommission, in einem Verweis auf die Ethik zu
sehen. Die Frage ist dabei aber, ob mit dem Verweis auf die Ethik nicht
auch eine verhngnisvolle Verschiebung der Beurteilungsmastbe ein-
hergehen kann. Die Inkorporierung von ffnungsklauseln fr ethische
Normen,2 wie die Forderung nach der Einhaltung ethischer Grund-
prinzipien in den Entscheidungen und Verordnungen des Rates bei der
Verabschiedung des Siebten Rahmenprogramms,3 knnte dafr spre-
chen, dass in diesem Zusammenhang der Boden des Rechts verlassen
wird und stattdessen eine rein ethische Errterung von Problemen er-
folgen soll.
Fr eine Abkehr von rechtlichen Mastben spricht auch die Verab-
schiedung unverbindlicher Steuerungsformen wie dem Verhaltensko-
dex fr verantwortungsvolle Forschung im Bereich der Nanowissen-
schaften und -technologien, angehngt an eine Empfehlung der Kom-

2 Formulierung bei Vneky, Recht, Moral und Ethik, 2010, 101.


3 Entscheidung ber das spezifische Programm Zusammenarbeit, ABl.
2006 L-400/86 Art. 4 Abs. 1; Entscheidung ber das spezifische Programm
Ideen, ABl. 2006 L-400/242 Art. 3 Abs. 1; Entscheidung ber das spezifische
Programm Menschen, ABl. 2006 L-400/270 Art. 4 Abs. 1; Entscheidung ber
das spezifische Programm Kapazitten, ABl. 2006 L-400/299 Art. 4 Abs. 1;
Entscheidung ber das von der Gemeinsamen Forschungsstelle innerhalb des
Siebten Rahmenprogramms durch direkte Manahmen durchzufhrende spezi-
fische Programm, ABl. 2006 L-400/368 Art. 4 Abs. 1; Entscheidung ber das
spezifische Programm zur Durchfhrung des Siebten Rahmenprogramms der
Europischen Atomgemeinschaft (Euratom) fr Forschungs- und Ausbil-
dungsmanahmen im Nuklearbereich (2007-2011), ABl. 2006 L-400/404 Art. 4;
Entscheidung ber das von der Gemeinsamen Forschungsstelle innerhalb des
Siebten Rahmenprogramms der Europischen Atomgemeinschaft (Euratom)
fr Forschungs- und Ausbildungsmanahmen im Nuklearbereich (2007-2011)
durch direkte Manahmen durchzufhrende spezifische Programm, ABl. 2006
L-400/434 Art. 4.
Ethisierung des Europarechts Grenzen und politische Praktiken 287

mission, der die Forschung an Nanopartikeln und -materialien durch


Vorgaben freiwilliger Befolgung regulieren soll. Damit knnte der Ein-
druck erweckt werden, dass Instrumente wie eben dieser Verhaltensko-
dex, die lediglich als ethische Leitlinien mit dem Hinweis der Freiwil-
ligkeit tituliert werden, nicht an rechtlichen Beurteilungsmastben
gemessen werden knnten.
Diese Entwicklung wird noch deutlicher, wenn man die offiziellen Er-
luterungen zum Begriff der sogenannten ethischen Grundprinzipien
betrachtet,4 die im Rahmen der untersttzten Forschungsttigkeiten
laut Beschluss zum Siebten Forschungsrahmenprogramm beachtet wer-
den sollten.5 Dort wird zur inhaltlichen Konkretisierung dieser Grund-
prinzipien zunchst auf rechtliche Dokumente wie die Grundrechte-
charta und vlkerrechtlich verbindliche bereinkommen verwiesen,
zudem aber auch auf soft law-Dokumente wie die Allgemeine Erkl-
rung der UNESCO ber das menschliche Genom und Menschenrech-
te6 und berufsstndische, vlkerrechtlich nicht verbindliche Regelungen
wie die Erklrung von Helsinki.7 Zustzlich sollen auch die Stellung-
nahmen ethischer Beratungsgremien wie der European Group on Ethics
in Science and New Technologies zur Konkretisierung der ethischen
Grundprinzipien beitragen. Durch diese Verweise scheint der Europi-
sche Gesetzgeber zu beabsichtigen, sich im Bereich der Forschung von
rechtlichen Mastben zu distanzieren und ethische Prinzipien dyna-
misch in das Recht zu integrieren. Diese Entwicklung birgt gleichzeitig
Potentiale und Gefahren, wie im Folgenden aufzuzeigen sein wird.
Bereits 1991 wurde sich die Kommission der ethischen Implikationen
der Biotechnologie auch fr ihre Arbeit bewusst,8 was zur Einrichtung
der Group of Advisers on the Ethical Implications of Biotechnology
fhrte, die die Kommission in diesen Angelegenheiten beraten sollte.9

4 Id.
5 30. Erwgungsgrund, Beschluss Nr. 1982/2006/EG des Europischen Par-
laments und des Rates vom 18. Dezember 2006, ABl. 2006 L-412/1.
6 UNESCO Gen. Conf. Res. 29 C/Res.16, reprinted in Records of the Ge-
neral Conference, UNESCO, 29th Sess., 29 C/Resolution 19, 41 (1997).
7 Aktuelle Version abrufbar unter http://www.wma.net/en/30publications/
10policies/b3/index.html.
8 Mitteilung der Kommission Promoting the Competitive Environment
for the Industrial Activities based on Biotechnology within the Community
SEC(91) 629 endg., 11.
9 Id., 16 und 18.
288 Wilms

Diese wurde 1997 in die European Group on Ethics in Science and New
Technologies (EGE) berfhrt. Dieser Ethikrat der Europischen Uni-
on ist interdisziplinr mit 15 Experten aus Naturwissenschaften, Medi-
zin, Theologie und Philosophie besetzt und wird durch die Kommissi-
on mandatiert.10 Die Gruppe versorgt auf Anfrage oder Eigeninitiative
die Europische Kommission mit Stellungnahmen zu verschiedenen
Themen aus ihrem Aufgabenspektrum.11 Dabei ist ihre Verankerung im
Europischen Primr- und Sekundrrecht jedoch strittig. Ihr Beitrag
zur Verbesserung der Entscheidungsfindung in ethisch sensiblen Berei-
chen, zur Erhhung von deren Legitimation und zur Bildung von Ver-
trauen wird in der Literatur zwar zumeist grundstzlich positiv bewer-
tet,12 kritisiert wird jedoch eine fehlende Anknpfung an die Vertrge.13
Zwar ist es nicht eindeutig diesen Gremien zuzuschreiben, dass legisla-
tive Formulierungen wie die Einhaltung ethischer Grundprinzipien
ihren Weg in die Rechtsakte der Kommission fanden.14 Diese fllten sie
jedoch mit tatschlichem Gehalt, der zuvor weitgehend unklar war. Zu-
nchst wurden dieser Begriff und die Verpflichtung zur Einhaltung der
ethischen Grundprinzipien in einer Stellungnahme der European Group

10 Vgl. die Kommissionsentscheidung vom 16.12.1997, SEC(97)2404; Das


zweite (C(2001)691) und dritte Mandat (2005/383/EG) verlngerten ihr Mandat
bis heute. Ihr Vorlufer, die Group of Advisers on the Ethical Implications of
Biotechnology (eingesetzt durch den Kommissionsbeschluss SEC(91)629) wur-
de bereits 1991 eingerichtet. Zur EGE ausfhrlich Vneky (Fn. 2), 316 ff.
11 Stellungnahmen wurden bislang u.a. zu Gewebebanken, Embryonenfor-

schung, Doping im Sport, Stammzellforschung, Klonen von Tieren und Nano-


medizin abgegeben. Eine bersicht findet sich auf http://ec.europa.eu/bepa/
european-group-ethics/publications/opinions/index_en.htm.
12 Busby, Hervey, Mohr, Ethical EU Law? The Influence of the European
Group on Ethics in Science and New Technologies, 33 European Law Review 6
(2008) 842; Schielke, Vertrauensbildende Manahmen Partizipatorische und
advokatorische Beratungsformen in bioethischen Streitfragen auf der Ebene der
EU, in Vneky, Hagedorn, Clados, von Achenbach (Hrsg.), Legitimation ethi-
scher Entscheidungen im Recht, 2009, 209, 222; Vneky (Fn. 2) 350.
13 Busby, Hervey, Mohr (Fn. 12) 835 ff.
14 Diese Bestimmung wurde bereits in das 5. FRP aufgenommen, bevor die
EGE dazu Stellung genommen hatte, vgl. Art. 7 des Beschlusses des Europi-
schen Parlaments und des Rates vom 22. Dezember 1998 ber das Fnfte Rah-
menprogramm der Europischen Gemeinschaft im Bereich der Forschung,
technologischen Entwicklung und Demonstration (1998-2002), ABl. 1999 L-
26/6.
Ethisierung des Europarechts Grenzen und politische Praktiken 289

on Ethics als absolut gerechtfertigt bezeichnet.15 Im Folgenden zeigt


sie aber auch detailliert auf, was ihres Erachtens die Einhaltung ethi-
scher Grundprinzipien bei der Frderung wissenschaftlicher Vorhaben
in der Europischen Union erfordert.16 So sind die ethischen Grund-
prinzipien, die sowohl bei den Umsetzungsmodalitten, als auch bei der
Planung des Ziels und der Anwendung der Ergebnisse von Forschungs-
vorhaben zu bercksichtigen sein sollen, die Prinzipien der Autonomie,
der Menschenwrde, der Nichtdiskriminierung, der Nichtausbeutung,
des besonderen Schutzes fr besonders schutzbedrftige Personen-
gruppen, des weitest mglichen Tierschutzes, der Verhltnismigkeit
und schlielich auch die Forschungsfreiheit. Bis auf Letztere sollen sich
die vorgenannten Prinzipien dabei wiederum aus internationalen ber-
einkommen ergeben, wobei diese Dokumente noch weitere Prinzipien
umfassen sollen, die aber nicht genannt werden.17
Abgesehen vom Einfluss der EGE auf spezifische Rechtsakte im Be-
reich der Biotechnologie18 hat sie durch diese Form der Implementie-
rung ethischer Prinzipien in die Rechtsetzung der Europischen Organe
eine Ethisierung des Europarechts bewirkt, die zum einen vorteilhaft,
zum anderen aber auch bedenklich ist.

15 Stellungnahme Nr. 10 der EGE zu den ethischen Aspekten des fnften

Forschungsrahmenprogramms, Punkt 2.1.


16 Id. Punkt 2.3 ff.
17 Id. Punkt 2.9. Die dabei erwhnten internationalen bereinkommen
werden in der Prambel der Stellungnahme aufgezhlt und sind zum Teil de-
ckungsgleich mit den spter vom Rat konsultierten Dokumenten: das berein-
kommen der Vereinten Nationen vom 6. Juni 1992 ber die biologische Vielfalt,
die Konvention des Europarates ber die Menschenrechte und die Biomedizin
vom 4. April 1997, die Allgemeine Erklrung ber das menschliche Genom und
die Menschenrechte der UNESCO vom 11. November 1997 und die Deklarati-
on des Weltrztebundes von Helsinki vom Juni 1964 ber Empfehlungen fr
rzte, die in der biomedizinischen Forschung am Menschen ttig sind, gendert
im Oktober 1975, Oktober 1983, September 1989 und Oktober 1996.
18 Vgl. dazu die detaillierte Ausarbeitung von Busby, Hervey, Mohr (Fn. 12)

809 ff. bezglich der Richtlinie 98/44 ber den rechtlichen Schutz biotechni-
scher Erfindungen und die Richtlinien 2002/98 und 2004/23 zu Qualitts- und
Sicherheitsstandards bei menschlichem Blut bzw. Gewebe.
290 Wilms

II. Vorteil: Kompensation von Defiziten im Bereich der


Europischen Regulierung wissenschaftlicher Fragen

Der Union sind durch die Vertrge nicht nur die Schaffung eines Euro-
pischen Forschungsraums,19 sondern auch die Sicherstellung eines
mglichst hohen Gesundheitsschutzniveaus20 aufgegeben. Damit gehen
auch zwangslufig Entscheidungen in sensiblen Bereichen der Medizin,
Biotechnologie und Wissenschaft einher. Dabei sieht sie sich jedoch
stets dem ethischen Pluralismus einer supranationalen Staatengemein-
schaft gegenber, der eine Entscheidungsfindung in jenen Bereichen
ber das Ausma nationaler ethischer Entscheidungen hinaus weiter er-
schwert. In Anbetracht der Tatsache, dass das duale Konzept demokra-
tischer Legitimation in der Union ohnehin nicht zweifelsfrei als ausrei-
chend angesehen werden kann, um Entscheidungen zu legitimieren21
und auch die Vertrauensbildung gegenber Multilevel-Governance-
Systemen besonderen Schwierigkeiten ausgesetzt ist,22 ist das Bemhen
der Kommission, ihre Entscheidungsfindung durch ein unabhngiges
und interdisziplinres Beratungsgremium23 mit einer ethischen Fundie-
rung auszustatten, zunchst positiv zu bewerten. Gerade weil der Re-
spekt fr den Pluralismus24 innerhalb der Union als Prinzip anerkannt
wird, und dieses in Zusammenhang mit den oben bereits aufgezhlten,
aus internationalen bereinkommen abgeleiteten Prinzipien in Zu-
sammenhang gebracht werden soll, und nicht eine bestimmte vorherr-
schende ethische Ansicht durchgesetzt wird,25 liefert die EGE einen
wichtigen Beitrag im Rechtssetzungssystem der Union,26 indem zumin-

19 Art. 179 AEUV.


20 Art. 168 AEUV.
21 Vgl. von Achenbach, Theoretische Aspekte des dualen Konzepts demo-
kratischer Legitimation fr die Europische Union, in Vneky, Hagedorn, Cla-
dos, von Achenbach (Fn. 12) 191 ff.
22 Aus einer soziologischen und politikwissenschaftlichen Perspektive
Schielke, Vertrauensbildende Manahmen Partizipatorische und advokatori-
sche Beratungsformen in bioethischen Streitfragen auf der Ebene der EU, in
Vneky, Hagedorn, Clados, von Achenbach (Fn. 12) 201, 220 ff.
23 Zur Besetzung und Unabhngigkeit der EGE, aber auch ihrem teils man-
gelhaften ffentlichkeitsbezug siehe Vneky (Fn. 2) 319 ff.
24 EGE-Stellungnahme 21, Punkt 4.4.2.1.
25 Vneky (Fn. 2) 357.
26 Busby, Hervey, Mohr (Fn. 12) 26.
Ethisierung des Europarechts Grenzen und politische Praktiken 291

dest die Kommission mit Expertenwissen versorgt wird, das im Sinne


einer ethischen Kartographie27 die Optionen knftiger Rechtssetzung
aufzeigt und auch wichtiger Impulsgeber sein kann.28
Die Leistung der EGE, die in ihrer Rechtsnatur zum Teil umstrittenen
internationalen bereinkommen zu ethischen Fragen in Wissenschaft
und Medizin29 in die Entscheidungsfindungen der Kommission bei der
Forschungsfrderung zu integrieren, ist ebenso wenig zu unterscht-
zen, wie ihre Bemhung, die Aufklrung und Einbeziehung der ffent-
lichkeit in einem Dialog mit den Entscheidungstrgern zu frdern.30
Die Rolle, die der EGE in der Entscheidungsfindung der Europischen
Organe, vor allem der Kommission, zukommt, ist insofern vom sozio-
logischen und politikwissenschaftlichen Standpunkt aus gesehen be-
merkenswert und zu frdern, was aus dieser Perspektive auch fr eine
grundstzliche Entwicklung der Ethisierung des Europarechts gilt. Er-
hebliche Probleme ergeben sich jedoch hinsichtlich des konkreten Zu-
sammenspiels von ethischen Erwgungen und rechtlichen Grundlagen.

III. Nachteil: Unkontrollierte Diffusion von Ethik und


Recht

Der Nachteil der Ethisierung des Rechts wird dann offensichtlich,


wenn der ethische Diskurs sich von den (grund-)rechtlichen Rahmen-
bedingungen lst, dieser aber dann von den Europischen Organen in-
stitutionalisiert wird.31 Die Stellungnahmen der EGE zeigen deutlich,

27 Zur Unmglichkeit der Entscheidungsfindung durch ethische Experten

in demokratischen Prozessen Vneky, Ethische Experten und moralischer Au-


toritarismus, in Vneky, Hagedorn, Clados, von Achenbach (Fn. 12) 84 ff.
28 Vneky (Fn. 2) 359.
29 Beispielsweise ist die Deklaration von Helsinki des Weltrztebundes von
hoher praktischer Relevanz, ihre Einordnung in den Kanon vlkerrechtlicher
Quellen aber nicht mglich, vgl. Chang, Ethische und rechtliche Herausforde-
rungen einer globalisierten Arzneimittelprfung (im Erscheinen); Hohnel, Die
rechtliche Einordnung der Deklaration von Helsinki Eine Untersuchung zur
rechtlichen Grundlage humanmedizinischer Forschung, 2005, 55.
30 Vneky (Fn. 2) 358.
31 Den Begriff der staatlichen Institutionalisierung von Ethikdiskursen
brachte Sommermann, Ethisierung des ffentlichen Diskurses und Verstaatli-
chung der Ethik, Archiv fr Rechts- und Sozialphilosophie 89 (2003) auf, vgl.
dort 83.
292 Wilms

dass diese nicht an die grundrechtliche Ordnung der Europischen


Union anknpfen, sondern sich grtenteils allein innerhalb ethischer
Diskursregeln bewegen. So werden die bereits aufgezhlten Prinzipien,
anhand derer sich die Stellungnahmen der EGE orientieren, nicht an die
offensichtlich vorhandenen Anknpfungspunkte der Europischen
Grundrechte32 rckgebunden,33 sondern als grundlegende ethische
Prinzipien im ethischen Diskurs als Rahmenbedingungen ihrer Argu-
mentation verwendet. Solange dies die rechtliche Bewertung von Sach-
verhalten nicht tangiert, sondern lediglich vorbereitende Hilfe fr diese
ist, ist dies auch legitim. Dass sich die EGE selbst nicht an einer solchen
Maxime orientiert, lsst sich in Passagen ablesen wie Punkt 1.10 der
Stellungnahme Nr. 10 zum Fnften Forschungsrahmenprogramm:
In Anbetracht der Tatsache, da die Europische Gemeinschaft
keine Rechtsetzungsbefugnisse in den Bereichen hat, die die Bio-
ethik betrifft (Forschung und Gesundheitswesen), obliegt es der
Kommission, ethische Mastbe an von ihr finanzierte Forschungs-
projekte anzulegen und fr diese eine ethische Bewertung vorzuse-
hen.34
Die EGE vermittelt mithin die Auffassung, die fehlende Rechtset-
zungskompetenz der Kommission erfordere eine Verlagerung der rele-
vanten Mastbe zu einer rein ethischen Bewertung, also einer Ord-
nung neben der vorhandenen Rahmenrechtsordnung der Grundrechte.
Genau diese Betrachtungsweise verdeutlicht die Gefahr der Schaffung
einer parallelen Sollensordnung, die die rechtliche de facto oder doch
potentiell unterhhlen kann.35 Vor allem wenn sich Divergenzen zwi-
schen der ethisch diskursiven Bewertung eines Sachverhalts mit der
grundrechtlichen Analyse desselben ergeben, kann die Kommission auf
diesem Wege ethische Parameter implementieren, die von den Mit-
gliedsstaaten und auch der vertraglichen Unionsrechtsordnung nicht

32 U.a. lsst sich das Prinzip der Autonomie an Art. 1 und 3 GRC rckbin-

den, das der Menschenwrde ist bereits in Art. 1 GRC kodifiziert, die Nicht-
diskriminierung ist in Art. 21 GRC ausfhrlich geregelt und die Forschungs-
freiheit in Art. 13 GRC gewhrleistet.
33 Die Grundrechtecharta war bereits seit 2000 als Orientierungsdokument

der EGE zugnglich, die Grundrechte als allgemeine Rechtsgrundstze der Un-
ion im Allgemeinen sind bereits lnger verbindliches Recht.
34 Stellungnahme Nr. 10 der EGE zu den ethischen Aspekten des fnften

Forschungsrahmenprogramms, Punkt 1.10.


35 Vneky (Fn. 2) 350.
Ethisierung des Europarechts Grenzen und politische Praktiken 293

geteilt werden.36 Dies ist umso mehr zu befrchten, je mehr die Kom-
mission an den jeweiligen Rechtsetzungsverfahren beteiligt ist und we-
niger die deliberativen Organe Parlament und Rat,37 die sehr viel mehr
von der ethisch diskursiven Vorbereitung ihrer Debatten durch Bera-
tungsgremien profitieren wrden.38
Notwendig bleibt es jedoch, dass die (grund-) rechtliche Ordnung der
Europischen Union zuvrderst den Mastab bilden soll, an dem sich
die Europischen Organe orientieren mssen.39 Der Eindruck der
Rckbindung wird zwar durch die Nennung des Rechtsrahmens auch
bei den Stellungnahmen der (weder damals noch heute) nicht durch die
Grundrechtecharta gebundenen40 EGE erweckt und mithin der Ein-
druck einer rechtlichen Fundierung ihrer ethischen Erwgungen.41 Die
materielle Auseinandersetzung mit dem Thema erfolgt dann jedoch al-
lein unter Rekurs auf ethische berlegungen und Prinzipien. Dies ist
fr ein Ethikgremium auch legitim, kann der ethische Diskurs doch
durch Rechtsnormen zunchst nicht begrenzt werden.42 Problematisch
wird es nur dann, wenn durch die bernahme ihrer Stellungnahmen in
die Handlungsformen der Europischen Organe die Grenzen zwischen
Ethik und Recht verwischt werden. Denn so wnschenswert die Ausei-
nandersetzung mit ethischen Fragestellungen durch die rechtsetzenden
Organe auch ist, so bleibt dennoch festzuhalten, dass deren handlungs-
leitende Maxime sich aus den Vertrgen und der ihnen gleichgestellten
Grundrechtecharta ergeben mssen und sich nicht an einer parallelen
Sollensordnung mit unterschiedlichen Geltungsregeln orientieren darf.
Genau diese Gefahr besteht jedoch durch die zahlreichen, oben genann-

36 Die EGE daher mit einem Trojanischen Pferd vergleichend Plomer, The

European Group on Ethics -law, politics and the limits of moral integration in
Europe, 14 European Law Journal 6 (2008) 839, 856.
37 Vneky (Fn. 2) 350.
38 Fr eine Anbindung an die Parlamente auch Sommermann (Fn. 31) 75
(83) und Vneky (Fn. 2) 226 f.
39 So der eindeutige Wortlaut des Art. 51 Abs.1 GRC, der nach Art. 6 Abs.1

EUV als Primrrecht zu gelten hat.


40 Die GRC gilt gem Art. 51 Abs. 1 zwar fr alle Stellen der Union, je-

doch mssen diese nach den Vertrgen zur Ausbung von Hoheitsgewalt be-
fugt sein, Kingreen in Calliess/Ruffert (Hrsg.), EUV/EGV/GRC-Kommentar,
Art. 51 GRC Rn. 5. Gerade wegen ihres diffusen Status kann dies nicht fr die
EGE gelten, vgl. Busby, Hervey, Mohr (Fn. 12) 835 ff.
41 Plomer (Fn. 36) 855.
42 So die Formulierung von Vneky (Fn. 2) 359.
294 Wilms

ten Verweise auf die sogenannten ethischen Grundprinzipien in Rechts-


akten der Europischen Union. Durch eine solche Formulierung wird
besonders deutlich, dass die Europischen Organe im Bereich der Wis-
senschaft die bestehende Ordnung als nicht ausreichend empfinden und
sich bewusst auf die Ausfhrungen von Gremien verlassen wollen, die
auerrechtlich argumentieren und nicht an die Rahmenbedingungen der
Europischen Primrrechtsordnung gebunden sind. Die nachteiligen
Auswirkungen einer solchen Vorgehensweise kann man insbesondere
an einer Fehleinschtzung der Wissenschaftsfreiheit verdeutlichen.

IV. Insbesondere: Die Wissenschaftsfreiheit

Die Wissenschaftsfreiheit war bis zur Verabschiedung der Grundrech-


techarta im Jahr 2000 im Europarecht nicht als Grundrecht nachzuwei-
sen. So berrascht es auch zunchst nicht, dass die EGE in ihrer 10.
Stellungnahme zum Fnften Forschungsrahmenprogramm auf diese le-
diglich als Prinzip der Forschungsfreiheit eingeht, das sich aus dem
Recht auf Meinungsuerung ergebe.43 Damit wurde die Wissenschafts-
freiheit als ethisches Grundprinzip zwar anerkannt, nicht aber auf die-
selbe Stufe wie die Grundrechte gestellt.44 Solange sich jedoch bei ethi-
schen Bewertungen von Forschungsttigkeiten die verschiedenen ethi-
schen Prinzipien als gleichberechtigt gegenberstehen, wie es die EGE
in der weiteren Stellungnahme auch vorschlgt,45 ist an dieser Vorge-
hensweise auch keine Kritik notwendig.
Bedenklich ist in diesem Zusammenhang erst die Stellungnahme der
EGE zur Nanomedizin, die im Jahre 2007 verabschiedet wurde, also
sieben Jahre nach Verabschiedung der Grundrechtscharta und bereits in
Erwartung ihres Inkrafttretens als verbindliches Recht durch den Ver-

43 Stellungnahme Nr. 10 der EGE zu den ethischen Aspekten des fnften

Forschungsrahmenprogramms, Punkt 2.2.


44 Dies ergibt sich vor allem aus dem zweiten Satz des Punkt 2.2 in der Stel-

lungnahme: Der Ethik der Forschung mu es darum gehen, die freie Aus-
bung von Forschungsttigkeiten mit bestimmten Einschrnkungen vereinbar
zu machen, die sich aus dem Schutz der Grundrechte des europischen Brgers
sowie der Verantwortung des Menschen gegenber Tier und Umwelt ergeben.
45 In Punkt 2.9 der Stellungnahme werden die Menschenwrde, die Auto-
nomie des Einzelnen, Verhltnismigkeit u.a. ebenfalls nur als ethische Prinzi-
pien erwhnt, und keine Vorrangregelung aufgestellt.
Ethisierung des Europarechts Grenzen und politische Praktiken 295

trag von Lissabon. Dort wird die Forschungsfreiheit in Punkt 4.4.3.1


mit den Worten eingefhrt:
The basic rights of individuals are protected by the conventions
and declarations mentioned in section 4.4. These rights include pro-
tection of human dignity, integrity and autonomy, protection of pri-
vacy and of confidentiality of personal data, as well as protection of
the right not to know and of property rights.
These rights must be protected by the Member States. The conven-
tions establish the basis for a legal system to prevent and punish vio-
lations of these rights. Within these constraints, freedom of research
and free movement of goods and services is respected and encour-
aged.
Die EGE sah in der Forschungsfreiheit gegenber den Grundrechten
insoweit ein aliud, das nicht denselben Kollisionsregeln wie die Grund-
rechte selbst unterliegen, sondern subsidir gelten soll. Dies berrascht,
wenn zunchst in Punkt 3.4 zu lesen ist, dass sich die EGE der Wissen-
schaftsfreiheit, die die Grundrechtscharta gewhrt, durchaus bewusst
war.46 Dennoch behandelt sie diese Freiheit auch in ihrer abschlieen-
den Empfehlung nicht als gleichwertiges Grundrecht, sondern spricht
im Zusammenhang mit den Grundrechten nur von legitimen Interes-
sen der Wissenschaft, die dann gerechtfertigt seien, wenn sie mit den
Grundrechten kompatibel wren.47 Dies zeigt deutlich, dass die EGE
sich bei ihren Stellungnahmen nicht an der Grundrechtecharta orien-
tiert, sondern eigene Beurteilungsmastbe anlegt, anhand derer ihre
Empfehlungen gestaltet werden. Diese Diskrepanz zwischen ethischer
und rechtlicher Analyse ist aber nur deswegen bedenklich, weil die
Kommission diese nicht bercksichtigt, sondern vielmehr die Stellung-
nahmen der EGE als Schema ihren eigenen Manahmen wie dem Ver-

46 Vgl. Punkt 3.4 der Stellungnahme Nr. 21: Respect for human dignity, a

ban on human reproductive cloning, respect for peoples autonomy, non-


commercialisation of biological components derived from the human body,
prohibition of eugenic practices, protection of peoples privacy, freedom of sci-
ence: these are examples of values enshrined in the Charter, which was adopted
at the Summit of Nice in 2001.
47 Punkt 5.3 der Stellungnahme: As stated in many European and interna-
tional documents, the interests of science are legitimate and justified insofar as
they are compatible with human dignity and human rights. New technologies
are scrutinised with respect to the prospects of contributing to the improve-
ment in human wellbeing they are aiming at, and with respect to possible
threats to human wellbeing, be it at European or global level.
296 Wilms

haltenskodex fr verantwortungsvolle Forschung im Bereich der Na-


nowissenschaften und -technologien zugrunde legt.
So zeigt sich eine bemerkenswerte Kongruenz zwischen den Empfeh-
lungen der EGE in ihrer Stellungnahme zur Nanomedizin und dem
wenige Monate spter erschienenen Verhaltenskodex.48 Insofern ber-
rascht es auch nicht, dass die geringe Gewichtung der Wissenschafts-
freiheit der EGE sich auch im Verhaltenskodex der Kommission fort-
setzt. Obwohl sich dort mehrere Hinweise auf die Grundrechte finden
lassen, wird dabei die Wissenschaftsfreiheit zumeist ausgeblendet. Es
wird davon gesprochen, dass gegebenenfalls auch die Grundrechte
der Grundrechtecharta beachtet werden sollten,49 und auch dass die
Nanoforschung die Grundrechte respektieren und das Wohlergehen der
Brger und der Gesellschaft im Auge haben sollte.50 Es wird jedoch
nicht erwhnt, dass auch die Forscher und Forschungseinrichtungen
selbst einen Grundrechtsschutz genieen, die Begriffe Forschungsfrei-
heit oder Wissenschaftsfreiheit finden sich weder im Kodex, noch in
der diesem zugrundeliegenden Empfehlung.51 Durch die fehlende Sen-
sibilitt fr das Grundrecht lassen sich auch bedenkliche Prinzipien wie

48 In der Stellungnahme wird gefordert, die Nanotechnologie und -wissen-


schaft stets unter Beachtung des Vorsorgeprinzips zu betreiben, was einen der
Kernpunkte des Kodex ausmacht. Darber hinaus wird in der Stellungnahme
auch eine fortlaufende Risikoevaluierung aller Projekte gefordert, die sich, in-
klusive der Erforschung neuer Methoden zu diesem Aspekt, auch im Kodex als
Forderung wiederfindet. Die EGE fordert eine Frderung wissenschaftlicher
Projekte, die stets am grtmglichen allgemeinen Nutzen ausgerichtet ist, was
auch der Kodex als Maxime der Forschungsfrderung ausgibt. Der gesamten
Forschung im Nanobereich soll nach Meinung der EGE das Gebot der Trans-
parenz zugrunde liegen, was eine verstndliche Verffentlichung von Ergebnis-
sen umfassen und das Misstrauen der Bevlkerung reduzieren soll. Auch dies
wurde von der Kommission entsprechend umgesetzt. Vgl. dazu auch Vneky
(Fn. 2) 347 ff.
49 Dritter Absatz der Einleitung des Kodex: Akteure, die den Verhaltens-

kodex anwenden, sollten gegebenenfalls auch die Grundstze der Charta der
Grundrechte der Europischen Union beachten.
50 Punkt 3.1, zweiter Satz des Kodex.
51 An dieser Stelle kann an die Warn- und Besinnungsfunktion des Zitierge-
bots im deutschen Recht nach Art. 19 Abs. 1 GG erinnert werden, die den Ge-
setzgeber dazu anhalten soll, sich ber die Auswirkungen seiner Regelungen
fr die betroffenen Grundrechte Rechenschaft [zu] geben, vgl. BVerfGE 64, 72
(79). Die Abwesenheit eines jeden Zitats erweckt jedenfalls einen gegenteiligen
Eindruck.
Ethisierung des Europarechts Grenzen und politische Praktiken 297

Punkt 3.7 des Kodexes erklren, der eine generelle Rechenschaftspflicht


fr die knftigen Folgen von Forschern und Forschungseinrichtungen
postuliert. Aufgrund einer mangelnden Beachtung fr ein zugegebe-
nermaen damals noch nicht verbindliches Grundrecht ist die Kommis-
sion, trotz der Wahl einer originr unverbindlichen Handlungsform,
weit ber das Ziel, eine sichere und vertretbare Nanoforschung in Eu-
ropa zu gewhrleisten, hinaus gegangen.
Daher ist festzuhalten, dass die Auslagerung des ethischen Diskurses
auf ein Europisches Ethikgremium tatschlich einen parallelen Sol-
lensmastab generiert hat, der die rechtlichen Verpflichtungen der Eu-
ropischen Kommission zu unterhhlen droht.

V. Schlussfolgerungen

Die Ethisierung des Europarechts im Bereich der Wissenschaft hat dazu


gefhrt, dass Adressaten der verschiedenen Rechtsakte der Europi-
schen Organe stets die Konformitt mit den sogenannten ethischen
Grundprinzipien nachweisen mssen, um im Europischen For-
schungsraum eine Rolle spielen zu knnen. Der Inhalt jener ethischen
Grundprinzipien wird durch mehrere Faktoren konkretisiert: internati-
onale bereinkommen, die Stellungnahmen der EGE und auch die
Umsetzungsmanahmen der Europischen Kommission wie der Ver-
haltenskodex. Whrend die EGE aber als unabhngiges Beratungsgre-
mium ohne Hoheitsgewalt nicht an die Grundrechte gebunden ist, trifft
dies fr die Kommission umso mehr zu. Deren Verhaltenskodex entwi-
ckelt als rechtsbegleitendes und -ausgestaltendes Instrument zur Ver-
haltenssteuerung durch einen Hoheitstrger eine beachtliche rechtliche
Relevanz bei der Spezifikation der ethischen Anforderungen im Euro-
pischen Wissenschaftsrecht.
Will man jedoch die oben beschriebenen Nachteile der Ethisierung des
Europarechts vermeiden, so mssen zumindest die Manahmen der
Kommission grundrechtlich rckgebunden, mithin auch gerechtfertigt
sein, um einer zu befrchtenden Diffusion der Sollensmastbe vorzu-
beugen. Sollen die Grundrechte in Zukunft ihre Funktion in Europa als
Grundlage gemeinsamer, universeller Werte ausfllen knnen, drfen
die Europischen Organe nicht durch eine Diffusion paralleler Sollens-
mastbe einzelne Grundrechte aushebeln. Insofern mssen sich die
politischen Entscheidungstrger der Tatsache beugen, dass bereits eine
ethische Rahmenordnung als geltendes Recht in der Union gilt und in-
298 Wilms

soweit eine Verlagerung von Beurteilungsmastben nicht im Sinne der


gemeinsamen Idee von Europa sein kann.
Die Zivilgesellschaft als einsame Verteidigerin
der guten Sitten? berlegungen zur Ethisierung
am Beispiel des Biopatentrechts
Rafael Hcki

I. Evolution des Patentrechts

1. Klassisches Patentsystem

Als Ausgangspunkt der vorliegenden berlegungen zur Ethisierung


wird im Folgenden zunchst das klassische Patentsystem kurz umris-
sen. Der Fokus liegt dabei auf der Ausrichtung des Patentschutzes auf
technische Erfindungen (a.), den spezifischen Eigenschaften der Ge-
meinschaft der im Patentwesen involvierten Akteure (b.) sowie der in
dieser Patentgemeinschaft verbreitet postulierten These der Wertfreiheit
des Patentrechts (c.).

a) Schutz technischer Erfindungen


Klassischerweise ist das Patentsystem auf die Frderung des techni-
schen Fortschritts ausgerichtet.1 Die Geschichte des Patentrechts er-

1 Zu den klassischen Patenttheorien grundlegend Machlup, An Economic


Review of the Patent System, Study No. 15 of the Subcommittee on Patents,
Trademarks, and Copyright of the Committee on the Judiciary, United States
Senate, 85th Congress, 2nd Session, 1958; (leicht gekrzte) deutsche berset-
zung Machlup, Die wirtschaftlichen Grundlagen des Patentrechts, Gewerbli-
cher Rechtsschutz und Urheberrecht Internationaler Teil (GRUR Int.) 10
(1961), 373 ff., 473 ff., 524 ff.

S. Vneky et al. (eds.), Ethik und Recht - Die Ethisierung des Rechts/Ethics and Law - 299
The Ethicalization of Law, Beitrge zum auslndischen ffentlichen Recht und
Vlkerrecht 240, DOI 10.1007/978-3-642-37090-8_12, by Max-Planck-Gesellschaft
zur Frderung der Wissenschaften e.V., to be exercised by Max-Planck-Institut
fr auslndisches ffentliches Recht und Vlkerrecht, Published by
Springer-Verlag Berlin Heidelberg 2013
300 Hcki

zhlt daher jeweils auch die Geschichte der technischen Entwicklung.2


So finden sich erste Patente und Patentgesetze zur Frderung von
Handwerk und Gewerbe bereits zu Beginn des 15. Jahrhunderts in Ve-
nedig; nicht zufllig im damaligen Zentrum der auf schpferische T-
tigkeiten ausgerichteten Renaissance. Die Frhzeit des modernen Pa-
tentrechts setzte sodann ein, als im Zuge der industriellen Revolution in
England (1623),3 den USA (1790)4 und Frankreich (1791)5 die Vorbilder
und Vorlufer moderner Patentgesetze weltweit erlassen wurden. Die
vertiefte dogmatische Auseinandersetzung im 19. Jahrhundert fhrte
schlielich zur systematischen Grundlegung und verbreiteten Kodifi-
zierung des Rechtsgebiets, etwa in Deutschland (1877),6 Grobritan-
nien (1883)7 und der Schweiz (1888)8. Dieses klassische Patentrecht ist
charakterisiert durch seine Ausrichtung auf technische Erfindungen auf
der Basis unbelebter Materie. Seine Grundstze und Grundbegriffe
etwa die Bestimmung patentfhiger Erfindungen,9 die Abgrenzung zur

2 Zur Geschichte des Patentrechts ausfhrlich Kurz, Weltgeschichte des Er-


findungsschutzes, 2000; May/Sell, Property Rights. A Critical History, 2005,
66 ff.
3 Statute of Monopolies 1623. An Act concerning Monopolies and Dispen-
sations with penall Lawes and the Forfeyture thereof, 21 Jac. 1, c. 3.
4 Patent Act of 1790. An Act to promote the progress of useful Arts, Ch. 7,
1 Stat. 109 - 112 (April 10, 1790) Chap. VII.
5 Loi relative aux dcouvertes utiles, et aux moyens den assurer la propri-
t ceux qui seront reconnus en tre les auteurs, vom 7. Januar 1791.
6 Patentgesetz, vom 25. Mai 1877, Deutsches Reichsgesetzblatt Band 1877,
Nr. 23, 501.
7 Patents, Designs and Trade Marks Act 1883, 46 & 47 Vict., c. 57.
8 Bundesgesetz betreffend die Erfindungspatente, vom 29. Juni 1888, Bun-
desblatt (BBl.) 1888 Band III, 719 ff. Zuvor bestand bereits whrend der von
Napoleon oktroyierten Helvetischen Republik vom 25. April 1801 bis zu deren
Auflsung 1803 ein einheitliches Patentgesetz nach franzsischem Vorbild (s.o.
Fn. 5).
9 Die frhere terminologische Unterscheidung zwischen patentfhiger Er-
findung (d.h. technischer Natur und nicht von patentrechtlichen Ausschluss-
grnden erfasst) und patentwrdiger Erfindung (d.h. die weiteren Patentie-
rungsvoraussetzungen der Neuheit und erfinderischen Ttigkeit erfllend)
wurde im Rahmen verschiedener Gesetzesrevisionen zu Gunsten einer unspezi-
fischen Verwendung der Begriffe der patentfhigen und der patentierbaren
Erfindung aufgegeben, siehe Briner, Die Erfindung als technische Lehre,
Schweizerisches Immaterialgter- und Wettbewerbsrecht, Band IV, 2006, 49, 50
f. Vorliegend wird der Begriff in seiner ursprnglichen Bedeutung verwendet.
Die Zivilgesellschaft als einsame Verteidigerin der guten Sitten? 301

Entdeckung und weitere Grenzen des Patentschutzes haben weitge-


hend bis heute Bestand. So prgen die damalige wissenschaftliche, tech-
nische und wirtschaftliche Weltsicht auch weiterhin das moderne Pa-
tentrecht.10
Im Ergebnis steht der Begriff der Technik im Zentrum des modernen
Patentrechts. Der Kreis patentfhiger Erfindungen wird jeweils anhand
des technischen Charakters und der Technizitt bestimmt.11 Dabei
werden Weiterentwicklungen und Anpassungen des gesetzlich nicht de-
finierten Erfindungsbegriffs jeweils durch Lehre und Rechtsanwendung
mittels Ausdehnung des Begriffs der Technik vorgenommen.

b) Epistemische Patentgemeinschaft
Aufgrund dieser technischen Ausrichtung haftet dem Patentrecht ver-
breitet der Ruf eines eher randstndigen Fachgebietes der Rechtswis-
senschaft an.12 So erfordern die Anmeldung, Beurteilung und Erteilung
von Patenten spezifische rechtliche und technische Fachkenntnisse.
Entsprechend sind die Akteure des Patentwesens hauptschlich Techni-
ker, Naturwissenschaftler und spezialisierte Juristen; nicht selten han-
delt es sich dabei um technisch oder naturwissenschaftlich geschulte
Experten mit juristischer Zusatzausbildung oder vice versa. Die Zulas-
sung als Patentanwalt in der Schweiz setzt zum Beispiel einen natur-
oder ingenieurwissenschaftlichen Hochschulabschluss sowie mehrjh-
rige praktische Ttigkeit auf dem Gebiet des Patentrechts voraus (Art. 2
PAG13).

10 Vgl. Beier, Zukunftsprobleme des Patentrechts, Gewerblicher Rechts-


schutz und Urheberrecht (GRUR) 74 (1972), 214, 215.
11 Bezglich der Schweiz statt vieler Briner (Fn. 9), 51 ff. Fr das Technizi-

ttserfordernis in Europa und Deutschland exemplarisch Krefft, Patente auf


human-genomische Erfindungen. Rechtslage in Deutschland, Europa und den
USA, 2003, 61 ff.
12 Exemplarisch Emmott, No Patents on Life. The Incredible Ten-year
Campaign against the European Patent-Directive, in Tokar (Hrsg.), Rede-
signing Life? The Worldwide Challenge to Genetic Engineering, 2001, 373, 374:
a dry and dusty corner of the law.
13 Bundesgesetz ber die Patentanwltinnen und Patentanwlte vom 20.
Mrz 2009 (Patentanwaltsgesetz, PAG; SR. 935.62).
302 Hcki

Die exklusive Patentgemeinschaft (patent community)14 entwickelte und


pflegte im Verlaufe der Jahrzehnte eine eigenstndige Expertenkultur,
verbunden mit der Auslegungshoheit ber das Patentrecht und der
Entwicklung einer eigenen Dogmatik.15 So blieb aufgrund des unbe-
stimmten Erfindungsbegriffs die Diskussion ber den Kreis patentfhi-
ger Erfindungen whrend langer Zeit einer epistemischen Gemeinschaft
(epistemic community) des Patentrechts16 vorbehalten. Den Mitgliedern
dieser epistemischen Patentgemeinschaft kam als Experten im Rahmen
von Patentanmeldung, Patentprfung und Patenterteilung Autoritt zu.
Gleichzeitig bten sie dank ihres spezifischen Wissens groen Einfluss
auf die politischen Entscheidungstrger aus, denen es an hinreichenden
eigenen Fhigkeiten mangelte. Als illustratives Beispiel dient diesbezg-
lich die gesttzt auf Artikel 4 des Europischen Patentbereinkommens
von 1973 (EP)17 im Jahre 1977 gegrndete Europische Patentorgani-
sation (EPO).18 Mit verwaltungsmiger Selbstndigkeit ausgestattet
und autonom ber Anmeldungs- und Patentgebhren finanziert,19 ver-
eint die EPO legislative, exekutive und judikative Funktionen unter ei-
nem Dach. So verfgt der aus Vertretern der Vertragsstaaten meist

14 Drahos, Biotechnology patents, markets and morality, European Intellec-


tual Property Review (EIPR) 21 (1999), 441, 441 f.
15 Kritisch Godt, Eigentum an Information. Patentschutz und allgemeine
Eigentumstheorie am Beispiel genetischer Information, 2007, 503 f.
16 Zu den Merkmalen ep