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Towards EU Sexual Risk Regulation: Restrictions on Blood Donation as Infringement of Active Citizenship

Published online by Cambridge University Press:  20 January 2017

Uladzislau Belavusau
Uladzislau Belavusau*
Affiliation:
European Law at the T.M.C. Asser Institute (The Hague) - University of Amsterdam
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Abstract

Case C-528/13, Léger v. Ministre des Affaires sociales, de la Santé et des Droits des femmes; Établissement français du sang [2015] ECLI: EU:C:2015:288 (Fourth Chamber).

In the case of Léger commented on, the Court of Justice of the European Union dealt with a blanket ban on blood donation for men who had sexual relations with other men (MSM) in France. The Court found that such restrictions can be justified in light of specific epidemiological context and scientific knowledge available in Member States. The judgment, therefore, sheds lights on the boundaries of public health justifications, discrimination of gay and bisexual individuals, as well as the rising scope of EU sexual risk regulation. The present annotation argues that the Court has undermined the principle of non-discrimination and shows how the matter of blood donations should have been treated instead as a prerequisite of active sexual citizenship.

“[T]he sanguine substance is intimately tied to both identity and public culture. Blood is a metaphor of life and of death; it fosters insider and outsider relations; it has economic clout and emblematic significance; these primal fluids are far from natural, organic, or self-evident, being imbued with cultural connotations reflecting imagined connectedness, tentative securities and demonstrable anxieties.”

Jefrey A. Bennet

Type
Case Notes
Information
European Journal of Risk Regulation , Volume 7 , Issue 4 , December 2016 , pp. 801 - 809
Copyright
Copyright © Cambridge University Press 2016

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References

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2- Case C-528/13, Léger v. Ministre des Affaires sociales, de la Santé et des Droits des femmes; Établissement français du sang [2015] ECLI: EU:C:2015:288.

3- Arrêté du 12 janvier 2009 fixant les critères de sélection des donneurs de sang, Ministère de la Sanlé et des Sports, available at: https://www.legifrance.gouv.fr/jo_pdf.do?numJO=0&dateJO=20090118&numTexte=23&pageDebut=01067&pageFin=01076

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13- Commission Directive 2004/33/EC of 22 March 2004 implementing Directive 2002/98/EC of the European Parliament and of the Council as regards certain technical requirements for blood and blood components.

14- Point 2.1 of Annex III to Directive 2004/33/EC. In the French version of this Annex, both permanent deferral (point 2.1.) and temporary deferral (point 2.2.2.) apply to persons whose sexual behaviour puts them at “risk” of acquiring diseases transmitted by blood. However, in some language versions of this instrument, while temporary deferral requires the presence of “risk”, permanent deferral requires a “high risk”. That is the case, in particular, in the Danish (stor risiko), English (high risk), Italian (alto risico), Dutch (groot risico) and Polish (wysokie ryzyko) versions of those provisions. Yet in other language versions, points 2.1. and 2.2.2. both refer to “high risk”, as in Spanish (alto resgo) and German (hohes Risiko). The Court found it logical that applicable criteria to permanent and temporary deferral must be different, despite the discrepancy amongst language versions (para. 36 in the Judgment).

15- CaseC-528/13 Léger, supra note 2, at para. 44.

16- CaseC-528/13 Léger, supra note 2, at para. 45.

17- CaseC-528/13 Léger, supra note 2, at para. 52.

18- CaseC-528/13 Léger, supra note 2, at para. 64.

19- CaseC-528/13 Léger, supra note 2, at para. 65.

20- CaseC-528/13 Léger, supra note 2, at para. 66.

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32- Just in the past 10 years, the FDA has changed its recommendations for donor deferral several times. The latest changes came in November 2014. According to this latest version, the 12-month deferral since the most recent sexual contact with another man is prescribed, inter alia, for MSM. Likewise, a recommendation is made to defer for 12 months since the most recent contact a female who has had sex in the past 12 months with a man who has had sex with another man in the past 12 months. For summary, seehttp://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/QuestionsaboutBlood/ucm108186.htm.

33- Ahmed, Aziza, “‘Rugged Vaginas’ and ‘Vulnerable Rectums’: The Sexual Identity, Epidemiology, and Law of the Global HIV Epidemic”, Columbia Journal of Gender and Law 26(1), 2013, at p. 25 Google Scholar. At the time epidemiologists isolated and promoted anal sex as the key mode of transmission of HIV amongst gay men. The vagina, to the contrary, was seen as a much stronger barrier for HIV infection to enter the body.

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36- About emancipation of various LGBT causes via EU law, see Belavusau, Uladzislau and Kochenov, Dimitry, “Federalizing Legal Opportunities for LGBT Movements”, in Slootmaeckers, Koen et al. (eds.), The EU Enlargement and Gay Politics (Palgrave, 2016), pp. 69–96 Google Scholar.

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38- E.g. in the United States 44% (19,540) of estimated new HIV diagnoses in 2014 were among African Americans, who comprise only 12% of the US population. See Center for Disease Control and Protection, HIV Surveillance Report, 26, 2014, available at: http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf. See also McCree, Donna Hubbard, Jones, Kenneth Terrill, O’Leary, Ann (eds.), African Americans and HIV/AIDS: Understanding and Addressing the Epidemic (New York: Springer, 2010)CrossRefGoogle Scholar.

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40- Sayare, Scott, “Amid Much Tumult, France Approves ‘Marriage for All’”, The New York Times (23 April 2013), available at: http://www.nytimes.com/2013/04/24/world/europe/france-approves-same-sex-marriage.html?_r=0 Google Scholar.

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42- Véran, Oliver, Rapport: La filiere du sang en France, (July 2013) available at: http://social-sante.gouv.fr/IMG/pdf/Rapport_Veran_filiere-sang.pdf Google Scholar.

43- Avis no. 123, Questionnement éthique et observations concernant la contre-indication permanente du don de sang pour tout homme déclarant avoir eu une ou des relation(s) sexuelle(s) avec un ou plusieurs homme(s) (2002), available at: http://www.ccne-ethique.fr/sites/default/files/publications/avis_ndeg123.pdf.

44- Ibid.

45- “Les conditions de l’ouverture du don de sang aux homosexuels, une « discrimination pure et simple »”, Le Monde, 5 November 2015, available at: http://www.lemonde.fr/sante/article/2015/11/05/les-associations-partagees-sur-les-conditions-de-l-ouverture-du-don-du-sang-aux-homosexuels_4803440_1651302. html.

46- On the general rise of risk regulation in EU law, see Alemanno, Alberto, EU Risk Regulation: Towards a European Government of Health, Safety and Environmental Risks (Oxford: Hart, 2017)Google Scholar. Risk regulation is becoming a new lens through which to analyse the European integration process.

47- Initially Directive 89/38/EEC.

48- Directive 2002/98/EC and the relevant implementing Directives 2004/33/EC, 2005/6/EC and 2005/62/EC.

49- For recent critique, see de Kort, Wim et al., “Blood Donor Selection in European Union Directives: Room for Improvement”, Blood Transfus, 14(2), 2016, pp. 101–108 Google Scholar. For a wide overview of the EU instruments in the area, see C-C/EAHC-EU Commission-EU Overview of the Landscape of Blood and Plasma / Creative Ceutical Executive Report Revised by the Commission to Include the Stakeholders’ comments, 2015, available at:http://ec.europa.eu/health/blood_tissues_organs/docs/20150408_cc_report_en.pdf.

50- Blutsicherheitsgesetz, 1999, para. 8(9).

51- C-421/09, Humanplasma [2010] ECLI:EU:C:2010:760.

52- Hervey, Tamara K. and McHale, Jean V., European Union Health Law: Themes and Implications (Cambridge: CUP, 2015), at p. 115 CrossRefGoogle Scholar. In its reasoning, the CJEU relied in part on the fact that blood safety Directive 2002/98/EC permits reimbursement of donors’ expenses and other small tokens of payment.

53- “Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions: Combating HIV/AIDS in the European Union and neighbouring countries, 2009-2013”, COM(2009)569, available at: http://ec.europa.eu/health/ph_threats/com/aids/docs/com2009_en.pdf.

54- “Action Plan on HIV/AIDS in the EU and Neighbouring Countries 2014-2016”, SWD(2014) 106, available at: http://ec.europa.eu/ health/sti_prevention/docs/ec_hiv_actionplan_2014_en.pdf.

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58- For a major œuvre in this area, see Alemanno, Alberto and Garde, Amandine (eds.), Regulating Lifestyle Risks: The EU, Alcohol, Tobacco and Unhealthy Diets (Cambridge: CUP, 2015)Google Scholar.

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60- Opinion of AG Mengozzi in Case C-528/13 Léger [17 July 2014] ECLI:EU:C:2014:2112, at para. 15.

61- Council Directive 2000/78/EC of 27 November 2000 establishing a general framework for equal treatment in employment and occupation, Official journal L 303, 02/12/2000 P. 0016 – 0022.

62- Opinion of Advocate General Jääskinen in C-147/98, Jürgen Römerv. Freie und Hansestadt Hamburg [15 July 2010] ECLI:EU:C:2010:425, para. 80, 146, 147.

63- Opinion of AG Mengozzi in Case C-528/13 Léger [17 July 2014] ECLI:EU:C:2014:2112,para. 62

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66- See my analysis in the case of C-81/12, Asociaţia ACCEPT [2013], in Belavusau, Uladzislau, “A Penalty Card for Homophobia from EU Non-Discrimination Law”, Columbia journal of European Law 21(2), 2015, pp. 237–259 Google Scholar.

67- See also para. 50 in the Opinion of AG Mengozzi in Case C-528/13 Léger [17 July 2014] ECLI:EU:C:2014:211.

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