Commentary on the Judgment of the Grand Chamber of the European Court of Human Rights in the Case of Pindo Mulla v. Spain Dated 17 September 2024

The commented judgment of the Grand Chamber of the European Court of Human Rights in the case of Pindo Mulla v. Spain concerns a judicial authorization for a blood transfusion administered to a member of the Jehovah’s Witnesses in an emergency situation, despite her formally and repeatedly expressed wish — based on religious beliefs — not to undergo a transfusion under any circumstances. The applicant lodged a complaint under Articles 8 (right to respect for private life) and 9 (freedom of thought, conscience, and religion) of the European Convention on Human Rights. The Court held that the complaint under Article 9 fell within the scope of Article 8 and found a violation of this provision under its procedural limb, focusing primarily on procedural shortcomings. The Court’s reasoning is based on the idea that, although Article 8 does not explicitly impose procedural requirements, the decision‑making processes affecting private life must be fair and ensure due respect for the protected interests. The judgment addresses complex issues at the intersection of philosophy, religion, health, law, and morality. According to the Court, the rejection of a blood transfusion cannot be equated with a rejection of life itself but rather constitutes an exercise of the right to therapeutic self‑determination. Consequently, the patient’s choice cannot be considered unlawful; instead, it represents an expression of religious freedom. At the same time, a refusal of treatment must not only reflect the patient’s clear and unequivocal will but must also remain relevant, ensuring a fair balance between two fundamental rights: on the one hand, the right to health and life, and on the other, the right to religious freedom and self‑determination. While the tenets of any belief system may be respected due to their religious nature, this does not preclude individuals from exercising free choice, making autonomous decisions by weighing the values of life and health against certain religious doctrines based on their merits.