Denial of access to sexual and reproductive health services in Europe: an analysis of cases from the European court of human rights (1976-2023).

In June 2021, the European Parliament agreed to ensure universal and adequate access to high-quality sexual and reproductive health (SRH) care and to promote SRH education in all European Member States, in accordance with the European Convention on Human Rights. The aim of this research was to systematically pursue a qualitative analysis of applications concerning the denial of access to SRH services which have been brought before the European Court of Human Rights (ECtHR) up to December 2023 from an ethical perspective. A systematic search of judgments by the ECtHR was conducted in the HUDOC database using a combination of keywords resulting in nine thematic search categories. A thematic analysis approach was then used to describe and interpret the judgments through the lens of intersectionality and according to the four bioethical principles of “autonomy”, “beneficence”, “non-maleficence” and “justice”. N = 23 judgments from n = 15 EU Member States of the Council of Europe that met the research objectives were included in the descriptive analysis. These confirmed the violation of Articles 3, 5, 8 and 10 of the Convention. Violations of SRH services are indicators of social and public health policies that increase the vulnerability of marginalised groups. Our analysis shows that the discourse on access to SRH needs to shift from reproductive choices being unavailable to marginalised people to reproductive rights. Given the complexity of scientific advances in biomedicine and in response to evolving reproductive health needs, SRH services in Europe need to be monitored by the EU to secure equitable and non-discriminatory access.