PREMATRIMONIAL, VISIT. — A medical examination imposed or recommended, according to the various nations, upon those intending to marry, involving the issue of a “premarital medical certificate,” mandatory in certain States in order to proceed with the celebration of the marriage. The premarital examination forms part of the complex eugenic measures whose purpose is to improve the population, particularly those termed “negative,” because they tend to eliminate the birth of individuals who are sick or otherwise unsuited to social life.
In comparison with other means that are far more injurious to freedom and personal dignity, and intrinsically more unlawful, the measure under consideration is open to various criticisms from the moral point of view, depending on the conclusions and practical sanctions associated with II.
The purpose of the premarital examination is to ascertain the state of health of the future spouses, in particular the absence of contagious diseases or existing pathological conditions, and of mental or physical illnesses transmissible by heredity. In America, this form of marriage control has been widely implemented, especially in relation to syphilis: seventeen States require anyone wishing to marry to submit a medical declaration certifying that he is free from this disease, while others require such a declaration for all venereal diseases; some impose a medical examination, whereas others require only a medical certificate. In many States the restriction is extended to tuberculosis and mental disorders, particularly in North America; in South America, because of the predominance of the Catholic element, the restrictions are much more limited.
Europe, too, has adopted such precautionary measures, although not to an equal extent in the various nations. Among the first, Sweden should be mentioned: in 1915 it introduced the obligation of the premarital certificate, with severe penalties for violators, extending even to annulment of the marriage. In 1907, in Germany, the “Society for Racial Hygiene” began a campaign for the health control of marriages, proceeding from the concept that it is the duty of the State to limit the fertility of the weaker, while requiring it of the stronger (this path led to the aberration of sterilization and State breeding). In 1920, again in Germany, the National Assembly established that civil-status offices should require the exchange of health certificates between the spouses, with penalties for offenders; this requirement was intensified by the Hitler government. In 1919, Norway introduced a questionnaire to which engaged couples had to respond in order to be admitted to marriage. In 1922, the first premarital counselling centre was established in Austria, and the Hygiene Office undertook its promotion with posters that met with good results. Russia, by art. 131 of the 1934 law, prescribed a compulsory premarital certificate, with particular regard to venereal and mental diseases and tuberculosis, and severe penalties for offenders; Yugoslavia likewise introduced the compulsory certificate in 1935. France, which had already rejected such an institution for the second time in 1903, established in 1942 that engaged couples had to submit to the civil-status office a certificate showing that each of them had undergone a medical examination; this was not intended as a prohibition, but rather to place the parties before their own responsibility, so that, while safeguarding freedom, the sense of responsibility would be stimulated. In 1946, following repeated petitions by the “French Society of Eugenics,” those intending to marry were required to submit the reports of a radiological examination of the chest and of the Wassermann reaction. In Turkey, since 1930, marriage has been prohibited to anyone lacking a certificate attesting to the absence of venereal diseases. In Denmark, a declaration of the same condition is required on one’s word of honour.
In Italy, the issue emerged in 1920 within the “Italian Society of Dermatology and Syphilography,” which submitted to the Directorate-General of Public Health a draft regulation concerning the adoption of a prohibitive premarital certificate in cases of certain diseases. In June 1923, Prof. Cirisezione made the first proposal in the Chamber for a compulsory medical certificate for spouses, but without result. Since that time, the issue has been debated in various ways on the legislative front. In a bill submitted to the Senate on 28 Sept. 1949, concerning measures to combat venereal diseases and introduced on the initiative of Senator Monaldi, art. 7 refers to the duty of a consultative premarital examination.
On 19 Dec. 1949, a bill was announced in the Chamber of Deputies, introduced on the initiative of Mary Chiesa Tibaldi and others, for the establishment of premarital counselling centres. It rests on three principal points: 1° recognition of the necessity of the premarital examination; 2° recognition of the necessity of the premarital medical certificate; 3° refusal to make the examination legally compulsory, but rather the “advisability of creating an awareness of the problems of marriage and offspring” and of conducting the widest possible propaganda concerning the usefulness of premarital counselling centres.
At present, there is a premarital prophylaxis counselling centre in Milan, already advocated by E. Alfieri as early as 1924 and founded at the Italian Red Cross on his initiative, together with L. Ronzoni and P. Malcovati. Also in Milan, a premarital counselling centre operates at the Opera card. Ferrari, with legal, medical and genetic sections, in association with the University’s Centre for Human Genetics, directed by Prof. L. Gianferrari. In Rome and Verona, a centre promoted by the “Family Front” operates on the same organizational plan.
With regard to the issue from the medical, medico-legal and moral points of view, the following considerations apply. From the medical point of view, there is no doubt that the premarital examination represents an effective means of combating the spread of serious diseases transmissible to the other spouse or to offspring, without violating the dignity of the human person; it also constitutes a legitimate intervention by the public authorities in defence of higher interests of a social nature (in the same way as compulsory vaccination and the reporting of infectious diseases), as well as of the right that every spouse has to know the other’s actual state of health. Therefore, even from the moral point of view, there is nothing objectionable in the possible compulsory nature of the premarital examination. In order, however, to assess within proper limits the possible harm caused by certain pathological conditions to offspring, the limited and relative nature of our knowledge concerning the phenomena of heredity must be kept in mind (v. EUGENICA).
The question appears different from the moral point of view when the examination entails the compulsory completion of a medical certificate, when its exchange between the future spouses is mandatory, or when the authorities impose sanctions or impediments on account of particular diseases. While the moral liceity of a legal obligation to obtain the premarital certificate and to exchange it between the future spouses would seem admissible, in accordance with the moral duty of each party to disclose any hidden defects capable of compromising the validity of the marriage and family happiness, every sanction or prohibition imposed by the State—temporary or permanent—against celebrating the marriage in cases where the premarital examination does not meet certain requirements must be considered morally unlawful. Such an imposition would violate the attributes of the human person and would infringe “man’s natural right to ...”
contrarre matrimonio» (Pio XI, Casti connubii). Inoltre tale istituzione, di diritto divino e non umano, è retta e riconosce impedimenti solo dal primo e da quello canonico, essendo di competenza civile solo gli effetti civili del matrimonio (CIC, cann. 1016, 1038). Trattandosi di matrimonio tra non battezzati sembra che lo Stato possa lecitamente porre impedimenti temporanei, proibendo il matrimonio finché perdurino determinate circostanze.