PREMARITAL MEDICAL EXAMINATION. – A medical examination imposed or recommended, according to the laws of various countries, on those intending to marry, which involves the issuance of a “premarital medical certificate,” mandatory in some States before the marriage can be celebrated. The premarital medical examination is part of the complex eugenic measures aimed at improving the population, particularly those termed “negative” because they seek to prevent the birth of individuals who are sickly or otherwise unfit for social life.
Compared with other means that are far more damaging to freedom and personal integrity and intrinsically illicit, the premarital medical examination is subject to varying moral criticism depending on the conclusions and practical sanctions attached to II.
The purpose of the premarital medical examination is to ascertain the health status of the prospective spouses, particularly the absence of contagious diseases or active morbid conditions, mental or physical infirmities, or hereditary transmissible defects. In America, such control over marriage has been widely implemented, especially regarding syphilis; seventeen States require prospective spouses to provide a medical declaration attesting to their immunity from this disease, while others require it for all venereal diseases; some impose a medical examination, while others require only a medical certificate. In many States, restrictions extend to tuberculosis and psychological defects, particularly in North America; in South America, due to the prevalence of the Catholic element, restrictions are much more limited.
Europe has also adopted such precautionary measures, though not to the same extent in all nations. Among the first was Sweden, which in 1915 established the mandatory premarital certificate with severe penalties for violators, including annulment of the marriage. In 1907, Germany’s “Society for Racial Hygiene” launched a campaign for the sanitary control of marriages, based on the principle that it is the State’s duty to limit the fertility of the weak while encouraging that of the strong (a path that led to the aberration of sterilization and State-controlled breeding). In 1920, Germany’s National Assembly decreed that civil registry offices require the exchange of health certificates between spouses, with penalties for transgressors; this requirement was intensified under the Hitler regime. In 1919, Norway introduced a questionnaire that fiancés had to complete to be permitted to marry. In 1922, Austria established the first premarital consultation office, and the Public Health Office launched a propaganda campaign with posters that achieved good results. Russia, under Article 131 of the 1934 law, prescribed mandatory premarital certificates, with particular regard to venereal diseases, mental illness, and tuberculosis, and severe penalties for violators; Yugoslavia also introduced mandatory premarital certificates in 1935. France, which had already rejected such an institution in 1903, established in 1942 that fiancés had to present to the civil registry office a certificate attesting that each had undergone a medical examination—not to prohibit marriage but to impress upon the parties their responsibility, thereby safeguarding freedom while stimulating a sense of responsibility. In 1946, at the urging of the “French Eugenics Society,” applicants for marriage were required to submit the results of a chest X-ray and a Wassermann test.
In Turkey, since 1930, marriage has been prohibited for those lacking a certificate attesting to the absence of venereal disease. In Denmark, a sworn declaration of the same condition is required.
In Italy, the issue emerged in 1920 within the “Italian Society of Dermatology and Syphilography,” which submitted a draft regulation to the General Directorate of Public Health regarding the adoption of a prohibitive premarital certificate in cases of certain diseases. In June 1923, Prof. Cirincione presented the first proposal to the Chamber of Deputies for a mandatory medical certificate for spouses, but it came to nothing. Since then, the matter has been debated in various legislative proposals. In a bill introduced to the Senate on September 28, 1949, concerning measures to combat venereal diseases, initiated by Senator Monaldi, Article 7 refers to the duty of a consultative premarital examination.
On December 19, 1949, a bill was announced in the Chamber of Deputies, initiated by Mary Chiesa Tibaldi and others, for the establishment of premarital consultation offices, based on three main points: 1) recognition of the necessity of premarital examination; 2) recognition of the necessity of the premarital medical certificate; 3) no legal obligation to make the examination mandatory, but rather “an opportunity to raise awareness of the problems of marriage and progeny” and to promote the usefulness of premarital consultation offices.
Currently, a premarital prophylaxis consultation office exists in Milan, first advocated by E. Alfieri in 1924 and founded at the Italian Red Cross through his initiative, along with L. Ronzoni and P. Malcovati. Similarly, in Milan, a premarital consultation office operates under the Cardinal Ferrari Foundation, with legal, medical, and genetic sections, in collaboration with the University’s Human Genetics Center, directed by Prof. L. Gianferrari. Premarital consultation offices with the same organizational structure also operate in Rome and Verona, promoted by the “Family Front.”
Regarding the matter from medical, medico-legal, and moral perspectives, the following considerations apply. From a medical standpoint, there is no doubt that the premarital examination is an effective means of combating the spread of serious diseases transmissible to the other spouse or to offspring, without violating human dignity. It represents a legitimate intervention by public authority in defense of higher social interests (akin to the obligation of vaccinations and the reporting of infectious diseases) and the right of each spouse to know the actual health condition of the other. Therefore, from a moral standpoint, there is nothing to object to regarding the possible mandatory nature of the premarital examination.
However, when the examination entails the obligation to compile a medical certificate, its mandatory exchange between prospective spouses, and the imposition of sanctions or impediments by the authorities for the presence of certain diseases, the moral question becomes more complex. While the legal obligation of the premarital certificate and its exchange between the parties may be morally licit—consistent with the moral duty of each party to disclose any hidden defects that could compromise the validity of the marriage and family happiness—any State-imposed sanctions or prohibitions, whether temporary or permanent, on marriage due to a premarital examination failing to meet certain requirements must be considered morally illicit. Such measures would violate the attributes of the human person and infringe upon “the natural right of man to contract marriage” (Pius XI, *Casti connubii*). Furthermore, since marriage is a divine institution and not merely a human construct, it is governed by divine and canonical law alone, with civil authority limited to regulating its civil effects (CIC, can. 1016, 1038). In the case of marriage between unbaptized persons, the State may licitly impose temporary impediments, prohibiting marriage as long as certain circumstances persist.