Guarding the child’s health: Legal and ethical tensions in newborn screening in Türkiye

Abstract

Newborn screening through heel-prick blood sampling is a routine public health intervention in Türkiye. However, in recent years, a growing number of parental refusals have led to legal disputes, raising questions about decision-making on behalf of children, legal basis and obligation of the interventions, and the protection of children's best interest. This article examines the legal and ethical dimensions of heel-prick newborn screening in Türkiye, with a particular focus on Constitutional Court decisions and their implications for public health policy, parental rights, and protecting the child’s best interest. Using a descriptive legal-ethical analysis, the article reviews four recent rulings by the Turkish Constitutional Court concerning parental refusals of heel-prick testing. The analysis considers these cases within the broader context of the principles of legality, legitimate aim, proportionality, and the best interests of the child. Comparative legal examples from international jurisprudence are also discussed. The Court upheld the legitimacy of the Newborn Screening Programme and recognized the state's duty to protect child’s health. However, it also acknowledged legal ambiguities, the lack of explicit statutory mandates requiring parental compliance, in particular. The contradiction between providing a formal mechanism for refusal and subsequently overriding those refusals through court orders highlights a gap in legal coherence. To ensure consistency, transparency, and respect for both parental autonomy and child’s welfare, Türkiye must revise its legal and administrative framework for newborn screening. Explicitly defining the mandatory status and scope of heel-prick testing is essential to strengthening public trust and upholding children’s health rights within a democratic legal order.