Amid the weakening of constitutional safeguards in Slovakia, the recently amended Statute on Healthcare now allows a person authorised to perform clerical activities to enter an institutional health care facility, provided that their presence does not disrupt care activities. At face value, it aims to ensure the patient’s right to spiritual care in institutional health care facilities, especially in serious life situations where the presence of clergy is said to be irreplaceable in a holistic model of care. Crucially, however, the Statute omits any reference to a patient’s request and consent – a silence that sits at the centre of this post. By inviting clergy into clinical spaces without spelling out that patients can refuse, withdraw, or set limits on such visits, the law trades clarity for ambiguity and pushes real protection into the uncertain realm of future court interpretation. In a place where patients are sedated, frightened, or dependent on staff for even the smallest needs, that ambiguity matters. It creates a grey zone in which unsolicited spiritual contact – and, at the margins, improper proselytism – can take root. Arguably, Article 9 ECHR does not tolerate that kind of vagueness in such a vulnerable environment. For Slovakia to make this regime Convention-proof, the Statute must directly state that access is based on explicit patient consent, which can be refused or withdrawn at any time, and that clergy have no automatic right to the bedside.

The lack of consent in context

After the amended Statute was adopted in June 2025, critics condemned both the method and the wording. The former embedded the change within a larger education reform, while the latter created a statutory right of entry, omitting consent requirements. Moreover, a refusal of entry by a healthcare facility is now even fined up to EUR 500. SaS MP Cigániková from the opposition characterised the law as a doorway to uninvited clerical presence even in gynaecological and paediatric wards, warning about priests appearing as a ghost in intimate, emotionally loaded settings and raising the spectre of pressure on women seeking lawful abortions, as well as exposure of sensitive medical details to non-medical personnel. On the other end, KDH’s Stachura dismissed the opposition’s interventions as theatre, insisting that abortion procedures are scheduled and secured, with only competent persons having access, not phantom clerics haunting operating areas. The Health Minister tried to defuse the uproar, promising ministry guidance that visits will be only on request and refusable by patients. In the same vein, the Catholic Bishops’ Conference emphasised that “[n]o clergyman will provide spiritual care without the patient’s consent”, that they do not have a right to view medical records, and that the change mainly removes visitor obstacles so that requests can be met even outside visiting hours. At the level of lived practice, hospital chaplains describe years of strictly consent-based work: “I have always visited patients with their permission and at their express request. If the patient refused us, we respected their decision,” one priest recounts; the point, he says, is “for the patient’s good”.

The change in light of Article 9 ECHR

How does this legislative change align with Slovakia’s obligations under the European Convention on Human Rights (ECHR)? This is relevant, as pursuant to Article 7(5) of the Slovak Constitution, international human-rights treaties take precedence over domestic law (once ratified and promulgated). Slovakia must therefore apply the ECHR directly where relevant. Article 9 ECHR protects both the forum internum – the absolute right to hold beliefs – and the manifestation of religion “in worship, teaching, practice and observance,” which may be limited when “prescribed by law” and “necessary in a democratic society” to protect legitimate aims such as the rights and freedoms of others (Guide to Article 9, para 27). The Court has consistently framed Article 9 as one of the “foundations of a ‘democratic society,’” a guarantee that in its religious dimension “is one of the most vital elements that go to make up the identity of believers” and on the flip side as “a precious asset for atheists, agnostics, sceptics and the unconcerned.” (Kokkinakis v. Greece, para 31, see also Lewis, p 401, Murdoch, p 41). Hence, Strasbourg has drawn a line between, for instance, the legitimate activities of a Christian Witness and improper proselytism – offering material or social advantages, applying undue pressure, or exploiting vulnerability, i.e. conduct not compatible with respect for the freedom of thought, conscience and religion of others (Kokkinakis, para 47, 48). In short, as Murdoch puts it, Article 9 protects against improper proselytism (p 21). In Larissis and Others v. Greece, the Court extended this logic to structurally coercive environments such as the military, where approaches by officers to subordinates risked exerting undue or abusive pressure. The convictions for improper proselytism were upheld on account of the power imbalance intrinsic to the setting.

Further points of Strasbourg doctrine are crucial in the present context. First, the Court recognises positive obligations. States need to enable access to ministers of religion so that the right to manifest faith is guaranteed in practice (see Article 9 Guide, para 273ff). The Pastoral case for the Slovak amendment is in line with that obligation, and the parliamentary report’s language about psychological balance at the end of life resonates with Strasbourg’s sensitivity to closed or controlled institutions. However, the Court also insists on State neutrality and pluralism in public institutions, which describes the negative aspect of Article 9 – the right not to be subjected to unwanted religious activity sanctioned or facilitated by the State (Alexandridis v. Greece, para 32, 38; see also Lautsi and Others v. Italy on neutrality in public-school classrooms).

Against that background, the amended Statute needs to be evaluated under the “quality of law” lens (see e.g. Ukraine and the Netherlands v. Russia, para 1267-1277). “Prescribed by law” is not a mere formality that can automatically overrule the obligations under human rights law simply because it is fulfilled. The respective law must be sufficiently foreseeable and precise to cabin discretion and to protect affected individuals against arbitrary interference, particularly where the setting is one of heightened vulnerability (Murdoch p 37-39). In hospitals, that is not an abstraction. Patients are often captive in their beds, in pain, or in shock. They may be minors or not in a clear state of mind. They may be facing agonising choices. A legal framework that textually opens the hospital door to clergy and threatens administrative fines for providers who resist, without further conditions, raises significant concerns. As the Court stressed in C.G. et al v. Bulgaria, “domestic law must be accessible and foreseeable, in the sense of being sufficiently clear in its terms to give individuals an adequate indication as to the circumstances in which and the conditions on which the authorities are entitled to resort to measures affecting their rights under the Convention” (para 39).

The Statute, as formulated now, falls short of that standard: its lack of consent-based safeguards and clear operational conditions creates a real risk of arbitrary or unsolicited clerical presence in clinical settings. It further fails to clarify that clergy have no right to access or overhear medical confidential consultations, and that clergy are barred from clinical spaces during examinations or procedures absent explicit consent. Ministerial assurances to the contrary cannot remedy deficiencies at the level of primary legislation, as informal guidance does not satisfy the Convention’s demand for stability, foreseeability, and effective protection. Although domestic courts must interpret the Statute in conformity with the Charter (Art. 7(5) Slovak Constitution), relying on post hoc judicial interpretation cannot remedy the core problem. Namely, the legislative silence on consent reduces legal predictability, prolongs potential conflicts, and leaves patients exposed to uncertainty until jurisprudence eventually clarifies the point.

Such ambiguity, particularly in clinical environments marked by vulnerability, also opens grey zones in which unsolicited spiritual approaches may edge into the kind of pressure or improper proselytism that Strasbourg jurisprudence warns against. Whilst a hospital bed is not a barracks, the structural vulnerability of a sedated patient, an anxious adolescent, or someone in post-operative recovery, is real. The Kokkinakis Court’s description of “improper proselytism” explicitly includes exerting pressure on “people in distress or in need,” as incompatible with respect for the freedom of others (para 48). The more the Slovak government allows unsolicited bedside approaches in sensitive wards, the more it enables the very scenario Kokkinakis warns against.

On the flip side, the government argues that this is a false fear. “No clergyman will provide spiritual care without the patient’s consent,” the Conference of Bishops likewise insists. Clergy are trained; they cannot access records; they simply gain the ability to respond when called, even outside visiting hours. That sounds precisely like what Strasbourg would expect from a well-tuned positive-obligation system. However, the problem here is one of legal certainty. As things stand, those guarantees are words of informal promises rather than clearly spelled obligations under the Statute. Crucially, they are not obvious to the vulnerable patient who needs them most. To borrow and bend Trindade: “Words, words, words… where are the [safeguards]?” (para 249).

A narrow legislative fix

A possible remedy is in sight. Slovakia should amend the provision under §79(23) to codify that the presence of clergy can occur only upon the explicit request of the patient (or of a lawful representative where the patient lacks capacity). Moreover, any previously given consent can be withdrawn at any time and must be respected. Furthermore, clergy have no right to view medical records or to be present during examinations or procedures absent prior, specific consent. Finally, visits are mediated through staff to ensure no interference with clinical care. Those four safeguards would bring the regime within the Convention’s requirement of neutrality and legal certainty in public institutions, render them effective in practice (Article 9 Guide, para 175; see also the ICCPR’s parallel, rights-protective reading in General Comment No. 22). They would also mirror the Court’s established approach to balancing interests: protecting the genuine manifestation of rights when others’ rights are not at risk (Eweida, para 106), and imposing stricter limits when clinical safety or the rights of others require it (Eweida, para 109).

Conclusion

On paper, the amended Statute has created a general right of entry for clergy into hospitals. In the public discourse, ministers and bishops tell patients that “nothing will happen without your consent”. Strasbourg, however, has made clear for decades that when the State enters the terrain of conscience in public institutions, intent is not enough – the law must protect. It was in Kokkinakis, where the Court first insisted on respecting the freedom of others in moments of vulnerability (para 48). If Slovakia’s government wants the new Statute on Healthcare to align with human rights jurisprudence, it should codify the consent-first safeguards that its ministers and clergy already profess in practice.

All translations from Slovak into English are the authors’ own and are provided for informational purposes only. They do not constitute official or authoritative translations. The authors would like to thank Wim Zimmermann and Sara Wissmann for feedback on earlier draft versions of this post. 

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