The case of Bielau v. Austria addresses a key legal conflict surrounding the limits of online free speech in the context of medical professionals providing public information. In this case, Dr. Klaus Bielau, an Austrian general practitioner and advocate of holistic medicine, was subjected to disciplinary proceedings for publishing controversial statements about the ineffectiveness of vaccines on his website. The European Court of Human Rights (ECtHR) ruled on the matter on August 27, 2024, upholding the disciplinary sanction imposed by Austrian authorities, despite the doctor’s appeal under Article 10 of the European Convention on Human Rights, which guarantees the right to freedom of expression.

Dr. Bielau’s website had presented a skeptical view of vaccinations, questioning the existence of pathogenic viruses and making claims such as “vaccinations never protect against diseases.” These statements, deemed scientifically untenable by expert medical authorities, were found to contradict established medical science and the public health consensus. In response, Austrian medical authorities imposed a suspended fine of €2,000 on Dr. Bielau, with the fine only coming into effect if he committed similar disciplinary offenses within a one-year probationary period. The doctor contested the disciplinary action, arguing that his statements fell under his right to free speech, as he was merely encouraging healthy skepticism and alternative approaches to medicine. The Court found that the disciplinary sanction imposed on Dr. Bielau was indeed justified. The central issue was that as a practicing doctor, Dr. Bielau had a professional duty to provide accurate and objective information to the public. His website, linked to his medical practice, was not just a platform for personal opinion but was also viewed as an extension of his professional role. This distinction played a crucial role in the Court’s analysis, as it recognized the potential harm that unverified or false medical information could cause if disseminated by someone in a position of public trust like a doctor. The Court noted that doctors have a heightened responsibility when making public statements about medical issues due to the trust patients place in their expertise.

The Court’s decision in this case raises several important legal and ethical issues related to free speech, particularly when it intersects with public health and the responsibilities of professionals. First, it reiterates that freedom of expression, while a fundamental right, is not absolute. Article 10 of the Convention allows for certain restrictions on free speech i. e. if they are “necessary in a democratic society,” particularly for reasons such as protecting public health or the rights of others. Vaccinations, in particular, have been widely recognized as one of the most effective public health interventions available. The World Health Organization (WHO) has consistently emphasized the crucial role vaccines play in preventing disease outbreaks and maintaining public health. According to the Court, in this context, Dr. Bielau’s statements not only misrepresented scientific facts but also had the potential to mislead individuals and discourage vaccination, thereby posing a direct risk to public health. The Court referenced its prior decision in Vavřička and Others v. Czech Republic, where it noted the broad consensus on the importance of vaccines in protecting the population from preventable diseases. According to the Court, doctors, by virtue of their training and expertise, hold a privileged position in society. Their statements, especially on health-related matters, carry considerable weight and influence. This position of trust creates a duty to communicate responsibly, ensuring that the public receives scientifically accurate and objective information. The Court recognized that while medical professionals have the right to participate in public debates, including expressing critical or minority views, such contributions must be made in a manner that does not endanger public health or undermine the trust placed in the medical profession. The Court also addressed the proportionality of the sanction imposed on Dr. Bielau. It found that the fine of €2,000, which was suspended pending a probationary period, was relatively modest given the possible range of disciplinary measures, which could have included a temporary or permanent ban on practicing medicine. The suspended nature of the fine further mitigated the severity of the sanction, as it would only be enforced if Dr. Bielau committed further infractions within the probationary period. This aspect of the ruling underscored that the Court viewed the disciplinary action as a measured response aimed at ensuring compliance with professional standards without unduly stifling freedom of expression.

Interestingly, one judge, Faris Vehabović, dissented, arguing that the restriction on Dr. Bielau’s freedom of expression was disproportionate. He emphasized that the doctor’s statements encouraged skepticism and critical thinking rather than promoting outright rejection of vaccines. In his view, the sanction amounted to unnecessary censorship of a minority viewpoint in a democratic society, which should allow for the free exchange of ideas, including unconventional ones. This dissent also highlights a broader debate about the role of alternative medicine and unconventional views in public discourse. While mainstream medicine is grounded in evidence-based practices, there is a persistent interest in alternative approaches to health and wellness. The question arises: to what extent should medical professionals be allowed to express views that fall outside the conventional framework, especially when such views may contradict established public health policies?

In legal cases involving medical facts, the court’s role is not to establish scientific truths as absolute but rather to evaluate how medical information is communicated and the potential harm caused by its dissemination. Courts can rule on whether certain statements about medical issues are misleading or harmful, but they should refrain from declaring a particular scientific position as definitive. This is because science, by its nature, evolves as new evidence emerges. Instead, the court may focus on whether the speech in question has been responsibly conveyed to the public or if it constitutes misinformation that could result in tangible harm. In such cases, the legal judgment is less about resolving scientific debates and more about assessing the consequences of how these differing medical opinions are represented in the public domain. Therefore, the court does not decide scientific truths; it evaluates the impact of presenting varying medical perspectives in a way that may mislead or endanger the public.

While individuals, including medical professionals, are entitled to hold and express divergent views, those rights are not unfettered, particularly when public health is at stake. In the case of vaccinations, which play a critical role in preventing the spread of infectious diseases, the state has a compelling interest in ensuring that the public receives accurate and reliable information. This decision reaffirms the principle that freedom of expression can be restricted when necessary to protect public health, particularly when statements are made by professionals who have a duty to provide accurate information. It underscores the importance of maintaining trust in the medical profession and ensuring that public health policies are not undermined by the spread of misinformation. While alternative viewpoints are an essential part of democratic discourse, they must be presented responsibly, especially when they have the potential to influence public behavior in ways that could harm overall societal well-being.

János Tamás Papp, PhD is an assistant professor at Pázmány Péter Catholic University, Hungary and a research expert at the National Media and Infocommunications Authority of Hungary. He earned his JD and PhD in Law at the Faculty of Law and Political Sciences of the Pázmány Péter Catholic University where he has taught civil and constitutional law since 2015 and became a founding member of the Media Law Research Group of the Department of Private Law. His main research fields are freedom of speech, media law, and issues related to freedom of expression on online platforms. He has a number of publications regarding social media and the law, including a book titled „Regulation of Social Media Platforms in Protection of Democratic Discourses”