The applicant lodged an application for international protection on 13 February 2023 in the Netherlands. A EURODAC search revealed that the applicant had previously applied for asylum in Croatia on 2 February 2023. A transfer decision under the Dublin III regulation was taken on 20 June 2023 by the Minister for Asylum and Migration. The applicant appealed this decision before the District Court of the Hague seated in Roermond, and a request for interim relief was granted. The proceedings were stayed pending medical advice from the Bureau Medische Adviesing (BMA). The BMA issued its advice on 4 April 2025; however, the minister took an additional decision on 14 April 2025 upholding the transfer decision. Following this, the court requested up to date medical information from the applicant. The applicant complied and subsequently, the minister requested the proceedings to be stayed pending further medical advice from the BMA. The court granted the stay of proceedings and the BMA issued its advice on 8 October 2025. The court considered it necessary to refer questions to the CJEU for a preliminary ruling in order to resolve the dispute.

On appeal, the applicant argued that the principle of mutual trust cannot be relied on in respect of a Dublin transfer to Croatia and that based on his poor state of health, the transfer itself would result in a violation of Article 4 of the EU Charter in accordance with the CJEU Judgment, C.K. and Others v Republic of Slovenia (Case C-578/16 PPU, 16 February 2017).

The court noted that it did not dispute that the applicant suffered from a particularly poor state of health within the meaning of the C.K. judgment, in which the CJEU held that in circumstances where the transfer of an asylum seeker with a serious mental or physical illness would entail a real and proven risk of significant and irreversible deterioration in the applicant’s health, the transfer would constitute a violation of Article 4 of the EU Charter.

The court noted that the BMA’s advice declared the applicant fit to travel if certain travel conditions were met and held that according to national legal practice, when such travel conditions are fulfilled, it is assumed that the risk of a breach of Article 4 is eliminated. Therefore, the court noted that the question arose whether, considering the applicants situation and the risk of suicide linked to the possible transfer to Croatia, an examination limited to the actual conditions of travel is sufficient to assess the full impact of the transfer.

It also referred to the CJEU judgment in X v Staatssecretaris van Justitie en Veiligheid (C-69/21, 22 November 2022) in which the CJEU held that Articles 5 and 9(1)(a) of the Return Directive read in conjunction with Articles 1, 4 and 19(2) of the EU charter, must be interpreted as preventing the competent national authority from assessing the effect of the expulsion measure itself on the state of health of a third country national only for the purpose of examining whether the person is fit to travel, and questioned whether this same reasoning must also be applied even when the Dublin III Regulation is the basis for the removal.

The court stated that it is also faced with the question of whether the potential suspension of a transfer, especially its effects on the applicant’s health, should influence the legality of the transfer decision. Referring to the C.K. judgment, the court noted that Article 4 of the EU Charter is an absolute prohibition, however, it held that if a transfer would currently pose such a risk, the authorities are entitled to consider postponing it within the permissible time frame. The court thus required clarification from the CJEU on when medical evidence shows that uncertainty about the transfer could seriously worsen the applicant’s mental health or hinder effective treatment, the transfer period must be shortened or the transfer barred entirely. It stated that this specific issue was not answered in C.K., which only confirmed that Member States may, but are not required to use Article 17 on discretionary clause to take responsibility for the asylum application.

The court noted that it required further clarification regarding the assessment framework set out by CJEU in the C.K judgment, holding that in view of the absolute nature of the principle of non-refoulment, a further clarification of what is meant by ‘the impact of the transfer’ would be necessary and whether all the consequences of the adoption of the transfer decision on the applicants health must be considered in the judicial review of the transfer decision.

The court highlighted that even if no deterioration in the applicant’s health occurs before, during or after the transfer, the suspension of the transfer and the uncertainty it creates could independently result in inhuman or degrading treatment. It therefore asks whether the entire impact of the transfer decision, including uncertainty during suspension, must be assessed on appeal, particularly where medical evidence shows that the mere prospect of transfer hinders treatment and makes improvement unlikely.

The court clarified that its questions do not concern discretionary powers under Article 17 of the Dublin III Regulation or the principle of mutual trust regarding healthcare standards in the responsible Member State. Instead, the questions relate to the responsible state’s obligation to examine the asylum claim when the transfer decision itself, under Articles 1, 4, and 47 of the EU Charter, creates a risk of inhuman or degrading treatment. Given the fundamental nature of human dignity and the absolute ban on refoulement, the court asks how the interpretation of Article 4 in the C.K. judgment should apply since Article 47 of the EU charter guarantees the fundamental right to an effective remedy, noting that limiting judicial review only to the ability to physically transfer could prevent full protection of human dignity and compliance with the non-refoulement principle.

The district court therefore referred the following two questions to the CJEU for a preliminary ruling:

1. Is Article 4 of the EU Charter, read in conjunction with Article 47 of the EU Charter, Article 27(1) of the Dublin III Regulation and Articles 43(1)(a) and (b) of the AMMR, to be interpreted as meaning that a third-country national may be transferred under these regulations only if it is not possible that the impact of the transfer decision entails a real and proven risk that that third-country national will become  subjected to inhuman or degrading treatment within the meaning of Article 4 of the EU Charter? In particular, does Article 4 of the Charter preclude the competent national authority, including the judicial authority, from taking into account the impact of the transfer decision on the state of health of that third-country national solely for the purpose of examining the fitness of the third-country national to travel?
2. Are Articles 1 and 4 of the EU Charter, read in conjunction with Article 47 of the EU Charter, Article 27(1) of the Dublin III Regulation and Articles 43(1)(a) and (b) the AMMR, to be interpreted as meaning that the judicial authority reviewing the lawfulness of a transfer decision is required, if necessary of its own motion, to declare that the transfer is absolutely prohibited under these regulations and cannot be suspended if it is apparent from objective evidence that the suspension of the transfer would in itself entail a real and proven risk of a significant and irreversible deterioration in the state of health, or must be regarded as incompatible with human dignity?