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Bolivia August 15, 2014 REPORT NO. 72/14 CASE 12.655 MERITS I.V. BOLIVIA AUGUST 15, 2014 I. SUMMARY......................................................................................................................................................................2 II. PROCESSING SUBSEQUENT TO ADMISSIBILITY REPORT ............................................................................ 3 III. POSITIONS OF THE PARTIES .................................................................................................................................. 4 A. The Petitioner .............................................................................................................................................................4 B. Position of the State .................................................................................................................................................. 8 IV. PROVEN FACTS ........................................................................................................................................................ 11 1. The surgical tube ligation procedure performed on I.V. ......................................................................................11 2. Bolivian regulations regarding informed choice and consent ...........................................................................12 3. Physical effects of the surgical procedure on I.V. ....................................................................................................13 4. Medical audits and administrative proceedings with respect to the alleged facts ................................... 13 5. Criminal Proceedings ...........................................................................................................................................................15 6. The nature of the surgical sterilization procedure to which I.V. was subjected ........................................ 19 V. ANALYSIS OF THE LAW .............................................................................................................................................. 20 A. Background definitions and preliminary considerations ....................................................................... 20 B. The right to personal integrity (article 5.1 of the American Convention) in relation to Article 1.1 of the American Convention .................................................................................................................................. 20 C. The right to access to information (Article 13.1 of the American Convention), in relation to Article 1.1 of the American Convention .................................................................................................................... 23 1. The right to access to information for the selection of healthcare services ................................................ 24 2. Informed consent in sexual and reproductive matters ........................................................................................26 3. Analysis of the instant case ...............................................................................................................................................29 D. The right to privacy (article 11.2 of the American Convention) and right of the family (article 17.2 of the American Convention), in relation to article 1.1 of the American Convention .................... 31 1. The sterilization without consent and the right to a private and family life and to form a family ... 31 2. The sterilization without consent and gender-based discrimination ............................................................ 33 E. Right to a fair trial and right to judicial protection (Articles 8.1 and 25.1 of the American Convention, in conjunction with Article 1.1 of the American Convention) ................................................. 35 F. Article 7 of the Convention of Belém do Pará .............................................................................................. 37 VI. CONCLUSIONS ........................................................................................................................................................... 40 VII. RECOMMENDATIONS ............................................................................................................................................. 40 1 REPORT NO. 72/14 CASE 12.655 MERITS I.V.1 BOLIVIA I. SUMMARY 1. On March 7, 2007, the Inter-American Commission on Human Rights (hereinafter "the Inter- American Commission," "the Commission," or "the IACHR") received a petition filed by the Ombudsman (Defensor del Pueblo de la República de Bolivia, hereinafter "the petitioner") on behalf of I.V. (hereinafter "the alleged victim"), alleging that the State of Bolivia (hereinafter "the State" or "the Bolivian State") is responsible internationally for having subjected I.V. to a sterilization procedure without her consent. The judicial authorities also denied her access to justice to a remedy for the alleged violations of her rights. 2. The petitioners state that the facts described constitute violations of rights protected by Articles 5 (Right to Humane Treatment), 8 (Right to a Fair Trial), 11 (Right to Privacy), 13 (Freedom of Thought and Expression), 17 (Rights of the Family), and 25 (Right to Judicial Protection), in conjunction with the general obligations established in Article 1.1 of the American Convention on Human Rights (hereinafter "the American Convention" or "the Convention") They also allege violation of Article 7 of the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence against Women, (hereinafter "Convention of Belém do Pará”). 3. The petitioner maintains specifically that in 2000, the alleged victim was subjected in a public hospital to a surgical tubal ligation procedure without her informed consent, and therefore to sterilization without consent, as a result of which she suffered the permanent loss of her reproductive function. The petitioner argues furthermore that these acts have gone completely unpunished due to improper and unwarranted delays in the criminal proceedings and that I.V. is still suffering the physical and psychological consequences of the aforementioned procedure and of the alleged denial of justice. 4. For its part, the State argues that the sterilization procedure was carried out on I.V. because of the risk that another pregnancy would pose to her future life and that she consented orally to the procedure. It further argues that the alleged victim had access to appropriate judicial remedies to rule on possible legal liabilities. 5. On July 23, 2008, the IACHR examined the positions of the parties on the matter of admissibility and, without prejudging the merits of the case, decided to admit the claims set forth in the petition with respect to Articles 5.1, 8.1, 11.2, 13, 17, and 25 of the American Convention, in conjunction with the general obligations established in Article 1.1 of that instrument. It also admitted the claims regarding the alleged violation of Article 7 of the Convention of Belém do Pará and decided to continue analyzing the merits of the case. It also decided to publish Report No. 40/08, notify the parties thereof, and include it in its Annual Report. 6. In this report, after analyzing the claims and evidence adduced by both parties, the Commission concludes that Bolivia violated 5.1, 8.1, 11.2, 13, 17, and 25 of the American Convention, in conjunction with the general obligations established in Article 1.1 of that instrument, as well as Article 7 of the Convention of Belém do Pará. 1 The IACHR withholds the identity of the alleged victim (hereinafter “I.V.”) by virtue of an express request from the petitioner made on March 7, 2007. 2 II. PROCESSING SUBSEQUENT TO ADMISSIBILITY REPORT 7. On August 7, 2008, the Commission remitted Admissibility Report No.40/08 to the State and the petitioner. Pursuant to its Rules of Procedure, the Commission set a period of two months for the petitioner to submit additional observations on the merits. In addition, the Commission placed itself at the disposal of the parties should they be interested in reaching a friendly settlement. 8. On October 22, 2008, the Commission received a communication from the State with its observations on the exhaustion of domestic remedies and on the merits of the case. The State's observations were transmitted by the Commission to the petitioner on October 31, 2008, with a request for a reply within one month. 9. The Commission received the petitioner's comments on the State's report on January 5, 2009. In that communication, the petitioner conveyed his refusal to reach a friendly settlement. The Commission acknowledged receipt of the petitioner's observations on February 17, 2009 and granted another two months for submission of additional observations on the merits of the case, given that the information available indicated that no progress had been made toward a possible friendly settlement. It also transmitted the document containing the petitioner's observations to the State. 10. On May 26, 2009, the petitioners submitted additional observations on the merits of the matter. On May 29, 2009, the Commission acknowledged receipt of the petitioner's communication and forwarded it to the State, giving it two months to remit its observations. On August 19, 2009, the State asked the Commission for an extension of the deadline for the submission of its observations on the merits of the case. On September 3, 2009, the Commission granted
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