regulated and implemented effectively, in accordance with the relevant national and international standards.” 197. The representative agreed with the Commission’s request and added that the Ecuadorian State should “adopt legislative and any other measures to strengthen the civil and criminal liability of doctors and health workers in Ecuador.” 198. For its part, the State affirmed that the Ecuadorian Organic Health Act, amended on January 24, 2012, regulated, among other matters, the exercise of the medical profession and the civil liability of health care professionals and health care services. 237 Consequently, it asked the Court “not to rule on these requests, because, as has been proved, currently structural changes are being put in place that benefit not only the family of the complainant, but all of society; in other words, the State is seeking to gradually achieve positive changes that lead to what is known as the good life or sumak kawsay.” 199. The Court observes that, in the Compliance Agreement, the State undertook “to enact or reform laws addressed at health care professionals [and] to present a bill that includes the pertinent reforms concerning medical malpractice and patients’ rights.” 200. In Chapter IX of this Judgment, the Court declared the violation of the obligation to guarantee the right to personal integrity of Melba Suárez Peralta by the effective supervision and control of the medical attention provided, in relation to Article 1(1) of the American Convention. However, it also indicated that the laws of the State of Ecuador at the time of the facts granted the corresponding State authorities the necessary powers to carry out this control, either as regards supervising the functioning of the public and private establishments, or supervising the exercise of the medical profession (supra para. 139). On this basis, the Court finds it unnecessary to order a measure of reparation in this regard. b) Request to provide health care professionals with responsibilities involved in the exercise of their profession training on the 201. The representative asked the Court to order the State “to adopt urgent measures to provide training to doctors and health personnel from public hospitals and private clinics, in human rights, criminal law, patients’ rights, and the case law of the Inter-American Court, so that the actions of these professionals are adapted to the international human rights obligations to which the Ecuadorian State is subject.” 237 The State indicated the following norms: Art. 191. The national health authority shall implement regulation and control procedures to avoid the practice of traditional medicine harming the health of the individual; Art. 192. The members of the National Health System shall respect and promote the development of alternative medicines within the framework of comprehensive health care. Alternative medicines must be exercised by health care professionals with recognized qualifications and certifications from CONESUP who are registered with the national health authority. The practice of alternative therapies shall require a license issued by the national health authority; Art. 196. The national health authority shall analyze all aspects of the training of human resources in the area of health care, taking into account local and national needs, in order to promote reforms in the education and training plans and programs of the institutions that train human resources in the area of health care; Art 201. It is the responsibility of the health care professionals to provide attention of quality, with warmth and efficacy, within their sphere of competence, seek the highest level of health of their patients and of the general population, respecting human rights and bioethical principles. It is their duty to demand the basic conditions to comply with the provisions of the preceding paragraph. Art. 202. A violation in the exercise of the health care professions is constituted by any individual and non-transferable, unjustified act that harms the patient and that results from: (a) failure to comply with the norms; (b) malpractice in the actions of the health care professional with partial or total absence of technical knowledge or experience; (c) recklessness in the actions of the health care professional, failing to provide the required care and diligence, and (d) negligence in the actions of the health care professional by the omission or an unjustified delay in his or her professional obligations; Art 203. The health care services shall bear civil co-responsibility for the actions of the health care professionals that it employs. 54