13. At around 7:00 p.m., the petitioner claims that Dr. Edgar Torrico introduced himself to the alleged victim and informed her that he would carry out the surgery but that she should wait a little while longer. He states that I.V. asked the doctor whether the caesarian would be done at the same scar as the one before, to which he responded that he would decide it in the operation room that and that he would see her later. 14. The petitioner alleges that at around 8:45 p.m., I.V. was taken to the surgeon, prepared for the operation, and given an epidural anesthetic. He claims that during the operation, Dr. Torrico asked I.V. where she had had her first caesarian to which she replied that it had been done in Lima, Peru. He also asked her whether she had previously had an infection, to which I.V. replied in the negative. The petitioner alleges that these were the only questions made by the doctor to I.V. during the operation and that at no time was she told or asked anything relating to the ligature of the fallopian tubes. 15. The petitioner claims that I.V. asked the anesthetist to tell her what time her child would be born. He alleges that a short time afterwards, I.V. realized that the caesarean had taken place and she asked the time. The anesthetist answered that it was 9.26 p.m. The petitioner says that she saw her baby being handed to the neonatologist. He also says that at about 22.40 the alleged victim was taken into another room where she remained for about one hour. The petitioner alleges that throughout this process her partner and daughter remained at the hospital. 16. The petitioner adds that on July 2, 2000, at around 9.30 a.m., during a medical round, I.V. asked the third year intern, Marco Vargas, about the caesarean. He states that it was at that time that the doctor told her that they had performed a fallopian tube ligature and that she would not be able to have more children. Having been told this, the petitioner alleges that I.V. asked why it had been done to her and whether perhaps her life or the life of her baby had been at risk, to which the doctor replied that no, they had discovered many adhesions and that a future pregnancy could be very dangerous for her. The petitioner alleges that I.V. was left feeling very upset because at no time during the operation had they “spoken to her, informed her, or consulted her with regard to a ligature of the fallopian tubes” and she was only told about the operation the day after it had happened. 17. The petitioner says that I.V’s partner asked for a written explanation concerning what had happened and that Dr. Vargas responded that the request should be made in duplicate, signed by a lawyer, addressed to the Hospital de la Mujer, and they would have the reply within 48 hours. The petitioner alleges that I.V’s partner appealed to the Permanent Human Rights Assembly of Bolivia, organization which sent a note dated July 4, 2000, asking the hospital to report on the matter. 18. The petitioner states that on July 3, 2000, that is, two days after the operations, Dr. Vargas wrote on I.V’s case history, “3/7/2000, 9.00 a.m.: The patient was told yesterday that the bilateral salpingo-oophorectomy2 was carried out for medical reasons, and this was accepted by the patient who understood that her life could be endangered by another pregnancy. Dr. Vargas.” The petitioner alleges that this act provides conclusive proof that I.V. was neither informed nor consulted about the fallopian tube ligature that was carried out on July 1 during a second surgical operation. 19. The petitioner claims that Bolivian Health Law MSPS-983 insists on “informed choice” from the point of view of the client by which it means that persons who must make a healthcare decision do so on the basis of all the necessary information and with full comprehension. Equally, it refers to the definition of “informed consent” which it says is defined as the “act by which one agrees to receive medical care or treatment, after a process of informed choice.” Bilateral salpingo-oophorectomy or tubular occlusion, also known as surgical contraception and fallopian tube ligature. According to the petitioners, the Bolivian Health Law MSPS-98: Voluntary Surgical Contraception, Volume 1, Bilateral tubular occlusion in reproductive risk, approved by the Ministry of Health by Ministerial Resolution No. 517, November 17, 1998. 2 3 3