177. The State argued that “women with obstetric problems are treated based, above all, on the rules prescribed by technical guidelines […] which do not establish the need for the medical staff to report women with obstetric complications because obstetric complications do not constitute an offense.” It also argued that “if a woman is admitted to a hospital with signs of having given birth outside the hospital and is unable to explain the whereabouts of the baby, it is perfectly reasonable for the doctor to inquire about its whereabouts and, if he/she does not obtain a response, to inform the authorities in order to avoid any serious consequences for the child’s health and life.” 178. In addition, the State argued that “Manuela received various types of medical care from the public health system.” On admittance to the San Francisco Gotera National Hospital “the patient was stabilized in keeping with the existing hospital protocol for the treatment of deliveries of this nature and, subsequently, she remained in the hospital for seven more days until she was discharged based on her recovery and medical evolution.” It indicated that Manuela had also been treated in the Rosales National Hospital where she was diagnosed with Hodgkin’s syndrome in 2009 and received nine cycles of chemotherapy between February 14, 2009, and April 29, 2010. Also, “on September 9, 2009, the Eastern Regional Criminological Council decided that it was appropriate to transfer Manuela from the San Miguel Prison to the Ilopango Women’s Rehabilitation Center to facilitate the medical care that her health required.” Furthermore, it argued that the circumstances of Manuela’s death had been “verified by the attending physician, and Manuela’s family had not filed a complaint requiring a review of the medical treatment in her case or a determination of criminal responsibility for the circumstances of her death.” 179. With regard to the allegations concerning torture, the State argued that “the alleged use of handcuffs, shackles and restraints while she was in the hospital bed is derived from a single statement made before notary public by Manuela’s father, who also affirmed that when he arrived to see his daughter the guards took off the handcuffs, which renders his statement contradictory; moreover, no other evidence exists to substantiate his statement incriminating the State.” Regarding the use of handcuffs when Manuela received chemotherapy while she was deprived of liberty, El Salvador indicated that the representatives’ arguments were speculative and based on testimony that could not be considered “reliable to determine any State responsibility.” B. Considerations of the Court 180. The Court has asserted repeatedly that the right to life is fundamental in the American Convention because the realization of all the other rights depends on its safeguard. 290 Consequently, States have the obligation to ensure the creation of the conditions required for its full exercise and enjoyment.291 181. In addition, the right to personal integrity is of such importance that the American Convention protects it specifically by establishing, inter alia, the prohibition of torture or cruel, inhuman or degrading treatment, and the impossibility of suspending this right under any circumstance.292 Moreover, Article 5 also provides specific protection to anyone deprived of Cf. Case of the “Street Children” (Villagrán Morales et al.) v. Guatemala, supra, para. 144, and Case of Chinchilla Sandoval et al. v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment of February 29, 2016. Series C No. 312, para. 166. 290 Cf. Case of the “Street Children” (Villagrán Morales et al.) v. Guatemala, supra, para. 144, and Case of Chinchilla Sandoval et al. v. Guatemala, supra, para. 166. 291 Articles 5 and 27 of the American Convention. See also, Case of the “Juvenile Re-education Institute v. Paraguay, supra, para. 157, and Case of Hernández v. Argentina. Preliminary objection, merits, reparations and costs. Judgment of November 22, 2019. Series C No. 395, para. 55. 292 52