287. The Court recalls that, in the instant case, after suffering an obstetric emergency, Manuela was reported by her physician for the possible “perpetration of a crime.”446 Based on this report, Manuela was investigated for “the unlawful act of abortion. ”447 The laws of El Salvador regulate medical professional secrecy ambiguously and, in practice, this has meant that, to avoid being sanctioned, medical personnel report women suspected of having committed the offense of abortion (supra paras. 213 to 216). Moreover, the confidentiality of medical records and the exceptional nature of their disclosure is not regulated sufficiently (supra para. 228). Consequently, the Court deems it pertinent that the State adopt, within two years of notification of this judgment, clear regulations on the scope of medical professional secrecy, the protection of medical records, and the exceptions, pursuant to the standards described in this judgment (supra paras. 211 to 228). These regulations should explicitly establish: (i) that medical and nursing staff do not have an obligation to report women who have received medical attention for possible abortions; (ii) that, in such cases, health personnel must observe medical professional secrecy when questioned by the authorities; (iii) that the failure of health personnel to report such cases does not entail administrative, criminal or any other type of reprisal, and (iv) the situations in which medical records can be disclosed, and clear safeguards for the protection of this information and the way in which it may be disclosed, requiring that this only occurs as the result of a reasoned order from a competent authority, following which, only the part required in the specific case may be disclosed. Until such regulations come into force, the Court finds it appropriate to order the State, as it has in other cases,448 to refrain from applying the current laws concerning the obligation of health personnel to report possible cases of abortion. 288. In addition, the Court notes that the clinical and technical guidelines provided by the State lack clear directives on medical professional secrecy. Consequently, and in light of the context in which the facts occurred, the Court finds it necessary that the State adopt, within one year of notification of this judgment, a protocol on attention for women who require urgent medical care for obstetric emergencies. The protocol must be addressed to all public and private health care personnel in El Salvador, establishing clear criteria to ensure that, when attending to these women: (i) the confidentiality is ensured of the information to which the medical staff have access owing to their profession; (ii) the access to health services is not conditioned by their presumed perpetration of an offense or by the patients’ cooperation in criminal proceedings, and (iii) the health personnel refrain from questioning the patients in order to obtain confessions or to report them. When elaborating this protocol, the State must take into account the criteria developed in this judgment and in the Court’s case law, and it should conform to the standards described in paragraphs 211 to 228 of this judgment. D.2 Adaptation of the regulation of the imposition of pretrial detention 289. The Commission asked the Court to order El Salvador to “ensure that, in both law and practice, the use of pretrial detention adheres to the standards described in [the Merits Report].” The representatives replicated the Commission’s request. The State referred to 2020 (evidence file, folios 5813 to 5914); Ministry of Health of El Salvador. Technical guidelines for the application of code orange in the health service network (RIIS), December 2017 (evidence file, folios 5915 to 5943); Ministry of Health of El Salvador. Technical guidelines for the application of code yellow in the health service network (RIIS), June 2016 (evidence file, folios 5949 to 5972), and Ministry of Health of El Salvador. Technical guidelines for the application of code red in the health service network (RIIS), July 2015 (evidence file, folios 5973 to 6006). 446 Report of the treating physician of February 27, 2008 (evidence file, folio 22). 447 Request for a search warrant of February 28, 2008 (evidence file, folio 27). Cf. Case of Hilaire, Constantine and Benjamin et al. v. Trinidad and Tobago, supra, para. 212, and Case of Fermín Ramírez v. Guatemala. Merits, reparations and costs. Judgment of June 20, 2005. Series C No. 126, para. 130(c). 448 79