27
and non-discrimination, States must “abstain from producing regulations that are discriminatory or
have discriminatory effects on certain groups of population when exercising their rights,” that
States must “combat discriminatory practices at all levels, particularly in public bodies,” and finally
that States “must adopt the affirmative measures needed to ensure the effective right to equal
protection for all individuals.” 107
127. Before analyzing the facts under article 24 of the American Convention, the
Commission clarifies that it will not refer to the scope of the Executive Decree No. 24029-S of
February 3, 1995. Said decree was not part of the allegations presented before the Commission,
and was rendered without effect within the legal system of Costa Rica. The Commission will solely
refer to the resulting prohibition of the Constitutional Chamber in Costa Rica of March 15, 2000.
128.
In this sense, the Commission is examining a ban prohibiting access to a procedure
that could have helped the victims in the case have biological children, which is what they wanted.
The Commission deems that this ban had two effects that are within the scope of the right to
equality: i) it prevented the victims from overcoming the disadvantage they were up against by
availing themselves of the benefit of scientific progress, specifically a medical treatment, and ii) it
had a very specific and disproportionate impact on women.
129. As to the first point, while the victims’ infertility cannot be blamed on the Costa
Rican State, the assisted reproductive technique of in vitro fertilization was the only medical
treatment that might have made it possible for them to have biological children. By denying access
to this treatment, the State not only intruded into a fundamental side of the victims’ private and
family life –as explained throughout this report- but also denied them the possibility of overcoming a
disadvantage they had in having biological children, a disadvantage in the form of infertility. And
while this disadvantage was not the State’s doing, it is to blame for the fact that the disadvantage
persisted even though there were ways to overcome it or, at the least, lessen its effect.
Furthermore, the ban on in vitro fertilization compounded the difficulties that infertile couples would
normally have in trying to have children, since it forced them to look for alternatives abroad, with all
the economic, personal, family and emotional consequences this implies. 108
I/A Court H.R., Case of the Girls Yean and Bosico. Judgment of September 8, 2005. Series C No. 130, par.
141, and Juridical Condition and Rights of the Undocumented Migrants. Advisory Opinion OC-18/03 of September 17, 2003,
Series A No. 18, par. 88, cited in I/A Court H.R., Case of López Álvarez. Judgment of February 1, 2006. Series C No. 141,
par. 170; see also, Juridical Condition and Human Rights of the Child. Advisory Opinion OC-17/02 of August 28, 2002.
Series A No. 17, par. 44; and Proposed Amendments to the Naturalization Provision of the Constitution of Costa Rica.
Advisory Opinion OC-4/84 of January 19, 1984. Series A No. 4, párr. 54, cited in I/A Court H.R., Case of Yatama. Judgment
of June 23, 2005. Series C No. 127, par. 185.
107
108
In the words of one of the victims in the case, Andrea Bianchi Bruno:
For a couple like us, a husband and wife, taking out this amount of money is an economic strain; it has to
be done as soon as possible, because once one has the diagnosis, time becomes a factor […] one doesn’t
know how long it will take to put together that amount of money, especially if one has to do it several
times. The financial stress is difficult for a couple; how many couples separate because of everyday
financial stresses. Then there’s the question of the loss of privacy: all of my employers had to know that
I was undergoing this treatment, because I was constantly requesting leave; I had to say I was resigning
just before I was scheduled to travel, because no one is going to give me leave with just 24 hours’ notice.
They could continue to monitor me for up to 24 hours before I travelled; then I had to travel to Colombia
with 24 hours’ advance notice. They monitored me for five days following the procedure; then I went
back to Costa Rica, where a pregnancy test was done 10 days later. After that, the pregnancy was
monitored. With all this, everyone realized what was happening […]
One’s privacy is completed violated; everyone knows what’s happening. And even though it is the
woman who is infertile, everyone assumes the couple is infertile, too, or has been unable to have children.
This was very difficult for my husband as well. He had to be there giving me constant support in things
he really doesn’t understand […] I experienced social and family stress as well, since my family was
suddenly divided.