following elements into account: (i) the legality of the restriction—that is, if it is established in law both formally and in practice; (ii) the existence of a legitimate aim; (iii) suitability—that is, if the measure has a logical connection to the aim pursued; (iv) necessity—that is, determination of whether other alternatives exist that would be less restrictive and equally suitable; and (v) strict proportionality—that is, balancing the interests in question against the degree of sacrifice.132 133. With regard to legality, the IACHR notes that the criminal legislation on doctors’ obligation to report cases involving obstetric emergencies is not clear. The Commission observes that Article 312 of the Criminal Code establishes that medical personnel who do not report the admission of injured individuals to the competent authorities within eight hours of their admission shall be fined in cases in which the injuries could rationally be considered to have been the result of a crime.133 However, the Criminal Procedural Code provides for exceptions to doctors’ obligation to report when the knowledge acquired is protected by professional confidentiality. 134. The Commission also notes that the procedure that a doctor must follow to determine whether an obstetric emergency could be the result of the commission of a crime—the result of a natural versus intentional miscarriage—is not clear, 134 and therefore not punishable pursuant to criminal law. The Commission observes that the failure to adequately regulate medical confidentiality and obstetric emergencies in a way that details the exceptions to it and that properly weighs the interests and rights in question in this context could cause doctors to automatically report patients who have had obstetric emergencies on the mere suspicion that (for example) they sought an abortion due to fear that they could suffer a criminal or disciplinary sanction, thereby completely erasing the rights protected by professional confidentiality. 135. By virtue of these considerations, the IACHR concludes that the restriction on the privacy of the alleged victim did not fulfill the requirement of legality, making it an arbitrary restriction. Without prejudice to this, the IACHR considers it appropriate to present some general considerations regarding the requirements of the legitimate aim and suitability of the restriction. 136. Regarding the aim and suitability of the restriction, based on the reporting and the delivery of Manuela's private medical history, the Commission observes that healthcare workers’ obligation to report can, in general terms, pursue a legitimate aim that is consistent with contributing to the administration of justice and preventing impunity; however, analysis of the suitability of the restriction with regard to this objective cannot be conducted in isolation, as the characteristics of the facts required to be reported criminally must also be considered. The Commission highlights that in this case, not all the information protected by professional confidentiality that was provided to the authorities in the framework of the investigation was associated with the indicated aim. In this regard, the IACHR notes that certain information had to do with the sexual background of the alleged victim, including when she began having sexual relations and the sexually-transmitted diseases she had had, even noting that her pregnancy was the result of infidelity. None of these elements has a meansto-an-end relationship with the aforementioned legitimate aim. Therefore, the Commission concludes that, in addition to failing to fulfill the requirement of legitimacy in its totality, a significant portion of the information provided also fails to comply with the requirement of suitability of the restriction on Manuela's privacy. Taking this into account, the IACHR finds that it is not necessary to continue on to analyze the requirements of necessity and strict proportionality. 137. In light of these considerations, the Commission concludes that in this case, the violation of professional confidentiality constituted an arbitrary restriction on Manuela's right to privacy. The Commission also finds that this meant that Manuela did not receive treatment under equal and acceptable conditions in accordance with the above described standards on medical ethics and confidentiality that are part of the right Inter-American Court, Case of Artavia Murillo et al. (in vitro fertilization) v. Costa Rica. Preliminary Objections, Merits, Reparations, and Costs. Judgment of November 28, 2012. Series C No. 257, para. 273. 133 Article 312 of the Criminal Procedural Code of El Salvador. 134 Article 137 of the Criminal Code of El Salvador states that “those who intentionally cause an abortion will be punished with between six months and two years in prison. Intentional miscarriages caused by the pregnant woman herself and attempts to cause a miscarriage will not be punishable. 132 25