58 190. The State indicated that, in 2000, there was no consensus on whether a patient should be informed about alternative treatments; rather, agreement existed that information should be provided on the nature of the procedure, the purpose and risks. The Court considers it relevant to underscore that several international documents, and also the case law of the European Court of Human Rights, referred to the need to provide information on alternatives to the patient.243 In the Court’s opinion, if alternative treatments exist, this information forms part of the concept of necessary information in order to give informed consent, and providing information on these alternatives is considered a basic element of this consent. 191. That said, as already established, obtaining consent should be the result of a communication process, in which qualified personnel present clear, non-technical, impartial, exact, true, timely, complete, adequate, and reliable information; in other words, information that provides the necessary elements for the adoption of an informed decision. Health personnel should not act in a coercive or inducive manner in order to achieve the acceptance of the medical procedure, based on the understanding that the physician’s opinion should prevail over the patient’s desires and autonomy. Health care providers are essential agents to ensure that adequate information is provided, so that the way in which the information is presented is very important, because both the health care personnel and the patient herself may have preconceived ideas about the treatment, added to the fact that people frequently have difficulty communicating ideas.244 192. In this regard, in order to ensure that the information is fully understood, the health care providers must take into account the particularities and needs of the patient,245 such as their culture, religion, lifestyle, and level of education. This forms part of the obligation to provide culturally acceptable health care. The Court underlines that, since the Declaration of Helsinki the need was established that “[s]pecial attention should be given to the specific information needs of individual potential subjects as well as to the methods used to deliver the information.” 246 Similarly, the Declaration of Lisbon indicates that the information must be delivered “in a way appropriate to the Nations Interagency Statement “Eliminating forced, coercive and otherwise involuntary sterilization,” adopted by OHCHR, UN Women, UNAIDS, UNDP, UNFPA, UNICEF and WHO, 2014 (evidence file, volume VIII, annex 25 to the brief with motions, pleadings and evidence, folios 2452 to 2454 and 2457). Some of these documents published up until 2000 are: UN, Committee for the Elimination of Discrimination against Women, General Recommendation No. 24, Women and health, 1999, paras. 20 and 22; UN, Principles for the protection of persons with mental illness and the improvement of mental health care, A/RES/46/119, December 17, 1991, Principle 11.2; FIGO, Recommendations on ethics issues in obstetrics and gynecology by the FIGO Committee for the Study of Ethical Aspects of Human Reproduction and Women’s Health of November 2003, which include the Guidelines regarding informed consent, adopted in 1995, pp. 166 to 167, as well as the Ethical recommendations on female sterilization of 1989, 1990 and 2000, pp. 55 to 57 and 213 to 218, and WHO, Female sterilization: a guide to provision of services, 1993 (evidence file, volume XIII, annex 3 to the State’s final arguments, folios 5496 to 5498 and 5514 to 5516). In addition, see the rulings of the European Court of Human Rights, as in the case of V.C v. Slovakia, in which it referred to the fact that the patient had not been informed of alternative treatments to sterilization. Cf. ECHR, Case of V.C. v. Slovakia, No. 18968/07. Judgment of November 8, 2011, para. 112 (evidence file, volume VIII, annex 28 to the brief with motions, pleadings and evidence, folios 2531 to 2577). See also, Report of the Special Rapporteur on violence against women, its causes and consequences, Ms. Radhika Coomaraswamy, Policies and practices that impact women’s reproductive rights and contribute to, cause or constitute violence against women. E/CN.4/1999/68/Add.4, January 21, 1999, para. 52. 243 Cf. UN, Report of the Special Rapporteur on the right of everyone to the highest attainable standard of physical and mental health, Anand Grover, A/64/272, August 10, 2009, para. 59. 244 Cf. WHO, Female sterilization: a guide to provision of services, 1993 (evidence file, volume XIII, annex 3 to the State’s final arguments, folios 5510 to 5520), and FIGO, Recommendations on ethics issues in obstetrics and gynecology by the FIGO Committee for the Study of Ethical Aspects of Human Reproduction and Women’s Health of November 2003, October 2012 and October 2015, which include the Guidelines regarding informed consent, adopted in 1995 and reaffirmed and supplemented in 2007, pp. 166 to 167 (2003), pp. 316 to 318 (2012) and pp. 399 to 401 (2015), as well as the Ethical recommendations on female sterilization of 1989, 1990, 2000 and 2011, pp. 55 to 57 and 213 to 218 (2003), pp. 436 to 440 (2012) and pp. 537 to 541 (2015). 245 246 Declaration of Helsinki, Principle 26.