69 was subjected to sterilization was regulated under the 1997 and the 1998 Bolivian standards which required a written and signed consent. The evidence before this Court reveals that the decision to perform the tubal ligation on I.V. was taken during the peri-operative period, and there is no record that she gave her consent in any written form. 295 However, the State itself has argued that the said standards were not applicable to the instant case, because the sterilization was not requested voluntarily, but responded to medical criteria. 220. Consequently, the Court concludes that, despite the existence of general standards on informed consent, the State of Bolivia had not adopted sufficient measure of prevention for health personnel to guarantee I.V. her right to take her own decisions on her reproductive health and the contraception methods that were most appropriate to her life project, so that she would not be subjected to sterilization without her prior, free, full and informed consent. Accordingly, the Court considers that the State failed to take the necessary regulatory preventive measures that would have established clearly the medical obligation to obtain consent in cases such as that of I.V. and, therefore, failed to comply with its obligation to act with due diligence to prevent a non-consensual or involuntary sterilization. B.3.b Obligation to respect the rights recognized in Articles 5, 7, 11, 13 and 17 of the American Convention and 7(a) of the Convention of Belém do Pará 221. The Court has established that, pursuant to Article 1(1) of the Convention, States are obliged to respect and ensure the human rights recognized therein. The international responsibility of the State is based on acts or omissions of any of its powers or organs, regardless of their rank, that violate the American Convention.296 222. Regarding the obligation of respect, the Court has maintained that the foremost obligation assumed by the State under the said article is “to respect the rights and freedoms” recognized in the Convention. Thus, the restriction of the exercise of the power of the State is necessarily included in the protection of human rights.297 Similarly, it is a principle of international law that the State responds for actions executed by its agents in their official capacity, and also for their omissions, even if they are acting outside the limits of their competence or in violation of domestic law. 298 223. In this regard, contrary to previous decisions of the Court, 299 in which it declared the international responsibility of the State owing to the failure to regulate and monitor health care provided by third parties to individuals subject to its jurisdiction, this case refers to actions carried out by a State agent, because the sterilization of I.V. was performed in a public hospital by health Cf. Record of the surgical procedure transcribed by the Women’s Hospital (evidence file, volume VII, annex 8 to the submission of the case, folio 2138); Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folio 3937), and Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016. 295 Cf. Case of “The Last Temptation of Christ” (Olmedo Bustos et al.) v. Chile, supra, para. 72, and Case of García Ibarra et al. v. Ecuador. Preliminary objections, merits, reparations and costs. Judgment of November 17, 2015. Series C No. 306, para. 107. 296 Cf. The Word “Law” in Article 30 of the American Convention on Human Rights. Advisory Opinion OC-6/86 of May 9, 1986. Series A No. 6, para. 21, and Case of Gutiérrez and family v. Argentina. Merits, reparations and costs. Judgment of November 25, 2013. Series C No. 271, para. 76. 297 Cf. Case of Velásquez Rodríguez v. Honduras. Merits, supra, paras. 169 and 170, and Case of García Ibarra et al. v. Ecuador, supra, para. 107. 298 Cf. Case of Ximenes Lopes v. Brazil, supra, paras. 86, 89 and 90; Case of Albán Cornejo et al. v. Ecuador, supra, paras. 121 and 122; Case of Suárez Peralta v. Ecuador, supra, paras. 149 and 150, and Case of Gonzales Lluy et al. v. Ecuador, supra, para. 175. 299

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