malfunctioning of hospital services and did not have access to the appropriate emergency care and, thus, it concluded that there was a substantive violation of Article 2 of the European Convention on Human Rights.65 The ECHR also considered the case of Elena Cojocaru v. Romania, which concerned a pregnant woman who was taken to a hospital because it was thought that she was suffering from pre-eclampsia. In spite of her grave condition, the attending physician did not provide emergency medical care, which consisted, among others, in a cesarean procedure. Rather, it was decided to send her to another hospital some 90 miles away, where she died 40 minutes after arrival. The ECHR held that there was a substantive violation of Article 2 of the European Convention and referred to the State’s obligation to adopt a normative structure that would require hospitals to take adequate measures to protect the life of patients.66 66. The Committee for the Elimination of Discrimination against Women, in its decision on Communication 17/2008 against Brazil in the case of Alyne da Silva Pimentel Teixeira, a Brazilian national of African descent who died as the result of obstetrical complications after having been denied quality maternal health care in both a public and a private health center, considered that the claim referred to the lack of access to medical attention related to the pregnancy and that the death of Ms. Da Silva Pimentel Teixeira could be considered as a case of maternal mortality.67 It concluded that she did not receive “appropriate services in connection with her pregnancy”68 and held the State responsible for having failed to comply with its obligations under Article 12(2) of the Convention.69 In its decision, the Committee also affirmed that “the lack of appropriate maternal health services has a differential impact on the right to life of women.”70 67. The Office of the UN High Commissioner for Human Rights has also referred to this matter. In its 2022 Report, it recalled that maternal mortality and morbidity are matters of human rights71 and expressed that “[i]nternational human rights law includes fundamental commitments of States to enable women to survive pregnancy and childbirth as part of their enjoyment of sexual and reproductive health rights and living a life of dignity.”72 Similarly, in a 2010 report on avoidable maternal mortality and morbidity, it stated that preventable maternal deaths may result in State responsibility not only for violating the right to life, but may also imply violations of the right to enjoy the highest attainable standard of physical and mental health, including sexual and 65 97. 66 Cf. ECHR, Mehmet Şentürk and Bekir Şentürk v. Turkey, No. 13423/09. Judgment of April 9, 2013, para. Cf. ECHR, Elena Cojocaru v. Romania, No. 74114/12. Judgment of March 22, 2016, para. 101. Committee for the Elimination of Discrimination against Women, Alyne da Silva Pimentel Teixeira v. Brazil (Communication No. 17/2008), CEDAW/C/49/D/17/2008, September 27, 2011, para. 7(3). 67 68 Committee for the Elimination of Discrimination against Women, Alyne da Silva Pimentel Teixeira v. Brazil (Communication No. 17/2008), CEDAW/C/49/D/17/2008, September 27, 2011, para. 7(4). 69 “Article 12. […] 2. Notwithstanding the provisions of paragraph I of this article, States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation.” Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). 70 Committee for the Elimination of Discrimination against Women, Alyne da Silva Pimentel Teixeira v. Brazil (Communication No. 17/2008), CEDAW/C/49/D/17/2008, September 27, 2011, para. 7(6). Cf. Office of the UN High Commissioner for Human Rights. Preventable maternal mortality and morbidity and human rights, UN Doc. A/HRC/14/39, April 16, 2010, para. 8 and Office of the UN High Commissioner for Human Rights. Technical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality, UN Doc. A/HRC/21/22, July 2, 2022, para. 9. 71 Cf. Report of the Office of the UN High Commissioner for Human Rights. Technical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality, UN Doc. A/HRC/21/22, July 2, 2022, para. 8. 72 19