continuous manner, by qualified medical personnel, including the required food and medications, either within or outside the prison, for her illnesses or ailments throughout the time she was incarcerated.38 In other words, although the Judgment insists on limiting the violations declared to Articles 4 and 5 of the American Convention, the truth is that we are faced with a situation in which the right to health is affected, which also has an impact on the right to life and to physical and emotional integrity within the detention center. 31. In the Judgment, the standards developed by the Inter-American Court focus on the right to health, more than on the rights to life and to personal integrity. Thus, the InterAmerican Court considers that, in order to ensure that persons deprived of liberty receive a dignified and humane treatment, they should have access to medical treatment, which must include initial and regular checkups when necessary. Furthermore, when an inmate is known to suffer a disease that requires supervision and appropriate treatment, a complete record must be kept of his state of health and of the treatment he receives while in detention. In the case of prisons, the Inter-American Court, referring for the first time since its approval of the United Nations Minimum Standard Rules for the Treatment of Prisoners, or the “Mandela Rules”, indicated that to implement effective and qualified medical care for persons deprived of liberty, the State must provide this either within the place of detention or prison or, if this is not available, in hospitals or health care centers where that service is provided.39 32. The Inter-American Court reached the conclusion that the right to life and to personal integrity were violated by the fact that the prison in which the victim was confined lacked the necessary resources, specialized staff, equipment and infrastructure to be able to provide adequate care when faced with the deterioration of her health; that she also required regular examinations and care, both by the prison’s in-house doctor and by external consultants and that, although she could receive ambulatory treatment for her disease, the prison system did not provide the necessary treatment, or it was not clear if the COF could do so, or who administered the medication that she required. Moreover, it was evident that at any time she could suffer a decompensation that would require specialized hospital treatment and that her life could be at risk if that treatment was not adequate and consistent, or if she was left to administer her own medications, since the COF did not have the necessary equipment to provide emergency treatment for a diabetic coma, a complication that could be fatal. 40 33. Although the Judgment does not expressly declare the violation of the right to health in developing the standards related to the State’s obligation to ensure the right to health through the provision of medical care to persons deprived of liberty, in this first phase the Court should have analyzed the essential and interrelated elements of availability, accessibility, acceptability and quality of the right to health with greater scrutiny. In this regard, the Judgment merely states that: Cf. Case Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment of February 29, 2016, Series C No. 312, para. 185. 38 Cf. Case Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment of February 29, 2016, Series C No. 312, para. 178. 39 Cf. Case Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment of February 29, 2016, Series C No. 312, paras. 196, 197, 198 and 199. 40 12

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