VII-1 RIGHTS TO PERSONAL INTEGRITY AND TO LIFE (Articles 5(1) and 4(1) of the Convention) A. Arguments of the Commission and of the parties 153. The Commission considered that the State´s duty to protect persons deprived of liberty extends to their health, as part of the rights to life and personal integrity, and specifically to the obligation to provide adequate, timely, and specialized medical treatment, in accordance with the special health care needs of persons detained in its custody, when required. It indicated that the lack of adequate medical care does not meet the basic requirements of treatment with dignity established in Article 5 of the Convention and, in the case of a person deprived of liberty in the custody of the State, could be considered a violation of that right, depending of the specific circumstances of the particular individual. 154. In particular, the Commission concluded that there was no proper diagnosis or record of Mrs. Chinchilla’s health condition and treatment while in detention and that the State’s response to her health condition was limited, since “there are no certifications attesting to a comprehensive diagnosis or follow-up on all Mrs. Chinchilla´s ailments.” It added that the enforcement judge requested medical certifications only for two reasons: first, to verify whether or not it was necessary to grant the alleged victim permission to leave the prison to attend her medical appointments; and secondly, to determine if the illnesses were “terminal” when deciding on the motions for early release and whether or not she could receive care at the detention center. Thus, there were numerous contradictory and isolated references to certain physical and mental ailments, which had not been treated. In other words, no steps were taken to understand Mrs. Chinchilla’s overall health condition and thereby determine the required treatment and provide adequate monitoring. 155. As to the treatment of Mrs. Chinchilla’s diabetes and related ailments, the Commission concluded that: i) the prison system did not provide Mrs. Chinchilla with the medication that she needed and she obtained it by her own means, contingent on her financial circumstances or those of her next of kin; ii) the COF lacked adequate facilities and specialized staff, either to offer her medical treatment or provide care in an emergency; iii) the COF did not provide her with the diet that she needed to control her illness and she obtained her food either through her own means, according to her possibilities, or through other COF inmates; iv) the COF had no defined strategy to provide her with conditions to prevent her disease from growing worse; and v) the above situation had an impact on the evolution and deterioration of Mrs. Chinchilla’s diseases, leading to, inter alia, the amputation of one of her legs, diabetic retinopathy and occlusive arteriosclerosis, with 80% probability of losing her other leg. 156. Regarding the State’s response to Mrs. Chinchilla’s disability after the amputation of one of her legs and the progressive loss of her sight, the Commission argued that no reasonable accommodation was made to help her move around in a wheelchair within the prison and to transport her to medical appointments. As a result, she suffered two falls, among other difficulties. Although the State reported that it had installed a special toilet and washbasin and provided Mrs. Chinchilla with her own cell, the Commission considered that those measures did not demonstrate the special care required to guarantee the conditions appropriate to her special needs. Therefore, the State did not fulfill its special obligations to ensure her dignity and her personal integrity, in light of her disability. In its final written observations, the Commission argued that the fact that she had to be carried by male staff to attend her appointments constitutes “a multiple form of discrimination given her condition as a disabled woman.” 48