37 123. The representative indicated that I.V. was sterilized without her prior, full, free and informed consent, because she was never told that a tubal ligation would be performed. She indicated that there was no record that the protocols on consent and on tubal ligation had been complied with in the case of the presumed victim and based on existing laws. The representative indicated that I.V. found out about the surgical procedure the day after it had been performed – in other words, July 2, 2000 – as revealed by the “progress sheet” signed by the resident doctor, which records that I.V. was only informed about the tubal ligation at that time. Accordingly, this disproves the evidence used by the State to assert that I.V. had given her consent – that is, the contradictory statements of some members of the medical team. She also indicated that: (i) requesting a woman’s consent to a tubal ligation in the circumstances described was inadmissible, especially if there was no medical emergency; (ii) the medical indication could not be taken as a factor that excluded the need to obtain prior, full, free and informed consent, and (iii) it was inadmissible to consider that written consent was a “mere and unimportant formality,” when domestic law required this. Regarding the international standards for informed consent, the representative considered that they already existed and were in force at the time of the facts, and indicated that the Court had the authority to consider this matter in accordance with an evolutive interpretation of the Convention. 124. The State affirmed that the tubal ligation procedure had not been planned by either the medical professionals or I.V., because the surgical procedure was performed during the caesarean section in light of the clinical picture observed, consisting of the adhesions found and the type of incision that had to be made in the uterus. It indicated that I.V. was informed of these complications, of the risks that another pregnancy would involve, of the benefits of the tubal ligation, and of the existing alternatives, “in a reasonable time, taking into account the circumstances,” and added that the bilateral tubal ligation procedure was performed to safeguard the health and life of the mother under the assumption that she could become pregnant again. The State argued that I.V. gave her verbal consent, as proved by the statements of the medical team, after they had tried unsuccessfully to find her husband to formalize the verbal authorization. The State added that: (i) nothing revealed that I.V.’s cognitive faculty was impaired in a way that would have prevented her understanding the situation; during the operation, she did not suffer surgical stress; the administration of an epidural anesthesia would not have inhibited her from understanding, and I.V. had full use of her intellectual capacity; (ii) in addition, there was no indication that the information provided to the patient had been misleading or distorted or that the health personnel had exerted any kind of pressure, so that the verbal consent was provided freely by the patient on understanding that a new pregnancy would endanger her life, and (iii) owing to the circumstances of the case, it was not possible to apply the rules of written consent, and its absence did not signify the absence of consent and, in particular, a forced sterilization. Therefore, the State considered that the actions complied with the basic parameters of a process of informed consent. 125. Additionally, following the public hearing of the case and in its final written arguments, the State indicated that, although it was admissible for the Court to incorporate the elements of prior, free and informed consent in the interpretation of the provisions of the Convention, it would be legally incorrect to apply retroactively elements that not only did not exist in international law at the time of the facts, but whose complete development stems from instruments that are non-binding for the State. Furthermore, it indicated that I.V.’s consent was obtained in accordance with the standards that were in force at the time, which did not require, for example, that this was written or that the health personnel should inform the patient of alternative methods. It indicated that, even based on the 1994 WHO document “Female sterilization: a guide to provision of services,” the standard, in 2000, was that, in cases such as that of I.V., the doctor could perform sterilization even without the patient’s consent, although this was exceptional and when the sterilization arose from a medical indication and there were reasonable and non-arbitrary criteria that there was a high probability that a further pregnancy would have fatal consequences. The State argued that, even though the standards authorized the doctor to perform sterilization without I.V.’s consent, he had asked for this