71 contrary versions of the same fact, because while the State affirms that it had obtained the informed consent of I.V., she indicates the contrary and denies having provided this. 226. In this case, the presumed victim had few means available to prove this fact. Her allegation is of a negative nature, indicating the inexistence of a fact that presumably occurred while she was in the absolute care of the health care personnel who were performing the caesarean section in a public health institution. The State’s allegation is of a positive nature and, therefore, possible to prove, especially if medical personnel are obliged to record the existence of informed consent (supra para. 195). 227. Nevertheless, leaving to one side the evidentiary dispute on the factual circumstances, based on what it has previously indicated, the Court finds that the legal consequence of both factual versions is the same; in other words, that both in the hypothesis of the inexistence of consent, and in the hypothesis that verbal consent was obtained from I.V. during the peri-operative period, the physician failed to comply with his obligation to obtain a prior, free, full and informed consent as required by the American Convention. 228. Indeed, with regard to the version of the facts proposed by the representative, the Court considers that the physician’s actions were not in keeping with the treaty-based requirements, because he did not obtain I.V.’s consent before performing the said medical procedure. This is so, because sterilization is a medical procedure with serious consequences, as it results in the permanent loss of a woman’s reproductive capacity. Consequently, a female surgical sterilization should only be performed after having obtained the patient’s prior, free, full and informed consent, above all because the procedure consists in a significant medical procedure, which entails an important interference in a woman’s reproductive health, and also involves various aspects of her personal integrity and private life. 229. In this regard, the Court finds it relevant to point out that I.V.’s case was not of an urgent or emergency medical nature because she was not in a situation of imminent risk to her life. As the Court has established, there are exceptions to the obligation to obtain informed consent (supra paras. 177 and 178). However, female sterilization cannot be considered to fall within these exceptions. Moreover, this has been verified in the instant case because, different statements 303 have indicated Health Service on July 25, 2002 (evidence file, volume XIV, annex 3 to the representative’s final arguments, folio 5769); Statement made by Edgar Torrico Ameller on November 11, 2002, according to the record of the oral hearing issued by the Second Trial Court of La Paz (evidence file, volume XII, annex 1(a) to the State’s final arguments, folios 4101 to 4103); Statement made by Edgar Torrico Ameller on July 26, 2004, according to the record of the oral hearing issued by the Copacabana Trial Court (evidence file, volume XII, annex 1(c)) to the State’s final arguments, folio 4735); Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016; Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folios 3931, 3934, 3937 and 3938); Statement made by Marco Vladimir Vargas Terrazas on August 22, 2000, according to the medical record of the surgical procedure performed on I.V. issued by the Medical Audit Committee of the Women’s Hospital (evidence file, volume VII, annex 1 to the submission of the case, folio 2116); Statement made by Marco Vladimir Vargas Terrazas on July 28, 2004, according to the record of the oral hearing issued by the Copacabana Trial Court (evidence file, volume XIV, annex 1(d)) to the State’s final arguments, folio 4789); Statement made by María Modesta Ticona on August 17, 2000, according to the medical record of the surgical procedure performed on I.V. issued by the Medical Audit Committee of the Women’s Hospital (evidence file, volume VII, annex 1 to the submission of the case, folio 2116); Statement made by María Modesta Ticona on August 13, 2004, according to the record of the oral hearing issued by the Copacabana Trial Court (evidence file, volume XIV, annex 1(d)) to the State’s final arguments, folios 4819 to 4822), and Statement made by Rodrigo Arnez on August 17, 2000, according to the medical record of the surgical procedure performed on I.V. issued by the Medical Audit Committee of the Women’s Hospital (evidence file, volume VII, annex 1 to the submission of the case, folio 2115). Cf. Statement made by Edgar Torrico Ameller on November 11, 2002, according to the record of the oral hearing issued by the Second Trial Court of La Paz (evidence file, volume XII, annex 1(a) to the State’s final arguments, folios 4101 to 4103); Statement made by Edgar Torrico Ameller on July 26, 2004, according to the record of the oral hearing issued by the Copacabana Trial Court (evidence file, volume XII, annex 1(c)) to the State’s final arguments, folio 4735); Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folios 3931, 3934 and 3937 to 3938); Statement made by Marco Vladimir Vargas Terrazas on August 22, 2000, according to the medical record of the 303