42
145. The State rejected the Commission’s arguments that, for I.V., the presumed non-consensual
sterilization constituted a form of violence and interference in her private and family life, “because
I.V. gave her free and voluntary consent, with appropriate counseling concerning the risks and
benefits of the procedure, so that the tubal ligation was performed as a prophylactic measure and to
comply with the protection of her life.” The State also argued that it had not failed to comply with
Article 7 of the Convention of Belém do Pará, because its public institutions had not committed any
act of violence against I.V., with regard to her decision-making either in her private life, or in the
sphere of her intimacy. Consequently, the State argued that it had complied with the obligations
established in Article 7 of the Convention of Belém do Pará.
146. Regarding the duty to refrain from any act or practice of violence against women and to
ensure that the conduct of its authorities, officials, personnel, agents and institutions complied with
this obligation, the State argued that, during the surgical procedure, “it was I.V. who, with
appropriate counseling about the risks and benefits of the procedure, gave her consent to the tubal
ligation,” and that “[t]he medical personnel performed the tubal ligation procedure abiding strictly
by the lex artis of the medical profession, offering information on the procedure, performing the
operation as a prophylactic measure, and providing the medical care services in accordance with the
patient’s needs.” The State also argued that it had not facilitated or consented to any violence against
I.V. Lastly, the State indicated that, at the time of the facts, its laws contained provisions that
protected women, as well as measures that regulated the actions of professionals trained in surgical
contraceptive procedures. It added that, “even though the form for granting informed consent existed
when I.V. underwent the surgical procedure, this could not be used because the patient took the
decision in the operating theater, based on the best medical criteria for her health.”
B.
Considerations of the Court
147. The main dispute in the instant case consists in determining whether the tubal ligation
performed on I.V. on July 1, 2000, in Bolivia, by a public official in a State hospital was contrary to
the State’s international obligations. The key aspect to elucidate is, therefore, whether this procedure
was performed after the patient’s informed consent had been obtained in accordance with the
parameters established in international law for this type of medical act at the time of the facts. If it
is determined that this consent was not properly obtained, there is an additional dispute between
the parties as to how the Court should classify the facts of this case; in other words, the legal
classification that should be assigned to the conduct. Taking this into account and in order to
determine whether the international responsibility of the State has been constituted, the Court finds
it pertinent to proceed, first, to provide content to the scope of the rights established in the American
Convention that have been alleged in this case and that are applicable with regard to sexual and
reproductive health. Accordingly, the Court will now interpret the scope of the rule of informed
consent and determine the parameters for the analysis of the facts of this case. The Court will then
make the corresponding determinations, taking into account the factual dispute that exists
concerning whether or not consent was obtained during the procedure and, if appropriate, how this
was obtained. Lastly, the Court will make the corresponding determinations on the international
responsibility of the State.
B.1
Scope of the rights established in the American Convention in this case
148. In this section, the Court will interpret the American Convention in order to determine the
scope of the rights to personal integrity, to personal liberty, to dignity, to private and family life, to
raise a family, and of access to information, as relevant to decide the dispute in this case.
149. The Court notes that Article 11 of the American Convention protects one of the most
fundamental values of the human being, understood as a rational being; and this is recognition of
his or her dignity. Indeed, the first paragraph of this article contains a universal clause of protection