80 C. Conclusion 256. Based on the above, the State of Bolivia is responsible for violating the obligations to respect and to ensure rights and not to discriminate with regard to the rights recognized in Articles 5(1), 7(1), 11(1), 11(2), 13(1) and 17(2), in relation to Article 1(1) of the American Convention, to the detriment of I.V. The State is also responsible for failing to comply with its obligations under Article 7(a) and b) of the Convention of Belém do Pará. VIII-2 RIGHT TO PERSONAL INTEGRITY AND THE PROHIBITION OF TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT,338 IN RELATION TO THE OBLIGATIONS TO RESPECT AND TO ENSURE RIGHTS A. Arguments of the parties 257. The representative indicated that the State had violated the three dimensions of I.V.’s personal integrity. With regard to her physical integrity, she indicated that, as a result of the nonconsensual sterilization, I.V. permanently lost her reproductive function, and this led to the mental and moral dimensions, because I.V. felt damaged, mistreated and traumatized since she considered that she was no longer a “whole woman.” The arbitrary deprivation of her reproductive function destroyed her hope of conceiving a male child and produced a series of physical, sexual, psychological and psycho-social effects, as well as feelings of profound anguish and suffering because an essential part of her desired life project had been taken from her. The representative indicated that to this was added a feeling of guilt with regard to her daughters, because as a result of the sterilization and her search for justice, they had to endure her irritability and absence during their childhood and in later years. The representative considered that these aftereffects resulted in I.V. being diagnosed with an organic schizophreniform disorder in 2013. 258. The representative, based on the factual framework set out in the Merits Report, argued that Article 5(2) of the American Convention had been violated to the detriment of I.V. The first part of this paragraph establishes that: “[n]o one shall be subjected to torture or cruel, inhuman or degrading treatment or punishment.” Following the reasoning of the Special Rapporteur on torture or cruel, inhuman or degrading treatment or punishment,339 she indicated that it was important to identify certain abuses in medical and hospital care not as mere violations of the right to health, but also as forms of torture and ill-treatment, while recognizing that “[t]he conceptualization of the abuses committed in health-care settings as torture or ill-treatment is a relatively recent phenomenon.” 259. In particular, she argued that, on July 1, 2000, I.V. “was in a situation of […] total defenselessness, on an operating table, under the absolute control of a medical team who took the decision on her behalf, without prior, full, free and informed consent, to subject her to a tubal ligation.” She indicated that the procedure performed on I.V. was totally invasive and irreversible, because in I.V.’s case, “there was no need, urgency or vital reason related to the patient’s survival for the doctors to proceed as they did.” Therefore, she argued that I.V. “was a victim of cruel, 338 The pertinent part of Article 5 of the American Convention stipulates that: 1. Every person has the right to have his physical, mental, and moral integrity respected. 2. No one shall be subjected to torture or to cruel, inhuman, or degrading punishment or treatment. All persons deprived of their liberty shall be treated with respect for the inherent dignity of the human person. Cf. UN, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, A/HRC/22/53, February 1, 2013 (evidence file, volume VIII, annex 24 to the brief with motions, pleadings and evidence, folios 2412 to 2437). 339