82
women’s human rights equate gender-based torture and ill-treatment.341
264. The Court has already emphasized the vulnerability to torture and other forms of cruel,
inhuman or degrading treatment of individuals in institutional setting such as public and private
hospitals, because the medical personnel in charge of patient care exercise strong control or power
over those in their care.342 When torture and other forms of cruel, inhuman or degrading treatment
are inflicted on those individuals, it affects their mental, physical and moral integrity and is an affront
to their dignity, as well as a serious constraint to their autonomy. 343 Similarly, the Court has stressed
the important role of physicians and other health-care professionals in safeguarding personal
integrity and preventing torture and ill-treatment.344
265. Evidently, the context of health-care services may signify a greater risk of women being
subjected to acts contrary to Article 5(2) of the American Convention, especially in relation to those
practices or policies addressed primarily against women, which affect them disproportionately, or
those that women are particularly vulnerable to, owing to negative or prejudicial gender-based
stereotypes, including the social and cultural assignation to women of responsibility for reproductive
functions and for contraception. In this regard, the Committee against Torture has recognized that
the situations in which women run the risk of being subjected to torture or cruel, inhuman or
degrading treatment, include medical treatment, particularly involving reproductive decisions.345
266. The Committee for the Elimination of Discrimination against Women has stated that
compulsory sterilization adversely affects women's physical and mental health. 346 In the case of an
involuntary sterilization, the European Court has also recognized that this was liable to arouse
feelings of fear, anguish and inferiority and entail lasting suffering, and that the victim may feel
degraded and humiliated on finding this out, as well as suffering depression and feelings of isolation
and humiliation.347 The Inter-American Court considers that non-consensual or involuntary
sterilization may cause severe mental and physical suffering by permanently ending a woman’s
reproductive capacity, causing infertility, and imposing serious and lasting physical changes without
her consent.
267. This Court has indicated that the violation of a person’s right to physical and mental integrity
has diverse connotations of degree, which range from torture to other types of abuse or cruel,
inhuman or degrading treatment, the physical and mental effects of which vary in intensity based on
endogenous and exogenous factors (including duration of the treatment, age, sex, health situation,
context, and vulnerability), which must be analyzed in each specific situation.348 In other words, the
Cf. UN, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment,
Juan E. Méndez, A/HRC/31/57, January 5, 2016, paras. 5 and 9.
341
342
Cf. Case of Ximenes Lopes v. Brazil, supra, paras. 106 and 107.
343
Cf. Case of Ximenes Lopes v. Brazil, supra, para. 106.
Cf. Case of Tibi v. Ecuador, supra, paras. 152 to 156; Case of Montero Aranguren et al. (Retén de Catia) v. Venezuela.
Merits reparations and costs. Judgment of July 5, 2006. Series C No. 150, para. 102, and Case of Díaz Peña v. Venezuela.
Preliminary objection, merits, reparations and costs. Judgment of June 26, 2012. Series C No. 244, para. 137.
344
Cf. UN, Committee against Torture, General Comment No. 2, Application of Article 2 by the States Parties, January 24,
2008, para. 22.
345
Cf. UN, Committee for the Elimination of Discrimination against Women, General Recommendation No. 19, Violence
against women, 1992, para. 22.
346
Cf. ECHR, Case of V.C. v. Slovakia, No. 18968/07. Judgment of November 8, 2011, para. 118; Case of N.B. v. Slovakia,
No. 29518/10. Judgment of June 12, 2012, para. 80, and Case of I.G., M.K. and R.H. v. Slovakia, No. 15966/04. Judgment
of November 13, 2012, para. 123 (evidence file, volume VIII, annexes 26, 27 and 28 to the brief with motions, pleadings and
evidence, folios 2474 to 2577).
347
348
Cf. Case of Loayza Tamayo v. Peru. Merits, supra, paras. 57 and 58, and Case of Herrera Espinoza et al. v. Ecuador,