mortality in pregnant women with SLE.” 19 For its part, on May 7, 2013, the Institute of
Forensic Medicine indicated that it was necessary to maintain “a strict medical supervision
of the condition of the mother and fetus, and not to suspend the medical treatment for the
chronic ailments from which she suffers, and […] required that she remain interned in a
level three hospital.” In addition, another example of the complex nature of her health
situation is that the specialists agree that she must be kept under permanent medical
supervision. Consequently, the Court considers that the gravity of the situation is high, so
that the extreme gravity of this matter is proved prima facie.
13.
Regarding the element of urgency, the Court observes that information was
presented indicating that, actually, B. is stable and appears to be responding to the medical
treatment that she is receiving (supra considering paragraph 8). Despite this, the Court
underlines that, on May 2, 2013, the treating physician of B. indicated that “even though
the patient’s disease is stable, […] owing to the physiological changes inherent in
pregnancy, added to the natural history of the underlying disease, a crisis could occur at
any time, and it cannot be predicted when a medical emergency may occur.” Similarly, the
Constitutional Chamber’s ruling of May 28, 2011, stressed that “the fact that B. is in a
stable condition at this time, does not mean that the risk implicit in her medical history –
which has been classified as severe and exceptional – has disappeared, owing to the
unpredictable behavior of the underlying disease from which she suffers (SLE), and the
biological changes that her body may undergo during the final stages of pregnancy during
which the probability of the medical complications that she suffered during her first
pregnancy is increased, or others may occur.” It is precisely the fact that it is impossible to
foresee whether the condition of B. will continue to be stable or whether, at any moment, a
crisis could occur that creates a medical emergency that proves that it is urgent and
necessary to take measures that prevent an impairment of her rights to life and to personal
integrity. Moreover, the passage of time could have an impact on the right to the life and
integrity of B., bearing in mind that the Constitutional Chamber itself noted that “the
medical records” indicate that “as her pregnancy progresses, the patient may suffer from a
worsening of the SLE and the above-mentioned obstetric complications, and these
symptoms are aggravated by the fetal anencephaly, which would cause other problems,”
and that the Pan-American Health Organization indicated that “the physiological changes
inherent in pregnancy may accelerate and exacerbate the disease of [B.] and even cause a
series of obstetric complications, which had already occurred in her first pregnancy,
including preeclampsia.”
14.
Regarding the alleged irreparable damage that could be produced if the necessary
measures are not taken, the Court underscores that B.’s treating physicians have concluded
that her disease, added to the fact that she is pregnant with a fetus with “anencephaly, a
major anomaly, incompatible with life outside the uterus,” could entail risks to her health
such as major obstetric hemorrhage, deterioration of the lupus, worsening of her kidney
failure, severe preeclampsia and complex forms of this, such as hypertensive crisis, cerebral
hemorrhage, arterial and venous thrombosis and pulmonary thromboembolism, postpartum infections or maternal death (supra considering paragraph 8). In addition to the
physical harm that B. could suffer, the Court emphasizes that her mental health would also
be placed at risk. Indeed, the Court stresses that the documentation attached to this
request contains some expressions of the intentions of B. in relation to her situation. In
particular, B. has stated to the media that: “I want to live … yes, I want to live for my other
child. I think that as this child is unfortunately ailing, and is going to die, then they should
remove it … because my life is in danger.” 20 Also, on May 7, 2013, the Institute of Forensic
19
Report of the “Latin American Center for Perinatology, Women and Reproductive Health” of the PanAmerican Health Organization of April 22, 2013 (file of request for provisional measures, annex 4).
20
Newspaper article entitled “Yo quiero vivir, por mi otro hijo… si este viniera bien, arriesgaría mi vida” [I
12