health and medical attention, for example in Bolivia,275 Canada,276 Colombia,277 Costa Rica,278
Mexico,279 Panama,280 and Peru.281
182.
In the following section, the Court will examine the violations alleged in this case.
B.2
The State’s obligation to provide adequate treatment to the
alleged victim for her diabetes and related ailments after her
incarceration
183.
In the instant case, after Mrs. Chinchilla Sandoval’s admission to the COF in May
1995, it is clear that from 1997 she underwent various medical examinations, partial diagnoses
and referrals, based on which a number of illnesses, symptoms or ailments were detected. 282
This confirms that she was admitted to the COF in a poor state of health, though without
certainty of the illnesses she suffered. There is no clinical record of her diagnosis or of the
treatment she received when she was deprived of her liberty. 283 Furthermore, subsequently,
Plurinational Constitutional Court, Plurinational Constitutional Judgments 0561/2015-S3 of May 14, 2015
and 0017/2015-S1 of February 2, 2015.
275
Supreme Court of British Columbia, Canada, British Columbia (Attorney General) v Astaforoff, 1983 510
(BC SC), of July 14, 1983. See also, Canadian HIV/AIDS Legal Network, Clean Switch: The Case for Prison Needle
and Syringe Programs in Canada, 2009.
276
Constitutional Court of Colombia, Judgment T-1326/05 of December 15, 2005, and Judgment T-714/96 of
December 16, 1996.
277
Constitutional Court of the Supreme Court of Justice of Costa Rica. Judgment 13266, File: 03-010418-0007CO of November 18, 2003; and Judgment 04918, File: 05-002087-0007-CO of 29/04/2005.
278
First Collegiate Circuit Court of the Auxiliary Center of the Eighth Region, Direct Amparo 798/2011, of
November 30, 2011, record 2000769.
279
Supreme Court of Justice of Panama: Habeas Corpus 194-10, March 30, 2010; and Second Criminal
Chamber, Special Request for Medical Evaluation, File 768-G, January 14, 2011.
280
281
Constitutional Court of Peru, file 1429-2002-HC/TC, November 19, 2002.
A report of the Medical Records Department of the HSJD (where she was treated several times) indicates
that “the patient in question is known in this institution since March 4, 1997, the date on which she was evaluated at
the outpatient clinic for problems of venous insufficiency in her lower limbs and a tumor in her vagina” (adding that
she had “a medical history of diabetes mellitus and arterial hypertension”). Although finally two of the doctors
indicated that the supposed cervical cancer was never confirmed, the file contains references to that possibility. Thus,
at the hearing on August 29, 2003, the Judiciary’s medical examiner referred to “something regarding cervical cancer,”
whereas the doctor at the HSJD indicated that he “[had] no knowledge” of that disease, while the doctor of the Public
Prosecution Service said that there was “no record of that pathology” and the COF doctor said he was aware of her
cervical cancer but “not of its degree” or “whether or not if it [was] non-terminal.” Subsequently, at the hearing on
April 21, 2004, the Judiciary’s medical examiner stated that “ there [was] nothing about cancer, only mention of a
[tumor] or cervical lesion;” for his part, the attending doctor at the HSJD said that he had “no medical knowledge
[…]that she ha[d] cervical or vaginal cancer” and the medical examiner of the Public Prosecution Service stated that
the file “describe[d] a tumor in the vagina in March 1997, but there [were] no other medical notes on the progress
of the disease.” Furthermore, the disease “cancer of the cervix” is recorded in the certifications of the Judiciary’s
medical examiner of August 7 and October 14, 2003, after an “anterior vaginal mass” was identified; and in 2000 “a
firm, mobile mass above the pubic hairline” was detected. In 2003, Mrs. Chinchilla herself stated that she “[did] not
know if the cancer detected [in the vagina] is benign or malignant.” Similarly, there was evidence of other symptoms
or possible ailments, both physical and mental, identified separately in Mrs. Chinchilla, for which there are no
subsequent certifications as to their progress or treatment, for example references to “problems of leukemia” and
“osteoporosis” in 1998; “urethrocele” in 2001; “chronic adult malnutrition” in 2003; and “severe depression with risk
of suicide” and “anasarca” in 2004.
282
In this regard, the State argued that prior to being convicted and sent to the COF to serve her sentence, the
alleged victim already suffered from diabetes mellitus and arterial hypertension, which was being treated and
controlled by the Guatemalan Social Security Institute (a State institution); therefore, a diagnosis of her physical and
emotional health did exist. It noted that a socioeconomic report by the Social Work Unit of the Public Criminal Defense
Institute of Guatemala of 2004, records that her diabetes was being treated and controlled by the Guatemalan Social
283
57