92 institutions for their protection.373. 297. Non-consensual or involuntary sterilization is one of the many practices encompassed by the concept of violence against women (supra para. 254) and, to this extent, the standards development in this Court’s case law regarding the obligation to investigate in cases of violence against women become applicable. However, contrary to previous cases which related to rape, death, ill-treatment and violations of personal liberty committed in a general context of violence against women, 374 the Court notes that this cases refers to a violation of sexual and reproductive rights, in which the physician deprived I.V. of her reproductive function without her informed consent in a public hospital during a caesarean section. According to the evidence that has been presented, this non-consensual sterilization did not form part of a State policy and did not take place during an armed conflict or as part of a general and systematic attack on the civilian population. However, in this Court’s opinion, this does not mean that the said act should be classified merely as the ineptitude of the physician, but rather it constitutes a significant violation of human rights and, in particular, a crass disregard for the sexual and reproductive rights and the autonomy of women. 298. Indeed, as stressed by the Special Rapporteur on violence against women, its causes and consequences, “[v]iolence and violations of women’s reproductive health may result either from direct State action, via harmful reproductive policies, or from State failure to meet its core obligations to promote the empowerment of women[, and this implies] the State’s obligation to act with due diligence to prevent, investigate, and punish violation.”375 299. Therefore, the protection of the rights of women by access to opportune, adequate and effective remedies to redress such violations comprehensively and to avoid a recurrence of such facts in future is extremely relevant if it is considered that, nowadays, in the context of medical care and access to health care services, women continue to be vulnerable to violations of their sexual and reproductive rights, in most cases through discriminatory practices that are the result of the application of prejudicial stereotypes. 300. That said, the Court considers that the need to criminalize certain violations of sexual and reproductive rights, as well as the evaluation of cases in which a criminal investigation is appropriate, should respond to a careful and balanced examination of the circumstances of the case, since some criminal offenses may be openly incompatible with human rights obligations because they limit or deny access to sexual and reproductive health.376 301. It is clear that international criminal law establishes an obligation, as a domestic legal reflection of the Rome Statute, to define forced sterilization as a crime against humanity and a war crime (supra para. 204), and this practice may even constitute an act of genocide. 377 That obligation Cf. Case of Fernández Ortega et al. v. Mexico, supra, para. 193, and Case of Velásquez Paiz et al. v. Guatemala, supra, para. 108. 373 Cf. Case of the Miguel Castro Castro Prison v. Peru, supra, para. 344; Case of González et al. (“Cotton Field”) v. Mexico, supra, para. 287; Case of Fernández Ortega et al. v. Mexico, supra, para. 193; Case of Rosendo Cantú et al. v. Mexico, supra, paras. 176 and 177; Case of J. v. Peru, supra, para. 350; Case of Veliz Franco et al. v. Guatemala, supra, para. 185; Case of Espinoza Gonzáles v. Peru, supra, paras. 241 and 242, and Case of Velásquez Paiz et al. v. Guatemala, supra, paras. 145 and 146. 374 UN, Report of the Special Rapporteur on violence against women, its causes and consequences, Ms. Radhika Coomaraswamy, Policies and practices that impact women’s reproductive rights and contribute to, cause or constitute violence against women, E/CN.4/1999/68/Add.4, January 21, 1999, paras. 44 and 47. 375 Cf. UN, Committee on Economic, Social and Cultural Rights, General Comment No. 22, The right to sexual and reproductive health, March 4, 2016, para. 40. 376 Even though it is not expressly established as genocide, forced sterilization may constitute a genocidal act if, based on paragraphs (b) and (d) of Article 6 of the Rome Statute, it is performed on individuals of a specific “national, ethnical, racial or religious group,” irrespective of the means used to perform the sterilization and provided that the intent is to destroy this 377