I.V. v. Bolivia decision: Forced sterilization is based on harmful gender stereotypes

Many thanks to Christina Zampas, a Reproductive and Sexual Health Law Fellow at the University of Toronto’s Faculty of Law, for summarizing this decision of the Inter-American Court of Human Rights.  She also presented oral expert testimony in this case during its hearing on 2 May 2016 in San Jose, Costa Rica, focusing on international and regional human rights standards in relation to informed consent to sterilization, and on gender discrimination and stereotyping. (Overview of her testimony.)

Caso I.V. v. Bolivia,   Sentencia de 30  Noviembre de 2016 (Excepciones Preliminares, Fondo, Reparaciones y Costas) Corte InterAmericana de Derechos Humanos  Decision in Spanish.

I.V. v Bolivia concerns the involuntary sterilization in 2000 of an immigrant woman from Peru in a public hospital in Bolivia during a caesarean section.   In its first case alleging forced sterilization and indeed, its first case on informed consent to a medical procedure, the Inter-American Court of Human Rights struck at the heart of such practices by addressing underlying causes of such violations: gender discrimination and stereotyping.

The Court held that the State violated the woman’s rights to personal integrity, personal freedom, private and family life, access to information and rights to found a family, and to be free from cruel, inhuman and degrading treatment contrary to the dignity of a human being, all contained in the American Convention on Human Rights.  The State had also violated its duties to condemn all forms of violence against women under the Convention of Belem do Pará.   In finding these violations, the Court recognized that sterilization without consent annulled the right to freely make decisions regarding one’s body and reproductive capacity, resulting in loss of control over one’s most personal and intimate decisions, with lasting implications.

While generally agreeing with decisions about forced sterilization of Roma women issued by the European Court of Human Rights and the CEDAW Committee , the Inter-American Court’s decision is groundbreaking in that it uniquely highlighted the transcendent role of state obligations to respect and guarantee the right to non-discrimination in the context of women’s human rights violations. Thus, the Court recognized that the freedom and autonomy of women in sexual and reproductive health, generally, has historically been limited or annulled on the basis of negative and harmful gender stereotypes in which women have been socially and culturally viewed as having a predominantly reproductive function, and men viewed as decision-makers over women’s bodies. The Court recognized that non-consensual sterilization reflects this historically unequal relationship. The Court noted how the process of informed decision-making operated under the harmful stereotype that I.V., as a woman, was unable to make such decisions responsibly, leading to “an unjustified paternalistic medical intervention” restricting her autonomy and freedom.  The Court thus found a violation of the right to non-discrimination based on being a woman. It also stressed the particular vulnerability to forced sterilization facing certain women, based on other characteristics such as socioeconomic status, race, disability, or living with HIV.

The Court ordered both individual reparations and general measures, including ensuring education and training programs for healthcare and social security professionals regarding informed consent, gender-based violence, discrimination and stereotyping.  The Court’s unequivocal articulation of the right of women to make decisions concerning reproductive health, without being subjected to discrimination based on stereotypes or power relations, is important in this first case by an international or regional tribunal addressing this in the context of sterilization.  It could also apply to other reproductive health care contexts, such as the case for abortion.

Links for this case:
Caso I.V. v. Bolivia,   Sentencia de 30  Noviembre de 2016 (Excepciones Preliminares, Fondo, Reparaciones y Costas) Corte InterAmericana de Derechos Humanos  Decision in Spanish
Report on the Merits (2014) in English.
Amicus Curiae brief by Ciara O’Connell, Diana Guarnizo-Peralta and Cesar Rodriguez-Garavito:  in English.

Related decisions, alluded to above:
V.C. v. Slovakia, European Court of Human Rights (Decision 8 November 2011)
N.B. v. Slovakia,  European Court of Human Rights (Decision 12 June 2012)
VC and NB decisions, summarized by Andy Sprung
I.G. and others v. Slovakia  European Court of Human Rights (Decision 13 November 2012).
IG decision, summarized by Andy Sprung

UN Committee on the Elimination of Discrimination against Women (CEDAW)
A.S. v. Hungary  (Decision online).
Summary  and documents from CRR.
Analysis by Simone Cusack, OP CEDAW blog.
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Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   For Program publications and resources, see our website, online here.     TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.

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