In 1998, three-year-old Talía Gonzales Lluy was diagnosed with a blood disorder that required multiple blood transfusions to be treated. However, the donated blood was transfused into her body before it was tested for infectious diseases. Shortly thereafter, Talía tested positive for HIV. When she began attending primary school, she faced severe discrimination from school officials and teachers, and was barred from attending her classes. Further, the Gonzales Lluy family (the mother Teresa Lluy and the brother Ivàn Mauricio Lluy) was evicted and forced to move multiple times when landlords discovered Talía’s HIV status. After failing to obtain recourse in the domestic courts, the family sought redress from the Inter-American Court.
The Inter-American Court of Human Rights found unanimously that the State had violated Article 4 (Right to Life) and Article 5 (Right to Humane Treatment), in relation to Article 1(1) of the Convention, to the detriment of Talía, because the State must refrain not only from violating human rights, but must also take the necessary measures to ensure the protection of its citizens. Article 4 (Right to Life) includes both the right of every individual to not be arbitrarily deprived of life and the duty of the State to take the necessary steps to ensure this right. This includes monitoring the private sphere for violations of legally protected rights. Further, the right to personal integrity is directly connected to healthcare, and the failure to ensure adequate medical care can violate Article 5(1) (Right to Physical, Mental, and Moral Integrity) of the Convention. This requires the state to ensure that health care regulations are effective and persons are protected. The Court noted that the State ratified the Convention on the Rights of the Child, which requires Ecuador to ensure that children have access to the highest attainable standard of health and to medical and rehabilitation facilities for treatment.
The Court reaffirmed that consequences of private health care providers’ actions are attributable to the State and that States not only have an obligation to regulate and supervise the conduct of public health care entities, but also any private institutions that provide health care services. In this regard, States must implement procedures to investigate complaints against medical institutions and to discipline professional misconduct that may violate patients’ rights. The Court held that due to the State’s negligence, and the dangers and risks faced by Talía, resulting from the blood contamination by a private entity, the State is responsible for violating Article 4 (Right to Life) and Article 5 (Right to Human Treatment) in relation to Article 1(1) of the American Convention.
The Court also concluded that the State violated Article 13 (Right to Education) of the Protocol of San Salvador. The Court acknowledged that individuals living with HIV have experienced discrimination at different levels because of the stigma the illness brings, making rights less accessible. Living with HIV is not in and of itself a disability; however, the circumstances surrounding these individuals “place them in a situation of disability.” The Court noted three obligations inherent in the right to education for persons living with HIV/AIDS: (i) the right to have timely, prejudice- free information on HIV/AIDS; (ii) the prohibition on denying access to educational establishments to persons with HIV/AIDS; and (iii) the right that education should promote their inclusion and non-discrimination by their social milieu. The Court found Talía was treated differently due to her health status. The Court found that it is the State’s responsibility to take the necessary measures in providing the proper education in order to dispel the discrimination persons with HIV/AIDS. The Court found that the risk of infection to other students was too small to warrant the means of meeting the school’s objective of protecting the other students. There were other measures that would have been more appropriate in this situation, instead of using stereotypes to justify an extreme, discriminatory decision.
The Court found that the discrimination Talía faced stemmed from multiple forms of discrimination, such as “being a woman, a person living with HIV, a person with disabilities, a minor, and also her socio-economic status,” and left her more susceptible to discrimination. The State was obligated to provide her more support by combating the stigma associated with these factors that led to greater vulnerability.
The Court also found a violation of Article 8(1) (Right to a Hearing Within Reasonable Time by a Competent and Independent Tribunal), with regard to the civil proceedings, in relation to Article 1(1) and 19 of the Convention, to the detriment of Talía,
The Court examined the State’s responsibility in relation to Talía’s family, who were often stigmatized due to their relationship with someone infected with HIV. The Court found that Ms. Teresa Lluy and Iván Mauricio Lluy were both affected by the isolation, social stigma, financial burdens, and health complications that resulted from the discrimination stemming from Talía’s contraction of HIV. Ms. Teresa Lluy was fired from her job of ten years because of the social stigma that followed her daughter’s disease, and could not thereafter find a steady job for the same reason. She was forced to sell everything she had. She also suffered severe emotional and physical harm due to the anxiety that resulted from the discrimination. Iván Mauricio Lluy also experienced emotional and physical harm. He stopped attending university and took on responsibilities that prevented him from enjoying his adolescence in order to work and help his family with their expenses, especially providing his sister with adequate food and treatment. The Court held unanimously that the State had violated Article 5(1) (Right to Physical, Mental, and Moral Integrity), in relation to Article 1(1) of the Convention, to the detriment of Ms. Teresa Lluy and Iván Mauricio Lluy, on the grounds that State actions or omissions with regard to victims of human rights violations can significantly impact the lives of those closest to the victims.
The Court ordered the State to:
- award reparations to Talía and her mother through pecuniary and non-pecuniary damages;
- provide Talía with her required medical treatments, including providing immediately and free of charge prompt, adequate and effective medical and psychological or psychiatric treatment to Talía including the provision, also free of charge, of the medicines that she may require, taking into consideration her ailments;
- fund Talía’s university education, to cover all the expenses until she concludes her studies, for both academic materials and living costs if necessary;
- fully and effectively investigate the alleged human rights violations;
- ensure that mechanisms of non-repetition are established; and
- provide Talía Gonzales Lluy with decent housing, free of charge.
It also found that the state must organize a public act in Ecuador, in the presence of senior State authorities, as well as with the participation of the victims in this case, to acknowledge international responsibility and human rights violations in relation to the fact of this case and the judgement.