Ms. Konovalova (“the Applicant”), a Russian citizen who was pregnant, went into labor and was urgently transferred to a hospital. Upon arrival, she was given a booklet issued by the hospital that contained a notice stating, “We ask you to respect the fact that medical treatment in our hospital is combined with teaching for students studying obstetrics and gynaecology. Because of this, all patients are involved in the study process.” On being admitted to the hospital, due to complications, the Applicant was put into a drug-induced sleep twice in an effort to postpone labor. Delivery was scheduled the next day.
During labor, despite the Applicant’s objections, a group of medical students observed the birth in the delivery room and related interventions, including an episiotomy, and were given information about her health and medical treatment. Relevant domestic law provided that medical students could assist in medical treatment under supervision, but made no provision for obtaining patients’ informed consent.
Konovalova later filed claims against the hospital in the Russian courts, seeking compensation as well as a public apology for the intentional delay to her labor and the non-consensual presence of third parties during the birth. Her claims were rejected and the domestic court held that although written consent was not necessary under domestic law, the applicant had given implied consent to the presence of the medical students. During the proceedings, an expert for the hospital outlined to the court that “Childbirth is stressful for every woman…During the bearing down phase, a pregnant woman is usually focused on her physical activity. The presence of the public could not adversely affect her labour.” Konovalova filed an application with the European Court of Human Rights alleging violations of Article 8 of the European Convention on Human Rights (“Convention”), which protects the right to private and family life, and Article 3, which prohibits torture and inhuman or degrading treatment.
The Court held that the concept of private life encompasses “the right of choosing the circumstances of becoming a parent … [and] the physical integrity of a person, since a person’s body is the most intimate aspect of private life, and medical intervention, even if it is of minor importance, constitutes an interference with this right.” The Court found that “given the sensitive nature of the medical procedure” which was witnessed by medical students who thus had access to the applicant’s confidential medical information “there is no doubt that such an arrangement amounted to ‘an interference’ with the applicant’s private life.”
It found that “the absence of any safeguards against arbitrary interference with patients’ rights in the relevant domestic law at the time constituted a serious shortcoming”. It emphasized that it was “unclear whether the applicant was given any choice regarding the participation of students on this occasion”, and noted that as the applicant learned about the planned presence of the medical students between two sessions of drug-induced sleep, and at a time when the applicant was in a condition of “extreme stress and fatigue”, she was not given an opportunity to make an informed decision as to their presence.
The Court was also critical of the handling of the applicant’s complaint by the domestic courts. It noted that “the domestic courts did not take into account other relevant circumstances of the case, such as the alleged insufficiency of the information contained in the hospital’s notice, the applicant’s vulnerable condition during notification as pointed out by the Court earlier, and the availability of any alternative arrangements in case the applicant decided to refuse the presence of the students during the birth.” It therefore concluded that there had been a violation of Article 8.
The Court also found that domestic courts had failed to take account of the “alleged insufficiency of the information contained in the hospital’s notice, the applicant’s vulnerable condition during notification … and the availability of any alternative arrangements in case the applicant decided to refuse the presence of the students during the birth.”