N.B., a 17-year-old adolescent of Roma ethnic origin, was sterilized without her informed consent following a caesarean section delivery at a public hospital. During labor, N.B. was given various sedative medications, after which, she was approached by a member of the medical staff who took her hand and assisted her in signing some forms. N.B. described feeling “intoxicated” from the medication and felt too weak to inquire about the contents of the documents. She only remembered a doctor instructing her to sign the papers or she would die. About six months later, N.B. found out she had been sterilized and was informed about the irreversible nature of the procedure. She also experienced inferior treatment at the hospital where women of Roma origin were accommodated separately from non-Roma women in the so called “Gypsy rooms.” N.B. also claimed that she had suffered serious physical and mental health problems as a result of the procedure, including being ostracized by her community because of her infertility.
N.B. argued that the forced sterilization violated her right to be free from inhuman and degrading treatment (Article 3), right to respect for private and family life (Article 8), right to found a family (Article 12), right to an effective remedy (Article 13), and freedom from discrimination based on sex and ethnic origin (Article 14) read in conjunction with Articles 3, 8, and 12 of the European Convention on Human Rights.
The European Court of Human Rights found that the failure to obtain the applicant’s informed consent meant that the sterilization procedure was not respectful of her human freedom and dignity, even though the doctors believed that the procedure was necessary to safeguard her health and life as a future pregnancy, in their opinion, would pose a threat. The Court stated that asking the applicant to sign the form after she had received tranquilizing medication and with a false explanation that she would otherwise lose her life, “violated the applicant’s physical integrity and was grossly disrespectful of her human dignity.” While the Court did not find that the medical staff acted “with the intention of ill-treating the applicant…[t]hey nevertheless acted with gross disregard for her human freedom, including the right to freely decide … whether she consented to the procedure.” Considering her young age, the Court found that the sterilization “grossly interfered with her physical integrity.” Furthermore, given the seriousness of the procedure and the way she was asked to consent, the Court concluded that it, “was liable to arouse in her feelings of fear, anguish and inferiority and to entail lasting suffering,” and that the suffering reached the minimum threshold required for Article 3.
It further held that there had been no violation of Article 3 as concerned the applicant’s allegation that the investigation into her sterilization had been inadequate. In this regard the Court stated that “in the specific sphere of medical negligence the obligation to carry out an effective investigation may, for instance, also be satisfied if the legal system affords victims a remedy in the civil courts, either alone or in conjunction with a remedy in the criminal courts, enabling any liability of the doctors concerned to be established and any appropriate civil redress, such as an order for damages and for the publication of the decision, to be obtained.”
The Court ruled that the sterilization affected the applicant’s “reproductive health status” as well as her private and family life, and thus amounted to interference with her rights under Article 8. The Court also found that sterilization was performed contrary to the Slovak law because the applicant’s mother had not given her consent to the procedure. Furthermore, the Court ruled that the state failed to carry out its positive obligation under Article 8 by not “putting in place effective legal safeguards to protect the reproductive health of, in particular, women of Roma origin.” This all amounted to a violation of the applicant’s right to respect for private and family life.
Given the Court’s finding of violation of Article 8, the Court did not find it necessary to examine separately the complaint under Articles 12 and 14.
The Court awarded the applicant 25,000 euros in compensation for non-pecuniary damages and 5,000 euros for costs and expenses.