While undergoing surgery in connection with a miscarriage in a public hospital in Hungary, A.S., a Hungarian woman of Roma origin, was asked to sign a statement of consent to a caesarean section. The statement contained a barely legible hand written note using the Latin word for sterilization. Only after she was sterilized did A.S. learn that she had agreed to a procedure that would make her infertile. After A.S.’s claim of civil rights violations and negligent sterilization was rejected by the Hungarian courts, she then brought her case to the CEDAW Committee in 2004.
The CEDAW Committee addressed the fact that A.S. was sterilized before the Optional Protocol to CEDAW came into force in Hungary, determining that it still had the mandate to take up this case because the petitioner’s rights continue to be violated as a result of her permanent sterilization. In this regard, the Committee viewed the facts of the case to give rise to a violation of a continuous nature.
The Committee found a violation of Article 10(h) (right to information and advice on family planning) and Article 12 (right to access to health care services) as a result of the state’s failure to provide A.S. with detailed information about sterilization. The Committee also found a violation of Article 16 (1)(e) (right to decide on the number and spacing of children) as sterilization without her full and informed consent deprived A.S. of her natural reproductive capacity.
In finding a violation of Article 10, the Committee recognized that “the author has a right protected by Article 10(h) of the Convention to specific information on sterilization and alternative procedures for family planning in order to guard against such an intervention being carried out without her having made a fully informed choice.” It also noted that “any counselling that she received must have been given under stressful and most inappropriate conditions.” In finding a violation of Article 12, the Committee recognized that the state had failed to ensure that the author was provided with “thorough enough counselling and information about sterilization, as well as alternatives, risks and benefits.” The Committee also recalled its General Recommendation No. 19, in which it stated that “compulsory sterilization … adversely affects women’s physical and mental health, and infringes the right of women to decide on the number and spacing of their children”. Since the author had not given her free and informed consent to the procedure her right under Article 16 had been violated.
The Committee called on the state to provide appropriate compensation to A.S. and to ensure domestic legislation on informed consent for sterilization conforms to international human rights and medical standards. Specifically, the Committee urged Hungary to review the Public Health Act’s provision permitting doctors to sterilize women without first attaining their informed consent “when it seems to be appropriate in given circumstances.” The Committee also called on the state to monitor public and private health centers that perform sterilization procedures so as to ensure that patients give full and informed consent before any sterilization procedure is carried out, with appropriate sanctions in place in the event of a breach.