V.C., a woman of Roma ethnic origin, was sterilized in a public hospital without her full and informed consent, following the birth of her second child via Cesarean section. When she was already in advanced stages of labor medical staff told her that if she had one more child, either she or the baby would die. She was then asked to sign a note in her medical record indicating that she had requested sterilization. V.C. did not understand the word “sterilization,” and signed the form fearing that if she didn’t there would be fatal consequences. As a result of the sterilization, V.C. has had serious medical health problems and she continues to suffer psychologically, knowing that she can no longer have children.
V.C. argued that the sterilization without free, full and informed consent and a failure of the state authorities to carry out a thorough, fair and effective investigation violated her rights to be free from inhuman and degrading treatment (Article 3), 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, finding a violation of the right to freedom from inhuman and degrading treatment, recognized that sterilizing V.C. without her informed consent grossly interfered with her dignity and physical integrity, and that “the […] procedure, including the manner in which the applicant was requested to agree to it, was liable to arouse in her feelings of fear, anguish and inferiority and to entail lasting suffering.”
The Court dismissed the government’s claim that the sterilization of V.C. was a life-saving surgery and concluded that there was no emergency involving imminent risk of irreparable damage to her life or health. The Court also noted that “[t]he way in which the hospital staff acted was paternalistic, since, in practice, the applicant was not offered any option but to agree to the procedure which the doctors considered appropriate in view of her situation.” Although there was no indication that the medical staff concerned had intended to ill-treat V.C., the Court found that they had acted with “gross disregard for her right to autonomy and choice as a patient.” Her sterilization had therefore been in violation of Article 3.
The Court further held that there had been no violation of Article 3 as concerned the applicant’s claim that the investigation into her sterilization had been inadequate. The Court indicated that since the medical staff had not acted in bad faith with the intention of ill-treating her there was no clear duty on the state to conduct a criminal investigation of their own initiative once the matter had come to its attention. The Court also found that V.C. had an opportunity to have her case examined by domestic courts within a period of time that is not open to particular criticism.
The Court also found a violation of Article 8 as a result of the lack of adequate legal safeguards, giving special consideration to her reproductive health as a Roma woman.
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 found no violation of Article 13.
In relation to Article 14 the Court stated that there was insufficient evidence of an intention on the part of medical staff to ill-treat the applicant or that their conduct was racially motivated or part of an organized policy. In light of the finding of a violation of Article 8 the Court did not find it necessary to rule separately on whether Article 14 had been breached. One judge dissented, stating that the, “applicant was ‘marked out’ and observed as a patient who had to be sterilized just because of her origin, since it was obvious that there were no medically relevant reasons for sterilizing her. In [the judge’s] view, that represents the strongest form of discrimination and should have led to a finding of a violation of Article 14 in connection with the violations found of Articles 3 and 8 of the Convention.”
The Court awarded the applicant 31,000 euros for pain and suffering and 12,000 euros for legal fees.