Women and Justice: Topics: Abortion and reproductive health rights, Forced sterilization, Gender discrimination, International law, Sexual violence and rape

The Charter aims to protect and promote the human rights set out in Part 2, including property rights and freedom from forced work (slavery), as well as the right to enjoy those human rights without discrimination. With respect to any proposed new law, the Victorian Parliament must prepare a “statement of compatibility,” which must examine the proposed law’s compatibility (or incompatibility) with the human rights protected in the Charter. While this statement has no effect on the validity of any law, it furthers the purpose of the Charter in promoting human rights. Further, under section 32 of the Charter, all statutory provisions must be interpreted in a way that is compatible with human rights (to the extent it is possible to do so consistently with their purpose). The Charter also allows the Victorian Equal Opportunity and Human Rights Commission to intervene in any court or tribunal proceeding in relation to the Charter.

Art. 264e provides for a criminal penalty of not less than three years for any person who commits certain specified offenses in connection with an armed conflict, including (among other things) raping a person of the female gender protected by international humanitarian law or, after she has been forcibly made pregnant, confining her unlawfully with the intent of affecting the ethnic composition of a population, forcing a person to tolerate a sexual act of comparable severity or forcing a person protected by international humanitarian law into prostitution or to be sterilized. In especially serious cases, and in particular where the offense affects a number of persons or the offender acts in a cruel manner, life imprisonment may be imposed. In less serious cases, imprisonment of not less than one year may be imposed. Unofficial English translation available here.

The Abortion and Sterilization Act (the “Act”) was adopted from South Africa and prohibits abortions, except in extreme circumstances where either: (i) the mother’s life is in danger; (ii) not having an abortion would constitute a serious threat to the mother’s mental health; (iii) there is a serious risk that the child will be born with physical and/or mental defects; or (iv) the child is a product of rape or incest. It also criminalizes performing abortions, except in the circumstances listed above. Finally, the Act states the circumstances in which sterilizations may be performed, including on people incapable of consent.

The Criminal and Criminal Procedural Codes of Ukraine were amended in December 2017 to adopt provisions of the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (Istanbul Convention) adopted in 2011. As a result of these amendments, forced marriage (i.e. forcing a person to marry or to continue being in a forced marriage, or to enter into a cohabitation without official registration of marriage, or to continue such cohabitation) is punishable by restraint of liberty for up to three years or imprisonment for the same period and domestic violence (i.e. deliberate systematic violence against a spouse or ex-spouse or other person with whom the perpetrator is in family or intimate relationship, leading to physical or psychological suffering, disorder of health, disability, emotional dependence) is punishable with a sentence of public work for up to 240 hours, detention for up to six months, restraint of liberty for up to five years, or imprisonment for up to two years. In addition, the amendments: (i) introduce new crimes, such as “illegal abortion or sterilization” (i.e., performed by a person without medical education or without consent of the victim) which is punishable by imprisonment for up to 3 years; (ii) establish punishment for rape of a spouse or ex-spouse or other person with whom the perpetrator is in a family or intimate relationship (imprisonment for up to 10 years); and (iii) increase punishment for sexual violence to up to 15 years, if such acts resulted in serious consequences.

The eight applicants in this case were all women of Roma ethnicity. They each suspected they had been sterilized during caesarian section deliveries at two different hospitals. Both hospitals denied the applicants’ requests to obtain copies of their medical records, and the applicants brought actions in different District Courts. The courts ordered the hospitals to allow access to the records and handwritten notes to be taken, but dismissed the request to make photocopies of the records. The Regional Courts both upheld the decision on appeal. The Constitutional Court also upheld the decision of the lower court. Subsequently, the applicants’ legal representatives were permitted to make copies of the applicants’ records due to the passage of the Health Care Act of 2004. Only one applicant did not receive her records and was informed they were lost, but she received a summary of her surgical procedure confirming she had been sterilized. The applicants argued that the hospital’s refusal to allow copies of their medical records violated their Article 8 right to respect for their private and family life. The applicants argued that the State’s prohibition on photocopying medical records prevented them from gathering evidence required for future litigation in violation of their Article 6 right to access a court. The State argued that the Health Care Act of 1994 did not allow legal representatives of applicants to photocopy records, and this prevented potential abuse of records. The European Court of Human Rights found that access to health and reproductive status information was relevant to private and family life under Article 8, and that the burden lay with the refusing party to give compelling reasons for refusal. The Court found the State’s argument was not sufficiently compelling, and that the State had violated the applicants’ rights under Article 8. The Court also found a violation Article 6’s provision of a right to access a court, and awarded the applicants damages.

VC, a Roma woman, was forcibly sterilized in a state hospital in Eastern Slovakia during a cesarean section. While she was in the height of labor, hospital staff insisted that she sign a consent form for sterilization, without informing her about what the procedure entailed. She was only told that a future pregnancy could kill her and was pressured to immediately undergo the procedure. VC did not understand what she was agreeing to but fearing for her life, she signed the form. After learning that the sterilization was not medically necessary, VC filed a civil lawsuit in Slovakia. All her petitions were rejected, and she filed a complaint against Slovakia at the ECtHR The Court found a violation of Articles 3 and 8 of the ECHR, i.e. the right to freedom from inhuman and degrading treatment and the right to private and family life respectively. The court noted that sterilization is never a lifesaving procedure and cannot be performed without the full and informed consent of the patient even if doctors believe that future pregnancy may pose a risk to the woman. However, it did not address whether such conduct was a violation of the right to non-discrimination (Article 14), thus falling short of addressing the crux of the problem: racial stereotypes. The ruling is the first of its kind issued by the ECHR, and will have the major effect of bringing justice to the potentially thousands of Roma women who were sterilized without their consent in Central and Eastern Europe.

The court held that the applicants, as joint guardians of a 14-year-old child with a severe mental disability, were allowed to authorize the sterilization of the child without a court order, provided that (i) the circumstances were so compelling that the welfare of the child justified such an invasive procedure and (ii) there was no possibility of the child acquiring the capacity to decide for herself. Generally, it was established that children with the maturity and intelligence to fully understand proposed treatment can make such a decision even though they have not reached the age of adulthood. Parents or guardians of children who do not have sufficient capacity or maturity or intelligence to decide, can make such a decision on behalf of their children, provided that the treatment is in the child’s best interest. However, the parental ability to consent to sterilization is limited to circumstances in which sterilization is required to treat some malfunction or disease. In relation to non-therapeutic purposes, a court order is required to authorize sterilization.

In 2014, the Supreme Court of Namibia (“Supreme Court”) affirmed the High Court of Namibia’s (“High Court”) decision in LM and Others v. Government of the Republic of Namibia that sterilization procedures require informed consent. The three respondents sued the Namibian government, alleging that doctors at state hospitals forcibly sterilized them without their consent in violation of their constitutional rights. They claimed that the forced sterilizations left them unable to bear children, ruined their marriage prospects, constituted discrimination against them based on their HIV status, and caused ongoing pain and suffering. The defendants argued that the plaintiffs’ claims lacked merit because they consented to the procedures. The court found that the alleged “consent” was deficient because the defendants failed to prove that they adequately informed the plaintiffs of the consequences of sterilization, or that the plaintiffs clearly and knowingly consented to the procedures before they went into labor. However, the Court found no evidence that the complainants were sterilized because of their HIV status and dismissed that claim. Emphasizing the serious personal nature of the decision, the Supreme Court stated that the decision to be sterilized “must be made with informed consent, as opposed to merely written consent” (¶ 3). The Supreme Court stated that the choice to undergo a sterilization procedure must lie solely with the patient noting that “there can be no place in this day and age for medical paternalism when it comes to the important moment of deciding whether or not to undergo a sterilisation procedure.” (¶ 106). The Supreme Court also denounced the practice of obtaining “consent” for sterilization during labor noting that patients may not fully appreciate the consequences of giving their consent when experiencing the immense pain involved in labour. The Supreme Court also agreed with the lower court that plaintiff-respondents did not provide any evidence that they were sterilized because of their HIV status.

After having her first child in China in 1984, Cheung had three abortions and moved to a new province in 1986 to avoid problems with local authorities on the basis of China’s one-child policy. Cheung had another child in that province. Cheung moved to Canada, knowing that she would be sterilized if she returned to China. The Immigration and Refugee Board determined that Cheung and her daughter did not have the “well-founded fear of persecution” necessary for Convention refugee status, and Cheung appealed. The Court determined that forced sterilization “is such an extreme violation of basic human rights as to be persecutory,” and determined that Cheung did in fact have the “well-founded fear of persecution” necessary for refugee status. Furthermore, the Court determined that Cheung’s young daughter also qualified for refugee status because she would have been denied appropriate medical care and other necessities if she returned to China.