IACHR Files Case Concerning Peru with IA Court on Sterilization without Consent

August 18, 2023

Washington, D.C. - On June 3, 2023, the Inter-American Commission on Human Rights (IACHR) submitted case 13.752 to the Inter-American Court of Human Rights, concerning Celia Edith Ramos Durand, who died as a result of a sterilization to which she was subjected without her consent as part of the National Reproductive Health and Family Planning Program (PNSRPF).

Ms. Ramos Durand resided in the village of La Legua, Catacaos, in Piura, Peru, where a branch of the PNSRPF was operating, promoting surgical contraception. On July 3, 1997, Ms. Ramos Durand underwent this procedure and suffered medical complications that resulted in her death. That same day, medical personnel from the Ministry of Health sterilized fifteen women in the village of La Legua.

The investigation into these events was archived on several occasions. In 2002, a congressman referred the case to the Special Prosecutor's Office for Crimes against Human Rights, but the case was archived in May 2009 due to the statute of limitations. In October 2011, the Public Prosecutor's Office reopened the investigation against former health ministers and other officials and expanded it to include former president Alberto Fujimori on the grounds that the crimes constituted serious human rights violations and crimes against humanity.

After passing through several stages of judicial proceedings, in April 2018, the Third National Superior Criminal Prosecutor's Office of Lima ordered that Alberto Fujimori and others be formally accused as perpetrators of the crimes of serious injury followed by death, including in the case of Celia Edith Ramos Durand.

In its merits report, the IACHR analyzed whether the Peruvian State had complied with its obligations regarding regulating and monitoring the sterilization program, obtaining informed consent, and ensuring that the conditions for carrying out the medical procedure were suitable. The IACHR found that the Peruvian State had failed to comply with all of these obligations.

On the matter of regulation and monitoring, the IACHR concluded that the program established discriminatory goals aimed exclusively at women, which reinforced gender stereotypes and affected women's sexual and reproductive rights.

With regard to informed consent, the IACHR ruled that even though Ms. Ramos Durand signed a document consenting to the procedure before it took place, the requirements and conditions necessary for this consent to be free and informed were not met. Health personnel visited her numerous times to persuade her to have the surgery even though she did not want it. She was not given adequate information about other methods of contraception, and she gave her consent less than 48 hours before the operation.

On the matter of the conditions in which the medical procedure was carried out, the IACHR found that the healthcare center where the sterilization was performed did not have the necessary resources, which resulted in her not being provided adequate care during the medical emergency that occurred during the procedure.

The IACHR also emphasized that the purpose of the operation was the permanent loss of Ms. Ramos Durand's reproductive capacity, which violated her right to decide freely over her body and constituted an arbitrary interference in her private life. It also found that she was a victim of intersectional discrimination due to her gender and financial circumstances and that her nonvoluntary sterilization constituted an act of violence against women.

With regard to judicial guarantees and judicial protection, the IACHR noted that the investigations into the sterilization and death of Ms. Ramos Durand were archived on several occasions, demonstrating a lack of diligence on the part of the State. It also observed that although 24 years have passed since these events took place, an adequate investigation has not been carried out within a reasonable period of time. This has affected the victims' access to justice, especially that of Ms. Ramos Durand's daughters, who suffered serious emotional damage as a result of the loss of their mother when they were young.

Based on these findings, the IACHR concluded that the Peruvian State is responsible for the violation of the rights established in articles 4.1 (the right to life), 5 (the right to personal integrity), 11 (the right to privacy), 13 (access to information), 25 (judicial protection), and 26 (the right to sexual and reproductive health) of the American Convention, in relation to the obligations established in articles 1.1 and 2 of this instrument and article 7 of the Belém Do Pará Convention, to the detriment of Celia Edith Ramos Durand. In addition, it concluded that the State violated article 5.1 (the right to personal integrity) of the American Convention to the detriment of her family members.

The IACHR recommended that the State take the following reparation measures:

• Provide comprehensive reparation for these violations of the victims' rights, including financial compensation, other measures of redress, and physical and mental healthcare measures for the victims' relatives.
• Investigate the events thoroughly and effectively to identify and punish those responsible for them.
• Implement measures of nonrepetition, with a particular focus on reviewing practices for obtaining informed consent from patients.
• Adopt legislation and policies to guarantee respect for the rights of people receiving health-related guidance and giving informed consent, considering factors such as gender, race, financial circumstances, or migration status.

The IACHR is a principal and autonomous body of the Organization of American States (OAS), whose mandate stems from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has the mandate to promote the observance and defense of human rights in the region and acts as an advisory body to the OAS on the matter. The IACHR is made up of seven independent members who are elected by the OAS General Assembly in their personal capacity, and do not represent their countries of origin or residence.

No. 186/23

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