VC v Slovakia: A Step Toward Justice for Roma Women

In a groundbreaking decision, the European Court of Human Rights ruled that forced sterilization is a violation of the European Convention on Human Rights (specifically Article 3, which prohibits torture or inhuman and degrading treatment, and Article 8, which protects the right to private and family life). This long-awaited judgment in the case of VC v Slovakia is a step forward for efforts to bring justice to the potentially thousands of Roma women who were sterilized without their consent in Central and Eastern Europe. The extent of the abuse was first exposed in detail in the 2003 report, Body and Soul: Forced Sterilization and Other Assaults on Roma Reproductive Freedom in Slovakia.

VC, a Romani 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—and that the hospital staff violated her rights by not providing her with full information on the implications of the procedure—VC filed a civil lawsuit in Slovakia. The pursuit of justice at home failed, and in 2007 she filed a complaint against Slovakia at the European Court of Human Rights.

In its decision, the court noted that sterilization is never a life saving 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. The court wrote:

According to the Government, the applicant’s sterilisation was aimed at preventing a possibly life-threatening deterioration of her health. Such a threat was not imminent as it was likely to materialise only in the event of a future pregnancy. It could also have been prevented by means of alternative, less intrusive methods. In those circumstances, the applicant’s informed consent could not be dispensed with on the basis of an assumption on the part of the hospital staff that she would act in an irresponsible manner with regard to her health in the future.

The court found that the hospital staff acted without respect for human dignity and human freedom by not giving VC the time and information necessary to make a free and fully informed decision. The court wrote, “the 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.” It recognized that “the sterilization procedure grossly interfered with the applicant’s physical integrity” and that medical personnel acted “with gross disregard to her right to autonomy and choice as a patient.”

While the court alluded to the complicity of the state in grave human rights violations against Roma, it disappointingly did not address whether such conduct was a violation of the right to non-discrimination (Article 14). By not doing so, the judgment falls short of addressing the crux of the problem: that VC experienced these abuses because she is a Romani woman. The court rejected the government’s arguments in defense of its practice, which were based on negative stereotypes of Roma, but failed to call these arguments discriminatory. For example, the court explicitly rejected the government’s argument concerning VC’s failure to undergo regular check-ups and neglecting her health during pregnancy. This is a common stereotype that the government shamelessly exploits to justify “special treatment” of Roma—in other words, to allow for sterilization without consent.

One judge dissented, arguing that the court should also have ruled that Slovakia violated VC’s right to non-discrimination. Judge Mijovic wrote:

Finding violations of Articles 3 and 8 alone in my opinion reduces this case to the individual level, whereas it is obvious that there was a general State policy of sterilisation of Roma women under the communist regime (governed by the 1972 Sterilisation Regulation), the effects of which continued to be felt up to the time of the facts giving rise to the present case…. The fact that there are other cases of this kind pending before the Court reinforces my personal conviction that the sterilisations performed on Roma women were not of an accidental nature, but relics of a long-standing attitude towards the Roma minority in Slovakia. To my mind, the applicant was “marked out” and observed as a patient who had to be sterilised just because of her origin, since it was obvious that there were no medically relevant reasons for sterilising her. In my 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 VC v Slovakia ruling is the first of its kind issued by the European Court of Human Rights, but there are multiple similar cases pending. These cases can have a major impact in the lives of women who have had their fertility taken away from them. The court’s recognition of forced sterilization as a severe human rights abuse will hopefully bring some sense of justice to victims, as it has to VC. A court finding of discrimination would send a strong message that governments can no longer use racial stereotypes to defend abuse masquerading as medicine.

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Only time - and legal scholars - will be able to tell us whether this judgment might have wider implications for other kinds of forced medical procedures, for example, procedures forced on women in labor like cesarean sections, treatments judged necessary by medical professionals for certain children, or those with disabilities, or the aging.

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