CEDAW/C/73/D/102/2016
Background
1.
The authors, J.D. et al., are Czech nationals of Roma ethnicity born in 1966,
1969, 1960, 1960, 1964 and 1963, respectively. They submit that they have been
subjected to sterilization without their informed consent and are therefore victims of
an ongoing breach of article 2 (b) and (e) of the Convention, read in conjunction with
articles 5, 10 (h), 12 and 16 (1) (e) of the Convention. The Optional Protocol entered
into force for the Czech Republic on 26 February 2001.
Facts as presented by the authors
2.1 J.D. gave birth to four children by natural childbirth. After her last birth at the
age of 34 years, she decided to use an intrauterine device as a contraception method.
Following some difficulties, she visited her gynaecologist, who changed the
intrauterine device but did not recognize that she was pregnant again. She learned
about the pregnancy only when she sought treatment for complications. On 27 July
2001, she was hospitalized at the Ostrava municipal hospital. After diagnosing an
ectopic pregnancy, the gynaecologist informed her that she needed immediate surgery
to terminate the pregnancy, without mentioning sterilization. The hospital personnel
prepared her for the procedure and made her sign papers whose content she does not
remember, as she was suffering from pain caused by internal bleeding and there were
many people around. After signing the form, she was taken to surgery and sterilized.
The doctor told her about the sterilization only when he gave her the hospital
discharge summary. Two sentences in the record alluded to the consent to be
sterilized: “Patient requires sterilization. 27 July 2001” and “I agree with the surgery
to the extent we agreed on with doctor.” There is no indication as to whether the
doctor provided her with information about the sterilization. The consent of the
“sterilization committee” required prior to the procedure is dated 31 August 2001, a
month later. The Ombudsperson investigated the case and stated that the doctors had
acted against the law because they did not obtain the informed consent of J.D. H e
referred the case to the police but they did not carry out a full investigation. The
Medical Chamber, a professional self-regulatory body, found no misconduct.
2.2 G. gave birth to her first child in 1988 by caesarean section. Two years later, she
became pregnant again and was informed by a pregnancy-risk specialist that the
second birth might also have to be performed by caesarean section. No one mentioned
sterilization. On 23 September 1990, she had bleeding and pain. After her admission
to Vitkovice Hospital in Ostrava, the doctors let the birth progress naturally, but the
next day, following complications, decided to perform a caesarean section. A nurse
gave her an “antenatal form” and a consent form for sterilization. She was told “You
have to sign this!” without further details. She was in pain, under psychological
pressure and worried about her own life and the life of her child, and had no time to
read the form properly while she was being moved to the operating room. In the
document, it is stated: “I agree to the surgery I have been offered and to every other
intervention which will appear necessary during surgery. Patient asks for sterilization
at the same time.” The second sentence is written in a different typescript, raising the
possibility that it was added after the author signed. It does not include details on
whether the doctor provided any information about sterilization. Only 25 minutes
passed between the doctor’s decision to operate and the birth of the baby. G. reports
that she did not request sterilization. In the medical documentation, it is stated that
she did: “While providing information about her medical condition and indicated
surgery, patient in front of doctor and nurses asks for sterilization in order not to have
children.” She was first told about her sterilization by the consultant in the postoperative recovery room, but did not understand the meaning owing to the technical
language used. She learned about the full consequences from the doctor only the day
after the surgery. She was 21 years old and she and her husband wanted another child.
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