Like other medical procedures, sterilisation should be based on informed and voluntary consent. Its irreversible nature and consequences for the reproductive lives of individuals who have been sterilised, combined with a history of forced or coerced sterilisation of disenfranchised persons, persons who have a disability or belong to a marginalised group, requires special care to assure that the requirements of informed consent are met.
Involuntary sterilisation is a clear infringement of a persons’ reproductive autonomy and human rights.
Among those affected are women living with HIV, Romani or indigenous women, women with mental health problems or intellectual disabilities, transgender persons, women who use drugs, and other vulnerable groups.
Dr. Wonchat Subhachaturas, President of the WMA, said:
‘Regrettably, cases of coerced sterilisation continue to be reported in countries across the globe. Persons are being forcibly sterilised, either without knowing the procedure has been performed or without being given the opportunity to consent.This is a misuse of medical expertise, a breach of medical ethics and a clear violation of human rights. We call on all physicians and health workers to urge their governments to prohibit this unacceptable practice’.
Consent to sterilisation should be free from material or social incentives and should not be a condition of other medical care, social, insurance or institutional benefits. No threats – such as withholding other forms of medical care should be made to the person for refusing to consent to the procedure. For the sterilisation to be informed and voluntary, no financial or other material, psychological or social incentives should be provided to a person as an inducement to consent to sterilisation, nor should individuals be informed that certain benefits or privileges will be withheld for failure to consent. Particular care must be taken to assure protection from coercion of persons who are poor, uneducated or illiterate, HIV positive, members of a racial or ethnic minority or other stigmatised group, indigenous people, unmarried women, persons who have a mental or physical disability, are drug-dependent, or are otherwise vulnerable. Particular attention should be given to ensuring that health workers understand and comply with their obligations towards these individuals.
Dr. Adriaan van Es, Director of IFHHRO, said:
‘Health workers have an obligation to respect the right to self-determination and to obtain informed consent for any medical procedure. They also have a responsibility to respect a patient’s dignity, privacy, and autonomy, including the right to make decisions over all matters related to sexuality and reproductive health, including family planning, without coercion, discrimination, and violence. This includes the right to decide whether and when to have children and access to the means to exercise that right.’
The World Medical Association is the independent confederation of national medical associations from 97 countries and represents more than nine million physicians. Acting on behalf of patients and physicians, the WMA endeavours to achieve the highest possible standards of medical care, ethics, education and health-related human rights for all people.
The International Federation of Health and Human Rights Organisations (IFHHRO) is committed to the protection and promotion of health-related human rights, including the Right to Health and focuses on the important role of health workers in this regard. To increase the involvement of health workers, IFHHRO stimulates international cooperation between health and human rights organisations in various countries. Our institutional members are doctors’ associations interested in human rights work, human rights groups paying attention to health-related rights violations, or organisations that have been especially created to mobilise health workers for human rights protection.