(05.09.2011) The World Medical Association (WMA) and IFHHRO – International Federation of Health and Human Rights Organisations, today condemned the practice of forced and coerced sterilisation as forms of violence that severely harm physical and mental health and infringe human rights. They said that sterilisation is a form of birth control that should be available, accessible and affordable for every individual, within the full range of all alternative contraceptive methods. Barriers to sterilisation, once an informed choice has been made, should be minimised. Sterilisation should be available to any person who has reached the age of majority.
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.’