Czech government expresses regret for illegal sterilizations of Romani women

Yesterday, at the instigation of Czech Human Rights Minister Michael Kocáb, the Government of the Czech Republic expressed regret over the illegal sterilizations of women that have been performed in the country. Speaking after a cabinet session, Kocáb said a set of measures are being designed which should prevent similar cases from recurring.

The government wants to do its best to completely eliminate the risk of illegal sterilizations occurring in future. The most important aspect is the design of more careful, detailed arrangements for health care facilities to secure informed consent prior to performing sterilizations. There are currently no statistics on the number of women who have been harmed by this surgery in the Czech Republic.

Activists say dozens of Romani women have undergone forced sterilizations in the Ostrava region. In the past, several institutions have devoted attention to the issue of illegal sterilizations, including Czech ombudsman Otakar Motejl, to whom approximately 80 women, most of them Roma, complained in the past. He published his final statement on the issue in December 2005. Prior to his report, an Advisory Committee of the Czech Health Ministry also reviewed the cases. Human Rights Minister Kocáb is aware of the gravity of this issue and has continued to follow it carefully, preparing a motion to address the issue which he submitted to the government for approval yesterday.

During the 20th century, sterilizations without informed consent have been a problem not only in Central Europe, but also in Sweden, Switzerland and the USA. Kocáb’s motion concerns not only the problematic issue of sterilizations performed in the former Czechoslovakia, but also in the Czech Republic. The motion focuses particularly on the lack of the informed consent required from patients to the surgery and does its best to respond to criticism from national, non-governmental and international organizations.

Illegal sterilization is a serious violation of a person’s physical integrity and violates one of the most basic human rights, the right to the inviolability of one’s person, enshrined not only in the Charter of Fundamental Rights and Freedoms but also in all other international human rights documents. It is only possible to intervene into someone’s integrity under circumstances established by law. No other instances are justifiable. The most frequent kind of legitimate intervention is surgery performed by a doctor on the basis of the competent, free, and informed consent of a patient prior to the surgery. This consent is not required only in exceptional cases specifically listed in the law, such as cases in which immediate action is required to save a patient’s life or preserve their health. It is essential to not only guarantee that patients receive the required information and instruction on such procedures from professionals, but that physicians, medics and health care personnel be continually educated over the course of their careers on the human rights aspects of their work.

In his motion, Kocáb informed the government of the existence of the problem of illegal sterilizations. He proposed several measures to better clarify the practice and prevent the repetition of similar cases. The government expressed its regret over the past instances of errors found with respect to sterilizations performed in contravention of the Health Ministry directive on sterilizations.

The Czech Health Minister is to submit information to the government on the fulfillment of the recommendations made on the issues by the previous Advisory Council, which was established in 2004 to investigate women’s complaints about sterilizations. These recommendations included support for all forms of family planning, the establishment of unified procedures for informed consent to the performance of sterilizations including an interview with a psychologist, re-evaluation of the existing indications for the performance sterilization, and updating of the directive on sterilizations, particularly as it relates to the performance of Caesarian deliveries.

The government resolution has tasked the Czech Health Minister with including the issue of sterilization on the program of the Expert Forum for the Creation of Standards of Care and Concentrations of Selected Highly Specialized Care. As part of prevention and further education of professionals, the minister will address organizations directly administered by the Health Ministry and other health care facilities in the Czech Republic providing obstetrical and gynecological care to look into whether legal regulations on the performance of sterilizations are being upheld.