Report No. 120 (2017) IACHR. Petition No. 2003-13 (El Salvador)

CourtInter-American Comission of Human Rights
Report Number120
Respondent StateEl Salvador
Petition Number2003-13
Alleged VictimBeatriz
Case TypeAdmissibility
Report No. 120/17

REPORT No. 120/17

PETITION 2003-13





Doc. 141

7 September 2017

Original: Spanish

Approved by the Commission at its session No. 2098 held on September 7, 2017
164th Extraordinary Period of Sessions

Cite as: IACHR, Report No. 120/17. Petition 2003-13. Admissibility. Beatriz. El Salvador. September 7, 2017.

REPORT No. 120/17

PETITION 2003-13







Colectiva Feminista para el Desarrollo Local de El Salvador; Agrupación Ciudadana por la Despenalización del Aborto Terapéutico, Ético y Eugenésico de El Salvador; Ipas Centro América; and Centro por la Justicia y el Derecho Internacional

Beatriz and Family1

State denounced:

El Salvador

Rights invoked:

Articles 1.1, 2, 4, 5, 8, 9, 11, 24, 25, and 26 of the American Convention on Human Rights (hereinafter "American Convention"); Article 6 of the Inter-American Convention to Prevent and Punish Torture (hereinafter : "IACPPT"); and Article 7 of the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (hereinafter "Convention of Belém do Pará")


Date on which the petition was received:

November 29, 2013

Date on which the petition was transmitted to the State:

March 19, 2015

Date of the State's first response:

March 2, 2016

Additional observations from the petitioning party:

September 6, 2016

Additional observations from the State:

To date, the State has not presented additional observations

Precautionary measure granted:

PM 114-13. Precautionary measure granted on April 29, 2013

Provisional measure granted:3

Matter "B". Provisional Measure granted on May 29, 2013 and lifted on August 19, 2013.


Competence Ratione personae:


Competence Ratione loci:


Competence Ratione temporis:


Competence Ratione materiae:

Yes, American Convention (instrument deposited on August 21, 1990); Convention of Belém do Pará (instrument deposited on January 26, 1996); and IACPPT (instrument deposited on December 5, 1994)


Duplication of proceedings and international res judicata:


Rights declared admissible:

Articles 1 (obligation to respect rights), 2 (domestic legal effects), 4 (life), 5 (humane treatment), 8 (right to a fair trial/due guarantees), 9 (freedom from ex post facto laws), 11 (right to privacy/ to have honor respected and dignity recognized), 24 (equal protection), 25 (judicial protection), and 26 (progressive development of economic, social, and cultural rights) of the American Convention on Human Rights; Articles 1, 6, and 8 of the IACPPT; and Article 7 of the Convention of Belém do Pará

Exhaustion of domestic remedies or applicability of an exception to the rule:

Yes. Article 46.2.a of the American Convention applies

Timeliness of the petition:

Yes, as per Section VI


  1. The petitioners describe the alleged victim as a women who was born on October 30, 1990 in circumstances of extreme poverty, who was diagnosed in 2009 with systemic lupus erythematosus exacerbated by lupus nephritis and rheumatoid arthritis, which they refer to collectively as the "underlying illness." They state that in July 2011 she had a high-risk pregnancy and was referred to the National Maternity Hospital (hereinafter "the Hospital"), where, after a series of medical treatments for anemia, severe lupus condition together with pneumonia, hypertension and pre-eclampsia, she underwent a caesarian section and gave birth to a baby boy on March 4, 2012 who was regarded as premature and diagnosed with respiratory distress and necrotizing enterocolitis and only released from hospital 38 days after he was born. The petitioners say that Beatriz was offered sterilization but she declined it because she feared her child might die and that she would then not be able to try and have another one.

  2. They state that in November 2012, Beatriz suspected that she was pregnant and on February 18, 2013 went to the emergency room at the Rosales National Hospital, where she was diagnosed with a high-risk pregnancy in its 11th week. They say that in March she was again referred to that hospital on account of lupus-related injuries. There Beatriz was told that an ultrasound exam showed "no skullcap, with an image typical of an anencephalic fetus. A check-up was recommended in the 20th week”. They report that the defect was confirmed at the Hospital on March 12, 2013 and that the doctors decided to take the case before the Medical Committee "to reach a consensus (sic) on when the pregnancy should be interrupted because anencephaly is incompatible with life". They state that on March 14, 2013, the Head of the Perinatology Unit at the Hospital explained to Beatriz that the fetus had no chances of surviving and that there could be complications with her pregnancy due to her underlying illnesses and the sequels of her previous pregnancy. For that reason, Beatriz asked for her pregnancy to be interrupted, at which point the physician explained to her that her request was not legally permitted.

  3. They state that the Medical Committee of the Hospital agreed to file a petition with the Office of the Attorney General of the Republic (hereinafter "PGR") and to request the opinion of the Minister of Health. They say that two days later, the Head of the Legal Unit at the Hospital communicated with the Coordinator of the Board for the Protection of Children and Adolescents to request the opinion of the "competent authority or institution" to carry out the medical procedure recommended in order to "safeguard the life of the mother." They add that on April 9, 2013, the Board for the Protection of Children and Adolescents of San Salvador ruled on the request saying that it lacked authority in that area. It maintained, however, that there was a "possible risk and threat to the rights of the unborn child" so that it was obliged to uphold those rights and to notify the PGR so that the latter could appoint a state attorney to represent and defend the interests of the unborn child. The petitioners point out that, on that same day, Beatriz went to an appointment with the Director of the Hospital, who told her they could not act until one of the entities consulted pronounced on the matter. They say that the next day the Ancillary Prosecuting Attorney of San Salvador of the PGR sent a communication to the Minister of Health telling her that there would be no opposition to carrying out the procedure that health professionals considered pertinent and best in terms of safeguarding Beatriz's life.

  4. They assert that on April 12, 2013, the Medical Committee at the Hospital agreed to terminate the pregnancy on the grounds that in the short and medium term there was no possibility of the fetus surviving, that Beatriz's underlying illnesses would grow worse as pregnancy progressed, and that the duration of the pregnancy at that time (less than 20 weeks) meant that there was less risk of maternal health complications, given Beatriz's medical history and circumstances. They add that, despite the above, the Committee said it was subject to the law and as professionals of the Hospital they could not break the law. They say that on April 18, 2013, upon returning to the Hospital, the alleged victim was threatened and harassed by hospital personnel, due to the presentation of an action for enforcement of rights (recurso de amparo). A complaint was therefore filed with the Minister of Health. The petitioners also state that Beatriz told the Hospital psychologist that she had had suicidal thoughts and that the psychologist's only response had been to talk about God and give her religious books to read. They maintain that, on May 22, 2013, doctors at the hospital and the Head of the hospital's Perinatology Unit met and considered proposing to the Medical Committee that they would not perform surgery for the time being and that they planned to end the pregnancy at 28 weeks when the surgical risks would be lower.

  5. As regards the judicial actions brought on account of the facts reported, the petitioners say that Beatriz's representative filed an action for enforcement of rights on April 11, 2013 with the Constitutional Chamber of the Supreme Court of Justice (hereinafter "SC-CSJ") against the Director, the Head of the Legal Unit and the Head of the Perinatology Unit of the Hospital requesting that an order be given to operate on Beatriz immediately and save her life, given the Hospital's refusal to interrupt the pregnancy due to the criminal consequences they might suffer because of the absolute...

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