CEDAW/C/50/D/22/2009
6.5
L.C. arrived at the hospital with paraplegia from the fall she suffered, therefore it is
inaccurate to state that her condition necessarily worsened because the abortion was not
performed. What is more, according to the medical authorities, L.C. could not undergo the
spinal operation until the wound adjoining the surgical incision site had improved.
6.6
The situation of L.C. was evaluated on three occasions by the hospital medical board
(24 April, 7 May and 19 May 2007); there was no disinterest or lack of treatment. 8 On
those occasions psychiatric and neuropsychological evaluations were recommended and the
neurosurgeon believed that the surgery should be done when the occipito-cervical wound
had improved, as that was the area where the surgical incision would be made.
6.7
At the third meeting of the medical board, held on 19 May 2007, the following was
stated: “The operation required by the patient is not an emergency, it is elective ... The
luxo-fracture C6 and C7 cannot undergo the planned surgical stabilization because there
continues to be an infection in the area bordering the area of the surgical incision ... The
Department of Obstetrics and Gynaecology maintains that, despite this being a high-risk
pregnancy, the current condition of the patient is stabilizing in the neurological aspects and
favourable in the psychological aspects ... In line with the laws in effect, the majority of us
believe that the termination of pregnancy should not be performed”. This decision was
communicated to L.C.’s mother, who had requested the termination of pregnancy. She
submitted an appeal, to which the response was the same. Therefore, she did have the
possibility of appealing to the competent authorities to act on her request, independent of
the fact that the result was not what she had hoped.
6.8
With respect to the right to decide the number and spacing of children, it should be
evaluated based on existing family planning methods and programmes offered by the State.
In the present case, however, the author attempts to link this right to therapeutic abortion,
which the State party does not accept. Abortion is illegal as a general rule and is permitted
only as an exception in cases of therapeutic abortion, and it is necessary to take domestic
laws into account. It is not for the pregnant woman unilaterally to determine that the
conditions for a therapeutic abortion have been met, but for the doctors. That is effectively
what occurred in this case; they considered that the pregnancy did not represent a risk to
L.C. and therefore deduced that her condition would have neither improved nor worsened if
the abortion had been performed. As far as legal abortion is concerned, in reaching a
decision that did not depend exclusively on the wishes of the pregnant woman, it is not
possible, strictly speaking, to refer to the violation of a “right”, as there is no link to
reproductive freedom. Likewise, it would not be possible to link the fact that access to a
therapeutic abortion was denied to the alleged existence of a certain stereotype against
women.
6.9
According to the Technical Team of the General Directorate for the Promotion of
Health of the Ministry of Health, in the present case it is important to consider the family
environment, the risks to which L.C. had been exposed since the age of 11 (the age at
which the sexual abuse began) and the way in which it gravely harmed her physical and
mental health. These elements are a starting point for new initiatives for intervention with
at-risk populations.
8
The State party attached copies of the reports of the medical board. According to the first, of
24 April 2007, the doctors’ views regarding the pregnancy were that “because of the patient’s
diagnosis, age, invasive nursing procedures, immobility in bed, it is considered high risk, leading to
elevated maternal morbidity, which could diminish with appropriate multidisciplinary medical
management”. The report also noted that there was no guarantee that the baby would not be affected
by the spinal surgery.
9