A.S. v. Hungary, Communication No. 4/2004, CEDAW/C/36/D/4/2004

Communication that Ms. A.S.'s rights were violated when a doctor in a public hospital performed a forced sterilization procedure without providing adequate information regarding the sterilization procedure to obtain Ms. A.S.'s free and informed consent; Requirements of free and informed consent; Right to decide the number and spacing of children; Right to access sexual and reproductive health education and family planning information; Exhaustion of Domestic Remedies; Equality and Non-discrimination.

Date of the Ruling: 
Aug 29 2006
UN Committee on the Elimination of Discrimination Against Women
Type of Forum: 

Upon going into labor, Ms. A.S., a member of the Roma community, needed an emergency Caesarian section. Immediately before the surgery, a doctor asked Ms. A.S. to sign consent forms on which the doctor had hand-written a statement that Ms. A.S. consented to a sterilization procedure. Ms. A.S. did not understand the statement or that she had been sterilized until after the operation took place. Her claim of civil rights violations and negligent sterilization was rejected at the local level. In her communication to the CEDAW Committee, it found that the Ms. A.S. exhausted her domestic remedies becauase under Hungarian law she was unable to appeal this decision to the Constitutional Court given the nature and facts of her case. Hungary was found to have violated Ms. A.S.'s rights to (1) fully informed consent to medical procedures; (2) right to information on family planning; (3) right to appropriate services in connection with pregnancy and the post-natal period; and (4) right to determine the number and spacing of her children, under Articles 10(h), 12 and 16(1)(e) of the Convention on the Elimination of Discrimination Against Women. The Committee also found that the communication was admissible, even though the operation occurred before the Optional Protocol entered into force for Hungary, because sterilization was a continuous injury, and because sterilization is permanent, irreversible (despite the state's claims) and success of reversal is low.

Keywords: A.S. v. Hungary, Communication No. 4/2004, CEDAW/C/36/D/4/2004, Cultural, Rights

Enforcement of the Decision and Outcomes: 

The Committee recommended that Hungary compensate Ms. A.S. and take measures to make sure health officials give information to patients and obtain informed consent. In 2008, Hungary amended the Public Health Act to ensure that women received proper information regarding sterilization procedures.  Finally, in February 2009 the Ministry of Social Affairs and Labour announced that they will compensate Ms. A.S. according to the Committee's recommendations. 

Groups involved in the case: 

European Roma Rights Centre Legal Defense Bureau for National and Ethnic Minorities Center for Reproductive Rights

Significance of the Case: 

This is a landmark decision, in which for the first time an international body held a state responsible for failing to provide a woman with necessary information and obtain full consent for reproductive health procedures. This decision establishes that obligations to ensure women's human rights require that they must be provided with acceptable reproductive health services, specifically requiring free and informed consent to a sterilization procedure.  This decision was an important step in addressing the systemic discrimination against Romani women in Central and Eastern Europe, however, governments in the region remain highly reluctant to acknowledge marginalization and discrimination of Romani peoples.