Guachalá Chimbo et al. v Ecuador

Nature of the Case

The Inter-American Court of Human Rights affirmed that disability is a category protected by the American Convention and established general obligations to eliminate all disability-based discrimination and to promote full integration of persons with disabilities into society. The Court found that, due to the failure of the State to provide adequate accessible medical treatment and the public hospital to obtain informed consent from Mr. Chimbo, who disappeared during his custody at the hospital, the State violated his rights to recognition of juridical personality, life, integrity, personal liberty, dignity and privacy, access to information, and health. The court also held that the State violated the rights to judicial guarantees and protection and the right of personal integrity of his family.

Enforcement of the Decision and Outcomes

While Ecuador continues to investigate the disappearance of Mr. Chimbo, advocates note that the investigative measures have been conducted in a non-technical, unsystematic manner and that the State has not been diligent in their efforts. Further, as of April 2022, Ecuador had not made the required payments for damages or mental health treatment to Mr. Chimbo’s mother or sister. On January 20, 2022, the Ministry of Public Health of Ecuador (MSP) posted a public apology through an image on Twitter; the image did not name Mr. Chimbo or his mother as victims. The MSP also posted a short statement on the case with a link to the ruling on Twitter, but this publication fails to comply with the judgement that requires the posting be on the home page of the website and accessible to the public. In February 2022, Ecuador published two documents on the Ministry of Health website that summarized the judgement. But Ecuador did not coordinate this publication with the injured parties, Mr. Chimbo’s mother and sister, and it was published two months after the deadline. On September 15, 2022, Ecuador has made public act of acknowledgment of international responsibility and apology to the family.

Significance of the Case

This was the Court’s first case to involve the psychiatric hospitalization of a person with disability since the adoption the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2006. Guachalá Chimbo et al. v Ecuador establishes the right of a person with disabilities to provide informed consent in relation to the right to health and requires the provision of the necessary supports to obtain free and informed consent. This standard applies even if a patient is in crisis. If no advance planning measures are in place and significant efforts have been made to obtain consent, then the State must determine the best interpretation of the patient’s will and preferences.

For their contributions, special thanks to ESCR-Net members: the Program on Human Rights and the Global Economy (PHRGE) at Northeastern University.