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Resolution 1945 (2013) Final version
Putting an end to coerced sterilisations and castrations
1. Coerced, non-reversible sterilisations
and castrations constitute grave violations of human rights and human
dignity, and cannot be accepted in Council of Europe member States.
2. Defining the element of “coercion” in sterilisations and castrations
is not as self-evident as defining “forced” sterilisations and castrations,
which historically have involved physical force or procedures performed without
the knowledge of the victim or without the opportunity for the victim
to provide consent. The concept of “coercion” is currently evolving
in human rights law, based on the definition of the lack of free
and informed consent. Thus, even where consent is ostensibly given
– also in written form – it can be invalid if the victim has been
misinformed, intimidated or manipulated with financial or other
incentives. New concepts of “emotionally coerced sterilisation”
and “pressure that diminishes a patient’s autonomy” are currently
emerging. Some of these concepts go as far as considering as coercion
the lack of freedom from any bias introduced, consciously or unconsciously,
by health-care providers, and power imbalances in the patient–care
provider relationship which may impede the exercise of free decision
making, for example by those who are not accustomed to challenging
people in positions of authority.
3. In the first half of the 20th century, a considerable number
of European States – not just Nazi Germany – engaged in often massive
forced or coerced eugenic sterilisation and castration programmes,
some of whose victims are still alive. Five groups of people were
particularly targeted: Roma women, convicted sex offenders, transgender
people, people with disabilities, and the marginalised, stigmatised,
or those considered unable to cope.
4. There are very few sterilisations and practically no castrations
in Council of Europe member States today and in the most recent
past which can clearly be labelled as “forced”: most of these concern
people with disabilities. However, there is a small but significant
number of both sterilisations and castrations which would fall under
the various definitions of “coerced”. These are mainly directed
against transgender people, Roma women and convicted sex offenders.
Neither forced nor coerced sterilisations or castrations can be
legitimated in any way in the 21st century
– they must stop.
5. The Parliamentary Assembly believes that clear safeguards
need to be built up against future abuses, including preventive
work to change mentalities: there is a need to fight stereotypes
and prejudice against those who appear different. There is also
a need to fight paternalistic attitudes in the medical profession
which facilitate abuse.
6. The Assembly also believes that proper redress to victims
of coerced sterilisation and castration needs to be ensured, whoever
they are, and whenever the abuses occurred. In recent cases, this
includes the protection and rehabilitation of victims and the prosecution
of offenders. But in all cases, regardless of how long ago they
took place or however rare or individual they may be, official apologies
and at least symbolic compensation must also be given.
7. The Assembly thus urges the member States of the Council of
Europe to:
7.1. revise their laws
and policies as necessary to ensure that no one can be coerced into
sterilisation or castration in any way for any reason;
7.2. ensure that adequate redress is available to victims of
recent (and future) coerced sterilisation or castration, including
the protection and rehabilitation of victims, the prosecution of
offenders and financial compensation which is proportionate to the
seriousness of the human rights violation suffered;
7.3. issue official apologies and offer at least symbolic financial
compensation to surviving victims of coerced sterilisation or castration
programmes;
7.4. work towards eliminating prejudice, stereotypes, ignorance
and paternalistic attitudes which have a negative influence on the
capacity of medical providers to provide evidence-based health care respectful
of free and informed consent to vulnerable people, including through
awareness raising and human rights education.
8. The Assembly encourages the European Committee for the Prevention
of Torture and Inhuman or Degrading Treatment or Punishment (CPT)
and the Council of Europe Commissioner for Human Rights to continue
to pay attention to the issue of coerced sterilisations and castrations
in Council of Europe member States.