L.C. (represented by T.R.C) v Peru

Warning: This case deals with topics that are especially grave and may cause trauma invoked by memories of past abuse. If you have experienced violence and need assistance, please refer to this list of country help lines provided by UN Women.

What happened? Forms of violence committed

Between the ages of 11 and 14, L.C was raped on multiple occasions by a man in his 30s. When she was 14, she realised that she was pregnant and in a state of depression, attempted suicide by jumping off a building. She survived the suicide attempt, but had significant spinal injuries, leading to paraplegia of both arms and legs. The doctors treating her in a public hospital recommended emergency surgery to stabilise her condition, but once the pregnancy was discovered, the surgery was postponed. In Peru, abortion was criminalised, apart from

“abortion shall not be punishable if performed by a doctor with the consent of the pregnant woman or her legal representative, if any, when it is the only way to save the life of the mother or to avoid serious and permanent harm to her health”

However, the medical board of the hospital denied the request because it considered that the life of the patient was not in danger. Eventually, L.C. miscarried naturally and the surgery was carried out, almost three and a half months after it had been decided that surgery was necessary. She was discharged from hospital, and after more delay, she began physical rehabilitation: however, this was curtailed because she lacked the financial means to access that care.

The effects of these events has been catastrophic:

“[She] is paralyzed from the neck down and has regained only partial movement in her hands. She depends on a wheelchair to get around and on others to meet all her needs. She has a catheter which must be changed five times a day under totally sterile conditions, which prevents her from attending school. The author states that the family’s situation is disastrous. She cannot work because L. C. requires constant care, and the cost of the medicines and equipment she requires places a heavy burden on the family budget. The brothers of L. C. had to leave school in order to begin working.” (paragraph 2.11)

L.C.’s mother set out all the ways in which access to the limited legal pathway to abortion was entirely deficient, without clear and prompt procedures to ensure access to women and girls in need. (paragraph 2.12-2.15). She stated

“that the refusal by the doctors at the hospital to perform the therapeutic abortion violated the rights of L. C. to health, a life of dignity and to be free from discrimination in access to such care. L. C. was deprived of the possibility of walking again by the unjustified withdrawal of a surgical intervention that was totally necessary. The failure of the health system in the State party to ensure access to essential services for women, such as abortion, compromises its obligations under the Convention. The State party has not met its obligations by failing to provide a legal medical service required only by women, and on which the victim’s physical and mental health depended. This violation was aggravated by the fact that L. C. was a minor; in that respect the State had a double duty to protect her. Nor had the State party provided adequate and effective guarantees in its legislation to protect those rights.”

She also stated that “placing conditions on timely access to a medical treatment on which the exercise of the right to health, life and a life of dignity depended by continuing an unwanted pregnancy resulted in discriminatory treatment based on the stereotype of imposing the reproductive function on L. C., above her welfare. As for article 12, the author claims that since L. C.’s pregnancy constituted a threat to her physical and mental health, therapeutic abortion was appropriate and necessary. The medical needs of L. C. and the due protection of her right of access to both physical and mental health without discrimination were totally ignored by those whose duty it was to guarantee those rights.”

Observations by the Peruvian government to the CEDAW Committee in the course of this case sought to blame L.C. for her own situation, having attempted suicide, and to blame her family for allowing the sexual violence to continue. T.R.C responded that

“expecting a girl to have overcome her emotional trauma and sought assistance is a double victimization. It is cruel to create in a minor the idea that she was guilty for acts that were totally beyond her control, such as being sexually abused and consequently suffering a mental imbalance that worsened when she learned that she was pregnant. It further reveals a discriminatory attitude that responds to the gender stereotype tending to blame women who have been victims of violence for its consequences.” (paragraph 7.2)

The CEDAW Committee found that L.C, had been denied access to an effective and accessible procedure to secure the medical treatment that was required for her physical and mental health, both the spinal surgery and the therapeutic abortion, therefore a denial of her right to health under Article 12 of CEDAW. The CEDAW Committee noted that:

“This is even more serious considering that she was a minor and a victim of sexual abuse, as a result of which she attempted suicide. The suicide attempt is a demonstration of the amount of mental suffering she had experienced.” (paragraph 8.15)

The CEDAW Committee “also considers that the facts reveal a violation of article 5 of the Convention, as the decision to postpone the surgery due to the pregnancy was influenced by the stereotype that protection of the foetus should prevail over the health of the mother” and therefore a breach of Article 5.

The CEDAW Committee also found that the legal vacuum in terms of women’s access to legal abortion, and health workers’ decision-making, including a right to appeal, was a violation of Article 2(c) and 2(f) of the CEDAW Convention.

Want more?

See General comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights) UN Doc E/C.12/GC/22 for more information about the constellation of comprehensive sexual and reproductive health services, goods, education and information that should be available to all, including survivors of rape.