Hungary: Reports of the forced sterilization of women (2000-2011)

Background

On 14 August 2006, the United Nations (UN) Committee on the Elimination of Discrimination Against Women (CEDAW) found that the state of Hungary had violated the Convention on the Elimination of All Forms of Discrimination Against Women (the Convention) by not ensuring a Roma woman (A. S.) who was sterilized in January 2001 had given her fully informed consent to the sterilization (UN 29 Aug. 2006, 17). Hungary is a signatory to the Convention and ratified it on 22 December 1980 (ibid. 12 Oct. 2011).

A. S. went into labour in January 2001, and while she was on the operating table, the doctor discovered that the fetus had died in her womb (ibid. 29 Aug. 2006, 3). She was asked to sign a form consenting to a Caesarean section to remove the fetus (ibid.). The form had a doctor's handwritten note that used a Latin word for sterilization and included the following: "'I do not intend to give birth again; neither do I wish to become pregnant'" (ibid.). After signing the form, she was sterilized during the operation (ibid.).

Sources note that the CEDAW decision in the A. S. case marked the first time that an international human rights body held a government accountable for failing to provide sufficient information on the sterilization procedure (OSF 22 Nov. 2010, 129; Zampas and Lamačková 2011, 165). The CEDAW issued the following recommendations to Hungary regarding the case: provide appropriate compensation to A. S.; ensure that all employees in the health care sector understand and adhere to the Convention and the CEDAW's general recommendations as they relate to women's reproductive health and rights; review domestic legislation on informed consent for sterilizations and ensure it conforms with international standards; and monitor public and private health centres to ensure that fully informed consent is given by patients (UN 29 Aug. 2006, 18).

In correspondence with the Research Directorate, the State Secretary for Health Care of the Hungarian Ministry of National Resources indicated that, based on the CEDAW recommendations, legislation on sterilization was amended in 2008 in the following ways:

• The conditions of sterilization have been adequately legislated, making an appropriate differentiation - thereby incorporating legal guarantees - between persons of legal capacity, incompetent persons or persons with limited capacity;
• In case of women under 26, the waiting time was extended to 6 months (instead of 3);
• The application shall be submitted in a public/notarial document or in a private document of probative value.
• The conditions of sterilization became stricter, since it has been laid down that sterilization on health grounds shall only be carried out if other form of contraception is not possible or not applicable [for] health reasons, and the pregnancy would endanger the life, the physical integrity or the health of the woman, or the future child would probably be disabled. (Hungary 28 Oct. 2011)

The State Secretary also indicated that, based on a government decision made on 18 March 2009, the State of Hungary compensated A. S. in the amount of 5,400 forint (Ft) [CAD29,791 (XE 2 Nov. 2011)], produced brochures on women's rights that were distributed at health centres in 2006, and assigned the Office of the Chief Medical Officer and public health officials the responsibility to "monitor public and private health centres with appropriate sanctions in place…" (Hungary 28 Oct. 2011).

Situation after the A. S. vs. Hungary case

In an article on the forced sterilization of Romani women, the author, a human rights activist and consultant to the Council of Europe's Commissioner for Human Rights, notes that the European Roma Rights Centre (ERRC), an international public-interest law organization that works to fight human rights abuses of Roma through litigation services, research, policy development, advocacy and human rights education (ERRC n.d.), is supporting the case of a woman who had been sterilized in 2008 without her consent (Albert Summer 2011, 3, 4; see also Otherness Foundation 19 Oct. 2011). In correspondence with the Research Directorate, a legal officer at the ERRC stated that the case involves a woman who is not of Roma origin, but who lives in a Roma neighbourhood in Hungary with her Roma husband (ERRC 18 Oct. 2011). The legal officer indicated that it is presumed that the woman was sterilized because of being associated with Roma (ibid.). Corroborating information could not be found among the sources consulted by the Research Directorate.

In correspondence with the Research Directorate, the Parliamentary Commissioner for the Rights of National and Ethnic Minorities of the Republic of Hungary stated that his office does not have access to statistical information on the sterilization of Roma women and that complaints lodged by Roma women with the Office of the Ombudsperson "seldom" make reference to the practice (Hungary 10 Oct. 2011). The Parliamentary Commissioner further indicated that he is not aware of any victim currently seeking help after suffering forced or coerced sterilization (ibid.). In other correspondence, the General Director of the Justice Service at the Hungarian Ministry of Public Administration and Justice stated that forced sterilization in Hungary is a "felony" and that "there is and was no state policy promoting forced sterilization" (ibid. 5 Oct. 2011).

Livia Jaroka, a Member of the European Parliament for Hungary, issued a press release in which she calls the lack of official data on forced sterilization "alarming" (Jaroka 17 Mar. 2010). The press release also says that forced sterilization has occurred in "several Member States of the European Union" and that "[a]lthough the Member States concerned deny categorically that any such case has occurred since 2004, many human rights experts assert that forced sterilization still occurs" (ibid.). In a summary of stakeholders' submissions to the UN Human Rights Council's Universal Periodic Review for Hungary, various organizations stated that "coercive sterilisation remained a concern for Roma women" (UN 28 Jan. 2011, 8). It also indicated that Hungary has not fully implemented the recommendations made by CEDAW in 2006 (ibid.). The Council of Europe's European Commission Against Racism and Intolerance urged Hungary in the same summary to "repeal the legal provisions allowing [for] 'emergency' sterilisation to be performed without a women's informed consent" (ibid., 9).

The legal officer at the ERRC observed that the fact that there are not many cases of forced sterilization in the public domain does not mean that this practice has, or is not, occurring (ERRC 18 Oct. 2011). According to the official, many women are not aware that they have been sterilized and, in some cases, find out only when they try to get pregnant and the doctor tells them that they are infertile, or when they access their medical records (ibid.; see also Freelance Consultant 17 Oct. 2011). The ERRC legal officer notes that the difficulty in documenting these cases is due to the sensitive nature of the issue (18 Oct. 2011).

State Programs

The State Secretary for Health Care indicated that Hungary has "several legal institutions" to protect patients' rights, including the following:

• Patient Advocate who assists patients in accessing their medical records, is kept informed about investigations into patient complaints, and provides information to health care workers on patients' rights;
• Mediation Council, which provides an avenue for the resolution of legal disputes out of court; and
• Hospital supervisory boards and ethics committees, which "represent the interests" of patients and enforce their rights (Hungary 28 Oct. 2011)

Patients also have the right to file a complaint about the service provided by a health care provider and receive the results of the investigation within 30 working days (ibid.). The State Secretary also added that, following a proposal from the ERRC and the Legal Defense Bureau for National and Ethnic Minorities on "improving patient information regarding sterilization and informed consent" by explaining that the procedure is "irreversible," the Obstetrics, Gynecology, Assisted Reproduction Department of the Professional Chamber "prepared a professional protocol on female sterilization and a draft consent form to sterilization" (ibid.). These forms "will be published soon" (ibid.).

In correspondence with the Research Directorate, the former director of the League of Human Rights who is now a freelance consultant for the campaign to Stop Torture in Health Care, notes that because the women in some cases feel such a "sense of hopelessness," they do not consider any type of redress (17 Oct. 2011). She also points out that some Roma women belong to "extremely patriarchal and traditional" communities and may be ostracized because they are blamed for their lack of fertility (Freelance Consultant 17 Oct. 2011.). In such cases, their contact with the non-Roma community is mediated by male relatives or older women, thus making it difficult to access legal aid (ibid.). Stop Torture in Health Care is an international campaign that "promotes government accountability for all forms of torture and ill-treatment in health settings" (n.d.).

In separate correspondence with the Research Directorate, the freelance consultant notes that current Hungarian legislation does not accord with international standards since it continues to refer to sterilization in technical rather than plain language terms, thus violating the guidelines established by the International Federation of Gynecology and Obstetrics (FIGO) (Freelance Consultant 4 Oct. 2011; see also FIGO Mar. 2011). According to the legal officer at the ERRC, the section on informed consent needs to be clarified since Hungarian legislation focuses more on the '"chances of reversibility"' than on the permanent nature of the intervention, thus raising concerns that the counselling patients receive is based on that premise (ERRC 18 Oct. 2011).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of sources consulted in researching this Information Request.

References

Albert, Gwendolyn. Summer 2011. "Forced Sterilization and Romani Women's Resistance in Central Europe." Different Takes. No. 71. [Accessed 4 Oct. 2011]

European Roma Rights Centre (ERRC). 18 October 2011. Correspondence from a legal officer to the Research Directorate.

_____. N.d. "Who We Are." [Accessed 12 Oct. 2011]

Freelance Consultant for the Campaign to Stop Torture in Health Care 17 October 2011. Correspondence with the Research Directorate.

_____. 4 October 2011. Correspondence with the Research Directorate.

Hungary. 28 October 2011. Ministry of National Resources. Correspondence from the State Secretary for Health Care to the Research Directorate.

_____. 10 October 2011. Parliamentary Commissioner for the Rights of National and Ethnic Minorities of the Republic of Hungary. Correspondence from the Parliamentary Commissioner to the Research Directorate.

_____. 5 October 2011. Ministry of Public Aministration and Justice. Correspondence from the General Director of Justice Service to the Research Directorate.

International Federation of Gynecology and Obstetrics (FIGO). March 2011. "Female Contraceptive Sterilization." [Accessed 6 Oct. 2011]

Jaroka, Livia. 17 March 2010. "A Stand Must Be Taken Against Forced Sterilization." Translated by the Translation Bureau, Public Works and Government Services Canada. (C-Press) [Accessed 6 Oct. 2011]

Open Society Foundations (OSF). 22 November 2010. From Judgment to Justice: Implementing International and Regional Human Rights Decisions. [Accessed 7 Oct. 2011]

_____. N.d. "About the Open Society Foundations." [Accessed 12 Oct. 2011]

Otherness Foundation. 19 October 2011. Legal Defense Bureau for National and Ethnic Minorities (NEKI). Correspondence from a legal officer to the Research Directorate.

Stop Torture in Health Care. N.d. "About the Campaign." [Accessed 12 Oct. 2011]

United Nations (UN). 12 October 2011. Status of Treaties: Convention on the Elimination of All Forms of Discrimination Against Women. [Accessed 12 Oct. 2011]

_____. 28 January 2011. Human Rights Council. Summary Prepared by the Office of the High Commissioner for Human Rights in Accordance with Paragraph 15 (c) of the Annex to Human Rights Council Resolution 5/1. (A/HRC/WG.6/11/HUN/3) (ecoi.net) [Accessed 1 Nov. 2011]

_____. 29 August 2006. Committee on the Elimination of Discrimination Against Women (CEDAW). Views - Communication No. 4/2004. (CEDAW/C/36/D/4/2004) [Accessed 1 Nov. 2011]

XE. N.d. "Currency Data Feed Service." [Accessed 2 Nov. 2011]

Zampas, Christina, and Adriana Lamačková. 2011. "Ethical and Legal Issues in Reproductive Health: Forced and Coerced Sterilization of Women in Europe." International Journal of Gynecology and Obstetrics No. 114.. [Accessed 29 Sept. 2011]

Additional Sources Consulted

Oral sources: Attempts to contact representatives from the following organizations were unsuccessful: The Legal Defence Bureau for National and Ethnic Minorities (NEKI), and Phralipe Independent Roma Association. The State Secretary for Social Inclusion could not provide information within the time contraints of this Response.

Internet sites, including: Amnesty International; British Broadcasting Corporation; Factiva; Freedom House; Hungarian Civil Liberties Union; Human Rights Watch; International Federation for Human Rights; Minority Rights Group International; Radio Free Europe; United Nations — Integrated Regional Information Networks, ReliefWeb, Women; United States Department of State.