FINAL REPORT

During the course of the investigation into irregularities in the performance of sterilizations and vasectomies in the country, various difficulties arose. We note that the events under investigation occurred primarily in the years 1996–1997, that is, 5–6 years ago, and during this time many of the officials and authorities had left the Ministry of Health. Others were transferred or reside outside the country. Furthermore, we now know that the majority of orders and reports related to surgical contraception activities were given verbally. The supposedly voluntary nature of the sterilizations is called into question when one considers the existence of pressure, incentives, harassment, and threats. The freedom of those who did not wish to be sterilized was also violated. A significant number of the women interviewed fear being questioned because they have not yet overcome the effect of the threats made against anyone who dares to name those responsible, and others feel themselves questioned by their own families and communities. The clinical records examined are themselves evidence of the punishable carelessness with which this program was implemented: the majority do not meet the minimum requirements that a clinical record should contain, many are incomplete, others are illegible, and in many of them it is evident that data has been added after the fact. Since female and male sterilization is an act by which reproductive capacity is permanently lost — an event of such importance for human life — and given its practically irreversible nature, it requires careful reflection, as it involves a personal decision that must be made with full information and assurances that it will be carried out under optimal surgical conditions. The argument of "fighting poverty" has been used repeatedly and does not justify the violation of the beliefs and traditions of the poorest. Poverty is combated through education, work, and training; the regulation of birth rates is rather a result of the development process, and even in the so-called "developed" countries, current concerns relate to demographic problems affecting their well-being and future due to the generational gap that endangers the appropriate ratio between the active and retired population. The following are the conclusions of the investigation, which incorporated the analysis of testimonies gathered during the process by both the Commissioners and the support team.