A nurse in the US, Dawn Wooten, has come forward with allegations of “alarmingly high rates of hysterectomies” at Irwin County Detention Center (ICDC) in the state of Georgia. US Immigration and Customs Enforcement (ICE) holds detained immigrants at ICDC. Since Wooten’s whistleblowing, there have been calls for an investigation into the care provided at this detention centre. If Wooten’s allegations prove true, the US is in direct contravention of a number of international conventions and is grossly abusing the rights of vulnerable people in their care.

MEDICAL PROCEDURES CARRIED OUT WITHOUT INFORMED CONSENT

Wooten claims that sick call nurses at ICDC failed to consistently follow correct procedure when communicating with detainees in their care, electing to use Google Translate or else other detainees to interpret, rather than LanguageLine, a telephone interpreting service. Consequently, some women were reportedly unsure of the reason for procedures being performed on them and some were not even sure what exact procedures were being performed. Wooten also alleges that sick call nurses would “shred” medical request forms for detainees and “fabricate medical records such as vital signs” without conducting a medical examination.

A researcher on Refugee and Migrant Rights, Denise Bell, noted that “the United States has a history of forced sterilization…[and i]n addition to a violation of a person’s rights to health and safety & sexual and reproductive rights, forced sterilization can constitute a crime against humanity under international law.”

FORCED STERILISATION BREACHES INTERNATIONAL LAW

The Rome Statute of the International Criminal Court (ICC) recognises forced sterilisation as sexual violence and as a war crime and crime against humanity. The Rome Statute mirrors the language of the Genocide Convention, which states that “imposing measures intended to prevent births within [a] group” is an act of genocide when “committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group”.

Moreover, an interagency UN statement entitled “Eliminating forced, coercive and otherwise involuntary sterilisation”emphasises that sterilisation should only be pursued with “full, free and informed consent” of those undergoing the procedure. This draws on international human rights law and acknowledges that forced sterilisation is frequently discriminatory and conducted in violation of several fundamental rights, including the right to health, the right to privacy, the right to a found family, and the right to information. The UN Special Rapporteur on torture considered abuses in healthcare, Juan Méndez, wrote in 2013 that “[m]edical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose, may constitute torture or ill-treatment when enforced or administered without the free and informed consent of the person concerned”. 

ACCOUNTABILITY FOR US WILL BE CHALLENGING

Though the international prohibitions on forced sterilisations are clear, holding the US accountable may not be as clear cut. President Clinton did sign the Rome Statute in 2000, but he subsequently failed to submit it to the Congress for ratification, establishing with the UN that the US acknowledged no obligation towards the statute. Donald Trump has since refused to support or recognise the ICC; he stated that “as far as America is concerned, the ICC has no jurisdiction, no legitimacy, and no authority”. The court, though, still has the ability to investigate the US under certain circumstances, as the ICC has jurisdiction over any non-member that commits war crimes, crimes against humanity, or genocide on the territory of a member state. For example, in March 2020, the ICC launched an investigation into possible war crimes committed by US forces during the war in Afghanistan, which is party to the Rome Statute. In this case, however, as the alleged sterilisations took place on US territory by US persons, it is doubtful that the ICC has jurisdiction.

The UN may be able to intervene nonetheless, as the US signed and ratified the Genocide Convention. Accordingly, the United Nations Security Council (UNSC) can mandate the International Criminal Court to investigate the ICDC or the US at large. Even without ratifying the Convention, the ICC has this power, as the obligation not to commit genocide, and to prevent and punish the crime of genocide, is considered a norm of international customary law, which is binding on all states. As it is, the ICC will be able to investigate the US if they are empowered by the UNSC, regardless of whether their jurisdiction is acknowledged, due to the well-established importance of the principles of the Genocide Convention in international law.

Natalya is a third year Law student at the University of Manchester. Her goal after university is to become a solicitor, where she hopes to continue helping to bring human rights issues to light. While at university, she is working with the Innocence Project to appeal miscarriages of justice and will be working with the Legal Advice Centre in the coming year.

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