国連人権委員会の女性差別に関する活動
女性差別撤廃条約は1979年に国連で採択、1981年に発効、日本は1985年に締結している。
以下を見ると、国連は2010年から女性差別撤廃に向けて本格的に動き出した様子が窺われる。
UN OHCHR 2010年国連決議「女性に対する差別の撲滅」[A/HRC/RES/15/23]
この決議以降の人権委員会の活動報告は以下にある。
Human Rights Documents
活動報告のリストの中で、たまたま2019年のポーランド調査の結果が目に留まったので、以下にコピーしておく。アメリカの2016年の報告も興味深い。他に、チリ、アイスランド、中国、チュニジア、モルドバ、モロッコ、ハンガリー、クウェート、セネガル、スペイン、ギリシア、ホンジュラス、サモア、チャド……と全部で16か国分の調査結果があるようだ。
Human Rights Council
Forty-first session
24 June–12 July 2019
Agenda item 3
Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development
Visit to Poland
Report of the Working Group on the issue of discrimination against women in law and in practice
Summary
The Working Group on the issue of discrimination against women in law and in practice conducted a visit to Poland from 3 to 13 December 2018. In the present report, the Working Group assesses the situation regarding the human rights of women in the country, noting achievements and challenges. It examines the country’s legal, institutional and policy framework for promoting gender equality and the participation and empowerment of women in family, economic, social, political and public life, paying particular attention to women who experience intersecting forms of discrimination. The Working Group also makes recommendations for further progress in eliminating discrimination and promoting equality.
VI. Health
42. The Constitution provides for universal health care for the citizens of Poland, while the 2004 Act Concerning the Public Funding of Health Care extends the coverage to those granted refugee status or subsidiary protection in Poland. According to the same Act, care for pregnant women and girls during childbirth and confinement is financed through public funds, as are specialist obstetric-gynaecological health-care services for women and gynaecological services for girls.43. The Working Group acknowledges that the Government has in recent years adopted several measures aimed at protecting women’s health needs, particularly those related to maternal health care, including the recent adoption of standards on perinatal health care, the issuance of recommendations for reducing the number of caesarean sections, and the introduction of a programme to coordinate care for pregnant women. In addition, the Government has developed the Strategy for Persons with Disabilities 2018–2030, which should, inter alia, improve access for women with disabilities to medical facilities, and has started implementation of the Accessibility Plus for Health programme. The 2016 Act on Support for Pregnant Women and Families (“For Life”) provides for support for women with a prenatal diagnosis of severe defects of the foetus in relation to pregnancy, prenatal diagnostics and therapy as well as palliative and hospice care.
44. However, certain challenges remain in securing women’s right to health, particularly for women facing multiple and intersecting forms of discrimination. The Working Group learned that in certain places rural women still faced obstacles in their access to health services and health-care providers such as gynaecologists, for example due to geographical distance, and that women with disabilities, Roma women, sex workers and lesbian, bisexual, transgender and intersex women have limited access to health services that are tailored to their needs. Access to health services is particularly difficult for migrants in irregular situations, who constitute the majority of sex workers, according to interlocutors.
45. Moreover, notwithstanding the effort to improve the quality of care and women’s experience during childbirth, the Working Group learned of cases of negligence, mistreatment and various types of abuse experienced by pregnant women in health facilities. In addition, infertility treatment in the form of in vitro fertilization is no longer being funded by the State. The Working Group was informed of challenges to meeting the health needs of women and children with disabilities and ensuring their full integration into society. In addition, women’s right to reproductive self-determination (i.e., the right to decide whether or not to have children and to determine the number, timing and spacing of children, as well as to have the information and means to do so) is seriously restricted.
A. Affordable modern contraception
46. While the Government subsidizes some contraceptives, NGO interlocutors noted that modern contraceptives and related information and services were not readily available to many women because of costs, lack of information, geographic location and legal status.
It is reported that women have to pay full price for the vast majority of hormonal contraception, the costs of which are too high for many women.22 Adolescent girls face additional barriers in accessing contraceptives, as they require parental consent.
47. Furthermore, emergency contraceptive pills, which were previously available over the counter, can now only be obtained with a doctor’s prescription. Considering the circumstances in which emergency contraceptive pills are typically used, this requirement poses a significant barrier and defeats the very purpose of their use. Not only does it take time to be seen by a doctor, it has been reported that many doctors refuse to prescribe the pills, claiming conscientious objection. Moreover, some pharmacists have started to invoke the conscientious objection clause to refuse the sale of emergency contraceptives, even though this is illegal. Emergency contraception and antiretroviral drugs or related information are not provided to women victims/survivors of sexual violence at police stations.
48. Women cannot voluntarily choose surgical sterilization unless there are medical indications established by a doctor, such as that pregnancy would constitute a threat to life. This is not consistent with the State’s obligation to provide access to a full range of contraceptive methods. Conversely, there have been reports of women with intellectual and psychosocial disabilities living in institutions being sterilized.23 These allegations require investigation.
B. Voluntary termination of pregnancy
49. The 1993 Act on Family Planning, Protection of the Foetus and Conditions for the Admissibility of Abortion brought an end to decades of liberalization of the law whereby abortion was allowed on request. The 1993 law, often referred to as one of Europe’s most restrictive abortion laws, permits termination of pregnancy in three circumstances only: (1) when the pregnancy threatens the life or health of the pregnant woman; (2) when prenatal tests or other medical circumstances indicate the high probability of severe and irreversible impairment of the foetus or an incurable disease threatening its life; and (3) when there is a reasonable suspicion that the pregnancy arose as a result of a prohibited act. The first two circumstances need to be established by a doctor and the third one by a public prosecutor. A minor or a fully incapacitated woman will need to have the consent of her legal representative, and of a custody court if she is under 13 years of age. Moreover, some hospitals impose additional requirements such as the opinions of at least two specialist physicians, or a special council, or the head of the hospital maternity ward, which leads to a prolonged waiting period resulting in restricted access to the medical procedure guaranteed by law.
50. In addition, the mechanism for resolving disagreements between doctors and pregnant women in cases of risk to the health of the pregnant woman or the foetus, namely the Patients’ Ombudsperson appeal procedure, is not effective, as considered by the Committee of Ministers of the Council of Europe.24 Not only does the 30-day time limit on such a time-sensitive procedure represent a barrier to timely access, only four complaints have been received under the procedure, and all of them were dismissed. Analysis undertaken by the Commissioner for Human Rights has found significant irregularities in the procedure’s operation.
22 KARAT Coalition, Alternative report on the Implementation of the Convention on the Elimination of All Forms of Discrimination against Women, February 2014.
23 Association of Women with Disabilities ONE.pl and Women Enabled International, Submission to the Committee on the Rights of Persons with Disabilities for its Review of Poland, 2018.
51. Moreover, the regulatory framework on the use of conscientious objection is not effective, as recognized by the European Court of Human Rights judgments.25 No data is available on the extent of the use of the conscientious objection clause by doctors, who are no longer obliged to provide referrals since the lifting of the requirement by a Constitutional Court ruling in October 2015. It has been reported that in certain areas there are no abortion providers and that there have been attempts to create abortion free zones. According to some interlocutors, frequent use of conscientious objection by doctors is not only based on personal religious convictions but is also due to fear of prosecution and a stigmatizing environment for doctors.
52. As a result of the additional barriers in practice, access to legal abortion is limited. Some women travel abroad for abortion services or opt for illegal abortion in Poland and, in the event of complications, are afraid to seek medical attention in hospitals. The restrictive framework particularly affects women who are socioeconomically disadvantaged and migrant women in irregular situations.
53. In recent years, regulation of abortion has increasingly been a subject of national discussion, with repeated attempts to change the Act. The issue has come under a particularly intense spotlight in the last few years, when citizen-led legislative initiatives seeking to introduce a total ban on abortion and others aimed at liberalization of the law were introduced.
54. The Working Group stresses that restrictive laws on abortion increase maternal mortality and morbidity rates due to unsafe abortions and are not efficient in reducing the rate of abortion, as shown by data from the World Health Organization.26 The Working Group has previously called for allowing women to terminate their pregnancy on request in the first trimester (see A/HRC/32/44).
