Legislation about (forced) sterilisation

The legal status of sterilisation remains unclear in Bulgaria. The Bulgarian Health Act (Law 70/10 August 2004)never mentions the term ‘sterilisation’ and only refers to the term ‘sterility’ when it comes to methods of ‘assisted reproduction’.

Nevertheless, the Act states that the State shall ensure the protection of the reproductive health of its citizens through measures including the promotion of health and consultations for the preservation of the reproductive health of children and persons of reproductive age. It is thus reasonable that its provisions would also apply to sterilisation.

In this way, article 126 of the Health Law explicitly states that everyone has the right to information and freedom of decision regarding their reproductive health.

Under article 87 paragraph 1, medical activities shall be implemented after expressed informed consent of the patient, except when their life is immediately threatened. However, the same article also provides numerous exceptions. For instance, in paragraph 4, “when the patient is young or judicially incapable the informed consent shall be expressed by his parent or guardian except in the cases provided with a law.”

Article 89 provides that for any surgery or invasive intervention, the informed consent shall be conceded in written form. An exception remains for “persons with psychic disorders and established inability to express informed”, that can receive surgery with the permission of the commission for medical ethics and upon obtaining the consent of their legitimate representatives or the head of the medical establishment, where no such commission exists. 

Finally, article 90 (1) states that “the patient, respectively his parent, guardian or trustee can refuse at any time the proposed medical care or the continuation of the started medical activity.”

Furthermore, while the current penal legislation does not allow forced sterilisation, there is no specific law prosecuting it either.

Forced sterilisation may be treated as serious, medium, or light bodily injury (articles 128, 129, and 130 of the Bulgarian Criminal Code) under the general criminal law provisions, resulting in imprisonment for two to ten years.

Article 181 could also be used in the prosecution of cases when sterilisation is forced by a member of the family, providing that: “A person who violates an obligation to a spouse, a relative of ascending or descending line, incapable of taking care for himself, and thereby places him in a position of serious distress, shall be punished by probation as well as by public censure, provided the act does not constitute a graver crime.”