In a judgment delivered on 4 July 2025, the European Court of Human Rights (ECtHR) found that Spain violated Article 8 of the European Convention on Human Rights (right to respect for private and family life) due to the failure to obtain valid informed consent for a medical procedure resulting in the removal of a patient’s nipple and areola.
The applicant, S.O., a Venezuelan national residing in Madrid, was diagnosed with breast cancer in her right breast in 2016, following a previous cancer diagnosis. In January 2017, Gómez Ulla Hospital proposed breast-conserving surgery, and S.O. signed an informed consent form for the procedure.
During the February 2017 operation, two breast tissue samples were analysed, and surgeons decided to extend the procedure by removing S.O.'s nipple and areola. S.O. later claimed that she had not consented to this and lodged a complaint with the Health Department of the Madrid Autonomous Community, seeking €100,000 in compensation. After receiving no response, she initiated legal proceedings.
The Madrid High Court of Justice rejected her claim in September 2020, finding that her consent had been adequate, and that “oncological safety” was the priority. The Court also found that the possibility of modifying the surgical technique had been included in the information provided to her.
S.O. lodged an application with the ECtHR on 21 January 2022, arguing that the removal of her nipple and areola occurred without valid consent, violating her rights under Article 8.
The ECtHR held that such procedures have significant implications for a woman’s physical and psychological wellbeing, body image, self-esteem, and sexual life, and therefore fall within the scope of Article 8.
While Spain's legal framework on medical consent was found to be adequate in general, the Court determined that the specific consent obtained from S.O. was insufficient. The Court observed:
The consent form lacked clarity, particularly for individuals without medical expertise, on which surgeries might be classified as modifications within the meaning of the informed consent provided.
The High Court had not sufficiently examined whether S.O. had been explicitly informed about the potential removal of her nipple and areola.
The ECtHR emphasised that under Spanish law, written consent must include adequate information about the nature of the procedure and its risks to allow patients to make an informed decision. Given the nature of breast-conserving surgery and its potential impact on S.O.’s self-image and sexual life, the medical team was under a duty to inform her clearly of the possibility that her nipple and areola could be removed.
The ECtHR concluded that the Spanish authorities failed to apply the existing legal framework effectively, resulting in an infringement of S.O.’s right to private life under Article 8. The Court found that the authorities did not adequately safeguard her personal autonomy in the medical decision-making process.
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