Introduction
From the 1960s until the 1990s, the Danish government adopted a family planning policy in Greenland, commonly referred to as the “Spiral Campaign,” which saw four thousand and five hundred Inuit women and girls fitted with intrauterine devices. The procedure, which explicitly targeted the Greenlandic population of the former colony, was performed by Danish doctors, most often on underage girls. Victims were often schoolchildren as young as twelve who were called out of class by teachers to undergo the procedure, without their consent or that of their parents. The devices doctors used were designed for adults but were inserted indiscriminately among age groups despite several victims reporting excruciating pain, infections, and long-term medical complications. The policy was a consequence of the “legacies of colonialism that translate today into structural and systemic racial discrimination” against the Inuit people, as stated by the United Nations Special Rapporteur Cali Tzay upon concluding his visit to Denmark and Greenland.
The scope of this policy was immense, impacting half of all Greenlandic women and girls of childbearing age. Many of the women who had spirals inserted became infertile or suffered serious problems trying to have children. The psychological trauma from this procedure persists to this day, with some victims unable to speak about their experience even sixty years later. The practice only became public when Inuit women, now in their sixties and seventies, began speaking to the media. Since then, numerous women have come forward to share their story, with a hundred and forty-two of them taking their claims to the Danish domestic courts.
The treatment inflicted on Greenlandic women by the Danish authorities violated human rights, most likely breaching the European Convention on Human Rights (ECHR), of which Denmark is a party. In numerous cases, it comprised inhuman and degrading treatment, interfered with women’s family and privacy rights, and was explicitly discriminatory, only affecting Greenlandic women. Recently, the Danish government issued an official apology, acknowledging the “systematic discrimination” that occurred during the contraceptive campaign and recognizing these women had “experienced both physical and psychological harm.”
While the government has attempted redress, setting up a compensation scheme for victims, it still does not do an adequate job at acknowledging the systemic harm inflicted upon the Inuit community. The issue lies in the individualistic approaches of both Denmark and the European Court of Human Rights (ECtHR), which has jurisdiction over the matter. Drawing from the elaborate Indigenous jurisprudence developed by the Inter-American human rights system, there seemingly is a strong argument for moving from an individual-oriented remedial approach, which has historically been favored by the ECtHR and is reflected in the Danish approach, to a community-oriented one which could better address systemic violations against Indigenous communities.
Forced Contraception as a Breach of Human Rights
In 2022, Denmark opened an investigation into the “Spiral Campaign,” which collected testimonies from victims, authorities, and doctors involved in the matter. The broad focus of the investigation concluded that although it was beyond its remit, some of the conduct reported could still be categorized under Danish law as constituting a breach of human rights. Indeed, the Greenlandic government set up a separate inquiry to investigate the extent of such breaches to which a submission was filed. While the ECHR was only formally incorporated into Danish law in 1992, Denmark had already assumed human rights obligations by ratifying the Convention in 1953. This ratification means its human rights obligations were applicable to its colonies throughout the entirety of the forced contraception policy in Greenland, likely rendering Denmark in breach of several standards.
Within the ECHR, Article 3 is the applicable standard, identifying the policy as meeting the threshold of inhumane and degrading. The provision’s standards for non-emergency medical treatments were established in V.C. v. Slovakia and G.M. v. Moldova, where the ECtHR considered the lack of prior informed consent to contraception inhumane and degrading. The majority of contraception cases in Greenland are considered non-consensual, as victims were usually not asked or informed about procedures beforehand. Some underwent Intrauterine Device (IUD) insertions while seeking unrelated medical treatments, and others remained unaware of the devices in them for years. Furthermore, when obtained, consent as defined by the Convention must also be valid, meaning freely given by a competent adult. In Greenland, the frequent insertions of IUDs in pre-teenage girls meant that such “valid consent” was literally not possible. Additionally, the colonial power imbalance often rendered victims compelled to agree to medical procedures that doctors considered appropriate.
Similarly, under Article 8 of the ECHR, the policy conceivably breaches the right to private and family life. In G.M. v. Moldova, the ECtHR recognized forced contraception as a form of gender-based violence, and in V.C. v. Slovakia, considered it a violation of a woman’s reproductive and sexual autonomy. Following the precedent of previously mentioned case of V.C. v. Slovakia, the “Spiral Campaign” likely constitutes racial and gender-based discrimination against Indigenous women, leaving these actions prohibited and punishable by Article 14 of the ECHR. The existence of systemic discrimination is substantiated by the policy’s implementation solely across Greenland and at boarding schools for Greenlandic students in Denmark. This situation mirrors the practices faced by Roma women in Eastern Europe where the concurring Judge Elósegui in Y.P. v. Russia condemned these non-consensual sterilizations and contraception. These practices were viewed as medical interventions “based on eugenics” and identified as explicitly targeting women belonging to groups “that normally have more children than the rest of the population, with more poverty, and less social inclusion.” Much like with the Eastern European Roma, the primary target of the Danish authorities in Greenland was the marginalized Inuit population, who had a markedly higher birthrate than other groups.
The Limits of the European Protection of Indigenous Communities
Although the spiral campaign appears to have violated the ECHR, Denmark’s recent domestic actions seem to have diminished the prospects of Greenlandic victims successfully litigating the case before the ECtHR. Specifically, the ECtHR’s subsidiarity rule prevents applications from individuals who have been “sufficiently redressed” domestically. Typically, this redress requires the state to acknowledge the violations and, particularly in state-inflicted Article 3 cases, provide a meaningful, thorough, and effective investigation with sufficient compensation afterward. Given the recent investigation, Denmark’s official apology, and the compensation scheme, the ECtHR may consider these measures qualify as sufficient redress, thus depriving potential applicants of their victim status under the Convention and barring them from accessing the Court.
While Denmark’s proactive approach should be welcomed, it fails to address the harm suffered by the broader Inuit community. The policy imposed on Greenlandic women impacted the community as a whole, halving its size, undermining its future existence, and permanently straining its relationship with Denmark. Yet, even beyond Denmark, the general approach of the European human rights system, which focuses exclusively on individual harm, offers the Inuit community no judicial recourse to seek redress for the collective impact. This attitude contrasts considerably with the Inter-American human rights system, which underlines the need for redressing collective trauma in reparation processes, especially concerning Indigenous communities. The Inter-American system allows communities to be recognized as suffering a collective harm that is distinctive from any individual harm suffered by their members.
In Moiwana v. Suriname, the Inter-American Court of Human Rights (IACtHR) established the precedent that gross human rights violations against community members constitute both harm to the individual and the entire collective. In that case, the IACtHR acknowledged that a massacre of several members of the village caused spiritual and cultural harm to the community as a whole. Suriname’s violations led to the unrest of Moiwana deceased and the group needing to displace themselves from community land until rectifying actions were taken. The Court later expanded this idea, recognizing that certain violations transcend immediate harm by also permanently altering the trajectory of an individual’s life. The Court referred to this concept as harm to a life project (Proyecto de vida), which explicitly protects a person’s chosen life path and their future decisions. The IACtHR’s case law provides several examples of possible harm to a life project, including how an intrusion, for instance, into a woman’s reproductive autonomy impacts her both momentarily and for the rest of her life. The Court further extended this individual protection to a “community’s life project,” which may be affected, for example, by structural racial discrimination that renders a dignified collective life impossible. The IACtHR thus acknowledged how these harms directly and permanently impact the social tissue of the community as a whole, an aspect that could not be remedied at all through individual reparations.
In comparison to the wide protection accorded to Indigenous communities in the Inter-American human rights systems, the redress provided under the ECtHR is considerably limited. By examining the differences between these two systems, the pathways for how protections under the European Convention of Human Rights could be expanded become more apparent.
Policy Recommendations: The Way Toward Appropriate Redress
The Danish and the European approach, more broadly, lacks a comprehensive consideration of the full extent of harm that widespread human rights violations have on the lives of individuals and their communities. When comparing the European human rights system to the Inter-American Court, it becomes evident that the ECtHR needs to begin recognizing community claims and requiring a separate protection in human rights law. These changes would allow the Inuit community to seek reparations despite all the individual redress received from the Danish government.
In this vein, the recommendation in this case is twofold. On one hand, the ECtHR should reconsider its individualistic approach to Indigenous cases to be able to redress the actual extent of harm, which includes both community and the impacted individuals. This would require it to expand its spectrum of remedies to include such measures. In the Peru Sterilization cases in Latin America, for example, the Inter-American Commission, the CEDAW Committee and domestic courts ordered symbolic reparations such as public recognition and monuments, as well as educational opportunities. Furthermore, they have provided many forms of reparation to the families of victims, including physical and mental health assistance. Such remedial comprehensiveness is crucial, especially when cases involve members of vulnerable Indigenous communities where the harm often extends to their collective identity.
On the other hand, Denmark should expand its compensation scheme currently limited to the affected Greenlandic Inuit women to enable also redress for collective harm. This would require the political will of acknowledging the collective nature and impact of the violations, and establishment of additional forms of remedies such as community development funds for educational, health-related, and cultural benefits to restore communal life to ensure that the long-term community harm caused by the sterilization policy is redressed.
Conclusion
The treatment inflicted on Greenlandic women by the Danish authorities violated human rights, constituting inhuman and degrading treatment, discrimination, as well as interfering with their privacy and family life. In seeking to redress these violations, the Danish government has sought to apologize and compensate victims for the harm caused. Yet the Inuit community still suffers the consequences of the Spiral campaign. In this regard, we recommend that both the Danish government and the European Court of Human Rights look to the precedents set by the Inter-American human rights system and expand both their perception of harm, to include the damage caused to the community, and the concept of remedies, to include redress for the wider Indigenous people. Remedial action should be aimed at the whole Greenlandic Inuit population, with concrete measures determined in consultation with the community itself. Making such changes would provide the crucial first step at wholly redressing the Inuit community and facilitating its equal standing with the rest of Denmark’s population in the future.
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Veronika Fikfak is a Professor of Human Rights and International Law at University College London, School of Public Policy. She is also Director of the UCL Institute for Human Rights. She previously taught at the University of Cambridge and Sciences Po in Paris.
Ula Aleksandra Kos is a Postdoctoral Researcher at the University of Copenhagen, Faculty of Law. Her current research focuses on the impact of third-party interventions on the European Court of Human Rights.
Edward Pérez is a PhD Candidate at the University College London Faculty of Laws. He was formerly an attorney at the Inter-American Court of Human Rights and a Senior Legal Advisor at the Center for Reproductive Rights.
The authors are grateful to Urban Piskar Slak and Dimi Georgieva for excellent research assistance.
Image Credit: Mickaël Schauli, CC-BY-4.0, via Wikimedia Commons.
