Table 1: Palliative Care and Freedom from Torture and Cruel, Inhuman, and Degrading Treatment

Examples of Human Rights Violations

  • National laws restricting opioid availability and access cause cancer and AIDS patients to suffer unnecessary pain.• Fearing prosecution by the state, a doctor refuses to prescribe morphine to relieve a patient’s pain.
  • A country’s laws prohibit the prescription of morphine to former drug users. A former drug user is in the advanced stages of AIDS and suffers a great deal.
Human Rights Standards Treaty Body Interpretation
ICCPR 7: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. None.
Human Rights Standards Case Law
ECHR 3: No one shall be subjected to torture or to inhuman or degrading treatment or punishment. ECtHR: Finding continued detention of a cancer sufferer where it caused “particularly acute hardship” constituted cruel, inhuman or degrading treatment. Mouisel v. France, 67263/01 (November 14, 2002).

Other Interpretations

SR on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment: “The de facto denial of access to pain relief, if it causes severe pain and suffering, constitutes cruel, inhuman or degrading treatment or punishment.” A/HRC/10/44 (January 14, 2009), ¶ 72.

SR Health and SR Torture: “The failure to ensure access to controlled medications for pain and suffering threatens fundamental rights to health and to protection against cruel, inhuman and degrading treatment.” (Letter from Manfred Nowak, Special Rapporteur on Torture, and Anand Grover, Special Rapporteur on the right to the highest attainable standard of health, to Her Excellency Ms. Selma Ashipala-Musavyi, Chairperson of the 52nd Session of the Commission on Narcotic Drugs, December 10, 2008), pg. 4.

Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment (1987).

Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, G.A. Res. 37/194, UN Doc. No. A/RES/37/194 (December 18, 1982). Available at http://www2.ohchr.org/english/law/medicalethics.htm.

The European Charter of Patients’ Rights, Art 11: “Each individual has the right to avoid as much suffering and pain as possible, in each phase of his or her illness. The health services must commit themselves to taking all measures useful to this end, like providing palliative treatments and simplifying patients’ access to them.”

Declaration on the Promotion of Patients’ Rights in Europe: “Patients have the right to relief of their suffering according to the current state of knowledge.” [Art. 5.10]. “Patients have the right to humane terminal care and to die in dignity.” [Art. 5.11]. WHO, Declaration on the Promotion of Patients’ Rights in Europe Arts. 5.10 & 5.11 (Copenhagen: WHO, 1994).

Council of Europe, Recommendation 1418, Protection of Human Rights and Dignity of the Terminally Ill and Dying (1999). Available at http://assembly.coe.int/documents/adoptedtext/ta99/erec1418.htm.