July 18, 2012
In over 150 countries proper pain and palliative care treatment is the exception rather than the rule. Hence over 80 per cent of the world’s population has either no or poor access to pain relief services, including the prescription of morphine and other opioids.
As part of her education at the Utrecht University School of Law in the Netherlands, Marie Elske Gispen wrote an LL.M. Thesis about this issue, which she now has adapted at the request of IFHHRO.
Her report focuses on the Single Convention on Narcotic Drugs (SCND) of 1961 in relation to the realisation of the right of patients to adequate pain relief. Gispen states that pain relief could be easily attained if morphine, the key medicine used in effective pain treatment, were dispensed according to the WHO’s standards on pain management. The SCND clearly leaves room for the use of opioids for medical purposes, however, many states are either unwilling or poorly equipped to offer such services to their citizens – due in part to the SCND’s highly burdensome control mechanisms. As a result, opioid availability is limited in most developing countries.
The predicament that underlies the current poor access to pain relief is opium’s dual character of being both an essential medicine as well as an illicit drug. This dual character has led to strict and harsh international regulatory schemes, which practically disallow states to fulfil their human rights obligations. This strict approach – currently contested by multiple actors in the field including IFHHRO – motivates, among others, the present public health deficit of poor pain treatment services. The author argues that the human rights framework “proves to be a valuable tool to combat this deficit; for denial of pain treatment effectively translates into a human right to pain relief as part of the effective realisation of the right to health and, as increasingly argued, the freedom from inhuman and degrading treatment.”
Access to pain relief was one of the three themes of the Open Society Foundations campaign ‘Stop Torture in Health Care’, in which IFHHRO had been a partner. In this campaign, IFHHRO focused on raising broad awareness among health workers on the topic of pain relief.
More information about this issue
Download the report (PDF)
About the author:
Marie Elske Gispen is a PhD Candidate at the Netherlands Institute of Human Rights (SIM) and Ethics Institute of Utrecht University in the Netherlands. She is also attached to the London-based International Centre on Human Rights and Drug Policy as a Research Associate.