Dr Frank Brennan speaks to ehospice on International Human Rights Day

These rights, and the attendant obligations for States, are set out in various conventions and treaties to which individual States are signatories.

Palliative care advocates have called for the recognition of palliative care as part of the right to health. Dr Frank Brennan, distinguished palliative care physician and human rights advocate, spoke to ehospice about the importance of this day and the recognition of palliative care as a human right.

What is the importance of Human Rights Day? 

It is right and fitting that we pause for Human Rights Day. We honour the sense of human rights in our time and what they have brought to the world. 

The modern human rights movement arose in response to the shocking inhumanity of World War II. The UN Declaration of Human Rights, adopted on December 10 1948, is one of the great international documents of the last century and spoke into the darkness of a world ravaged and torn. 

“Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world. Now, therefore the General Assembly proclaims this UN Declaration of Human Rights…”

With those words, the world changed. That document and the conventions that followed spoke for the most vulnerable, the most dispossessed and the most marginalised and said: ‘You, too, are a member of the human family, you, too, have an inherent dignity that should be respected.’

The claim that palliative care is a human right is derived from the international right to health.

The right to health, articulated in several UN Human Rights Conventions, has been interpreted widely to include a series of obligations on nations who have signed these documents. In the context of palliative care it obliges nations to devise national palliative care policies and provide access to services and essential medications without discrimination. 

There has been several developments in this advocacy. Two recent international declarations by professional bodies have raised this issue. The Montreal Declaration (2010) emerged from the First International Pain Summit. The Summit was organised by the International Association for the Study of Pain (IASP). The Declaration, recognising the significant deficits in pain management globally, declared that pain management should be seen as a fundamental human right and reminded nations of their obligations under the international human rights conventions that contain the right to health. In 2013 the Prague Charter was promulgated by the European Association of Palliative Care (EAPC), the International Association of Hospice and Palliative Care (IAHPC), the Worldwide Palliative Care Alliance (WPCA) and Human Rights Watch. This document declared that palliative care is a human right.

Those documents have followed a series of declarations by professional bodies over the past decade declaring both pain management and palliative care as human rights. See the International Association of Palliative Care website.

Concurrently to these declarations, senior human rights officials of the United Nations have expressly stated that both pain management and palliative care constitute human rights that need promoting and protecting. 

Those officials – the UN Special Rapporteurs on the Right to Health and Against Torture and Cruel and Inhuman Treatment -pointed out the enormous disparities in the provision of pain management and palliative care around the world, stated they were human rights issues that needed urgent attention and reminded governments of their obligations.

How can palliative care advocates use the Special Rapporteurs’ statements and the Prague Charter in their countries to advance the development of palliative care?

There may be several ways. Firstly to advocate to their Ministries of Health of their countries for better palliative care services, access to essential palliative care medications, including opioids and the formation of national pain and palliative care policies.

As part of that advocacy to state these obligations have been expressly stated by the United Nations. Also, to use these documents to encourage their colleagues to found or join national, regional and international pain and palliative care societies.