Why is palliative care a human rights issue?

In an article by Brennan (2007), the argument for palliative care as a human right was presented. Under international law, there are two main sources for this right: the right to health and the right to be free from cruel, inhuman, and degrading treatment.

The main statement of the right to health is contained in the International Covenant on Economic, Social, and Cultural Rights (ICESCR) Article 12.1 (1966). Health care includes palliative care. The committee overseeing the ICESCR issued a general comment on the right to health that includes several core obligations of all signatory nations, irrespective of resources (2000). These obligations include access to health facilities, goods, and services on a non-discriminatory basis; the provision of essential drugs as defined by WHO; and the adoption and implementation of a public health strategy.

In the context of palliative care, it is clear that patients with life-limiting illness should have access to appropriate health care, basic medications for symptom control, and terminal care, as well as inclusion of palliative care in national health care policies. The UN Committee on Economic, Social, and Cultural Rights stated that it is critical to provide “attention and care for chronically and terminally ill persons, sparing them avoidable pain and enabling them to die with dignity”.

The WHO has stated that access to Essential Medicines is part of a nation’s human rights obligations. Palliative care medications are currently on the WHO Essential Drug List. In addition, the International Association for Hospice and Palliative Care (IAHPC), following a request from WHO, developed a list of Essential Medicines for Palliative Care.

Many international organisations and bodies have called for the provision of palliative care as an essential component of the right to health care, including the Canadian Senate (2000), the European Committee of Ministers (2003), the European School of Oncology (2004), the Worldwide Palliative Care Alliance (2005), the IAHPC (2008), UN Special Rapporteurs (2008, 2009), the International Narcotics Control Board (2011) and the World Health Assembly (2014).

This article was inspired by the Global Atlas of Palliative Care 2nd Edition.