This document discusses the development of pain treatment as a human right under international law. It provides three examples from India and Ukraine where individuals were denied adequate pain medication for medical conditions, violating their human rights. The document also outlines the legal framework that recognizes freedom from severe pain and access to palliative care as fundamental human rights. International organizations like the UN have affirmed that denying access to pain treatment can constitute cruel, inhuman or degrading treatment.

1. Pain treatment as
a human right
Jonathan Cohen
Open Society Foundations
April 24, 2012

2. Human rights
documentation
Development of
the international
legal framework
Human rights
advocacy

3. Human rights
documentation

6. I was in an accident at a construction site on 9
August 2004. A wall collapsed on me. People
dragged me to the medical college hospital. For
two days I had agonizing pain both in the back
and the front. I felt like I was going very weak. I
asked to see my children because I thought I
would die. I was told that I would be OK ... The
doctors said that the pain would go away [by
itself]. There was no need to medicate it. I was
on an IV and was given lots of medicines. But I
was told that no medications were needed for
the pain. I was screaming all through the night.
Human Rights Watch, India, 2009

7. I went to the chief doctor [of the hospital], the
chief medical officer. [There was] again a
scandal. The doctors said: ‘A fifth ampoule is
an overdose [is too much]. Michael Jackson
died of an overdose. Now they’re prosecuting
an innocent doctor. And no one is supporting
that doctor. It’ll be like with Michael Jackson.’
And I said: ‘But he screams from the pain,
disturbs the neighbors; you don’t know how he
howls, how much pain he has. People
[neighbors] hear how he howls in the
apartment. I can’t be in the apartment. I will go
crazy the way he howls.”
Human Rights Watch, Ukraine, 2011

8. He often didn’t sleep at night. He’d be in agony
because of the pain. Then he would sleep long in
the morning. So they would arrive at 9 a.m. and he
would be asleep. I would say: ‘Leave the
medication. I’ll take the syringe. When he wakes
up, that’s when it’s important for us to give him
the injection. He’s still sleeping.’ [But they would
wake him up and] he would say: ‘Nothing hurts
right now. I’m sleeping. I don’t need it.’ But they,
like zombies, would insist: ‘No, it’s necessary. We
will not come another time. Your prescribed time
is 9a.m. So they would inject him while he was
sleeping because they had to do the injection and
leave.
Human Rights Watch, Ukraine, 2011

9. Development of
the international
legal framework

10. “Relief from pain is part of the peaceful living that
was guaranteed to every Indian under the ambit
of Article 21 of the Indian Constitution . . . It is a
fundamental duty of the government to extent
such treatment to a patient and which then
crystallizes as part of a right to peaceful living of
a human bring, be he a citizen or otherwise.”
Kerala State Human Rights Commission, India,
2006

11. “[T]he Special Rapporteur is of the opinion that
the de facto denial of access to pain relief, if it
causes severe pain and suffering, constitutes
cruel, inhuman or degrading treatment or
punishment.”
Manfred Nowak, UN Special Rapporteur on torture
and other cruel, inhuman or degrading treatment
or punishment, January 2009

12. Human rights
advocacy

13. "States are under the obligation to respect the
right to health by...refraining from denying or
limiting equal access for all persons...to
preventive, curative and palliative health services
. . . [The Committee reaffirms the importance of]
attention and care for chronically and terminally
ill persons, sparing them avoidable pain and
enabling them to die with dignity.“
UN Committee on Economic, Social and Cultural
Rights, 2000

14. “We urge you to request the Ukrainian
government to investigate the current case and
take appropriate measures to ensure that: (1) Mr
Malinovsky gets access to appropriate pain
medication without undue delay; (2) Medical staff
responsible for denying Mr Malinovsky access to
appropriate pain medications are held
accountable; (3) Mr Malinovsky is rewarded
appropriate compensation for the suffering he
faced due to the unnecessarily suffering from
pain and the failure of the government clinic to
take appropriate steps to relieve his suffering.”
Human Rights Watch, Urgent Appeal to UNSRs on
Health and Torture, January 2011

15. Resisting
Reframing
Restraining