Health and Human Rights Division, Human Rights Watch, 34th Floor, New York, NY 10118, USA.
BMC Med. 2010 Jan 20;8:8. doi: 10.1186/1741-7015-8-8.
Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering. Yet, despite the existence of inexpensive and effective pain relief medicines, tens of millions of people around the world continue to suffer from moderate to severe pain each year without treatment.
Significant barriers to effective pain treatment include: the failure of many governments to put in place functioning drug supply systems; the failure to enact policies on pain treatment and palliative care; poor training of healthcare workers; the existence of unnecessarily restrictive drug control regulations and practices; fear among healthcare workers of legal sanctions for legitimate medical practice; and the inflated cost of pain treatment. These barriers can be understood not only as a failure to provide essential medicines and relieve suffering but also as human rights abuses.
According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.
近五十年前,世界各国政府通过了 1961 年《麻醉品单一公约》,该公约除了处理非法麻醉品管制问题外,还责成各国努力实现普遍获得用于缓解疼痛和痛苦的麻醉品。然而,尽管有廉价且有效的止痛药物,但全世界仍有数千万人每年因得不到治疗而遭受中度至重度疼痛。
有效治疗疼痛的主要障碍包括:许多政府未能建立运作良好的毒品供应系统;未能制定疼痛治疗和姑息治疗政策;医疗保健工作者培训不足;存在不必要的限制药物管制法规和做法;医疗保健工作者担心合法医疗行为会受到法律制裁;以及疼痛治疗费用过高。这些障碍不仅可以被理解为未能提供基本药物和减轻痛苦,而且还可以被理解为侵犯人权。
根据国际人权法,国家有提供疼痛治疗药物的核心义务,这是其健康权的一部分;未能采取合理步骤确保遭受疼痛的人能够获得足够的疼痛治疗,可能导致侵犯保护免受残忍、不人道和有辱人格待遇的义务。