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Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Legal status
- Non-negotiated soft law
- Document type
- Special Procedures' report
- Year
- 2013
- Document code
- A/HRC/22/53
Document
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 1
- Paragraph text
- The preceding examples of torture and ill-treatment in health-care settings likely represent a small fraction of this global problem. Such interventions always amount at least to inhuman and degrading treatment, often they arguably meet the criteria for torture, and they are always prohibited by international law.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 2
- Paragraph text
- The prohibition of torture is one of the few absolute and non-derogable human rights, a matter of jus cogens, a peremptory norm of customary international law. Examining abuses in health-care settings from a torture protection framework provides the opportunity to solidify an understanding of these violations and to highlight the positive obligations that States have to prevent, prosecute and redress such violations.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 3
- Paragraph text
- The right to an adequate standard of health care ("right to health") determines the States' obligations towards persons suffering from illness. In turn, the absolute and non-derogable nature of the right to protection from torture and ill-treatment establishes objective restrictions on certain therapies. In the context of health-related abuses, the focus on the prohibition of torture strengthens the call for accountability and strikes a proper balance between individual freedom and dignity and public health concerns. In that fashion, attention to the torture framework ensures that
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 4
- Paragraph text
- system inadequacies, lack of resources or services will not justify ill-treatment. Although resource constraints may justify only partial fulfilment of some aspects of the right to health, a State cannot justify its non-compliance with core obligations, such as the absolute prohibition of torture, under any circumstances.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 5
- Paragraph text
- By reframing violence and abuses in health-care settings as prohibited ill-treatment, victims and advocates are afforded stronger legal protection and redress for violations of human rights. In this respect, the recent general comment No. 3 (2012) of the Committee against Torture on the right to a remedy and reparation offers valuable guidance regarding proactive measures required to prevent forced interventions. Notably, the Committee considers that the duty to provide remedy and reparation extends to all acts of ill-treatment, so that it is immaterial for this purpose whether abuses in health-care settings meet the criteria for torture per se. This framework opens new possibilities for holistic social processes that foster appreciation of the lived experiences of persons, including measures of satisfaction and guarantees of non-repetition, and the repeal of inconsistent legal provisions.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Violence
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6a
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Enforce the prohibition of torture in all health-care institutions, both public and private, by, inter alia, declaring that abuses committed in the context of health-care can amount to torture or cruel, inhuman or degrading treatment or punishment; regulating health-care practices with a view to preventing mistreatment under any pretext; and integrating the provisions of prevention of torture and ill-treatment into health-care policies;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6b
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Promote accountability for torture and ill-treatment in health-care settings by identifying laws, policies and practices that lead to abuse; and enable national preventive mechanisms to systematically monitor, receive complaints and initiate prosecutions;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6c
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Conduct prompt, impartial and thorough investigations into all allegations of torture and ill-treatment in health-care settings; where the evidence warrants it, prosecute and take action against perpetrators; and provide victims with effective remedy and redress, including measures of reparation, satisfaction and guarantees of non-repetition as well as restitution, compensation and rehabilitation;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6d
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Provide appropriate human rights education and information to health-care personnel on the prohibition of torture and ill-treatment and the existence, extent, severity and consequences of various situations amounting to torture and cruel, inhuman or degrading treatment or punishment; and promote a culture of respect for human integrity and dignity, respect for diversity and the elimination of attitudes of pathologizaton and homophobia. Train doctors, judges, prosecutors and police on the standards regarding free and informed consent;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6e
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Safeguard free and informed consent on an equal basis for all individuals without any exception, through legal framework and judicial and administrative mechanisms, including through policies and practices to protect against abuses. Any legal provisions to the contrary, such as provisions allowing confinement or compulsory treatment in mental health settings, including through guardianship and other substituted decision-making, must be revised. Adopt policies and protocols that uphold autonomy, self-determination and human dignity. Ensure that information on health is fully available, acceptable, accessible and of good quality; and that it is imparted and comprehended by means of supportive and protective measures such as a wide range of community-based services and supports (A/64/272, para. 93). Instances of treatment without informed consent should be investigated; redress to victims of such treatment should be provided;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 6f
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Ensure special protection of minority and marginalized groups and individuals as a critical component of the obligation to prevent torture and ill-treatment by, inter alia, investing in and offering marginalized individuals a wide range of voluntary supports that enable them to exercise their legal capacity and that fully respect their individual autonomy, will and preferences.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Person(s) affected
- Ethnic minorities
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 7a
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Adopt a human rights-based approach to drug control as a matter of priority to prevent the continuing violations of rights stemming from the current approaches to curtailing supply and demand (A/65/255, para. 48). Ensure that national drug control laws recognize the indispensible nature of narcotic and psychotropic drugs for the relief of pain and suffering; review national legislation and administrative procedures to guarantee adequate availability of those medicines for legitimate medical uses;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 7b
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Ensure full access to palliative care and overcome current regulatory, educational and attitudinal obstacles that restrict availability to essential palliative care medications, especially oral morphine. States should devise and implement policies that promote widespread understanding about the therapeutic usefulness of controlled substances and their rational use;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 7c
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Develop and integrate palliative care into the public health system by including it in all national health plans and policies, curricula and training programmes and developing the necessary standards, guidelines and clinical protocols.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 8a
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Close compulsory drug detention and "rehabilitation" centres without delay and implement voluntary, evidence-based and rights-based health and social services in the community. Undertake investigations to ensure that abuses, including torture or cruel, inhuman and degrading treatment, are not taking place in privately-run centres for the treatment of drug dependence;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Violence
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 8b
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Cease support for the operation of existing drug detention centres or the creation of new centres. Any decision to provide funding should be made only following careful risk assessment. If provided, any such funds should be clearly time-limited and provided only on the conditions that the authorities (a) commit to a rapid process for closing drug detention centres and reallocating said resources to scaling up voluntary, community-based, evidence-based services for treatment of drug dependence; and (b) replace punitive approaches and compulsory elements to drug treatment with other, evidence-based efforts to prevent HIV and other drug-related harms. Such centres, while still operating as the authorities move to close them, are subject to fully independent monitoring;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Persons on the move
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 8c
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Establish an effective mechanism for monitoring dependence treatment practices and compliance with international norms;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Environment
- Governance & Rule of Law
- Person(s) affected
- All
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 8d
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Ensure that all harm-reduction measures and drug-dependence treatment services, particularly opioid substitution therapy, are available to people who use drugs, in particular those among incarcerated populations (A/65/255, para. 76).
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 9
- Paragraph text
- The Special Rapporteur calls upon all States to repeal any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery, involuntary sterilization, unethical experimentation, medical display, "reparative therapies" or "conversion therapies", when enforced or administered without the free and informed consent of the person concerned. He also calls upon them to outlaw forced or coerced sterilization in all circumstances and provide special protection to individuals belonging to marginalized groups.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Harmful Practices
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 10a
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Review the anti-torture framework in relation to persons with disabilities in line with the Convention on the Rights of Persons with Disabilities as authoritative guidance regarding their rights in the context of health-care;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Persons with disabilities
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 10b
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Impose an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock and mind-altering drugs such as neuroleptics, the use of restraint and solitary confinement, for both long- and short-term application. The obligation to end forced psychiatric interventions based solely on grounds of disability is of immediate application and scarce financial resources cannot justify postponement of its implementation;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Persons with disabilities
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 10c
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Replace forced treatment and commitment by services in the community. Such services must meet needs expressed by persons with disabilities and respect the autonomy, choices, dignity and privacy of the person concerned, with an emphasis on alternatives to the medical model of mental health, including peer support, awareness-raising and training of mental health-care and law enforcement personnel and others;
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Persons with disabilities
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 10d
- Paragraph text
- [The Special Rapporteur calls upon all States to:] Revise the legal provisions that allow detention on mental health grounds or in mental health facilities, and any coercive interventions or treatments in the mental health setting without the free and informed consent by the person concerned. Legislation authorizing the institutionalization of persons with disabilities on the grounds of their disability without their free and informed consent must be abolished.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Persons with disabilities
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 11
- Paragraph text
- Mistreatment in health-care settings has received little specific attention by the mandate of the Special Rapporteur, as the denial of health-care has often been understood as essentially interfering with the "right to health".
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 11
- Paragraph text
- The Special Rapporteur calls upon all States to ensure that women have access to emergency medical care, including post-abortion care, without fear of criminal penalties or reprisals. States whose domestic law authorizes abortions under various circumstances should ensure that services are effectively available without adverse consequences to the woman or the health professional.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Women
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 12
- Paragraph text
- While different aspects of torture and ill-treatment in health-care settings have been previously explored by the rapporteurship and other United Nations mechanisms, the Special Rapporteur feels that there is a need to highlight the specific dimension and intensity of the problem, which often goes undetected; identify abuses that exceed the scope of violations of the right to health and could amount to torture and ill-treatment; and strengthen accountability and redress mechanisms.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 13
- Paragraph text
- The Special Rapporteur recognizes that there are unique challenges to stopping torture and ill-treatment in health-care settings due, among other things, to a perception that, while never justified, certain practices in health-care may be defended by the authorities on grounds of administrative efficiency, behaviour modification or medical necessity. The intention of the present report is to analyse all forms of mistreatment premised on or attempted to be justified on the basis of health-care policies, under the common rubric of their purported justification as "health-care treatment", and to find cross-cutting issues that apply to all or most of these practices.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 14
- Paragraph text
- Both the European Court of Human Rights (ECHR) and the Inter-American Court of Human Rights have stated that the definition of torture is subject to ongoing reassessment in light of present-day conditions and the changing values of democratic societies.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph
Certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment 2013, para. 15
- Paragraph text
- The conceptualization of abuses in health-care settings as torture or ill-treatment is a relatively recent phenomenon. In the present section, the Special Rapporteur embraces this ongoing paradigm shift, which increasingly encompasses various forms of abuse in health-care settings within the discourse on torture. He demonstrates that, while the prohibition of torture may have originally applied primarily in the context of interrogation, punishment or intimidation of a detainee, the international community has begun to recognize that torture may also occur in other contexts.
- Body
- Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Violence
- Person(s) affected
- N.A.
- Year
- 2013
Paragraph