The Future

The Resolution of the UN, the Convention, the Treaty.

Why a United Nations Convention? Conventions and Covenants are clearly defined by the international covenant and convention law, it implies negotiation and requires ratification by the states, once this happens, it constitutes a treaty and becomes legally binding, which is fundamental for the execution of the principles that are the essence and motivation of the Initiative.  The implementation of the Initiative through a United Nations Treaty is the philosophical and practical equivalent to adding a third section to article 25 of the Universal Declaration of Human Rights, proclaimed in the Palace Charcot in Paris, on December the 10^th of 1948. 

Why not an amendment to the original Declaration as it was originally conceived?  The reiteration and reaffirmation of the principles and authority of the Universal Declaration of Human Rights, has caused legal scholars to consider the Declaration international customary law.  Is worth to noticing, however, that a Declaration is an international declaratory measure adopted by governments, usually in the UN General Assembly.  It does not require signature or ratification by governments and it is generally not amendable and not binding.  On the other hand, the Universal Declaration of Human Rights is a very special case; it is regarded as having a binding legal quality because it has for the reason that has been incorporated so often in constitutions of states, as well as in hundreds of UN resolutions and conventions.  However, because amendments to the Universal Declaration of Human Rights are not considered, a treaty through a Convention will serve identical purposes, implementing the objectives of the Initiative and legally binding through a pact the signatory member states of the United Nations.

There have been many instances of utilization of the quoted instruments and more than 25 other Declarations, Pacts, Conventions and covenants.

The Human Rights Treaty System encompasses today seven major treaties:

· the Convention on the Elimination of all forms of Racial Discrimination
     (in force on January 4, 1969)

· the International Covenant on Civil and Political Rights (CCPR)
     (in force on March 23, 1976)

· the International Covenant on Economic, Social and Cultural Rights
     (in force on March 23, 1976)

· the Convention on the Elimination of all forms of Discrimination Against Women
     (in force on September 3,  1981)

· the Convention Against Torture, and Other Cruel, Inhuman or Degrading Treatment or Punishment
     (in force on June 26, 1987)

· the Convention on the Rights of the Child (in force on September 2,1990)

· the International Convention on the Protection of the Rights of All Migrant            

     Workers and Members of Their Families
     (in force on July 1, 2003).

Although, for example, the rights of woman and the rights of children are implicit in the Universal Declaration of Human Rights, it was considered transcendental in order to adequately protect those rights to make a Treaty through a United Nations Convention, specific, to give to those rights the preponderance and legal stature that it was legitimately felt they deserve.  So is the case with the Treatment of Pain, it may be implicit in the Universal Declaration of Human Rights or mentioned in other statutes, but it is imperative that the United Nations Members recognize through a Treaty the relevance of this aspect of human rights, now days a dramatic case of injustice all over the world.  The under treatment of pain is, as said and as we all know, not only one of the greatest injustices in our world today but also the cause of much suffering and desperation among human beings.  The goal of this Initiative is, above all, to bring relief to millions of suffering human beings, to abolish the idea of euthanasia as a desperate mean to cut endless suffering, to provide quality of life to those among us who are the victims of that torture, and to bring hope and peace to the families and love ones of those who are suffering the flagellation of pain.

 The 106^th Congress of the United States passed a resolution declaring the decade beginning January 1, 2001 as the Decade of Pain Control and Research.  There have been many more declarations and initiatives to call the attention of every one to the desperate need of adequate pain management all over the World, not only that, the treatment of pain as a Human Right has been recognized by many.  Libeskind and Melzak did so when they wrote in a 1994 editorial:

“Freedom from pain should be a basic human right limited only by our ability to achieve it”

Also, Mauricio Gutfrajend, Carlos Fernández, Sara Bistre, Ricardo  Plancarte, Michael Cussings and many others have recognized that principle. Worth to mentioning has been the work with the Government of Mexico principaly  done by doctora Sara Bistre to promote that the Treatment of Pain will be  declared as one of the Human Rights of the Mexican people.  Also worth to mentioning are the Declarations of Acapulco and Bogota in which this concept is stressed as is in the Europe Against Pain Initiative.  As we mentioned before, when Dr. Niv, last June in Peru, presented to the Presidents of the IASP chapters from Latin America the plan for the declaration of October 11 as the Global day Against Pain, we stressed the importance and transcendentality of the Initiative to the United Nations to promote the recognition of the Treatment of Pain as a Human Right. He elegantly promised us that he would work for an official endorsement of the organization. The Declaration of the Global Day Against Pain on October 11, 2004 is now officially recognizing in its logo the treatment of pain as a Human Right, thanks to doctor Niv, and probably too, indirectly, acknowledging our recent communications with the President of that organization, Dr. Michael Bond.  It is fundamental to conclude that all this marvelous and extenuating work in the procurement of appropriate pain treatment in large areas of our world will reach a permanent goal with a Pact through a Convention of the United Nations in which all signatory countries, in fact, the whole Planet will legally compromise and bind for the appropriate treatment of pain to their populations.

The contribution of our organization in the universal struggle for an adequate treatment of pain to all human beings has been not only to recognize it as a Fundamental Human Right, but actually disseminating the concept around the World, getting the support of hundreds of organizations and thousands of individuals, and the most important, reaching various governments members of the United Nations that are right now working officially in its implementation through the appropriate United Nations and World Health Organization channels.  The movement needs at this precise moment the support and cooperation of all the World Societies dedicated to the treatment, study and research on pain. We need to contribute with the above-mentioned Governments that so kindly have heard our humanitarian concerns. Everybody must be conscious that the Initiative is already there, officially placed at the United Nations and that many intellectual experts in Human Rights at various Universities are working long hours on immense documents for what is called a Resolution Project.  Finally it is only fair to mention that this undertaking has taken up time and efforts of hundreds of persons around the World, uncountable work hours, and hundreds of thousands of dollars.  There seems to be a Universal Consensus that the Treatment of Pain constitutes a Fundamental Right of all Human Beings, now we should unite our efforts to actively support the Initiative which has being already placed through the appropriate United Nations and World Health Organization Channels.  We feel deep appreciation, respect and gratefulness to all those human beings and Governments that have being dedicating their time and efforts to this humanitarian endeavor.

Although a Convention of the United Nations on this matter and the pact that it promotes may become legally binding for all nations, of course we know that it will not instantaneously provide justice to all human beings, but it will be the basis and fundamentals for a revolution in the way pain is treated all over the world.  Not only that, it will provide all societies and human beings with the legal background to rightfully demand the consideration and appropriate treatment of pain, in themselves, in their loved ones or in their citizens.

As we previously mentioned, the Initiative to the United Nations to promote the Treatment of Pain to the level of one of the Universal Rights of Human Beings has received in the last months the official endorsement of various Governments.  So next, it will be officially presented to the United Nations by one of its members to organize a Convention in order to promote its principles through the vote of the Nation members and so constitute a Treaty. 

By all means the text of the suggested protocol of the Convention and so, the text of the subsequent Treaty has to be the result of the Universal consensus of the Pain Practitioners and its leadership from all the countries of the World and the input of experts in Human Rights, Sociology, Politics and Economy, to mention a few.  The accord will be extremely transcendental for our generation and for future generations.  It will have to include many aspects of the treatment of pain, among many others:

• The definition of Pain and Pain Treatment
• The education of professionals in the field in various different specialties
• The curriculum to be taught in the different levels
• The allocation of the appropriate funds for education
• Scholarships and international training
• The allocation of funds for the actual treatment of pain
• The role of the WHO in various of the aspects of the Treaty
• The terms of collaboration among Nations to share resources and technology
• The economic help that the different organizations can provide to the Nations in need.
• The political aspects of the Treaty
• The sociological aspects of the Treaty
• .  The economical aspects of the Treaty
• The legal binding aspects of the Treaty
• The adequate distribution of opioids and other medications around the World.

As with other Treaties, the aim of this one is primarily to:

• Encourage a culture of pain treatment as a human right
• Focus the treatment of pain in the framework of human rights system, standards and obligations
• Engage all states in the treatment of pain as part of the universal treaty system
• Interpret the treatment of pain as other treaties through reporting and communications
• Identify benchmarks on pain treatment through general comments and recommendations
• Provide an accurate, pragmatic, quality end product in the form of concluding observations for each state in the area of pain treatment
• Provide a remedial forum for individual complaints on violations on the adequate treatment of pain.
• Encourage a serious national process of review and reform through partnerships at the national level on the treatment of pain
• Operationalize standards on the treatment of pain
• Mainstream human rights in the UN system and mobilize the UN community to assist with implementation and the dissemination of the message of rights and obligations focused on the treatment of pain.  

I humbly propose that in order to reach consensus in all of these aspects, a Convention of the leaders of the World in the field of Pain and the other professionals mentioned will be necessary so as to work together in a parliamentary manner to rationally reach a universal accord on how the final protocol and consequently the final Treaty we will be suggested to read.

It all points to, that finally, the time and efforts that we have dedicated to this endeavor are about to reach their goal, thanks to the universal support that the Initiative has received from all over the World, however, the fight to combat human pain and suffering, as the fight for Human Rights are never ending endeavors, that is why Jran-Jaqueess Gandini rightfully said:

C’est pourquoi la question des droits de l’homme reste posée, et le combat pour les faire triompher est un éternel recommencement

This is why the human rights question stays open and the fight to succeed is an eternal recommencement.