Palliative Care: A Universal Human Right

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Palliative Care A Universal Human Right
Lisbeth Quesada Tristán Defensora de los Habitant
es
Republic of Costa Rica
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Human Rights are the nerve of the free life and
progress of the People(). The task of the def
enders (of Human Rights) is located in
the difficult space between listening directly to
the needs of the population and the
independence of opinion demanded by the
supervision of the public administration."King
Juan Carlos of Spain I Tri-Continental
Conference of Institutions for the
Defense and Promotion of Human Rights
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Pain and Suffering are NOT Neutral Experiences
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Neither are old age, nor sickness.
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Much less Death. Not our own, or that of a love
d one.
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• And, who says theres nothing else to do?

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Palliative Care
Its the total, integral care for a patient--and
his/her family--in limited life conditions, or
that faces the terminal stage of a disease.
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THE RIGHT TO HEALTH AS A HUMAN RIGHT
The benefit of enjoying high health levels is
one of the fundamental rights of every human
being, without distinction of race, religion,
political creed, social or economic condition
(WHO)
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What is a Human Right?
It is the faculty conferred by the norm, of the
protection of the person regarding his/her life,
freedom, social or political participation, or
any other fundamental issue that affects his/her
integral development as a person, in a community
of free men, demanding respect from other men,
social groups and the State, and with the
possibility of putting in action the coercive
system of the State in case of a violation.
Gregorio Peces Barba
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Constitutional and Jurisprudential Analysis
Right to Health

• Right not included expressly in the Political
  Constitution of Costa Rica, and others, but
  contemplated derivatively in it (Art. 21, 48 and
  70), as well as in International Human Rights
  Treaties.
• The Constitutional Chamber of the Supreme Court
  of Justice has established it as a derivation of
  the right to life, intricately related to the
  social rights. Ruling 2522-97.

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It is necessary to insist on the need to have
more palliative care centers that offer integral
attention, providing the sick person the human
assistance and spiritual accompaniment they
need... Its about a right that belongs to every
human being, and which we all must commit to its
protection... Its necessary to promote policies
that create the conditions for human beings to be
able to endure incurable diseases and to face
death in a dignified way. (Benedict
XVI )
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The Central American Council of Ombudsman
Within the frame work of the XXXIV Meeting, tha
t took place in San José, Costa Rica, on February
1-2, 2007, it declared that Palliative Care
materialize the right to a dignified and painless
death, derived from the fundamental right to
life, and thus, the actions to promote its
development are the responsibility of the
National Ombudsman Offices and the CCPDH.
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Political Constitution of Costa Rica
TITLE IV INDIVIDUALES RIGHTS AND Y GARANTIAS S
ingle Chapter Article 21.- Human life is in
violable.
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Experience in Costa Rica
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Appeal to the Constitutional Chamber in favor of
Mrs. Mónica Granados Chaverri
1990
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Constitutional Chamber
1- Even though its true that pharmacies are
private entities, they perform a social function
directly related to health, and cannot refuse to
provide a lawfully constituted prescription.
2- A pharmacist cannot refuse to provide a lawfu
lly constituted prescription and cannot change it
either. He/she cannot invade another professional
field. 3- What happens to the patient is the ex
clusive responsibility of the physician.
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Constitutional Chamber
Every Costa Rican has the Right to a Dignified
and Painless Death
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Dame Cicely Saunders June 22, 1918 - July 14, 200
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Lets Talk About Human Dignity
The word dignity is abstract and means quality
of being worthy. It comes from the Latin
adjective dignus, a, um, that translates to
valuable. Hence, dignity is an entitys qualit
y of being valuable.
Merriam Webster Dictionary
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Lets Talk About Human Dignity
The modern concept of human dignity does not deny
the existence of inequalities between
individuals. What it does deny is that these
natural and social inequalities justify an
unequal treatment by the institutions or a
degrading treatment among individuals. In other
words, anyone deserves respect out of the mere
fact that they are a human being.
www.revistasuniversitarias.org Antonio Pele
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Palliative Care as a progressive Human Right part
of the Right to Health. The progressive obligat
ion implies no regressiveness.
To have no resources is no excuse (UN). Refer to
ruling 5934-97 of the Constitutional Chamber on
antiretroviral drugs.
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Why a Human Right?
Human Rights comprise an integral system of
values, and a political juridical philosophy,
aceppted by individuals, societies,
goverments, and state , with the purpose
protecting us as a human species.
As members of humanity, we embrace this
paradigm of human rights.
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Why a Human Right?
This paradigm is so important that it is roote
d in the political constitutions of the
countries, declarations, and international
treaties Once human rights are integrated into
the constitutional system of a nation, they
are guaranteed, and may be demanded when
violated. This is the only way to protect them,
and protect us
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Why a Human Right?
Human beings does not invent a Human Rights, we
discover them as time goes by
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Why a Human Right?
Universal Declaration of Human Rights
Article 1. All human beings are born free and e
qual in dignity and rights.They are endowed with
reason and conscience and should act towards one
another in a spirit of brotherhood.
Article 3. Everyone has the right to life, li
berty and security of person.
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Why a Human Right?
Universal Declaration of Human Rights
Article 5. No one shall be subjected to tortu
re or to cruel, inhuman or degrading treatment or
punishment.
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Why a Human Right?
1- it is a specialized field of medicine that
deals with a very specific time in the life of
people facing the end of life with all its
consequences.
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Why a Human Right?
2- It tends to the pain of the patient and
his/her family within the concept of total
pain.
Social
Physical
Total Pain
Psychological
Spiritual
What other medical specialty?
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Why a Human Right?
3- Emotional Support for the Patient and his/h
er family. 4- Grief Support. 5- Support for
the interdisciplinary team, taking care of the
caretakers.
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Why a Human Right?
6- Integral Approach. 7- Continued Attention
, 24 hours a day, 365 days a year.
8- Accessible Attention for those who pay and th
ose who cant, at least in Costa Rica, Chile,
Canada, England, countries with socialized
medicine. 9- Personalized it respects the pati
ents wishes, values and beliefs.
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Why a Human Right?
10- It is based on the family as the handling
unit. 11- Palliative Care takes place at home,
the hospital or any other scenario. PC follows
the patient. 12- Palliative Care pays no attent
ion to race, politics or religion.
13- It is a component of quality care.
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Why a Human Right?
14- Humanizes a care that questions the biologic
, scientific, mechanic and positivistic
paradigm. 15- Participative state and communit
y resources, volunteering, associations,
foundations. 16- It has a bank of medical equip
ment it lends to the patients without cost.
17- All modes can be worked on together as a tea
m, or just one of them. Intra-hospital visit, ho
me visit, shelter, specialized center or
hospital by day.
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Why a Human Right?
Palliative care works on the end of life, its a
philosophy of life, its a way of facing life
and humanity, in a vulnerable moment of a human
being and its family. Its a way of facing one o
r maybe the most scaring moment in a individual
What other specialty does this for people?
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To declare Palliative Care as a Universal Human
Right, of compulsory observance in all
countries. To have it materialize as public healt
h policies and for the people to be able to
demand this right before a violation.
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You matter because you are you, and you matter
to the end of your life. We will do all we ca
n not only to help you die peacefully, but also
to live until you die. Dame Cicely Saunders

Thank You