A/HRC/22/53 settings meet the definition of torture, the following section provides an overview of the main elements of the definition of torture. B. Applicability of the torture and ill-treatment framework in health-care settings 1. Overview of key elements of the definition of torture and ill-treatment 17. At least four essential elements are reflected in the definition of torture provided in article 1, paragraph 1, of the Convention against Torture: an act inflicting severe pain or suffering, whether physical or mental; the element of intent; the specific purpose; and the involvement of a State official, at least by acquiescence (A/HRC/13/39/Add.5, para. 30). Acts falling short of this definition may constitute cruel, inhuman or degrading treatment or punishment under article 16 of the Convention (A/63/175, para. 46). The previous Special Rapporteurs have covered in great detail the main components of the definition of torture. Nevertheless, there are a few salient points worth elaborating for the purpose of the present report. 18. The jurisprudence and authoritative interpretations of international human rights bodies provide useful guidance on how the four criteria of the definition of torture apply in the context of health-care settings. ECHR has noted that a violation of article 3 may occur where the purpose or intention of the State‟s action or inaction was not to degrade, humiliate or punish the victim, but where this nevertheless was the result. 3 19. The application of the criteria of severe pain or suffering, intent, and involvement of a public official or other person acting in an official capacity, by consent or acquiescence to abuses in health-care settings, is relatively straightforward. The criterion of the specific purpose warrants some analysis.4 20. The mandate has stated previously that intent, required in article 1 of the Convention, can be effectively implied where a person has been discriminated against on the basis of disability. This is particularly relevant in the context of medical treatment, where serious violations and discrimination against persons with disabilities may be defended as “well intended” on the part of health-care professionals. Purely negligent conduct lacks the intent required under article 1, but may constitute ill-treatment if it leads to severe pain and suffering (A/63/175, para. 49). 21. Furthermore, article 1 explicitly names several purposes for which torture can be inflicted: extraction of a confession; obtaining information from a victim or a third person; punishment, intimidation and coercion; and discrimination. However, there is a general acceptance that these stated purposes are only of an indicative nature and not exhaustive. At the same time, only purposes which have “something in common with the purposes expressly listed” are sufficient (A/HRC/13/39/Add.5, para. 35). 22. Although it may be challenging to satisfy the required purpose of discrimination in some cases, as most likely it will be claimed that the treatment is intended to benefit the “patient”, this may be met in a number of ways. 5 Specifically, the description of abuses 3 4 5 See Peers v. Greece, Application No. 28524/95 (2001), paras. 68, 74; Grori v. Albania, Application No. 25336/04 (2009), para. 125. Open Society Foundations, Treatment or Torture? Applying International Human Rights Standards to Drug Detention Centers (2011), p. 10. Ibid., p. 12. 5