2 to grave,” if necessary, as the old welfare state slogan goes- trying to prevent, mitigate and redress the consequences. 3. THE STATE AS “GUARANTOR” 6. In addressing these issues, it is worth analyzing the position of guarantor of the state. Article 1 of the American Convention states that the State must (recognize), respect and ensure the rights and freedoms enshrined in the Pact of San Jose, Costa Rica. In Article 2, it also sets out that the State must remove the obstacles that hinder the exercise of said powers and adopt such measures as may be necessary to allow every person to effectively gain access to them. 7. In this regard, the exercise of the powers that shape the jurisdiction of the State to which the persons are subject –in their capacity as nationals, citizens, residents, refugees, etc.- ratifies the position of guarantor of the State in relation to the persons under its jurisdiction, allows for fixing the scope and characteristics of specific care and protection practices inherent to said capacity and must be confronted with actual authoritative and protective means. 8. Whoever acts as guarantor for something or of somebody, that is to say, whoever undertakes to secure protection of certain interests in favor of certain persons, undertakes the obligation to confer said interests and persons special care, compatible with the scope of the powers, as set out in the law, an agreement or any other source of guarantee. The State is, generally speaking, the guarantor of the persons under its jurisdiction. The duty of care of the State varies, according to the circumstances, due to several reasons: from the general guarantee of peace and security to the strict duty of care relative to the management of primary utility services and assistance to individuals who are unable to take care of themselves or whose capacity to do so is seriously impaired. The duty of care of the Stateguarantor varies then in quality and intensity, according to the characteristics of the secured interest and the interest holder. In the same line of thought, the provision of health care services, which is the subject matter of the judgment with which this Opinion concurs, demands a higher, if not the highest, protection. 9. The State acts as guarantor of the rights and freedoms of the persons under its jurisdiction as set forth in domestic fundamental laws –the political constitution, in particular- and in international decisions on human rights. The position of guarantor does not entail releasing individuals from their liability for their decisions and acts; on the contrary, it entails providing the means to help them decide and act the best way possible, develop their own capabilities and fulfill their dreams. The State ensures the enjoyment and exercise of rights and freedoms through omissions and acts. The guarantor function of the State, that gained strength through the protection of first generation rights and their resulting observance by the State – normally, by an omissive observance- evolved into a major function through the protection of second generation rights giving rise to a demand for public provision and promotion. 4. PERSONAL AUTONOMY 10. Obviously, the development of every human being is not dependant upon the promotion and care provided by the State. From a general standpoint, every human