At least some of your answer is at the beginning of the documents. Doc 4444 PANS-ATM, for example, says:
3. Status
3.1 The Procedures for Air Navigation Services (PANS) do not have the same status as the Standards and Recommended Practices. While the latter are adopted by Council in pursuance of Article 37 of the Convention on International Civil Aviation, subject to the full procedure of Article 90, the PANS are approved by the Council and recommended to Contracting States for worldwide application.
3.2 While the PANS may contain material which may eventually become Standards or Recommended Practices (SARPs) when it has reached the maturity and stability necessary for adoption as such, they may also comprise material prepared as an amplification of the basic principles in the corresponding SARPs, and designed particularly to assist the user in the application of those SARPs.
4. Implementation
The implementation of procedures is the responsibility of Contracting States; they are applied in actual operations only after, and in so far as, States have enforced them. However, with a view to facilitating their processing towards implementation by States, they have been prepared in language which will permit direct use by air traffic services personnel and others associated with the provision of air traffic services to international air navigation.