Right to Health as a Justiciable Right in India: Emerging Jurisprudence

Right to Health as a Justiciable Right in India: Emerging Jurisprudence

Written by Niharika Gupta

Introduction

The right to health occupies a pivotal position in modern democratic societies. In India, this right has taken center stage in both legal and socio-political discourse. While the Constitution does not specifically enumerate the “right to health” as a fundamental right, Indian courts—particularly the Supreme Court—have developed a robust jurisprudence that situates the right to health at the heart of the right to life and personal liberty under Article 21. This article traces the constitutional development, landmark cases, legislative evolution, and emerging trends that have shaped the right to health as a justiciable, enforceable right in India.

Constitutional Background: Where Does the Right to Health Stand?

Article 21: The Gateway Provision

Article 21 of the Indian Constitution states: “No person shall be deprived of his life or personal liberty except according to procedure established by law.” Judicial interpretation has expanded the scope of this article hugely—from mere animal existence to the right to live with human dignity, including the right to health as an inherent component.

Directive Principles of State Policy

Part IV of the Constitution, while not justiciable, guides the state to raise the level of nutrition, improve public health, and provide for humane conditions of work (Articles 39(e), 41, 42, 47). The Supreme Court has repeatedly leveraged these principles to interpret the right to health as a fundamental right.

Judicial Expansion: Key Supreme Court Pronouncements

The Indian judiciary, notably the Supreme Court, has played a transformative role in realizing the right to health as justiciable.

Landmark Cases Shaping the Right to Health

Bandhua Mukti Morcha v. Union of India: The Court recognized the right to health as intrinsic to the right to life under Article 21. It emphasized that the state must provide medical facilities, especially to vulnerable populations.
Consumer Education and Research Centre v. Union of India: The Supreme Court categorically held that the right to health and medical care is a fundamental right under Article 21, stressing that meaningful life requires safeguarding and promoting workers’ health and well-being.
State of Punjab v. Mohinder Singh Chawla: The apex court reaffirmed the state’s constitutional obligation to provide health services, observing that the right to health is fundamental to the right to life.
Paschim Banga Khet Mazdoor Samity v. State of West Bengal: The Court declared that failure on the part of a government hospital to provide timely medical treatment violates Article 21.
Parmanand Katara v. Union of India: The Supreme Court held that every doctor, whether at a government or private hospital, has an absolute obligation to extend medical assistance and preserve life, regardless of legal formalities1.
State of Punjab & Ors vs Ram Lubhaya Bagga: The Court held that denial of medical reimbursement for life-saving expenses curtails the right to life. The government is obligated to improve public health.
COVID-19 Jurisprudence: In 2020, the Supreme Court observed, “Right to health is a fundamental right guaranteed under Article 21… Right to Health includes affordable treatment. Therefore, it is the duty upon the State to make provisions for affordable treatment.”

Table: Key Judicial Decisions on Right to Health

Case	Year	Principle Established
Bandhua Mukti Morcha v. Union of India	1984	Right to health part of right to life under Art. 211 4
Consumer Education & Research Centre v. UOI	1995	Health, medical care, and social security are part of Art. 215 1
State of Punjab v. Mohinder Singh Chawla	1996	State’s constitutional obligation to provide health1 2 4
Paschim Banga Khet Mazdoor Samity v. WB	1996	Government duty to provide timely medical treatment
State of Punjab v. Ram Lubhaya Bagga	1998	Denial of medical reimbursement violates Art. 214
Supreme Court on COVID-19 Healthcare	2020	Affordable health is integral to Art. 21, State duty7

Right to Health: An Evolving Legal Understanding

From Directive to Justiciable Right

Though the right to health began as a directive principle, judicial activism and expansive interpretations have made it justiciable—meaning citizens can approach courts to enforce this right. The courts’ approach has gradually shifted from merely urging the government to act, to issuing binding orders for the provision of health services.

Interconnections with Other Rights

Right to Clean Environment and Sanitation: Cases have linked health to the environment (access to clean air, water, hygiene).
Dignity and Equality: The right to health closely intertwines with the right to dignity, equality, and non-discrimination, especially for marginalized sections.

International Commitments and Influence

India’s constitutional jurisprudence aligns with international treaties and guidelines:

Universal Declaration of Human Rights (UDHR): Article 25 recognizes “the right to a standard of living adequate for health and well-being…including food, clothing, housing and medical care.”
International Covenant on Economic, Social and Cultural Rights (ICESCR): Article 12 commits signatories to “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

Indian courts have referred to these instruments to reinforce constitutional principles, adding international legitimacy to domestic enforcement.

Legislative and Policy Developments

Absence of a Standalone Statute

India lacks a single, comprehensive legislation guaranteeing the right to health. The Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill, various draft National Health Bills, and state-level initiatives have yet to realize national, justiciable health rights statutes.

Sectoral Laws

Indian Medical Council Act, 1860
Clinical Establishments (Registration and Regulation) Act, 2010
National Health Mission, Ayushman Bharat, and related schemes

These laws and policies support health delivery but do not necessarily make health an actionable constitutional right for an individual citizen.

Challenges to Justiciability

Policy vs. Enforceable Right

Infrastructure & Resources: Courts have recognized the challenge of resource constraints in enforcing the right to health universally.
Federal Structure: States bear the principal responsibility for health, which leads to disparities in enforcement and access across regions.
Economic Development: Questions remain about whether India’s current economic and health systems are developed enough to make the right to health justiciable nationwide.

Judicial Limitations

While courts have expanded the scope of the right to health, they often refrain from specifying resource allocation, leaving that to the executive’s domain. However, when faced with gross violations, the judiciary has issued binding orders to provide treatments, reimburse expenses, and ensure the functioning of health facilities.

Recent Trends and COVID-19 Jurisprudence

The COVID-19 pandemic underscored the gaps in India’s health infrastructure and revived calls to recognize the right to health as a statutory and justiciable right. The Supreme Court’s suo motu intervention on COVID-19 health crises reaffirmed the obligation of governments to ensure affordable healthcare, thereby marking a significant shift toward judicial enforcement of the right to health as an inescapable duty of the State.

The Road Ahead: Need for Comprehensive Legal Framework

Policy Recommendations

Constitutional Amendment: Explicitly recognizing the right to health as a fundamental right would strengthen judicial enforcement and public legitimacy.
Comprehensive Legislation: Enacting a health rights statute will define minimum standards, obligations, remedies, and sanctions, providing practical enforceability.
Federal Coordination: Greater synergy between the central and state governments is crucial for uniform realization.
Public Investment: Raising public health expenditure is necessary for a robust, enforceable health rights framework.
Equity Focus: Addressing disparities due to economic, caste, gender, and rural-urban divides is vital for social justice.

Conclusion

Emerging Indian jurisprudence unequivocally recognizes the right to health as an enforceable and justiciable right. Armed with robust judicial support, constitutional values, and growing policy advocacy, the right to health stands at a critical juncture. While numerous challenges persist—related to resources, legal frameworks, and coordination across states—the onward march towards making health justiciable is irreversible. The urgent task before India is to translate these constitutional promises and judicial pronouncements into tangible, statutory entitlements for every citizen, fulfilling not only the constitutional ideals but also the nation’s international human rights obligations.

References