MODULE – II

HEALTH LAW IN INDIAN CONTEXT

INDIAN CONSTITUTION AND HEALTH

In the Indian Constitution, the "Right to Health" is not explicitly mentioned
as a stand-alone fundamental right. However, the judiciary has interpreted
health as an essential part of the Right to Life, and it is supported by several
Directive Principles that guide the State's duty toward its citizens.
1. Fundamental Rights (Part III)
● Article 21 (Right to Life and Personal Liberty): The Supreme Court of
India has ruled in multiple landmark cases that the "right to life"
includes the right to health and medical care.
● Article 23 & 24: These articles protect the health of women and
children by prohibiting human trafficking and hazardous child labour,
respectively.
● Article 25: While guaranteeing freedom of religion, this right is
subject to "public order, morality, and health," meaning religious
practices cannot compromise the physical well-being of the public.
2. Directive Principles of State Policy (Part IV)
These are non-justiciable (cannot be directly enforced in court) but
represent the State's primary duties to improve public health
(REFER EARLIER NOTES)
In the Indian constitution health is primarily a subject of state list (LIST II),
specifically under the seventh schedule, Entry 6 explicitly mentions ‘public
health and sanitation, hospital and dispensaries”, Entry 9 deals with [Link]
being as being under the exclusive of state legislature.
In concurrent list (list III), Entry 20A deals with population control and family
planning, Entry 29 deals with the prevention of extension from one state to
another of infectious or contagious diseases.
In the union list (list I), Entry 28 deals with Port quarantine, including
hospitals connected therewith; seamen's and marine hospitals. Entry 81
deals Inter-state quarantine and inter-state migration. Entry 66 deals with
Coordination and determination of standards in institutions for higher
education or research and scientific and technical institutions
There have been periodic proposals and expert recommendations (such as
from the 15th Finance Commission) to move "Health" from the State List to
the Concurrent List to ensure a unified national response to pandemics and
health crises, though no such constitutional amendment has been enacted
yet.
Local bodies
In the Indian Constitution, the 73rd and 74th Amendment Acts (1992)
decentralized health governance, empowering local bodies to manage
public health at the grassroots level.
1. Panchayats (Rural Local Bodies)
Under Article 243G, State legislatures may delegate powers to Panchayats
to prepare plans for economic development and social justice, specifically
including matters listed in the Eleventh Schedule. 
● Subject 23: Health and sanitation, including hospitals, primary health
centres (PHCs), and dispensaries.
● Subject 24: Family welfare programs.
● Subject 25: Women and child development, which includes maternal
and neonatal health.
Implementation: Panchayats exercise these duties through Village
Health Sanitation & Nutrition Committees (VHSNC), which monitor
local health workers (like ASHAs) and manage basic health services
and vaccination drives. 
2. Municipalities (Urban Local Bodies)
Under Article 243W, Municipalities are granted authority over functions
listed in the Twelfth Schedule to ensure urban social and economic
development. 
● Subject 6: Public health, sanitation, conservancy, and solid waste
management.
● Vital Statistics: Registration of births and deaths (Subject 16).
● Regulation: Monitoring of slaughterhouses, tanneries, and food
 safety to prevent the spread of infectious diseases.
● Amenities: Provision of safe drinking water and maintenance of
burial/cremation grounds. 
3. Integrated Planning
The Constitution also provides a mechanism for coordinated health
planning:
● District Planning Committee (Article 243ZD): Consolidates plans
from both Panchayats and Municipalities to create a comprehensive
development plan for the entire district.
● Metropolitan Planning Committee (Article 243ZE): Performs a
similar function for large metropolitan areas to manage shared
resources like water and health infrastructure. 

APPROACH OF JUDICIARY IN REALISATION OF RIGHT TO HEALTH

In India, the Right to Health is a "derivative" fundamental right. The Indian
judiciary has transformed the Right to Health from a non-
justiciable Directive Principle (Part IV) into an enforceable Fundamental
Right by reading it into the Right to Life (Article 21). While the Constitution
of India doesn't explicitly name it, the judiciary has carved it out of the Right
to Life (Article 21).8
The judicial approach has evolved through three distinct phases:
1. The Derivative Phase (Broadening Article 21)
The courts first established that "life" means more than "mere animal
existence". 
1. Maneka Gandhi v. Union of India (1978), the Supreme Court did
not rule directly on a medical health issue but laid the constitutional
foundation for the Right to Health to later emerge as a fundamental
right.
Before this case, Article 21 was seen as protecting only against
physical restraint (mere "animal existence"). The Court ruled that the
"Right to Life" encompasses the right to live with human dignity. This
 shift allowed subsequent courts to argue that one cannot live with
dignity without access to medical care and a healthy environment.
2. In Municipal Council, Ratlam v. Vardichan (1980), the Supreme Court
highlighted the state's responsibility for public health and
environmental sanitation.
3. Francis Coralie Mullin v. The Administrator, Union Territory of Delhi
(1981), the Supreme Court of India fundamentally expanded the
scope of Article 21, establishing that the right to health is an
inseparable part of a dignified life. It declared that Article 21 includes
the right to the bare necessities of life, specifically naming adequate
nutrition as a core component of human dignity.
4. Bandhua Mukti Morcha v. Union of India (1984) established that the
right to live with human dignity includes protecting the health of
workers and ensuring healthy development for children.
5. Vincent Panikurlangara v. Union of India (1987) linked public health
maintenance to the "Right to Life" in a welfare state.

2. The Enforcement Phase (Defining State Liability)

The judiciary moved toward holding the State and medical professionals
strictly accountable:
6. Parmanand Katara v. Union of India (1989) mandated that medical
professionals provide immediate medical aid to accident victims
regardless of legal formalities.
7. Consumer Education & Research Centre v. Union of India
(1995) formally recognized the right to health and medical care for
workers as a fundamental right under Article 21.
8. Paschim Banga Khet Mazdoor Samity v. State of West Bengal
(1996) found that government hospitals failing to provide timely
emergency treatment violate Article 21, emphasizing that lack of
funds is not an acceptable excuse.
9. State of Punjab v. Mohinder Singh Chawla (1997) reinforced the
state's obligation to provide medical facilities and the right of
government employees to be reimbursed for medical expenses.
 10. State of Punjab v. Ram Lubhaya Bagga (1998) declared public health
a primary duty of the state, essential for citizens' well-being.
3. The Holistic & Modern Phase (Mental & Environmental Health)
Recent trends show a shift toward "holistic health," including mental well-
being and environmental factors:
11. Suchita Srivastava v. Chandigarh Administration (2009), the
Supreme Court of India established that reproductive autonomy is a
fundamental aspect of the right to health and personal liberty under
Article 21. The case involved an orphaned woman with "mild mental
retardation" living in a government-run institution who became
pregnant following a rape. The Chandigarh Administration sought to
terminate her pregnancy, arguing it was in her "best interest," but the
woman expressed a desire to carry the child to term.
The Court declared that a woman’s right to make reproductive
choices including whether to carry a pregnancy to term or abstain
from procreating is a dimension of personal liberty, dignity, and bodily
integrity.
12. Laxmi Mandal v. Deen Dayal Harinagar Hospital
(2010) recognized maternal healthcare as a fundamental right linked
to gender justice and Article 21.
13. Mohd. Ahmed (Minor) v. Union of India (2014) held that the state
must provide lifesaving drugs for rare diseases, balancing costs with
individual dignity.
14. Navtej Singh Johar v. Union of India (2018) stated that the right to
life includes the guarantee of health, encompassing sexual and
mental health.
15. Common Cause (A Regd. Society) v. Union of India (2018), the
Supreme Court expanded the Right to Health to include the Right to
Die with Dignity as a fundamental right under Article 21.
The Court ruled that the right to life includes the right to a dignified
exit, specifically for patients in a permanent vegetative state or with
terminal illnesses. The Court legalized Passive Euthanasia
(withdrawing life support) under strict guidelines. It distinguished this
from Active Euthanasia, which remains illegal.
 16. Jacob Puliyel v. Union of India (2022), the Supreme Court of India
addressed the tension between individual bodily autonomy and the
state's power to enforce public health mandates during the COVID-19
pandemic.
17. Sukdeb Saha v. State of Andhra Pradesh (July 2025), the Supreme
Court recognized mental health as an integral part of the Right to Life,
issuing binding guidelines for schools and coaching centres to protect
student well-being.
Recent judgment Jaya Takur v. government of India – menstrual
hygiene (look into it)

RIGHT TO EMERGENCY CARE

The right to emergency medical care in India is an essential facet of the
Right to Life under Article 21 of the Constitution. While the Constitution
does not explicitly mention healthcare, the Supreme Court has expansively
interpreted "life" to include the right to health and timely medical
intervention. This right is further supported by the Directive Principles of
State Policy, specifically Article 47, which mandates the State to improve
public health as a primary duty. Judicial activism has shifted this from a
mere policy goal to an enforceable fundamental right, asserting that the
preservation of human life is "paramount" and "absolute". In a welfare
state, the government is constitutionally obligated to provide adequate
medical facilities, and any failure to do so, especially in life-threatening
emergencies, constitutes a direct violation of Article 21.
Key Supreme Court judgments have shaped the right to emergency
medical care in India.
In Parmanand Katara v. Union of India (1989), the Court mandated that
doctors in both government and private hospitals provide immediate
medical aid to preserve life, without waiting for police formalities.
The case Paschim Banga Khet Mazdoor Samity v. State of West Bengal
(1996) reinforced that the right to life includes access to timely medical
treatment in government hospitals, and the state cannot use financial
constraints as an excuse to deny this.
The National Consumer Disputes Redressal Commission in Pravat Kumar
Mukherjee v. Ruby General Hospital (2005) also ruled that emergency
treatment cannot be stopped, nor can upfront payment be demanded,
before a patient is stabilized.
India's legal framework for emergency medical care is a combination of
various laws, rather than a single dedicated act. The Clinical
Establishments Act, 2010 requires registered facilities to provide
immediate emergency care for stabilization.
Protection for those assisting accident victims is provided by Section 134A
of the Motor Vehicles (Amendment) Act, 2019, shielding "Good Samaritans"
from liability. Furthermore, the Mental Healthcare Act, 2017 ensures
access to immediate treatment during psychiatric emergencies. However,
challenges persist, including limited trauma centers, particularly in rural
areas, and issues with private hospitals sometimes refusing treatment
based on a patient's ability to pay.