"Right to Health as a Fundamental Aspect of the Right to Life: An Analysis Under Article 21 of the Indian Constitution"

 Explain the right to health as an integral part of the right to life under Article 21 of Indian Constitution.

Introduction

Health is a fundamental human right and a cornerstone of a life lived with dignity. The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” In India, while the Constitution does not explicitly recognize health as a fundamental right, Article 21 has been judicially interpreted to include health-related rights.

This interpretation has provided the basis for demanding government accountability, strengthening public healthcare systems, and addressing systemic inequities in healthcare access. The interplay between Article 21 and Directive Principles of State Policy (DPSP), such as Articles 39(e), 41, and 47, further reinforces the constitutional obligation to ensure public health as a critical component of the welfare state.

Right to Health under Article 21

1. Judicial Interpretation of Article 21

Article 21 of the Constitution states:  “No person shall be deprived of his life or personal liberty except according to the procedure established by law.”
The Supreme Court of India has interpreted this provision expansively to include the right to live with dignity, which encompasses access to healthcare, clean water, sanitation, and a healthy environment.

Key Judgments Establishing Right to Health

State of Punjab v. Mohinder Singh Chawla (1997):

           The Supreme Court held that the right to health is a fundamental right under Article 21. The court emphasized that it is the government's obligation to provide medical facilities to every individual.

Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996):

          This landmark case highlighted the state’s duty to ensure the availability of emergency medical facilities. The court ruled that failure to provide timely medical treatment constitutes a violation of Article 21.

Consumer Education and Research Centre v. Union of India (1995):

          The court observed that the right to health and medical care is a fundamental right of workers under Article 21, emphasizing the employer’s obligation to maintain occupational safety and health standards.

2. Interplay Between Article 21 and Directive Principles of State Policy

While the Directive Principles of State Policy (DPSP) are non-justiciable, they complement fundamental rights by guiding the state in creating policies that promote public health.

Key Provisions in DPSP Relevant to Health

· Article 39(e): The state must ensure that workers are not subjected to health risks.

· Article 41: The state must provide public assistance in cases of sickness, disability, and old age.

· Article 47: The state must improve public health, including measures to address malnutrition and substance abuse.

Judicial Interpretation

The Supreme Court has linked these provisions with Article 21 to impose actionable obligations on the state.

· Bandhua Mukti Morcha v. Union of India (1984): The court observed that ensuring decent living conditions, including healthcare facilities, is the state’s responsibility under Article 21, read with Article 39(e) and Article 47.

Key Dimensions of the Right to Health under Article 21

1. Access to Healthcare Services

The right to health ensures that individuals have access to medical services without discrimination. This includes preventive, curative, and rehabilitative care.

Relevant Cases

· Parmanand Katara v. Union of India (1989): The court ruled that medical professionals and hospitals, whether public or private, are duty-bound to provide immediate medical aid to accident victims to preserve life.

· Indian Medical Association v. V.P. Shantha (1995): The court brought medical services under the Consumer Protection Act, ensuring accountability for deficiencies in service.

2. Availability of Essential Medicines and Infrastructure

Adequate healthcare infrastructure and essential medicines are critical to realizing the right to health.

Relevant Cases

· Vincent Panikulangara v. Union of India (1987): The court highlighted the government’s obligation to ensure the availability of life-saving drugs and maintain adequate healthcare infrastructure.

· Khatri (II) v. State of Bihar (1981): The court held that failing to provide medical treatment to injured undertrials amounted to a violation of Article 21.

3. Environmental Health and Sanitation

A clean and healthy environment is an essential component of public health, closely linked to Article 21.

Relevant Cases

· Municipal Council, Ratlam v. Vardichand (1980): The Supreme Court directed local authorities to take measures to prevent public health hazards, affirming the right to a clean environment as part of Article 21.

· Subhash Kumar v. State of Bihar (1991): The court ruled that the right to live in a pollution-free environment is implicit in Article 21.

4. Reproductive Health and Maternal Care : Reproductive health is recognized as an integral part of the right to health.

Relevant Cases

· Laxmi Mandal v. Deen Dayal Harinagar Hospital (2010): The Delhi High Court held that failure to provide maternal healthcare violates Article 21.

· Suchita Srivastava v. Chandigarh Administration (2009): The Supreme Court emphasized the right to make reproductive choices as part of personal liberty under Article 21.

Challenges in Realizing the Right to Health

1. Inadequate Healthcare Infrastructure

· Insufficient public healthcare facilities, particularly in rural areas.

· Overburdened government hospitals and limited access to specialist care.

2. Financial Barriers

· High out-of-pocket expenditure for medical services.

· Limited reach of health insurance schemes.

3. Inequities in Access

· Socio-economic and geographical disparities affecting access to healthcare.

· Marginalized communities often lack access to basic healthcare services.

4. Accountability Issues

· Inadequate enforcement of health regulations.

· Delays in legal proceedings related to medical negligence and public health violations.

Role of Government and Judiciary in Advancing the Right to Health

1. Government Initiatives

· Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY): Aims to provide health insurance to vulnerable sections of society.

· National Health Mission (NHM): Focuses on improving primary healthcare infrastructure and maternal health.

2. Judicial Interventions

· Courts have played a proactive role in ensuring accountability and addressing systemic gaps in public healthcare.

· Judicial activism has expanded the scope of Article 21, ensuring that health rights are enforced even in the absence of explicit constitutional provisions.

Conclusion

The recognition of the right to health as an integral part of the right to life under Article 21 represents a significant achievement in constitutional jurisprudence. Through progressive judicial interpretation, this right has evolved to include access to healthcare, clean environments, reproductive rights, and protection against health hazards.

However, challenges such as inequities in access, inadequate infrastructure, and financial barriers persist. Addressing these requires a multi-pronged approach, involving stronger government policies, increased investment in healthcare, and continued judicial vigilance. By upholding health as a fundamental right, India can move closer to realizing the constitutional vision of a life lived with dignity for all its citizens.