Costa Rica, Supreme Court of Justice, 6 April 2022, No. 8036-2022
Case overview
Country
Case ID
Decision date
Deciding body (English)
Deciding body (Original)
Type of body
Type of Court (material scope)
Type of jurisdiction
Type of Court (territorial scope)
Instance
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Outcome of the decision
General Summary
A 27-year-old woman was diagnosed with a meniscus tear in her left knee, causing her pain, walking difficulties, and complications in her daily life. As a result, she was placed on a waiting list for knee surgery in January 2020. However, as of March 2022, she had not undergone surgery. Therefore, she filed a writ of amparo against the Costa Rican Social Security Fund, the public institution in charge of social security in the Republic of Costa Rica, to have the surgical procedure she required performed, as she considered that her right to health was being violated.
The Court indicated that although it understood the difficulties that the pandemic could imply for the Costa Rican Social Security Fund, the population still required that their other ailments be treated. It considered that the Claimant's right to health was violated by the Costa Rican Social Security Fund's failure to set a date for her surgery.
Facts of the case
A 27-year-old woman was diagnosed with a meniscus tear in her left knee, causing her pain, walking difficulties, and complications in her daily life. As a result, she was placed on a waiting list for knee surgery in January 2020.
However, as of March 2022, she had not undergone surgery. As a result, she filed a writ of amparo against the Costa Rican Social Security Fund, the public institution in charge of social security in the Republic of Costa Rica, to have the surgical procedure she required performed, as she considered that her right to health was being violated.
The State Hospital in charge of her care, belonging to the Costa Rican Social Security Fund, affirmed that her surgery had not been scheduled because although according to the institutionally established six months limit (that is, she should have been operated in July 2020 at the latest), it was not possible to do so due to the hospital reorganization and high congestion of the service that had occurred due to the pandemic.
The Hospital stated that the above justified the delay in scheduling the Claimant's surgery because her condition was not life-threatening, so the surgery could be elective and deferred without compromising her health or physical integrity. Furthermore, it added that as a consequence of the precautionary measure ordered in this case, the surgery had been scheduled for June 2022.
Type of measure challenged
Measures, actions, remedies claimed
Individual / collective enforcement
Nature of the parties
Claimant(s)
Private individualDefendant(s)
Public
Type of procedure
Reasoning of the deciding body
Firstly, the Court indicated that the Constitution of Costa Rica established as one of its cornerstones the right to life and health so that the social security, under the responsibility of the Costa Rican Social Security Fund, was fundamental for guaranteeing these rights. The Court pointed out that this institution must provide, per public service standards, the health services required by individuals.
Regarding this “public service” character, the Court emphasized that this imposed on the Fund and its health centers, the obligation to provide these services under the principles of continuity, adaptation, universality, efficiency, celerity, and equality [See the section on "Balancing techniques and principles (proportionality, reasonableness, others)"].
Regarding the specific case, the Court noted that the omission of the hospital authorities to provide the health services needed by the Claimant had been verified and that their arguments did not justify the delay because:
i) The lack of timely treatment could further impair her health and quality of life.
ii) Nearly 26 months had passed since the surgery was ordered
iii) It was not proven that the Hospital where the Claimant was being treated was in an emergency due to the pandemic
iv) In case of impossibility to perform the surgery by COVID-19, the Costa Rican Social Security Fund had other hospitals that had not been affected by the pandemic where the Claimant could be operated.
The Court indicated that although it understood the difficulties that the pandemic could imply for the Costa Rican Social Security Fund, the population still required that their other health conditions be treated, so the medical centers had to implement the necessary organizational changes to obtain the resources needed to provide those services.
Finally, the Court noted that the Claimant's right to health continued to be violated because no concrete date had been given for the Claimant's operation.
Conclusions of the deciding body
The Court considered that the Claimant's right to health was being violated by the omission of the Costa Rican Social Security Fund to set a date for her surgery.
Fundamental Right(s) involved
- Right to bodily integrity
- Right to health (inc. right to vaccination, right to access to reproductive health)
Fundamental Right(s) instruments (constitutional provisions, international conventions and treaties)
Rights and freedoms specifically identified as (possibly) conflicting with the right to health
General principle applied
- Equality
- Continuity, adaptation, universality, efficiency, celerity
Balancing techniques and principles (proportionality, reasonableness, others)
In its decision, the Court referred to the following principles:
- Continuity: the service must be uninterrupted.
- Adaptation: the entities in charge of providing the service must have the foresight, programming, and planning capacity to face the new demands and challenges.
- The Court mentioned but did not develop other principles, such as universality, efficiency, celerity, and equality.
