Costa Rica, Supreme Court of Justice, 6 April 2022, No. 8054-2022
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
Area
Outcome of the decision
General Summary
A 54-year-old man, the Claimant, presented for two years a severe pain in his left arm, which he indicated was affecting his daily life, and despite the fact that in January 2022 surgery was ordered, after several medical controls and examinations, it had not been scheduled, therefore he considered that his right to health was being violated. The Claimant filed an amparo action against the Costa Rican Social Security Fund, a public institution in charge of social security in the Republic of Costa Rica, to perform the required surgical procedure. The Court rejected the Claimant's petition because it considered that the Caja Costarricense del Seguro Social had provided timely medical attention to the Claimant and that the six-month term to perform his surgery was not unreasonable nor unconscionable.
Facts of the case
A 54-year-old man, the claimant, presented severe pain in his left arm for two years, which he indicated was affecting his daily life. In January 2022 surgery was ordered, after several medical controls and examinations. However, it had not been scheduled, so he considered that his right to health was being violated. The Claimant filed an amparo action against the Costa Rican Social Security Fund, a public institution in charge of social security in the Republic of Costa Rica, to perform the required surgical procedure.
The Costa Rican Social Security Fund Hospital in charge of this patient's care indicated that he had undergone periodic check-ups since January 2020, and several tests to diagnose and treat his condition. Specifically, he noted that in January 2022, due to an ultrasound exam, a medical doctor put him on the orthopedic service's elective surgery waiting list, as a high-priority surgery, because he had a tear in his rotator cuff.
The Hospital pointed out that according to the clinic guidelines, there were six months to perform this surgery and that since this was not a life-threatening procedure, the care given to the patient was timely and did not violate his right to health. It added that the hospital and service reorganization that occurred due to the pandemic, had to be considered because this could result in the service being delayed.
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 it was a notorious fact that due to the pandemic and the new guidelines of the Costa Rican Social Security Fund to reorganize the public health services to be able to attend the current health emergency, certain services such as elective surgeries in the medical centers of the Fund had been suspended.
Second, the Court noted that the right to life, established in the Costa Rican Constitution, was the cornerstone on which the rest of the fundamental rights of the inhabitants of the republic were based. It indicated that the right to health was intimately linked to the right to life since the latter was inconceivable if people were not guaranteed minimum conditions for an adequate and harmonious psychic, physical, and environmental balance.
The Court said that any delay by the Costa Rican Social Security Fund hospitals could negatively impact the preservation of the health and life of its users. Therefore, the public entities that provided health services had an obligation to adapt them to the specific needs of their users or patients and, mainly, of those who demanded immediate and urgent medical attention, without the lack of human and material resources being legally acceptable arguments to exempt them from complying with such obligation, to provide an efficient, effective and fast service.
Thirdly, upon studying the specific case, the Court determined that it had been proven that the Claimant had received medical attention, had undergone the necessary tests, had had consultations with specialists, and that the term of six months set for the performance of his surgery was a reasonable period because it had been determined that he did not require emergency surgery so that the waiting time did not violate his right to health.
Conclusions of the deciding body
The Court rejected the claimant's petition because it considered that the Costa Rican Social Security Fund had provided timely medical attention to the claimant and that the six-month period to perform his surgery was reasonable.
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
- Reasonableness
- Efficiency, effectiveness, continuity, regularity, adaptation
Balancing techniques and principles (proportionality, reasonableness, others)
Firstly, the Court referred to the principles of efficiency, efficacy, continuity, regularity, and adaptation in public health services to say that, due to them, public entities providing health services had an obligation to adapt them to the specific needs of their patients and, above all, of those who demanded immediate and urgent medical attention, without the lack of human and material resources being legally valid arguments to exempt them from complying with such obligation.
Secondly, the Court implicitly applied the principle of reasonableness when studying whether the six-month term for the Claimant's operation was justified or excessive.
