Judicial Exceptionalism in Prisoner 804’s Medical Case

While the debate over the treatment of Prisoner 804 Imran Khan cannot be confined merely to the question of whether he should have been brought to Shifa International Hospital or PIMS Hospital, the constitutional debate relates to the issue of equality before law enshrined in Article 25 and whether an influential prisoner is being given a legal system which others cannot access. It is not about whether Imran Khan deserves good health care. He definitely does. The issue is about whether or not his political significance gives him more privilege than what is due.

The prisoner is entitled to life, dignity, and proper medical care. No one can deny such basic necessities just because the individual has been sentenced to prison. It is true that the courts must ensure that the prisoners do not suffer any harm. In such a situation, the judicial protection of a prisoner’s health must normally rest on the medical grounds which may apply in the same way in the case of all prisoners in general.

It is here that the order dated 18 August poses some genuine questions. While at the time when the order was passed, the question of maintainability had not yet been finally decided by the court, at the same time, the court had sought the entire medical records of the prisoner for review. The question is then whether the relief provided was actually ordered even before the necessity was established properly.

A crucial difference between medical examination and medical hospitalization must be appreciated here. If the prisoner has complained of his declining health status, psychological problems, high blood pressure, or palpitations, then certainly these allegations need to be investigated. However, mere symptoms do not amount to medical requirement for hospitalization, leave alone the requirement for being admitted in a particular private hospital. Normally, such issues are matters that require medical examination and assessment, unless there is evidence that medical needs of the prisoner are being ignored by prison authorities.

It is also evident from subsequent developments in the medical issue. The prisoner had been medically examined at PIMS hospital and specialists from Shifa International were involved in ophthalmology examination of the prisoner. This shows that the prisoner was examined by qualified medical experts through institutional channel. It does not mean that the allegations of the prisoner regarding his ailments were false and he was not in need of medical treatment. It simply highlights the fact that judicial intervention ought to be exceptional in nature and should follow the medical diagnosis.

Dr. Uzma Khan’s story is also worth noting, even if it cannot be taken as conclusive evidence. The sister of the detainee and a doctor who was allowed to associate with his case has been reported to have talked about stress, high blood pressure, and palpitation while claiming that he was “100 per cent fit”. This is by no means sufficient to prove the non-existence of medical emergency, but it is sufficient to complicate the narrative that a clear medical emergency existed which needed judicial intervention.

The issues related to equality under the Constitution can be analyzed using Article 25. The provision of equality does not imply equal treatment for all prisoners regardless of their medical condition. For instance, one prisoner who has a grave illness needs certain treatment that the other prisoner may not need.

The simple question then is whether, if an ordinary prisoner comes to the Court seeking a deterioration in health, will the same standards of law and evidence enable him to seek treatment in a private hospital of his choice, the presence of his own doctor, the involvement of his family members and separately determined custody arrangements? If medically justified, these safeguards must be available to all prisoners who are similarly situated. If the availability of such safeguards depends upon the fact that the individual happens to be politically powerful, the rule of equality becomes weakened.

The same is true with regard to compliance with the directions of the Court. If the 18 August order prevented the prisoner’s family, his political party and his lawyers from disclosing information about his medical condition or its use for political purposes, then such restrictions must be applied equally to everyone who is under the order of the Court. Statements made publicly about his blood pressure, pulse rate and palpitations and his alleged medical problems resulting from confinement need to be examined. But mere violation of the order would not be contempt since contempt involves deliberate and wilful disobedience. Yet, PTI and the family should be able to justify compliance with the relevant parts of the order.

In the same way, the actions of the Government must be evaluated objectively. Where the security situation at any specific hospital made a literal compliance with the Court order impossible, the issue is whether the authorities made any effort to follow the spirit of the Court’s directions. The involvement of experts of Shifa hospital in the medical examination of the accused is important in this context to see whether the authorities ignored the order or tried to fulfill the objective of the Court order through some other means.

Judicial independence demands equal detachment from all political actors. The judiciary must neither side with the government nor give undue favors to the opposition. Protection of prisoner’s constitutional rights is not giving favor to anyone in politics; rather any political significance should not become the ground for any exceptional order not supported by evidence.

It is, therefore, not an issue that the Court wanted to secure the health of Imran Khan. The issue is that the court could not take any personalized and extra ordinary action on the basis of incomplete medical evidence without first resolving the maintainability of the case and considering all implications of Article 25 of the constitution.

An interim order passed by the Supreme Court can still set a concrete judicial precedent. Other inmates are likely to wonder how the same remedy was not made available to them. Whether private admission, personal doctors, and family involvement are constitutionally required in cases like this, and if so, the rule must apply across the board. If not, there must be a clear rationale based on the law for such an exception.

Thus, the constitutional rule must continue to be simple: Prisoner 804 cannot have less protection or more privilege than other individuals. Any genuine medical issues he may have must be examined and dealt with without discrimination, while the special privilege requires special medical and legal justification.

In the end, the integrity of judicial independence cannot be judged by who the court protects, but by whether it maintains the same evidentiary burden, the same legal standard, and the same enforcement of the orders to everyone. The issue here, then, is no longer just about Shifa and PIMS.