Bridging gaps in healthcare

Why the law should step in for human rights

The dismissal of Public Interest Litigation (PIL) No.28 of 2019 by the Bombay High Court represents a missed opportunity for the Indian judiciary to bridge a lethal gap in the nation’s healthcare system. While the court in its judgment focused heavily on the academic "domain expertise" of the petitioner, it leaves thousands of newborns vulnerable to preventable, permanent brain damage and death caused by Inborn Errors of Metabolism (IEM). By prioritizing the messenger over the message, the court has effectively signaled that procedural perfection is more important than the substantive Right to Life under Article 21.

The Substance vs. The Scrutiny

The petition brought to the court was not based on mere whim; it was a desperate plea to implement mandatory screening for genetic disorders that, while individually rare, collectively occur in roughly 1 in 800 to 2,500 births. These disorders, such as Phenylketonuria (PKU) and Galactosemia, lead to the toxic accumulation of substrates that cause irreversible neurological damage unless detected immediately after birth.

The petitioner, a social worker, provided the court with extensive research papers from prestigious journals like Indian Pediatrics and the Indian Journal of Clinical Biochemistry. Yet, the court dismissed the petition as a "copy and paste" exercise. In a striking display of judicial elitism, the bench criticized the petitioner for his inability to explain complex medical terminology, despite the fact that the very purpose of a PIL is to allow "public-spirited individuals" to bring matters of grave importance to the court’s attention and not to serve as a substitute for expert witnesses.

A Failure of the PIL Mandate

The court’s observation that judicial time was being "squandered" by a poorly presented petition ignores the fundamental duty of the judiciary in a welfare state. PILs were designed precisely to bypass traditional legal rigidities so that the court could protect the marginalized. By labeling the petition a "misadventure" and criticizing the petitioner’s lack of "on-the-ground work," the court ignored the years of effort spent gathering evidence through Right to Information (RTI) applications.

These RTI responses, included in the petition, proved a systemic "apathy and ignorance" within the government. The state’s existing program, the Rashtriya Bal Swasthya Karyakram (RBSK), only screens for one metabolic error (Congenital Hypothyroidism), leaving infants with other lethal conditions entirely unprotected. When the government admits its screening policies are "under process" for years while children die, the court’s decision to dispose of the matter on the grounds of "casualness" feels like a rejection of its role as a protector of constitutional rights.

The Human Cost of Judicial Delay

The High Court admitted that IEMs cause "substantial morbidity and mortality". It acknowledged that simple dietary modifications could save these children if detected early. Yet, rather than appointing its own expert committee, as requested in the petition, to investigate these "complex technical matters," the court chose to wait for a more "well-versed" petitioner to emerge.

This judicial "wait-and-see" approach has real-world consequences. Every day the "cause remains open" without a mandatory screening policy is a day that more children in government hospitals are denied the chance to live a healthy life. While the court expressed concern over its "infinite" judicial time, it seemed less concerned with the finite window of time available to save a newborn from permanent intellectual disability.

Conclusion: A Misplaced Focus

Bridging gaps in healthcare requires a judiciary willing to look past a petitioner's academic credentials to the heart of a crisis. By focusing on the petitioner's status as a "social worker and nothing more," the court missed the forest for the trees. The "expertise" required was already in the room. It was in the scientific papers the court dismissed as "copy and paste".

The dismissal of this PIL is a reminder that in the hallowed halls of justice, the Right to Life can sometimes be silenced by a demand for technical perfection. Until the court prioritizes the health of India's youngest citizens over the academic polish of their advocates, the gap in newborn healthcare will only continue to widen.

Jacob Kadantot

Advocate