Laxmi Mandal v. Deen Dayal Harinagar Hospital & Ors, W.P.(C) Nos. 8853 of 2008

Petition brought on behalf of a women who died after repeatedly being denied adequate maternal healthcare; Failure to implement state-sponsored schemes aimed at reducing infant and maternal mortality; Birth Status; Right to Health, including reproductive health; Right to Food/Nutrition; Directive Principles; Domestic Application of International Law.

Date of the Ruling: 
Apr 6 2010
High Court of Delhi
Type of Forum: 

This case was brought on behalf of Shanti Devi, a women living in poverty from a Scheduled Caste, after she died as the result of being refused adequate maternal healthcare despite the fact that she qualified for the free services under existing state-sponsored schemes. In 2008, Shanti Devi was forced to carry a dead fetus in her womb for five days after being denied medical treatment at several hospitals because her husband was unable to show a valid ration card for medical services, despite being qualified for one as they lived below the poverty line. On January 20, 2010, Shanti Devi died immediately after giving birth at home to a daughter who was two months premature without any medical attention. The High Court of Dehli found that there was a failure to properly implement the pre and post natal services which should have been available to her. They stated that it was inappropriate to place the burden on the poor to prove their eligibility for health services; rather government should be facilitating their access to these essential services.

The Court related its finding to the decision in People's Union for Civil Liberties v. Union of India on the right to food and noted that this petition highlighted two critical "survival rights" enforceable under Article 21 of the Indian Constitution that protects the right to life: (1) the right to healthcare, including the right to access public health facilities, to receive a minimum standard of treatment and care, the enforcement of the reproductive rights of the mother, and the right to nutrition and medical care of a newly born child until the age of six years; and (2) the right to food, which is integral to the right to health and life.  The Court noted that all of these rights are interrelated and indivisible and emphasized that the lack of effective implementation of health and nutrition schemes essentially creates a denial of the right to life and cited in support several international human rights treaties and relevant General Comments of the UN Committee on Economic, Social and Cultural Rights.

Keywords: Laxmi Mandal v. Deen Dayal Harinagar Hospital & Ors, W.P.(C) Nos. 8853 of 2008, Enforceability, ESCR

[1] Scheduled caste is a legal term for someone from a so-called "untouchable" caste, which is specifically identified in the Indian Constitution, as entitled to specific rights and protections because of their untouchable status.  "Dalit" is a self-given and political term used that includes all scheduled castes but also includes those communities that are treated as untouchable but not recognized by the Constitution as needing protection.

Enforcement of the Decision and Outcomes: 

Financial compensation and "red cards", which allow the claimant's surviving family to access health and nutrition services were awarded. The Court also determined that the schemes themselves needed reformation: that access to health services should be available across states; that clarification be made regarding over-lapping provisions and gaps in the various schemes; that the administration of these schemes be over-hauled; that current recognition of a death-benefit for the "primary-breadwinner" be interpreted to include women who are homemakers; and that additional data be gathered on the percentage of home deliveries to aid in the improvement of service provision. Finally, the Court ordered the States of Haryana and Delhi to undertake corrective measures and institute monitoring policies to ensure the decision is implemented, including affidavits on compliance to be submitted 8 weeks from the date of the decision.  At the time of this summary, no updates on compliance with these measures are available, but when updates become available, they will be added.

Groups involved in the case: 

Human Rights Law Network, India

Significance of the Case: 

This case is a clear example of the gap that exists in India, and globally, between the existence of laws that protect women's economic and social rights and implementation of domestic policies which make these rights accessible and meaningful. This case was compounded by the intersectional discrimination Shanti Devi experienced being a poor woman from a Scheduled Caste. India has one of the highest rates of maternal mortality in the world, despite its burgeoning economy and rural health initiative. The maternal mortality crisis in India is linked to the deep inequalities faced by women and improving the situation will require substantive fulfillment of women's right to health, equality and non-discrimination. Advocates who worked on this case believe the judgment was an important victory and that it will have major implications for health policy in India, where a maternal death occurs every five minutes.