Soobramoney v. Minister of Health (KwaZulu-Natal)

Thiagraj Soobramoney (plaintiff) suffered from diabetes, heart disease, and the last stages of chronic renal failure. The only way to extend Soobramoney’s life was via dialysis two to three times weekly. Soobramoney appealed to Addington Hospital (Addington) for treatment, but the hospital did not have enough dialysis machines for everyone who needed treatment. Addington was a state hospital that lacked the finances needed to acquire additional staffing and machines, and the health department informed Addington that there were no funds available. In fact, the health department was projected to overspend its budget by 700 million rand that year without a significant reduction in services. Soobramoney was not wealthy and was unemployed. Soobramoney was able to procure treatment at private hospitals for a while. However, when Soobramoney’s funds ran out, he submitted an application to a court seeking to force Addington to provide weekly dialysis. The minister of health (KwaZulu-Natal) (defendant) opposed Soobramoney’s application, which was denied. Addington served all of KwaZulu-Natal and other areas with far more patients needing dialysis and suffering from chronic renal failure than it had machines to treat. This was a problem across South Africa. Persons suffering from acute kidney failure whose conditions could actually be remedied by dialysis were automatically treated. Because of the shortage of resources, guidelines were developed to aid in the agonizing determinations regarding who was prioritized for treatment among persons with chronic kidney failure. Per the guidelines, chronic patients who were eligible for a kidney transplant were given dialysis until they received kidney transplants. Unfortunately, Soobramoney was not eligible for a transplant due to his heart disease. Soobramoney appealed, arguing that the state was obligated to provide him treatment under § 27(3) of South Africa’s constitution, which provided that no one would be refused emergency medical care. Section 27(1) provided that everyone was entitled to healthcare, and § 27(2) indicated that the state had to take steps to actualize these rights within its available resources. Finally, § 11 recognized the right to life.