Maldonado, Sergio Adrián s/materia: previsional s/recurso de amparo

Corte Suprema de Justicia de la Nación [CSJN] [National Supreme Court of Justice], 23/11/2004, "Maldonado, Sergio Adrián s/ materia: previsional s/ recurso de amparo," (M.3805.XXXVIII) (Arg.).
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Man brought appeal for legal protection against the Superintendence for the Welfare of Federal Police of Argentina (Superintendencia de Bienestar de la Policía Federal Argentina), requesting that the court order the Superintendence to continue to provide the economic assistance needed to cover overseas treatment for his daughter, who suffered from spinal muscular atrophy (Werdning-Hoffman disease).  The Superintendence had discontinued the economic assistance upon learning about the “fatal” and “irremediable progressiveness” of the disease despite the child’s improvement during the treatment.  The lower court ordered, for “humanitarian reasons,” the coverage and the continuation of the approved treatment in Cuba, finding that there were not valid arguments that justified denying the right to the highest attainable quality of life to the child, based on the application of number of international human rights instruments that are incorporated into the Argentina Constitution.

The appeals court overturned the decision, finding that the original petition had requested treatment in Moscow and that changing the destination to Cuba because sufficient information on Moscow’s clinic was not obtained exceeded the limits of the legal action and constituted a violation of the Superintendence’s right to defense.  The appeals court also found that the lower court incorrectly evaluated the evidence and that there was no violation of the Constitution or arbitrariness in the Superintendence’s decision to discontinue the assistance.  Petitioner appealed the decision to the Supreme Court, requesting extraordinary measures and claimed arbitrariness in the decision for putting in jeopardy the credibility and application of Constitutional and international legal instruments that safeguard health and life.

The Court found that the appeals court failed to recognize the essential purpose of the appeal for legal protection, which was to preserve the life, health, and physical integrity of the child before a serious condition that would infringe rights prioritized and enshrined by the various international treaties that bind Argentina.  To provide the child the highest attainable standard of wellbeing and recognizing the positive effects that long-term treatment would have on her health, the Court ordered that the child be treated in Argentina and held that the Superintendence had the obligation of covering the treatment.  The Court based its decision on international instruments applicable through Art. 75(22) of the Constitution, as well as Law Nº 24.901, which provides comprehensive protection to persons with disabilities.

4th) That, in addition, the judge held that there remained "humanitarian reasons" which justified the opportunity to move the affiliate and attention the CIREN clinic, and did merit that the defendant had not alleged economic impossibility to repeat this procedure. Therefore, and application of various provisions of international treaties incorporated into the Constitution, concluded that there were no valid arguments for denying the right to obtain abroad the best possible quality of life (conf arts. 33, 43 and 75, inc 22 , the Supreme Law,. XI and XVIII of the American Declaration of the Rights and Duties of Man , 19 and 25 of the American Convention on Human Rights, 23 and 24 of the Convention on the Rights of the Child, among others).

4°) Que, además, el juez entendió que subsistían las "razones humanitarias" que habían justificado en su oportunidad el traslado de la afiliada y su atención en la clínica CIREN, e hizo mérito de que la demandada no había alegado la imposibilidad económica de reiterar ese procedimiento. Por lo tanto, y por aplicación de diversas cláusulas de tratados internacionales incorporados a la Constitución Nacional, concluyó que no existían argumentos válidos para negar el derecho a obtener en el exterior la mejor calidad de vida posible (conf. arts. 33, 43 y 75, inc. 22, de la Ley Suprema; XI y XVIII de la Declaración Americana de los Derechos y Deberes del Hombre; 19 y 25 de la Convención Americana sobre Derechos Humanos y 23 y 24 de la Convención sobre los Derechos del Niño, entre otros).

9th) That this Court has repeatedly ruled that when it comes to safeguarding the interests of the child, it is the responsibility of the judges to look for solutions that are in line with the urgency and nature of the claims, directing arrangements for expeditious ways and prevent the harshness that can lead to frustration of rights that have particular constitutional protection [...].

9°) Que este Tribunal ha resuelto reiteradamente que cuando se trata de resguardar el interés superior del niño, atañe a los jueces buscar soluciones que se avengan con la urgencia y la naturaleza de las pretensiones, encauzar los trámites por vías expeditivas y evitar que el rigor de las formas pueda conducir a la frustración de derechos que cuentan con particular tutela constitucional […].

10) That the decision of the lower court has overlooked these guidelines. With a ritualistic reasoning, improper for the matter under discussion, has emphasized the lateness of the change requested for treatment, without regard to the substantial purpose of the writ of amparo,* which has been, by definition, to preserve life, health and physical integrity of the minor to the serious risk that he finds himself in, compromising priority rights recognized in international treaties that bind our country ([...] arts. 3°, 23, 24 and 26 the Convention on the Rights of the Child [...]).

10) Que la decisión del a quo ha soslayado dichas pautas. Con un razonamiento ritual, impropio de la materia que se debate, ha hecho hincapié en la extemporaneidad del cambio de destino solicitado para el tratamiento, sin atender al propósito sustancial de la acción de amparo, que ha sido, en definitiva, preservar la vida, la salud y la integridad física de la menor ante el grave riesgo en que se hallaba, lo que compromete derechos reconocidos con carácter prioritario en los tratados internacionales que vinculan a nuestro país ([…] arts. 3°, 23, 24 y 26 de la Convención sobre los Derechos del Niño […]).

15) That the sum of opinions gathered by this Court confirm that the evolution of the diagnosed disease depends not only on personal factors but also timely health care that can prevent and contain the negative consequences that occur regularly in these cases, which is essential for the joint participation of professionals from various fields and institutions close to the home of the family [...]. Therefore, the problem cannot be solved by writ with a mere renewal of treatments performed inside or outside the country.

15) Que la suma de opiniones recabadas por esta Corte confirman que la evolución de la enfermedad diagnosticada depende no sólo de factores personales sino también de la asistencia sanitaria oportuna que pueda prevenir y contener las consecuencias negativas que regularmente se producen en estos casos, para lo cual es imprescindible la participación conjunta de profesionales de diversas áreas y de instituciones cercanas al domicilio de la familia […]. Por ello, el problema de autos no puede ser resuelto con una mera renovación de los tratamientos realizados dentro o fuera del país.

17) That the measures suggested by the Forensic Department and the work done so far by the specialists of the Garrahan Hospital, about which the parties have been heard , perfectly show that specific conditions to provide health care for the girl exist in the Republic of Argentina and arrange their continuity in places accessible to the family in order to achieve the highest possible level of personal welfare of the patient, which was corroborated by actor officials Advocacy Officer , who acted under the proposed treatment [...].

17) Que las medidas sugeridas por el Cuerpo Médico Forense y la labor desarrollada hasta el presente por los especialistas del Hospital Garrahan, acerca de lo cual han sido oídas las partes, demuestran acabadamente que existen en la República Argentina condiciones concretas para dar la atención sanitaria que es debida a la niña y organizar su continuidad en lugares accesibles para la familia, con miras a alcanzar el mayor nivel posible de bienestar personal de la paciente, lo que ha quedado corroborado por el actor y los funcionarios de la Defensoría Oficial, que han prestado conformidad con el tratamiento propuesto […].

18) That, accordingly, given the primary objective of the amparo action is certain and the obligation to ensure social work practices to facilitate improved life expectancy , according to the scientific resources available the country and the extent of benefits provided by law 24901, on the complete protection of persons with disabilities, it is admitting the claim and declare the right of the child concerned to get the care that his condition required, under the conditions indicated by the Forensic Department and Pediatric Hospital specialists 'Prof. Dr. Juan P. Garrahan'.

18) Que, en consecuencia, habida cuenta del objetivo primordial de la acción de amparo y de que es indudable la obligación que tiene la obra social de garantizar las prácticas que faciliten una mejor expectativa de vida, de acuerdo con los recursos científicos con que cuenta el país y la amplitud de las prestaciones previstas en la ley 24.901, sobre protección integral de las personas con discapacidad, corresponde admitir la demanda y declarar el derecho de la menor interesada a obtener los cuidados que su estado requiere, en las condiciones indicadas por el Cuerpo Médico Forense y los especialistas del Hospital de Pediatría 'Profesor Dr. Juan P. Garrahan'.

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