On Aug. 18, a three-judge bench of Pakistan’s Supreme Court, Justice Shahid Waheed, Justice Naeem Akhtar Afghan, and Justice Ishtiaq Ibrahim, ordered the transfer of jailed former Prime Minister Imran Khan from Adiala Jail in Rawalpindi to Shifa International Hospital in Islamabad. The order formed a medical board that included Khan’s sister, cardiologist Dr. Uzma Khan, and his personal physician, Dr. Aasim Yusuf, directed weekly family visits, and specified Khan remain hospitalized until the next hearing, now scheduled for Sept. 16. The government has since filed a second review petition challenging the order, while Khan’s family and PTI have separately accused authorities of violating it.
The dispute is not, at bottom, a dispute about whether Prisoner 804 was taken to Shifa or to PIMS. It is a dispute about equality before law under Article 25 of Pakistan’s Constitution, and about whether one politically prominent prisoner is being afforded a judicial regime that remains unavailable, in practice, to thousands of other prisoners in Pakistan’s custody. Khan is entitled to adequate medical treatment, dignity, and every protection the Constitution affords. His political status cannot by itself create an additional entitlement, a private hospital of choice, personal doctors, family participation in treatment, and individually prescribed custodial facilities, unless the same standard is available to every similarly placed prisoner.
The sequencing of the Aug. 18 order is the central problem. Maintainability of the underlying petitions remained undecided, and the Court itself sought Khan’s complete medical record for subsequent examination. Yet before receiving that record and before medical necessity had been independently established, the bench directed transfer to a specifically named private hospital and prescribed the treatment arrangement. The medical record that did exist at that point was modest as a PIMS cardiologist recorded Khan’s blood pressure at 140/100 mmHg on Aug. 1 and recommended stress reduction; a four-member medical board recorded 140/80 mmHg on Aug. 10 and recommended an hour of daily walking. That is a record consistent with moderate, manageable hypertension, not, on its face, a record establishing the kind of medical emergency that would ordinarily justify overriding a state’s standard custodial and treatment protocols.
That premise came under direct strain within days. On Aug. 21, Pakistan’s Ministry of Information said Dr. Uzma Khan had herself told a news conference that her brother was “100 per cent fit,” with blood pressure of 120/80 and his eye condition almost completely healed, even as she and PTI were, at that same appearance, alleging serious mistreatment, including claims of psychological abuse, punitive isolation, and inadequate medical care. Those two positions are difficult to reconcile. If Khan’s own family-appointed physician describes him as entirely fit while his party simultaneously presses allegations grave enough to warrant Supreme Court intervention, the medical premise behind the Aug. 18 order looks less like a response to a developing emergency and more like a negotiated custodial arrangement pursued under the language of one.
Concerns about Khan’s health were not new. In late January, his family said he had lost about 85 percent of the vision in his right eye, a claim the government disputed before authorities said his condition was improving. The Ministry of Information has said Khan has undergone roughly 30 examinations by specialists and medical boards from PIMS, Shifa International, Shaukat Khanum Memorial Cancer Hospital, and Al-Shifa Trust Eye Hospital since his 2023 imprisonment, and disputed characterizations of his confinement by citing more than 900 recorded visits from family, lawyers, doctors, and political representatives. The underlying medical questions have therefore been capable of objective evaluation by qualified specialists throughout, without the Court needing to accept either side’s characterization of an emergency on faith.
Article 25 makes the institutional implications of this order unavoidable. If an ordinary prisoner approaches the Supreme Court with a preliminary claim of deteriorating health, will the Court prescribe a private hospital, allow a personal physician and family member to participate in treatment, and determine the prisoner’s communication arrangements in the same way? If this is now a constitutional entitlement, it must be available equally. If it is not, the relief afforded in this case amounts to judicial exceptionalism, a standard of care calibrated to the litigant’s profile rather than to demonstrated medical need.
Even where an interim order does not formally bind future benches under Pakistani practice, a direction issued by the highest court functions as a judicial benchmark in every practical sense. Other prisoners, and their lawyers, can invoke it in seeking identical relief. The Supreme Court therefore has to weigh the rule it is creating for the prison system as a whole, not merely the circumstances of one politically sensitive case. Courts have an essential and legitimate role in ensuring prisoners receive adequate medical care, and should intervene where treatment is denied or medical necessity is ignored. But clinical decisions concerning hospital selection, admission, duration of treatment, and discharge should ordinarily follow professional medical assessment, not political preference or judicial prescription made in advance of that assessment.
The criticism of the Aug. 18 order is not that the Court protected Imran Khan’s health. It is that extraordinary and personalized relief was granted before the complete medical evidence was examined, while maintainability itself remained unresolved, and before the Aug. 21 episode had tested whether that relief could even be implemented as written. The constitutional principle at stake is straightforward. The prisoner must receive neither less protection nor greater privilege because of who he is. Article 25 requires one legal standard, one evidentiary threshold, and equal enforcement of the Court’s directions for every individual in Pakistan. Whether the fuller medical record now produces evidence that retroactively justifies the Aug. 18 order, and whether the Court weighs conduct on every side of the Aug. 21 dispute rather than one, will do more than resolve one case. It will answer a question Pakistan’s judiciary cannot avoid indefinitely that will courts now extend this standard of care to every other prisoner in the country, or does it remain, in practice, a privilege of rank.
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