State Health-Medical Liability: Reflections from the Philosophy of Law and Contemporary Justice

In Colombia, the healthcare system was implemented through Law 100 of 1993 and its complementary regulations, giving rise to the General System of Social Security in Health (SGSSS) and the Comprehensive Social Security System (SSSI). These systems are structured around four fundamental thematic axes: (i) public health, (ii) patients’ rights, risk management, and ethical and institutional responsibilities, (iii) system financing, and (iv) health technologies. Based on this normative and functional structure, the need arises to strengthen legality and policy in the field of healthcare. Within this framework, the proposal is made to implement an Autonomous Medical-Sanitary Liability Regime and to establish a specialized jurisdiction for the judicial review of medical acts in Colombia, grounded in distributive justice and the State’s duty of care. This initiative seeks to respond to the particularities of the healthcare system, ensuring an appropriate legal framework for the resolution of conflicts in the healthcare domain. The philosophical-legal, constitutional, and conventional analysis has consolidated the recognition of health as a constitutionally protected good, a fundamental right, and a constitutional social right, shaping a model based on Structural Pluralism. In this context, affiliation with and contribution to the healthcare system not only constitute a legal obligation but also materialize the citizen’s relationship with the healthcare structure. Methodologically, this study adopts a qualitative approach using a critical hermeneutic method, which enables the interpretation and analysis of the regulatory and doctrinal framework concerning medical liability. Additionally, the technique of expert interviews is employed, allowing for a deeper understanding of the legal and operational issues within Colombia’s healthcare system. Based on this analysis, the feasibility and necessity of establishing an autonomous regime of medical-sanitary liability is substantiated, complemented by a specialized jurisdiction that ensures efficient justice administration aligned with the specificities of the health sector. DOI: https://doi.org/10.52783/rcp.1122