The state's reparation duty in the social rule-of-law framework: a philosophical and healthcare perspective

Abstract

This article presents a philosophical, doctrinal, and legal analysis of the foundations of the State's patrimonial liability, with particular emphasis on its theoretical conguration within the healthcare sector. Using a qualitative and hermeneutic approach, the study examines the historical and conceptual development of the duty to compensate, beginning with Aristotelian corrective justice and its subsequent reformulation within modern theories of practical reason. Saavedra Becerra (2005) identies the emergence of extracontractual liability as a structural response to unjust harm, while Gil Botero (2010) explains its evolution toward objective models of imputation, detached from subjective fault. Likewise, Bernal Pulido y Fabra Zamora (2013) explore the axiological foundations of State liability, integrating corrective justice, distributive justice, and outcome responsibility as contemporary criteria for attributing harm. The article also incorporates Thomistic notions of natural duty, Hume's critique of the naturalistic fallacy, and Kant's conception of moral autonomy, as interpreted by Gil Botero (2010), to demonstrate that the obligation to repair arises from a rational mandate prior to positive law. Methodologically, the research adopts the hermeneutic perspective described by De la Maza (2005), in dialogue with the qualitative approach outlined by Taylor et al. (2016). This framework allows for an interpretive reconstruction of the normative and axiological
principles underlying State liability, especially in contexts of structural vulnerability such as public healthcare. In summary, the article argues that patrimonial liability of the State rests upon a philosophical and constitutional structure grounded in dignity,
justice, and equity. These principles establish that the duty to indemnify is not solely contingent upon the illegality of administrative conduct, but rather on the need to restore
the normative balance disrupted by harm unjustly borne by the citizen, in line with the tradition of corrective justice and contemporary models of objective imputation. The analysis encompasses a comparative jurisprudential examination of France, Panama, and Colombia, the Panamanian constitutional and statutory framework, Colombian scholarship on harm, and a distinction between public and private hospitals. It concludes
that patient vulnerability heightens institutional duties but does not justify presuming liability from every adverse outcome.