Pakistan’s Long Struggle Between Judicial Authority and Government Power
This article discusses proceedings pending before the Supreme Court of Pakistan. Nothing in it should be read as a finding of fact or of law. Facts are stated as of August 24, 2026. The matter is listed for hearing on September 16, 2026.
What happens when a superior court issues an order and the government disagrees with how that order should be implemented? In a constitutional democracy, this is not merely a political dispute. It is a question about judicial authority, executive power and the rule of law.
Pakistan has faced this tension repeatedly — from Tamizuddin Khan and Dosso to Asma Jilani, the 1993 restoration of the Nawaz Sharif government, the Gilani contempt proceedings, the 2022 National Assembly crisis and the reserved-seats litigation of 2024–25. The latest dispute over Imran Khan’s medical treatment is another chapter in this longer constitutional story.
On August 18, 2026, a three-member Supreme Court bench headed by Justice Shahid Waheed, sitting with Justice Naeem Akhter Afghan and Justice Ishtiaq Ibrahim, directed authorities to shift former prime minister Imran Khan from Central Jail Adiala in Rawalpindi to Shifa International Hospital in Islamabad within two days for medical examination and treatment. The order required the constitution of a medical board comprising an eye specialist, a cardiologist and a general physician, together with Khan’s personal physician, Dr Faisal Sultan. It directed that Khan remain at the hospital until the next hearing, and that the government arrange weekly meetings between him and his family.
The government first sought a legal remedy. On August 19 the Chief Commissioner of Islamabad filed a criminal review petition under Article 188 of the Constitution, arguing that the order was passed without jurisdiction and disregarded mandatory prison rules. Law Minister Azam Nazeer Tarar said publicly that the ruling did not fall within the four corners of the law, and that such examinations are not ordinarily arranged at private facilities absent evidence that government hospitals cannot provide the treatment. The review petition was subsequently withdrawn after the Supreme Court’s filing branch raised objections to it.
What happened next is not, in its essentials, disputed. During the night of August 20–21, Khan was taken not to Shifa International Hospital — where police had cordoned off the area and a large security contingent had been deployed in anticipation of his arrival — but to the state-run Pakistan Institute of Medical Sciences (PIMS). He was examined there and returned to Adiala Jail.
Information Minister Attaullah Tarar said Khan had been examined by a team comprising an ophthalmologist, a cardiologist and a physician, who declared him medically fit, and that Khan’s sister, Dr Uzma Khan, was present throughout. He attributed the change of venue to the security situation created by workers of the Pakistan Tehreek-e-Insaf (PTI) on the routes to and around Shifa. Parliamentary Affairs Minister Dr Tariq Fazal Chaudhry said the decision had been taken by security agencies rather than the political leadership and was not political in nature. Government representatives have rejected the allegation that Khan is being denied proper medical care.
PTI and Khan’s family take a different view of the same sequence. They note that Dr Faisal Sultan, named in the Court’s own order, waited at Shifa for around three hours and left without seeing his patient, and they have questioned the composition of the board that carried out the examination at PIMS. On August 22, Dr Uzma Khan, through Advocate Uzair Karamat Bhandari, filed a petition in the Supreme Court seeking contempt proceedings over what she describes as wilful non-compliance with the August 18 order. The Prime Minister, the law and information ministers, the Islamabad chief commissioner, the interior secretary, the Punjab inspector general of prisons and the superintendent of Adiala Jail are among those named as respondents.
The distinction matters: a contempt petition is an allegation, not a judicial finding, and being named as a respondent is not a determination of wrongdoing. The legal question remains for the Court to decide.
Pakistan’s constitutional structure has changed since many of the historical cases discussed below were decided. The Twenty-Seventh Constitutional Amendment, passed on November 13, 2025, established the Federal Constitutional Court and redistributed constitutional judicial authority. Article 189, as amended, provides that decisions of the Federal Constitutional Court are binding on all courts in Pakistan, including the Supreme Court, while decisions of the Supreme Court bind all other courts except the Federal Constitutional Court. Article 190 requires all executive and judicial authorities throughout Pakistan to act in aid of both courts.
That settlement is itself unsettled. In a judgment reported in May 2026, the Supreme Court held that it is not subordinate to the Federal Constitutional Court — a position the newer court, which maintains that constitutional adjudication now vests exclusively in it, has not accepted. The question in the title of this article therefore carries an institutional dimension that did not exist three years ago.
The underlying principle nonetheless remains clear. Disagreement with a judicial decision does not ordinarily give an executive authority a general right to disregard a binding order. At the same time, disagreement is not automatically contempt. Governments can use lawful remedies, including review under Article 188 or requests for clarification or modification where the law permits.
In Federation of Pakistan v. Maulvi Tamizuddin Khan (PLD 1955 FC 240), the Federal Court allowed the Federation’s appeal on the jurisdictional ground that the Sindh Chief Court could not issue the writs sought, the relevant provision not having received the Governor-General’s assent — with the practical effect of leaving the dissolution of the Constituent Assembly undisturbed. The case became a foundational episode in Pakistan’s constitutional history.
In The State v. Dosso (PLD 1958 SC 533), the Supreme Court applied the doctrine of revolutionary legality — the proposition that a successful change of regime is itself a law-creating fact — to recognise the legal consequences of the new order following the 1958 military takeover. The judgment later became highly controversial.
In Asma Jilani v. Government of the Punjab (PLD 1972 SC 139), the Supreme Court rejected the approach associated with Dosso and treated Yahya Khan’s assumption of power as unlawful.
In Mian Muhammad Nawaz Sharif v. President of Pakistan (PLD 1993 SC 473), the Supreme Court set aside the dissolution of the National Assembly as unconstitutional by a majority of ten to one and restored the elected government, demonstrating the practical force of judicial review. It is also a caution. The restored government lasted under two months before the Assembly was dissolved again in July 1993 under a negotiated political settlement. A court can vindicate a constitutional claim without settling the political dispute behind it.
The Gilani contempt proceedings provide a further lesson. Prime Minister Yousuf Raza Gilani was convicted of contempt by a seven-member Supreme Court bench on April 26, 2012, after declining to write to the Swiss authorities as the Court had directed. He chose not to appeal. On June 19, 2012, the Court held that he stood disqualified from Parliament and had ceased to hold the office of prime minister, with effect from the date of his conviction. The case remains the clearest illustration in Pakistani law of the difference between challenging a judgment through lawful procedures and simply declining to comply with it — and of what the second course can cost.
The 2022 National Assembly crisis again placed judicial review at the centre of a constitutional dispute, the Supreme Court holding on April 7, 2022 that the deputy speaker’s ruling rejecting a no-confidence motion, and the dissolution that followed it, were unconstitutional, and ordering the Assembly restored.
The reserved-seats litigation offers a different lesson again. On July 12, 2024, a 13-member Supreme Court bench ruled by a majority in favour of PTI-backed candidates who had contested under the banner of the Sunni Ittehad Council. On June 27, 2025, a constitutional bench allowed review petitions by a majority of seven to three, set that judgment aside and restored the decision of the Peshawar High Court. Whatever one makes of either outcome, the route in both directions was a judicial one: decisions can be challenged and reconsidered through the process the Constitution provides.
The present hospital controversy should not be reduced to “PTI versus the government.” The Court issued directions concerning Khan’s medical treatment. The government first sought review, then cited security circumstances for the change of venue. PTI says the order was not complied with as written. A contempt petition has now placed the dispute before the Court.
Several elements are common ground. Khan was examined at PIMS and not at Shifa. He was returned to Adiala rather than remaining in hospital. Dr Faisal Sultan did not attend the examination. What is contested is the legal characterisation of those facts — whether they amount to non-compliance with the August 18 order and, if so, whether that non-compliance was wilful.
An independent analysis should not prejudge that question. It would be inaccurate to say that the government has already been found guilty of contempt, just as it would be premature to declare that its conduct has definitively been held lawful. Those are matters for judicial determination.
The deeper constitutional question is not whether one supports Imran Khan, PTI or the present government. It is whether the same institutional rules apply regardless of who benefits.
A government has a legitimate right to disagree with a judicial decision and to challenge it through lawful procedures. The review petition filed on August 19 was precisely such a procedure, and the government was entitled to file it. But invoking a remedy is a different thing from a binding order not being carried out as written while that remedy is pending, or after it has been withdrawn. Whether that is what occurred here is the question now before the Court.
At the same time, courts must distinguish deliberate disobedience from genuine disputes about interpretation, implementation, security or factual circumstances. Not every disagreement is contempt, and a security assessment is not self-evidently a pretext.
The rule of law therefore requires two things at once: respect for binding judicial authority, and respect for the lawful mechanisms through which judicial decisions can be challenged.
Pakistan’s constitutional history shows that the relationship between courts and governments has never been simple. Judicial decisions have sometimes limited executive power, sometimes been revised by later courts, and sometimes become part of wider political crises.
The 2026 dispute over Imran Khan’s medical treatment matters not because it should determine which political side is right, but because it raises a recurring constitutional question: what should happen when the executive and the judiciary disagree?
The answer should not depend on political affiliation. If the government believes a judicial order is wrong, it should use the legal remedies available to it. If a party believes the government has failed to comply, it can ask the competent court to determine whether non-compliance occurred. Until that determination is made, neutral analysis should distinguish facts from allegations, and political claims from judicial findings.
The real test of the rule of law is whether constitutional institutions follow the same rules when the outcome is politically convenient — and when it is not.
That principle belongs to no political party. It belongs to the constitutional system itself.
The views expressed in this article are those of the author and not necessarily those of The Lahore Times.
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