What is unfolding in Pakistan over Imran Khan’s health is no longer merely about one prisoner, politician or political party. It is a test of whether Pakistan is governed by law or by the unchecked will of those in power.
Two days ago, the Supreme Court ordered that Imran Khan be shifted to Shifa International Hospital for examination and treatment by a multidisciplinary medical board, with arrangements concerning his personal physician and family access. The government sought modification of those directions, but its review petition was returned. Imran Khan was eventually taken for medical examination to Pakistan Institute of Medical Sciences (PIMS) in the later hours of last night even when the Supreme Court deadline had expired, and also to the hospital in defiance to the Supreme Court which had specified that Imran Khan should be shifted to Shifa International Hospital, Islamabad. In further violation, he was returned to Adiala Jail within hours.
Whatever justification the government may have for their violation of the court order: one principle should be beyond dispute: an order of the Supreme Court is not a suggestion that the executive may interpret according to its convenience.
This is how institutions decay. A court order becomes negotiable. Due process becomes an inconvenience. Political opponents become enemies of the state, and fundamental rights become privileges granted according to political loyalty.
The rulers have gone overboard completely as regards any humanity one can find in any sane person. They have shown complete disregard to the principle that a prisoner’s health, dignity and access to lawful medical treatment cannot depend upon whether the government likes him. The true test of the rule of law is how the state treats those whom the powerful fear or regard as political enemies.
Imran Khan is 73 years old. Serious concerns about his eyesight have previously been raised before the courts, including his lawyer’s assertion that he had lost 85 per cent of the vision in his right eye. His family and party, Pakistan Tehreek e Insaf (PTI) have repeatedly alleged inadequate medical access. The government has some ministers, confirmed liars’ sans any ethics who disagree. This is why independent medical examination and compliance with judicial safeguards are so important.
The deeper issue is Pakistan’s governing culture.
Ordinary Pakistanis are constantly told to obey the law, respect institutions and comply with court orders. But the people who most need to obey the law are those powerful enough to violate it.
When an ordinary citizen disobeys a court order, the state can arrest, fine or imprison him. When powerful authorities appear to circumvent one, suddenly there are explanations about security, procedure, administrative necessity and bureaucratic technicalities.
That is not equality before the law. It is the architecture of a two-tier state.
Pakistan’s Constitution cannot survive merely as a document ceremonially respected while substantive power operates outside it. Courts cannot remain credible if their orders are binding upon citizens but negotiable for governments.
A state does not demonstrate strength by humiliating prisoners, obstructing families or searching for ways around judicial orders. Nor does it demonstrate confidence by appearing frightened of an imprisoned 73-year-old politician receiving independent medical treatment.
Real state authority comes from legitimacy. Legitimacy comes from law. And law means very little when those administering the state behave as though they stand above it.
Those responsible for implementing the Supreme Court’s directions are required to explain before the appropriate court exactly what was done, what medical treatment was provided, whether the Court’s directions were fully followed and, if not, who authorized any departure and under what lawful authority.
If the Supreme Court ultimately determines that its order was deliberately disobeyed, accountability must follow according to law, regardless of the office, rank or institutional affiliation of those responsible.
Anything less would communicate a devastating principle: Pakistan has laws for citizens and discretion for rulers.
This controversy therefore raises a question far greater than Imran Khan’s political future:
Can the Pakistani state itself be compelled to obey Pakistani law?
Those exercising power today should remember that governments change, offices disappear, political fortunes reverse and individuals eventually leave positions of authority. But dangerous precedents survive them.
Every arbitrary power normalized against an opponent today can be used against its creators tomorrow.
The Supreme Court must defend not merely its order concerning Imran Khan, but the constitutional principle upon which the entire legal system rests:
No prime minister, minister, bureaucrat, jail authority, security official, general or institution is above the law.
If that principle is allowed to collapse, the greatest casualty will not be Imran Khan.
It will be the rule of law itself—and ultimately Pakistan.
First appeared on x.com on August 21, 2026