{
"id": "nexus-sen-1-0004-1276291",
"citation": "Res. 00258-2025 Sala Primera de la Corte",
"section": "nexus_decisions",
"doc_type": "court_decision",
"title_es": "Indemnización por daño moral subjetivo en ejecución de amparo de salud",
"title_en": "Subjective moral damages in health amparo enforcement",
"summary_es": "La Sala Primera debe revisar en casación una sentencia del Juzgado Contencioso Administrativo que, en ejecución de un fallo de amparo constitucional, condenó a la CCSS al pago del daño moral subjetivo, costas personales del amparo, intereses y costas de ejecución. El amparado había sido colocado en lista de espera por casi seis meses para una cirugía de columna no urgente, por lo que la Sala Constitucional declaró con lugar el recurso y ordenó realizar el procedimiento en tres meses. La Sala Primera rechaza el recurso de la CCSS. Sostiene que el juez de ejecución sí podía deducir el daño moral subjetivo por presunciones humanas a partir del hecho antijurídico declarado en sede constitucional (espera irrazonable), sin necesidad de prueba directa. Descarta que la atención médica recibida (calificada de justicia restaurativa) elimine la obligación de indemnizar, pues la persona sufrió afectaciones morales mientras duró la disfunción administrativa, y el principio de reparación integral exige su resarcimiento. Considera razonable el monto de ¢50 000 otorgado. También confirma las costas personales por patrocinio letrado, aunque el recurso haya sido presentado por una fundación sin fines de lucro, ya que consta la intervención de un abogado. Hay un voto salvado que estima improcedente la indemnización por haberse configurado justicia restaurativa y no concurrir los presupuestos de daño.",
"summary_en": "The First Chamber reviews a cassation appeal against a decision of the Contentious-Administrative Court that, in enforcing a constitutional amparo judgment, ordered the Costa Rican Social Security Fund (CCSS) to pay subjective moral damages, personal costs of the amparo, interest, and enforcement costs. The amparo plaintiff had been on the waiting list for almost six months for non-urgent spinal surgery, prompting the Constitutional Chamber to grant relief and order the procedure within three months. The First Chamber rejects the CCSS's appeal. It holds that the enforcement judge could infer subjective moral damages through human presumptions from the unlawful delay established by the Constitutional Chamber, without need for direct proof. It rules out the notion that the medical care provided (labeled restorative justice) extinguishes the duty to compensate, because the affected person suffered emotional harm during the administrative dysfunction, and the principle of full reparation mandates redress. It deems the amount of 50,000 colones reasonable. It also upholds the personal costs despite the amparo having been filed through a non-profit foundation, because the record shows an attorney represented the plaintiff. There is a dissenting vote arguing that damages are unwarranted because the restorative justice already operated and the prerequisites for liability were not met.",
"court_or_agency": "Sala Primera de la Corte",
"date": "20/02/2025",
"year": "2025",
"topic_ids": [],
"primary_topic_id": null,
"es_concept_hints": [
"recurso de amparo",
"daño moral subjetivo",
"ejecución de sentencia",
"justicia restaurativa",
"LGAP",
"casación",
"costas personales",
"voto salvado"
],
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"keywords_es": [
"daño moral subjetivo",
"ejecución de sentencia de amparo",
"indemnización",
"justicia restaurativa",
"CCSS",
"lista de espera quirúrgica",
"amparo de salud",
"Sala Primera",
"voto salvado",
"costas personales",
"artículo 196 LGAP"
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"keywords_en": [
"subjective moral damages",
"enforcement of amparo judgment",
"damages",
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"excerpt_es": "V. Sin embargo, dicha reparación no excluye, como bien lo indicó el Juzgador de Ejecución, que la persona perjudicada haya sufrido afectaciones en su esfera moral y patrimonial mientras la conducta anormal persistió por la disfunción administrativa. Si se demuestran menoscabos efectivos (preceptos 196 y 197 de la LGAP) propios del caso concreto y derivados de sus particulares características, coligiéndose su existencia, incluso, por medio del proceso intelectivo “in re ipsa”, pese haberse tutelado jurisdiccionalmente a la persona usuaria, procede su reparación. Es decir, la rectificación servicial no excluye que la persona perjudicada sufra afectaciones en su esfera moral y patrimonial mientras la conducta anormal persiste. Si eso ocurrió y así se acreditó, resulta obligado imponer la consecuencia resarcitoria correspondiente, si fue solicitado por quien vio su esfera jurídica damnificada.\n\nVII. [...] No requiere de una prueba directa y queda a la equitativa valoración del Juez. Si se trata de daño moral subjetivo los tribunales están facultados para decretar y cuantificar la condena. [...] Se deduce a través de las presunciones inferidas de indicios, ya que, el hecho generador antijurídico pone de manifiesto el daño moral, pues cuando se daña la psiquis, la salud, la integridad física, el honor, la intimidad, etc., es fácil inferir el daño, por ello se dice que la prueba del daño moral existe “in re ipsa”.\n\nXXIV. VOTO SALVADO DE LA MAGISTRADA ROJAS MORALES. [...] Resulta irracional imponerle al fondo de contribución tripartito de la seguridad social y, a los demás asegurados beneficiados con dichos fondos, una indemnización adicional a quien ha recibido por tutela judicial la atención médica requerida.",
"excerpt_en": "V. However, that reparation does not exclude, as the Enforcement Judge correctly stated, that the injured person suffered harm in his moral and pecuniary sphere while the abnormal conduct persisted due to administrative dysfunction. If effective detriments (articles 196 and 197 of the LGAP) specific to the case and derived from its particular characteristics are demonstrated, their existence even being inferred through the intellectual process “in re ipsa”, despite the user having been judicially protected, reparation is appropriate. That is, the service rectification does not exclude that the injured person suffers harm in his moral and pecuniary sphere while the abnormal conduct persists. If that occurred and was proven, the corresponding compensatory consequence must be imposed, if sought by the person whose legal sphere was damaged.\n\nVII. [...] It does not require direct proof and remains subject to the equitable assessment of the Judge. In the case of subjective moral damage, courts are empowered to decree and quantify the award. [...] It is deduced through presumptions inferred from indicia, because the unlawful generating event reveals the moral damage, for when the psyche, health, physical integrity, honor, intimacy, etc. are harmed, it is easy to infer the damage, which is why it is said that proof of moral damage exists “in re ipsa”.\n\nXXIV. DISSENTING VOTE OF JUSTICE ROJAS MORALES. [...] It is irrational to impose upon the tripartite contribution fund of social security and upon the other insured beneficiaries of those funds an additional compensation on someone who has already received, through judicial protection, the required medical attention.",
"outcome": {
"label_en": "Denied",
"label_es": "Sin lugar",
"summary_en": "The First Chamber denies the CCSS's cassation appeal and upholds the award of subjective moral damages and costs.",
"summary_es": "La Sala Primera rechaza el recurso de casación de la CCSS y confirma la condena al pago de daño moral subjetivo y costas."
},
"pull_quotes": [
{
"context": "Considerando VI",
"quote_en": "However, that reparation does not exclude, as the Enforcement Judge correctly stated, that the injured person suffered harm in his moral and pecuniary sphere while the abnormal conduct persisted due to administrative dysfunction.",
"quote_es": "Sin embargo, dicha reparación no excluye, como bien lo indicó el Juzgador de Ejecución, que la persona perjudicada haya sufrido afectaciones en su esfera moral y patrimonial mientras la conducta anormal persistió por la disfunción administrativa."
},
{
"context": "Considerando VII",
"quote_en": "It does not require direct proof and remains subject to the equitable assessment of the Judge. In the case of subjective moral damage, courts are empowered to decree and quantify the award.",
"quote_es": "No requiere de una prueba directa y queda a la equitativa valoración del Juez. Si se trata de daño moral subjetivo los tribunales están facultados para decretar y cuantificar la condena."
},
{
"context": "Voto salvado XXIV",
"quote_en": "It is irrational to impose upon the tripartite contribution fund of social security and upon the other insured beneficiaries of those funds an additional compensation on someone who has already received, through judicial protection, the required medical attention.",
"quote_es": "Resulta irracional imponerle al fondo de contribución tripartito de la seguridad social y, a los demás asegurados beneficiados con dichos fondos, una indemnización adicional a quien ha recibido por tutela judicial la atención médica requerida."
}
],
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"title_en": "General Law of Public Administration",
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"year": "1978"
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"title_en": "Contentious-Administrative Code",
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"date": "28/04/2006",
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{
"id": "nexus-sen-1-0004-1029345",
"citation": "Res. 00677-2021 Sala Primera de la Corte",
"title_en": "Cassation appeal rejected for failure to meet pleading requirements in environmental damage enforcement",
"title_es": "Rechazo por incumplir requisitos de fundamentación del recurso de casación en ejecución de sentencia por daño ambiental",
"doc_type": "court_decision",
"date": "25/03/2021",
"year": "2021"
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"source_url": "https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1276291",
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"body_es_text": "Revisión del Documento\n\n\n\nExp. 23-004070-1028-CA \n\nRes. 000258-F-S1-2025\n\n SALA PRIMERA DE LA CORTE SUPREMA DE JUSTICIA. San José, a las doce horas veintidos minutos del veinte de febrero de dos mil veinticinco .\n\nProceso de ejecución de la sentencia emitida por la Sala Constitucional de la Corte Suprema de Justicia en recurso de amparo establecido por LEONARDO GÓMEZ SALAZAR, abogado, portador de la cédula de identidad número 108760664 y del carné de colegiado número 17.049, en su condición de apoderado especial judicial de JOHNNY FRANCISCO VALVERDE PORRAS, operador, portador de la cédula de identidad número 108500565 contra la CAJA COSTARRICENSE DE SEGURO SOCIAL, con cédula de persona jurídica número 4-000-042147, representada por su apoderado general judicial sin límite de suma, Michael Montoya Jiménez, abogado, portador de la cédula de identidad número 108930513 y del carné de colegiado número 17.385. El apoderado general judicial del ente ejecutado formuló recurso de casación impugnando la sentencia número 2024001065 de las 07 horas 41 minutos del 17 de mayo de 2024, emitida por el Juzgado Contencioso Administrativo y Civil de Hacienda del Segundo Circuito Judicial de San José, integrado por el juzgador José Andrés Cruz Tenorio. \n\nRedacta el magistrado Leiva Poveda\n\nCONSIDERANDO\n\nI. La Sala Constitucional de la Corte Suprema de Justicia, mediante sentencia número 2023020609 de las 09 horas 45 minutos del 22 de agosto de 2023, acogió el recurso de amparo interpuesto por el licenciado Leonardo Gómez Salazar a favor de Johnny Francisco Valverde Porras contra la Caja Costarricense de Seguro Social (CCSS). Dicho recurso, presentado ante esa Cámara el 04 de agosto de 2023, se originó por la transgresión al derecho fundamental a la salud. El amparado es paciente del Hospital Monseñor Víctor Manuel Sanabria de Puntarenas. Fue valorado en el Servicio de Neurocirugía de ese Nosocomio los días 02 de febrero, 23 de abril, 21 de junio, las tres datas del año 2021; 09 de febrero, 21 de octubre, ambas de 2022 y 24 de febrero de A2023. Fue diagnosticado con HD C4-C5/C5-C6/C6-C7. Se documentó: “HERNIA DE DISCO L1 L2 CANAL 10.3 MM SIN ESTENOSIS FORAMINAL”, el cual amerita instrumentación quirúrgica”. El 24 de febrero de 2023 fue valorado por última vez y se emitió solicitud de hospitalización “para abordaje cervical anterior + disectomía C4-C5/C5-C6/C6-C7 + fusión con cage bloqueado”. Al momento de la formulación del recurso de amparo a don Johnny no se le había programado fecha para la práctica del procedimiento quirúrgico requerido. Al respecto, consideró esa Cámara: “[…] esta Sala tuvo por acreditada una vulneración al derecho fundamental a la salud del amparado. Pues, se logró demostrar que fue incorporado en lista de espera quirúrgica desde el 24 de febrero de 2023, y a la fecha en la que la autoridad médica recurrida rindió su informe respectivo –17 de agosto de 2023- han transcurrido casi 6 meses de espera e incerteza sobre dicha intervención. Es así, como este Tribunal Constitucional considera irrazonable, someter al amparado a una espera indefinida para que le sea efectuada la cirugía que requiere, más aún, cuando el padecimiento que le aflige interviene de forma constante es [sic] su disfrute de calidad de vida. Además, la Administración debe ejecutar de manera pronta y oportuna las acciones necesarias para resguardar, la salud y vida de sus usuarios. En consecuencia, lo procedente es declarar con lugar el recurso con la orden de que, dentro del plazo 3 meses, contado a partir de la notificación de la sentencia, el amparado sea intervenido quirúrgicamente en el nosocomio recurrido, bajo la responsabilidad de su médico tratante.” Le ordenó a la Directora General a.i. del referido Nosocomio girar las órdenes pertinentes y llevar a cabo las actuaciones que están dentro del ámbito de sus competencias, para que, dentro del indicado plazo de tres meses, contado a partir de la notificación de esa sentencia, se le efectúe al amparado la cirugía que le fue prescrita. Todo, bajo el criterio y responsabilidad de sus médicos tratantes y si otra causa médica no lo impide. Le advirtió que, de conformidad con lo establecido por el artículo 71 de la Ley de la Jurisdicción Constitucional, se impondrá prisión de tres meses a dos años o de veinte a sesenta días multa, a quien recibiere una orden que deba cumplir o hacer cumplir, dictada dentro de un recurso de amparo y no la cumpliere o no la hiciere cumplir, siempre que el delito no esté más gravemente penado. Condenó a la CCSS al pago de las costas, daños y perjuicios causados con los hechos que sirvieron de base a esa declaratoria, los cuales, dispuso, se liquidarán en ejecución de sentencia de lo contencioso administrativo.\n\nII. En escrito subido al expediente judicial electrónico el 20 de diciembre de 2023 a las 12:49:27, imágenes de la 02 a la 26, el licenciado Gómez Salazar, en su condición de apoderado especial judicial del ejecutante, Johnny Francisco Valverde Porras, presentó a estrados la liquidación correspondiente. Solicitó se acogieran las siguientes partidas: 1) se condene al ente ejecutado al pago de las costas del proceso de ejecución de sentencia; 2) ₡181.500,00 por las costas personales del recurso de amparo; 3) ₡300.000,00 por el daño moral subjetivo; y 4) el pago de los intereses de ley, desde el momento de la firmeza de la sentencia y hasta su efectivo pago. Mediante resolución de las 13 horas 51 minutos del 17 de enero de 2024, imágenes 28 y 29, el Juzgador, Giovanni Marchena Jara, dio curso a la demanda. En escrito subido al expediente judicial electrónico el 14 de febrero de 2024 a las 16:15:47, imágenes de la 31 a la 147, el apoderado general judicial sin límite de suma de la CCSS, Montoya Jiménez, se opuso a la liquidación. Formuló la defensa de falta de derecho. En la sentencia ahora cuestionada, el juzgador, José Andrés Cruz Tenorio, condenó a la CCSS al pago de: 1) 50.000,00 por el daño moral subjetivo, 2) 181.500,00 por las cotas personales del recurso de amparo; 3) los intereses legales sobre dichos montos a partir de la firmeza de esa resolución y hasta su efectivo pago y 4) las costas del proceso de ejecución de sentencia y sus réditos desde la firmeza de la resolución que las fije y hasta su cancelación. Disconforme, el apoderado general judicial de la CCSS formuló recurso de casación. Disconforme, el apoderado general judicial de la CCSS formuló recurso de casación. Para su resolución, se consideró el memorial subido al escritorio virtual de esta Cámara el 13 de febrero de 2025 a las 09:20:53, suscrito por el licenciado Gómez Salazar.\n\nIII. En el primer reproche, página dos del libelo, anunció el casacionista interponerlo por el motivo casacional por violación de normas sustantivas previsto en el inciso a) del canon 138 del Código Procesal Contencioso Administrativo (CPCA): “También procederá el recurso de casación por violación de normas sustantivas del ordenamiento jurídico, en los siguientes casos: / a) Cuando se atribuya a la prueba una indebida valoración o se haya preterido.”, por la indebida valoración de la ejecutoria de la sentencia constitucional del recurso de amparo. Invocó conculcado el canon 196 de la Ley General de la Administración Pública (LGAP). La sentencia cuestionada, señaló, basó su argumentación de otorgar el daño moral subjetivo en un extremo fáctico, pero sin analizar las aristas contenidas en la línea de esta Sala. Aludió al fallo no. 297-F-S1-2024 de las 17 horas 27 minutos del 21 de marzo de 2024 (mencionada en la contestación de la demanda). Dentro de esos aspectos, citó la determinación de necesidad extrema del caso del paciente desde el punto de vista médico (urgencia), su consentimiento en estar en una lista de espera o, bien, la existencia de un daño físico. De igual manera, citó los fallos nos.: 1502-S1-2022 de las 11 horas 24 minutos del 01 de setiembre; 1823-F-S1-2022 de las 14 horas 26 minutos del 04 de agosto; 2429-F-S1-2022 de las 14 horas 16 minutos del 03 de noviembre; las tres del año 2022; y 28-F-S1-2024 de las 11 horas 05 minutos del 11 de enero de 2024. Reprodujo, en lo de su interés, lo considerando en el apartado VIII del fallo cuestionado, denominado “SOBRE EL FONDO DEL ASUNTO”, en torno a la probanza para otorgar el daño moral subjetivo. De lo transcrito, alegó, se observa que el Juez puntualizó las condiciones de la parte actora y la situación jurídico-material surgida en torno al recurso de amparo, al haberse colocado al ejecutante en un plazo de espera desproporcionado para su valoración y atención médica, sin que se brindara el servicio requerido. Con la simple ejecutoria de una sentencia, anotó, pudo determinar que la Administración le provocó “un menoscabo emocional”, sin tomarse en cuenta los factores de justicia restaurativa, urgencia, conformación del paciente, los cuales se le hicieron ver en la contestación de la demanda. Incluso, añadió, utilizó el mismo machote para justificar su condenatoria a la CCSS. Pidió se evalúen dichas resoluciones “ad effectum videndi”, pues, el Juzgador está actuando de manera contraria a lo dispuesto por esta Cámara. Transcribió los hechos probados de la sentencia ejecutoria. No hacen referencia alguna, manifestó, al agravamiento de la condición del paciente, ni que sufriera “un menoscabo emocional”. El fallo cuestionado, indicó, de forma directa violentó el indicado numeral 196 de la LGAP, al haber determinado la existencia de una lesión, y de un daño, con una ejecutoria de sentencia. Se requería para ello, aseveró, prueba técnica que lo demostrara. Esto se agrava, afirmó, con el hecho de que, para el Juzgador, no es suficiente que se haya dado una justicia restaurativa -la atención médica-, incluso antes del vencimiento del plazo ordenado por la Sala Constitucional, pues, para él, hubo una lesión al derecho fundamental de la salud, y la atención no elimina la obligación de la Institución de indemnizarlo por la atención inoportuna. Copió un fragmento de una sentencia que no coincide con la cuestionada, pues, en lo reproducido, se alude al Servicio de Optometría, que no guarda relación con el padecimiento del amparado. El fallo objetado, anotó, conculcó dicho precepto -196 de la LGAP, que dispone que el daño debe ser efectivo, evaluable e individualizable, en relación con una persona o grupo-. Partiendo de la sentencia del recurso de amparo, por haberse colocado en lista de espera al ejecutante, señaló, no se tiene prueba alguna de su afectación en el fuero interno. Tampoco, dijo, de la lesión sufrida. Dicho concepto jurídico, apuntó, obedece a un daño, ya sea, producto de la falta de equivalencia entre lo que se da y lo que se recibe, en un título oneroso, o de un delito, donde se merma o transgrede el cuerpo de una persona; o, bien, una perturbación orgánica o funcional de un individuo. Es decir, acotó, el Juez, de una simple ejecutoria de sentencia, validó y determinó la existencia de una lesión en el paciente, sin puntualizar cuál tipo de lesión, ni tampoco tener prueba técnica que así lo acredite, desde ninguna arista, lo cual acarrea que el daño no sea real ni efectivo, violentando directamente el referido canon. La autoridad judicial, indicó, no tomó en cuenta los factores de la justicia restaurativa, urgencia, conformación del paciente, reiterados en la jurisprudencia de esta Cámara. Citó -acorde al orden de exposición-, las sentencias nos. 28-F-S1-2024 de las 11 horas 05 minutos del 11 de enero; 297-F-S1-2024 de las 17 horas 27 minutos del 21 de marzo, ambas del año 2024; 1502-F-S1-2022 de las 11 horas 24 minutos del 01 de setiembre; 1823-F-S1-2022 de las 14 horas 26 minutos del 04 de agosto; y 2429-F-S1-2022; las tres del año 2022. Agregó una tabla en donde expuso, en su criterio, lo puntualizado en cada uno de esos fallos. Esas resoluciones, manifestó, además de que son de conocimiento público, no fueron sopesadas en el caso bajo estudio, pese a que, anotó, las del año 2022 se le puntualizaron al Juzgador, quien debe conocer que la jurisprudencia es un medio para integrar, entender y aplicar el Derecho. Empero, expuso, con un “animus” de condena, ignoró dicha línea y decidió condenar a su representada por una lesión causada a la parte ejecutante, según su entender, sin tener prueba de esa lesión, aparentemente sufrida, con solo la ejecución del recurso de amparo y sin sopesar los alcances de la justicia restaurativa, como lo ha contextualizado esta Sala. Si el Juez hubiera analizado debidamente la prueba, aseveró, hubiera determinado que una ejecutoria es insuficiente para determinar la procedencia de un daño moral subjetivo. Máxime, tomando en consideración que la colocación de una persona en un tiempo de espera para realizarle las consultas y procedimientos médicos no es, “per se”, motivo suficiente para otorgar una indemnización. Sobre eso, indicó, esta Cámara, estableció, en la resolución no. 1502-S1-2022 de las 11 horas 24 minutos del 01 de setiembre de 2022 que, en cuanto a indemnizaciones por recursos de amparo por colocación en listas de espera, resulta irracional imponerle al fondo de contribución tripartito de la seguridad social una indemnización a quien ha consentido una espera para la atención médica requerida. Ello, expuso, le fue señalado a la autoridad jurisdiccional. Sin embargo, denotó que existe un “animus” de condenar a la CCSS a toda costa (y claro está, a los cotizantes), sin que medie sustento alguno desde el punto de vista probatorio. Si el Juzgador hubiera valorado adecuadamente la prueba, apuntó, la argumentación del fallo sería diferente. Se habría determinado, concluyó, que la prueba era insuficiente para establecer la existencia de un daño de cualquier tipo.\n\nIV. En torno a lo expuesto en el apartado anterior, precisa anotar lo siguiente. PRIMERO. Debe recordarse que, en procesos de ejecución de sentencia en general y, principalmente, los emitidos por la Sala Constitucional, lo ejecutado debe necesariamente constreñirse a lo resuelto en la sentencia de amparo objeto de la ejecutoria. Esta Sala ha indicado, el proceso de ejecución de sentencia procura materializar la condena -abstracta- impuesta al perdidoso. De otorgarse aspectos diferentes -o contrarios- al pronunciamiento que da lugar a la ejecución o contra personas que no resultaron condenadas, se vulnera la cosa juzgada. Ver, entre otros fallos de este órgano decisor: 383-2019 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-925036) y 309-2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1024927). En consecuencia, la labor fiscalizadora de esta Cámara se constriñe a un cotejo objetivo entre la sentencia ejecutoria y la resolución recurrida. En este sentido, pueden consultarse, asimismo y entre muchas otras, las resoluciones nos. 82-A-S1-22 de las 10 horas 06 minutos del 26 de enero (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1072742) y 1984-F-S1-2022 de las 11 horas 18 minutos del 08 de setiembre, ambas del año 2022 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112319). \n\nV. Como se apuntó en el Considerando I de esta sentencia, la Sala Constitucional, en el fallo que se ejecuta, acogió el recurso de amparo interpuesto por el amparado, al tenerse por comprobado que el 24 de febrero de 2023 fue valorado, emitiéndose la solicitud de hospitalización en el Hospital Monseñor Sanabria para “abordaje cervical anterior + disectomía c4-c5/c5-c6/c6-c7 + fusión con cage bloqueados”. Sin embargo, al momento de interponerse el recurso de amparo, el 04 de agosto de ese año, no se le había programado fecha para el procedimiento quirúrgico requerido. Por lo tanto, estimó dicha Cámara, el plazo transcurrido hasta ese momento, casi seis meses, resultaba desproporcionado y violatorio de su derecho fundamental a la salud. Por lo tanto, acogió el recurso de amparo y le ordenó tanto a la Directora General a.i. girar las órdenes pertinentes y llevar a cabo todas las actuaciones que estubiern dentro del ámbito de su competencia, para que, dentro del plazo de tres meses, contado a partir de la notificación de esa sentencia, se le realizara al amparado la intervención quirúrgica prescrita. Como se colige con nitidez, la Sala Constitucional acogió el recurso porque estimó que el plazo que llevaba el amparado en lista de espera era desproporcionado y violatorio de su derecho fundamental a la salud, considerando su patología. Precisamente, el Juez de Ejecución, en el apartado VIII de la sentencia cuestionada, ciñéndose a lo resuelto en sede constitucional, en lo de interés consideró: “[…] el daño moral alegado no se demuestra en sede constitucional, sino en la etapa que nos ocupa y al tratarse de un daño moral subjetivo, el mismo puede ser acreditado a través de presunciones humanas y el prudente arbitrio del Juzgador, eso sí, su acreditación y cuantificación debe ajustarse plenamente a los elementos circunstanciales del propio hecho generador, hecho que en caso [sic] concreto, es el hecho de someter al amparado a una espera indefinida para que le sea efectuada la cirugía que requería. […] en autos queda demostrada la cirugía que se llevó a cabo y además, es evidente que el padecimiento del señor Valverde Porras, aunque le ocasionaba dolores insoportables y afectaba el desarrollo normal de su vida cotidiana, técnicamente no era urgente ni representaba ningún riesgo inmediato, sin embargo, lo que se debe destacar es que la lesión al derecho fundamental a la salud ya se había configurado y tanto la atención médica como la cirugía en mención, se realizaron por orden de la Sala Constitucional y el hecho que se le haya dado atención al paciente, inclusive antes del vencimiento del plazo ordenado por la Sala, no elimina la obligación que posee la institución de indemnizarlo por el tiempo de espera irrazonable (a criterio de la Sala) en la lista correspondiente, para luego ser intervenido quirúrgicamente. […] sin embargo, a tenor de lo establecido en los artículos 190, 196 y 197 de la Ley General de la Administración Pública, sí existe una relación de causalidad entre la conducta del Hospital Monseñor Sanabria y el daño moral subjetivo, es decir, entre la espera irrazonable e indefinida para la intervención quirúrgica y las situaciones de angustia, inseguridad, inestabilidad e incertidumbre que se le ocasionaron al señor Valverde Porras, situaciones que reitero, no requieren de pruebas directas para su demostración, ya que las mismas pueden acreditarse a través de presunciones humanas. […] ya ha quedado demostrado que el padecimiento del señor Valverde Porras, aunque le generaba dolores y complicaciones en su vida cotidiana, no era urgente, sin embargo, el hecho que la atención no fuera urgente, no fue impedimento ni justificación para que la Sala Constitucional declarara la violación al derecho fundamental a la salud, de ahí que el hecho generador de la responsabilidad de la Administración no dependía de la urgencia de la atención, sino que el mismo se configura por el plazo irrazonable en esa atención y por la espera indefinida, lo cual motivó que el recurso de amparo se declarara con lugar y se ejecute en esta vía. […] es más que evidente que daño [sic] y los sentimientos negativos que eso genera, surgen por el tiempo irrazonable en la lista de espera (a criterio de la Sala) y además, reitero, el daño moral subjetivo no requiere de una prueba directa para su demostración […] el hecho de esperar tanto tiempo por una intervención quirúrgica que inclusive ya tenía una solicitud de hospitalización, ocasionó que la Sala Constitucional declarara con lugar el recurso de amparo y por ende, eso también ocasionó sentimientos o situaciones negativas en el actor, las cuales se indemnizan en esta sentencia. […] lo que analizó la Sala Constitucional en dicho recurso, fue el tiempo transcurrido entre la solicitud de hospitalización para la cirugía correspondiente y la presentación del recurso de amparo y a esa última fecha, ya el daño se había producido y aunque se toma nota del procedimiento quirúrgico realizado y los efectos restaurativos mencionados por la CCSS, lo cierto es que, a criterio de la Sala, ya se habían violentado derechos fundamentales, especialmente el de la salud.” El impugnante no objetó dicho fundamento para la determinación de la existencia de ese daño en debida forma, tal y como la técnica de la casación se lo impone, acorde a lo previsto en el artículo 139 inciso 3) del CPCA. Se limitó reiterar lo expuesto desde la contestación de la demanda en cuanto a que la sentencia ejecutoria resultaba insuficiente para su acreditación. No cuestionó, de manera clara y precisa, el meollo de lo dispuesto por el Juzgador de Ejecución en torno a la existencia del nexo de causalidad. Aludió a otros temas, también expuesto en la contestación de la demanda, como justicia restaurativa, urgencia y consentimiento. Sin embargo, se insiste una vez más, sin protestar el quid de lo expuesto por el Juzgador, tocante a que el hecho antijurídico dispuesto por la Sala Constitucional en la sentencia ejecutoria es motivo suficiente para determinar la existencia del daño moral subjetivo (nexo de causalidad), pues, este tipo de daño -moral subjetivo- se acredita con presunciones humanas y con el prudente arbitrio del Juzgador, acorde a los hechos analizados en la vía constitucional. Tal falencia hace que lo argüido resulte fútil a efecto de variar lo resuelto.\n\nVI. Sin perjuicio de lo indicado en el apartado anterior y, a mayor abundamiento de razones, se impone señalar lo siguiente. SEGUNDO. El casacionista, de manera insistente, aludió a que en el sub júdice operó lo que denominó “justicia restaurativa”, porque al paciente se le brindó la atención médica requerida. Al respecto, precisa señalar, esta Sala, en anteriores asuntos, reconoció su procedencia en materia de indemnización del daño moral subjetivo por la infracción al derecho fundamental a la salud (así reconocido por la Sala Constitucional de la Corte Suprema de Justicia al acoger el respectivo recurso de amparo, debido al retardo de la CCSS en la prestación del servicio médico requerido por la persona administrada), cuando la CCSS presta el servicio dentro del plazo ordenado en sede constitucional. Al respecto, pueden consultarse las sentencias nos. 1502-S1-2022 de las 11 horas 24 minutos del 01 de setiembre (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112330), 2429-F-S1-2022 de las 14 horas 16 minutos del 03 de noviembre (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1123608), ambas del año 2022; 28-F-S1-2024 de las 11 horas 05 minutos del 11 de enero (), 297-F-S1-2024 de las 17 horas 27 minutos del 21 de marzo (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250), 901-F-S1-2024 de las 12 horas 31 minutos del 04 de julio (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1240015) y 937 de las 14 horas 51 minutos del 10 de julio (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925); todas del año 2024. Empero, la actual integración de esta Cámara, luego de nuevo estudio, considera necesario reconsiderar esa posición. Sin duda, se trata de una reivindicación de la situación jurídica lesionada, por una falta de servicio, el que se suministre. Más aún, cuando resulte necesario, como ocurre con un servicio de salud pendiente. Sin embargo, dicha reparación no excluye, como bien lo indicó el Juzgador de Ejecución, que la persona perjudicada haya sufrido afectaciones en su esfera moral y patrimonial mientras la conducta anormal persistió por la disfunción administrativa. Si se demuestran menoscabos efectivos (preceptos 196 y 197 de la LGAP) propios del caso concreto y derivados de sus particulares características, coligiéndose su existencia, incluso, por medio del proceso intelectivo “in re ipsa”, pese haberse tutelado jurisdiccionalmente a la persona usuaria, procede su reparación. Es decir, la rectificación servicial no excluye que la persona perjudicada sufra afectaciones en su esfera moral y patrimonial mientras la conducta anormal persiste. Si eso ocurrió y así se acreditó, resulta obligado imponer la consecuencia resarcitoria correspondiente, si fue solicitado por quien vio su esfera jurídica damnificada. Esto es así conforme al principio de reparación integral del daño, el cual tiene raigambre constitucional y legal (cánones 9, 41, 49 constitucionales; 190 y 197 de la LGAP).\n\nVII. Dentro de esta línea de pensamiento, y respecto a la existencia y cuantificación del daño moral subjetivo, esta Sala, desde vieja data, ha indicado que: “IV. [...] proviene de la lesión a un derecho extrapatrimonial. Sea, no repercute en el patrimonio de manera directa. Supone una perturbación injusta de las condiciones anímicas. No requiere de una prueba directa y queda a la equitativa valoración del Juez. Si se trata de daño moral subjetivo los tribunales están facultados para decretar y cuantificar la condena. La naturaleza jurídica de este tipo de daño no obliga al liquidador a determinar su existencia porque corresponde a su ámbito interno. Ello no es problema de psiquiatras o médicos. Se debe comprender su existencia o no porque pertenece a la conciencia. Se deduce a través de las presunciones inferidas de indicios, ya que, el hecho generador antijurídico pone de manifiesto el daño moral, pues cuando se daña la psiquis, la salud, la integridad física, el honor, la intimidad, etc., es fácil inferir el daño, por ello se dice que la prueba del daño moral existe “in re ipsa”. Tampoco se debe probar su valor porque no tiene un valor concreto. Se valora prudencialmente. No se trata, entonces, de cuantificar el sufrimiento, pues es inapreciable, sino de fijar una compensación monetaria a su lesión, único mecanismo al cual puede acudir el derecho, para así reparar, al menos en parte, su ofensa. Para mayor detalle sobre este aspecto, se pueden consultar, entre otros, de este órgano colegiado, los fallos no. 112 ya citado, no. 17 de las 14 horas 30 minutos del 21 de febrero de 1996 y no. 41 de las 14 horas 40 minutos del 14 de mayo de 1997. Su otorgamiento no guarda una estrecha sujeción a factores probatorios (salvo que se refieran a la relación de causalidad), sino a la prudencia y objetivo arbitrio del juzgador. Sin embargo, su fijación está sujeta a los principios de razonabilidad y de proporcionalidad, los que deben ser valorados por la autoridad competente en cada caso, para que su cuantificación sea acorde a Derecho y no lleve a indemnizaciones excesivas que beneficien injustificadamente a una de las partes. Es decir, debe guardar un justo equilibrio derivado del cuadro fáctico específico, cuestión que ha de ponderarse dentro de los límites señalados.” (Entre muchas otras, puede consultarse la sentencia de esa Cámara no. 468-F-S1-19 de las 9 horas 45 minutos del 30 de mayo de 2019). Acorde a lo expuesto, una vez establecida la existencia del daño moral y su nexo de causalidad con la causa de pedir alegada por la parte actora -lo cual, no es objetado por el casacionista-, la determinación del cuántum depende de la equitativa valoración del Juez; para lo cual, se deberá atender a las circunstancias especiales del caso, así como a los principios constitucionales de razonabilidad y proporcionalidad.” Al respecto, puede consultarse, entre muchas otras, la sentencia no. 1098-F-S1-2023 de las 10 horas 09 minutos del 05 de julio de 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1170686). Es decir, es respecto al daño moral subjetivo que su demostración es “in re ipsa”, siempre y cuando sea como consecuencia de un hecho generador o motivo antijurídico.\n\nVIII. En esta lite, la Sala Constitucional, según ya se ha indicado, determinó la conducta antijurídica de la CCSS al verificar el quebranto al derecho fundamental a la salud de don Johnny Francisco. La postergación de la cirugía requerida era, al momento del dictado de la sentencia constitucional, de casi seis meses. Tal situación -hecho antijurídico-, conforme a las máximas de la lógica, experiencia y correcto entendimiento humano, tal y como fue resuelto, es causa adecuada (nexo causal) de una aflicción moral, asociada a ansiedad, molestia, frustración y preocupación, por el tiempo excesivo de atención -así declarado, se insiste, en sede constitucional- de una situación de salud que, “per se”, es causa de preocupación para quien lo padece, pese a no haber sido diagnosticada como urgente; pero que generaba fuertes dolores, tal y como lo indicó el Juzgador. Acorde con el correcto entendimiento humano y la experiencia, se insiste, se puede colegir, “in re ipsa”, tal y como lo hizo el Juez de Ejecución, la existencia de sentimientos como los antes descritos, sin que tuviera el deber jurídico de soportarlos, al derivar de un funcionamiento anormal de la Administración, así decretado, se repite una vez más, por la Sala Constitucional. Ergo, distinto a lo indicado por el recurrente, se determina su existencia y, por ende, la procedencia de su resarcimiento.\n\nIX. De igual manera, ha expuesto esta Cámara: “VIII. […] En otras oportunidades, este órgano de casación ha tenido oportunidad de resaltar la necesaria “razonabilidad jurídica” que deben guardar este tipo de indemnizaciones, para cuya verificación se debe constatar la observancia de una “razonabilidad de igualdad”, la que la Sala Constitucional ha definido como “…el tipo de valoración jurídica que parte de que ante iguales antecedentes deben haber iguales consecuencias, sin excepciones arbitrarias” (v.g., votos no. 5236-99 y 1354-2011). Es decir, para evitar tratamientos inequitativos e ilegítimos en los diversos asuntos en los que se discuta la indemnización de daños morales, resulta menester verificar que los montos reconocidos no resulten desproporcionados, al compararlos con los que fueron establecidos en otros asuntos similares. En ese orden de ideas, estima la Sala que la suma concedida se ajusta a la intensidad del daño causado.” Sentencia no. 760-F-S1-2023 de las 13 horas 24 minutos del 29 de mayo de 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1157835). En igual sentido, pueden consultarse, entre otros, los fallos nos. 1934-F-S1-2022 de las 15 horas del 12 de agosto; 2654-F-S1-2022 de las 10 horas 10 minutos del 08 de diciembre https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1132117), ambas del año 2022 y 1087-F-S1-2023 de las 09 horas 36 minutos del 05 de julio de 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1173505). Pese a que en la censura en estudio el objetante no cuestionó el monto otorgado por concepto de daño moral subjetivo, estima esta Sala, la suma concedida, ₡50.000,00, resulta razonable y proporcionada, considerando las circunstancias de este caso y otros asuntos similares. A modo de ejemplo, se pueden señalar los siguientes precedentes, en donde, este órgano decisor no consideró irrazonables las sumas otorgadas por el atraso en la prestación del servicio público de salud, nos. 429-F-S1-2024 de las 10 horas 41 minutos del 03 de mayo (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1229475), en donde la persona Juzgadora otorgó ₡500.00,00; 937-F-S1-2024 de las 14 horas 51 minutos del 10 de julio, (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925), en donde se fijó en ₡200.000,00; y 1302-F-S1-2024 de las 16 horas 14 minutos del 27 de setiembre, todas del año 2024 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1253306), en donde se concedió la suma de ₡200.000,00.\n\nX. TERCERO. Asimismo, el recurrente alegó que, en el caso del amparada, no existía urgencia en la práctica de la cirugía. Si bien es cierto, conforme lo señaló el Juzgador, el padecimiento del ejecutante no fue catalogado como médicamente urgente -pese a que le infligía fuertes dolores-; también lo es que, como se expuso en el apartado I de esta sentencia, fue la propia Sala Constitucional, en la sentencia ejecutoria, quien determinó la urgencia en que al ejecutante se le practicara el procedimiento quirúrgico requerido, disponiendo que debía efectuarse dentro del plazo de tres meses a partir de la notificación de ese fallo. Por consiguiente, dentro del cotejo objetivo que debe prevalecer en este tipo de procesos -ejecución de sentencia constitucional- el tema de la urgencia es un aspecto precluido, pues, se repite, así fue determinado y resuelto por el Tribunal Constitucional.\n\nXI. CUARTO. El impugnante también adujo que el amparado se conformó o consintió en permanecer en la lista de espera. Diferente a lo alegado, en esta lite no puede estimarse la existencia de consentimiento o acto consentido tácito y, mucho menos, expreso por parte del señor Valverde Porras. El recurso de amparo fue interpuesto en tiempo. Tanto es así que la Sala Constitucional lo admitió para su trámite y, posteriormente, lo acogió. Esto, con independencia del plazo transcurrido entre el momento cuando la CCSS lo ingresó en lista de espera y la presentación del amparo. Por lo tanto, el ejecutante mostró su disconformidad con su permanencia en la lista de espera, dándole la razón dicho órgano jurisdiccional. \n\nXII. En el segundo motivo de disconformidad, página nueve del recurso, anunció el recurrente interponerlo por el motivo casacional por quebranto de normas sustantivas previsto en el inciso d) del numeral 138 del CPCA: “d) Cuando la sentencia viole las normas o los principios del Derecho constitucional, entre otros, la razonabilidad, proporcionalidad, seguridad jurídica e igualdad.” Invocó infringido el postulado de razonabilidad. En la sentencia objetada, dijo, el Juzgador de Ejecución determinó la razonabilidad de la indemnización, pues, al ejecutante se le causó el daño y, como tal, no es suficiente con que se haya dado una justicia restaurativa. Reprodujo, en lo de su interés, lo considerado en el apartado VIII del fallo cuestionado. El Juez, anotó, distinguió que la conducta reprochada le generó un daño moral al ejecutante, y ello quedó determinado en sede Constitucional. No obstante, solo le bastó para arribar a esa conclusión el texto con el que se promovió la ejecución del recurso de amparo. La sentencia impugnada, dijo, dejó abierta la posibilidad para buscar, de manera irrestricta, obtener dobles indemnizaciones: la de tipo material, al recibir la atención médica, y la pecuniaria, sin que medie prueba alguna sobre ello. El Juez, indicó, con su análisis, violó el principio de razonabilidad. El espíritu de la CCSS, anotó, de conformidad con el precepto 73 de la Constitución Política, es garantizar los derechos fundamentales a la vida y salud; sin los cuales, las demás garantías consagradas en la Carta Magna no pueden ejercerse a cabalidad. Si bien, apuntó, existen listas o plazos de espera para realizar requerimientos médicos; también lo es que, otorgar una indemnización pecuniaria por colocar a una persona en una de ellas, pese a no existir criterio médico de urgencia, implica que los montos destinados a garantizar los dos referidos derechos fundamentales se vean mermados, lo cual, a todas luces, alegó, es irracional, pues, las personas cotizantes para el Seguro de Enfermedad y Maternidad lo hacen con el objetivo de que se brinde un servicio de salud y que se tengan recursos para garantizarlo. No para que se otorguen indemnizaciones por colocar a una persona en una lista de espera, o se fijen las atenciones en un plazo de espera razonable. El Juzgador, acotó, alejándose del principio de razonabilidad, determinó que el hecho que se hubiese realizado la prestación, resulta insuficiente para determinar la existencia de una justicia restaurativa en su totalidad. Por ello, anotó, debe haber también un resarcimiento económico. Es decir, expuso, se desprende con lo anterior que determinó que debe mediar, en todo momento, una doble indemnización, cuando se coloca a una persona en una lista de espera, o se le haya dado una cita programada superando un tiempo de espera razonable. Empero, afirmó, lo cierto es que ello genera un privilegio y un enriquecimiento sin causa alguna. Aludió a las sentencias de esta Cámara, según su orden de cita, nos. 1502-S1-2022, 297-F-S1-2024, 28-F-S1-2024 y 1823-F-S1-2022. El objetivo de quien recurre a la Sala Constitucional, dijo, es que se le realice un procedimiento quirúrgico, o se le brinde la atención médica. Busca, añadió, el restablecimiento de su salud, no una indemnización. Ello, argumentó, puede acarrear una merma en los recursos del servicio de salud, necesarios para mejoras de equipo, pago de medicamentos, y de instrumentos para brindar, adecuadamente, el servicio de salud, a través de profesionales preparados para ello. Se violó de forma directa dicho principio, dijo, al otorgarse un extremo indemnizatorio aduciéndose que no es suficiente con que se haya dado la prestación médica, pues, el hecho de esperar tanto tiempo par que se le practique el procedimiento médico ocasiona sentimientos o situaciones negativas en el ejecutante que merecen una indemnización. Conclusión a la que se arribó solo con el texto de la ejecución. El Juez transgredió dicho principio de razonabilidad, ya que, pese a que tuvo claridad de que operó una justicia restaurativa, le otorgó un monto pecuniario, bajo la premisa de que no es suficiente que se le haya realizado el procedimiento; sino que, una persona que se encuentra en una lista de espera o supere un plazo razonable de espera para que se le practiquen los procedimientos médicos o que se le atienda, merece una doble indemnización, lo cual genera un privilegio y un enriquecimiento sin causa alguna. No se sopesó que se le otorgó un privilegio sobre los demás asegurados, que se ven superados por la persona amparada en la lista de espera. Así fue previamente analizado por esta Sala, anotó, en la sentencia no. 1502-S1-2022, la cual reprodujo en lo de su interés. También, en la no. 297-F-S1-2024 de las 17 horas 27 minutos del 21 de marzo de 2024, que también copió en lo conducente. Esa situación, señaló, presentada al Juzgador, fue inobservada de forma directa e, incluso, dijo, se evidencia, de alguna forma, una posible existencia de un “animus” de condenar a su mandante bajo cualquier escenario. Es, alegó, contrario al principio de razonabilidad, pues, además de mermar los recursos con los que se cuenta para brindar el servicio de salud; otorga una posición de privilegio a la persona que recibió la atención requerida a cargo de quienes colaboran para que se brinde un adecuado servicio de salud. Por lo anterior, concluyó, otorgar una indemnización por concepto de daño moral, deviene en violatorio del principio de razonabilidad.\n\nXIII. En torno a lo señalado en el Considerando anterior, precisa indicar lo siguiente. PRIMERO. El objetante olvidó que esta instancia procesal no corresponde a un recurso ordinario (como es el de apelación). Tampoco resulta suficiente manifestar una serie de disconformidades generales y meramente argumentativas. Es menester el contraste de lo decidido con la infracción que, en su criterio, tuvo lugar. Al respecto, el numeral 139 inciso 3 del CPCA prevé un requerimiento de orden material necesario, tanto para la admisibilidad del recurso cuanto para su posterior valoración por el fondo. Se trata de la motivación del recurso que, por las características de la casación, ha de ser clara y precisa. En este sentido, debe contener, tal como lo dispone el precepto de comentario, la fundamentación fáctica y jurídica del caso. Fáctica, en la medida en que se muestre inconforme con los hechos que se han tenido por demostrados o por indemostrados (lo cual lleva a la ponderación de las probanzas), o con las circunstancias acaecidas en la violación de normas procesales. Jurídica, cuando se trata de un problema que se expone acerca de la aplicación, omisión o indebida interpretación de cualquier norma que integre el bloque de juricidad, incluidos, por supuesto, los principios de rango constitucional, o aquella que también opera por efecto reflejo o indirecto, después de que se modifican los hechos de la sentencia impugnada. Tanto en la infracción procesal, como en la probatoria, puede concurrir, junto con las razones jurídicas (siempre necesarias), las de carácter fáctico y, en ese sentido, los fundamentos de referencia deberán ser dirigidos en ambas vertientes, so pena de inadmisibilidad. Por su parte, es necesario aclarar que de la fundamentación jurídica se exonera, por expreso mandato legal, la indicación de aquellos cánones relativos al valor del elemento o elementos probatorios mal apreciados. De igual forma, resulta innecesario citar las normas que equivocadamente utilizó y mencionó el órgano jurisdiccional de instancia para emitir y razonar su decisión, porque constan en el mismo pronunciamiento recurrido. Y desde luego, no es para nada indispensable citar los preceptos que establecen los requisitos, plazos y reglas básicas para la admisión del recurso. Antes que la cita de estas últimas, lo imprescindible es que se cumplan, que se pongan en práctica al momento de elaborar e interponer la casación. Así las cosas, la fundamentación dispuesta por ley, puede entenderse, grosso modo, como aquella argumentación técnico-jurídica en la que se mencionan una serie de artículos, o reglas jurídicas entrelazadas o concatenadas entre sí y vinculadas razonablemente en una doble perspectiva: con los argumentos del recurso y con la sentencia que se ataca. En la medida en que se cite un conjunto de normas jurídicas (o si es del caso, una sola de ellas), atinente y vinculada de manera clara con la sentencia combatida (ya sea en el sustento de hecho o derecho) y los argumentos del recurso, hay fundamentación jurídica. Los agregados jurisprudenciales o las eventuales citas doctrinales, reforzarán en ocasiones las alegaciones efectuadas, pero, por lo general, no hacen a su esencia. Como ya lo ha indicado esta Sala interpretando el artículo 139 de referencia, “se requiere que el recurso cuente con una fundamentación jurídica mínima ... deben explicarse las razones en las cuales sustenta su gestión, combatiendo los argumentos de derecho de la sentencia recurrida y consignando, al menos, alguna referencia normativa que le dé sustento” (Resolución no. 318-A-2008, de las 14 horas 25 minutos del 8 de mayo del 2008). La fundamentación es, por tanto, ajena al despliegue confuso de normas y alegatos; a la mezcla de argumentos ininteligibles o a la simple exposición de opiniones sobre la procedencia o justicia del caso, o bien, al recuento de los desaciertos que se consideran cometidos en la sentencia recurrida, sin respaldo en normas o criterios jurídicos. De allí que, si el recurso omite por completo esa relación técnico-normativa a la que se ha hecho referencia, o la que realiza, resulta impertinente o desvinculada al caso de manera manifiesta y evidente, habrá que entender que carece de “total fundamentación jurídica”, y por tanto, incumple el necesario requisito establecido en el numeral 139.3, que se sanciona con el rechazo de plano, a tenor de lo dispuesto en el artículo 140 inciso c) del mismo Código de rito. del mismo Código de referencia. De igual manera, esta Sala, en forma reiterada, ha señalado, para que un recurso pase el control de admisión, se precisa, además de la suficiente exposición de motivos, la correspondiente mención y vinculación con la sentencia cuestionada de las normas aplicables que se estimen infringidas. En este sentido pueden consultarse, entre otras resoluciones, las nos. 677-A-S1-2021 de las 09 horas 40 minutos del 25 de marzo de 2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1029345); 755-A-S1-2022 de las 10 horas 55 minutos del 29 de marzo de marzo (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1082042); y 1663-A-S1-2022 de las 10 horas 05 minutos del 21 de julio (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112340) , ambas del año 2022.\n\nXIV. En esta línea de pensamiento, luego de un estudio concienzudo de la objeción en estudio, esta Sala determina que el casacionista alegó varias hipótesis disímiles, pero, por la manera como se estructuró, resultan inseparables entre sí. En este sentido, en las páginas 10 y 11 del recurso indicó: “Se observa en el párrafo antes copiado que, el Juez distingue que la conducta reprochada, le genero [sic] un daño moral a la actora [sic], y ello quedo [sic] determinado en sede Constitucional, no obstante, solo le basto [sic] para arribar a esa conclusión el texto con el que se promueve la ejecución del recurso de amparo. […] el hecho de esperar tanto tiempo para que se le practique el procedimiento médico ocasiona sentimientos o situaciones negativas en la actora, que merecen una indemnización, conclusión que arribo [sic] con solo el texto de la ejecución.” (Lo subrayado es suplido). De darse lo recriminado, originaría el motivo de casación por quebranto de normas sustantivas previsto en el inciso a) del canon 138 del CPCA, en virtud de la supuesta indebida valoración de la sentencia ejecutoria. No obstante, lo argüido es informal. El recurrente omitió señalar las normas sustantivas que resultaron quebrantadas por el desafuero alegado, con la explicación clara y precisa de cómo sucedió la transgresión, tal y como la técnica de la casación lo impone, según se expuso en el apartado anterior, a tenor de lo indicado en el numeral 139 inciso 3) íbid. En la página 10 añadió: “Nótese por parte de la honorable Sala Primera, que la sentencia de primera instancia prácticamente deja abierta la posibilidad a buscar [sic] de manera irrestricta el obtener dobles indemnizaciones, la de tipo material, al recibir la atención médica, y la de tipo pecuniaria, sin que medie prueba alguna sobre ello.” (Solo lo resaltado es del original). Lo ahora alegado, daría lugar al motivo casacional por violación de normas procesales previsto en el inciso 1) punto d) el canon 137 ibídem: falta de motivación. Empero, al igual que sucedió con el anterior, lo argumentado es informal, pues, el impugnante no indicó, con el rigor debido, las normas adjetivas que resultaron transgredidas, con la explicación clara y precisa de cómo sucedió la infracción. Luego, en las páginas 11 y 12, manifestó: “Aunado a lo anterior, el juez de primera instancia, alejándose del principio de razonabilidad, determina que el hecho que se haya dado la prestación, es insuficiente para hablar de justicia restaurativa en su totalidad, y que por ello debe haber también un resarcimiento económico […] En ese sentido, el juez de primera instancia viola de forma directa el principio de razonabilidad, al otorgar un extremo indemnizatorio, sosteniendo que no es suficiente con que se haya dado la prestación médica, siendo que el hecho de esperar tanto tiempo para que se le practique el procedimiento médico ocasiona sentimientos o situaciones negativas en la actora [sic], que merecen una indemnización, conclusión que arribo [sic] con solo el texto de la ejecución. / Sobre ello, el juez viola el principio de razonabilidad, siendo que pese a que tiene claridad de que opero [sic] una justicia restaurativa, le otorga un monto pecuniario, ello bajo la premisa de que no es suficiente que se le haya realizado el procedimiento, o atendido, sino que merece, una persona que se encuentra en una lista de espera y/o que supere un plazo razonable de espera para que se le practiquen los procedimientos médicos o que se le atienda, una doble indemnización, lo cual genera un privilegio y un enriquecimiento sin causa alguna. Amén de que, no sopesa que se le otorga un privilegio sobre los demás asegurados, que se vieron superados por la persona amparada, en la lista de espera. […] Esta situación, que como se infiere, le fue presentada el juez, fue inobservada de forma directa, e incluso, se evidencia de alguna forma, una posible existencia, se reitera, de un animus de condenar bajo cualquier escenario, lo cual se reitera, es contrario al principio de razonabilidad, toda vez que ello además de mermar los recursos con los que cuenta la Institución para brindar el servicio de salud, otorga una posición de privilegio a la persona que recibió la atención requerida, a cargo de quienes colaboren para que se brinde un adecuado servicio de salud.” (Lo resaltado es del original). Lo ahora expuesto daría lugar al motivo de casación por violación de normas sustantivas anunciado, por el supuesto quebranto del principio constitucional de razonabilidad. La ambigüedad puesta en evidencia riñe con la técnica de la casación, la cual impone que los motivos del recurso deben indicarse de manera clara y precisa, con la fundamentación fáctica y jurídica del caso (precepto 139 inciso 3) del CPCA). Ergo, se impone el rechazo de la objeción en estudio. \n\nXV. SEGUNDO. Lo argüido por la impugnante, tocante a que en esta lite operó la justicia restaurativa (sustento para alegar el quebranto al principio de razonabilidad), la inexistencia de urgencia en la cita del amparado, su consentimiento en permanecer en lista de espera y la improcedencia del otorgamiento de una indemnización por concepto de daño moral subjetivo, ya fue objeto de análisis en los apartados del VI al XI de esta sentencia, por lo que, a fin de evitar reiteraciones innecesarias, se remite a lo ahí expresado.\n\nXVI. En la tercera objeción, página 13 del recurso, anunció el recurrente interponerlo por el motivo casacional por quebranto de normas sustantivas previsto en el inciso c) del canon 138 del CPCA: “c) Cuando se haya aplicado o interpretado indebidamente una norma jurídica o se haya dejado de aplicar.” Invocó transgredidos los ordinales 46 del Decreto Ejecutivo no. 41457-JP del 17 de octubre de 2018, “Arancel de honorarios por servicios profesionales de abogacía y notariado” y 73.1 del Código Procesal Civil (CPC). En torno a las costas personales del recurso de amparo, dijo, el Juez de Ejecución se decantó por otorgarlas. Ello, pese a tener certeza de que, para presentar el recurso de amparo, no se requiere de patrocinio letrado. Incluso, añadió, el recurso de amparo que se ejecuta fue interpuesto por una fundación sin fines de lucro. Sostuvo que el derecho fue otorgado en la propia resolución emitida por la Sala Constitucional. Transcribió lo señalado en el Considerando IX del fallo objetado, denominado “SOBRE LAS COSTAS DEL AMPARO”. A pesar de que el recurso de amparo, señaló, fue presentado a través de una fundación sin fines de lucro, que promueve, según su publicidad, de manera gratuita la presentación de recursos de amparo, y que no le generó gasto alguno a la amparada que se haya demostrado, tomó la determinación de otorgar ese extremo. Se tiene claridad, indicó, que fue la “Fundación Derecho sin Fronteras” quien interpuso el recurso de amparo, utilizando, al efecto, la plantilla generalizada con la cual ha interpuesto más de 4.000 recursos de amparo -según su propio dicho, publicidad de su página-, los cuales gestiona de manera gratuita. El mismo principio de gratuidad, manifestó, debe aplicarse al caso, ya que, como fundación sin fines de lucro le basta, para su estigma, el favorecer a un usuario adelantando su cita, cirugía, y demás procedimientos médicos brindados por la CCSS. Coincidió con la autoridad judicial, aseveró, con que participó un profesional en derecho en el acompañamiento de la formulación de la plantilla. Empero, dijo, la gestión se formuló a través de una fundación sin fines de lucro, interponiendo de manera gratuita el recurso. En consecuencia, siendo que, para la presentación del recurso de amparo aplica el principio de gratuidad, la fundación es promotora del mismo principio, aunado a que, bajo la premisa de que no existe prueba alguna de gasto por parte de la amparada, ni factura presentada por el abogado a la fundación sin fines de lucro, lo procedente era la exoneración en costas. La sentencia cuestionada, alegó, aplicó indebidamente el artículo 46 del Decreto Ejecutivo no. 41457-JP. No existe, dentro del expediente, aseveró, prueba que acredite que la presentación, formulación y trámite del recurso de amparo le haya generado un costo a la ejecutante. Se tiene certeza, indicó, la fundación que interpuso el recurso lo gestionó de manera gratuita, por lo cual, no procede que se le otorgue esa compensación, siendo que, además, no hay prueba de gasto alguno. Por ello, afirmó, la gestión está cobijada bajo el principio de la gratuidad. El recurso de amparo lo presentó una fundación a través de su departamento legal. Gestión que se hizo de forma gratuita, como lo publicitan, y no existe prueba en el expediente que demuestre gasto o cobro alguno o salario de parte del profesional en la planilla de la fundación. Razón de más, dijo, para afirmar que la fundación promueve el bienestar de la población sin esperar nada a cambio. Fue la Fundación Derecho Sin Fronteras la que gestionó el recurso de amparo, por lo que es improcedente otorgar honorarios al amparo de lo preceptuado en el artículo 46 del referido Decreto no 41457 -JP. Reprodujo, en lo conducente, el precepto primero de ese cuerpo normativo. De conformidad con ese texto, indicó, sería válida la aplicación de ese Arancel de honorarios, en el tanto el profesional realice una prestación de servicios bajo el cobro de un canon. En esta lite, comentó, además de que el recurso es formulado por una fundación, no existe prueba que acredite el cobro de honorarios por el estudio, análisis, redacción y tramitación del recurso de amparo. Incluso, añadió, la premisa que sostiene la fundación que promovió el recurso, es que se brinda de forma gratuita. Consideró, al no haber honorarios que deban sufragarse por la formulación del recurso, pues, la gestión la hizo una fundación sin fines de lucro, que utiliza la misma plantilla -más de 4.000 casos-, y que el servicio lo brinda de manera gratuita. Por eso, anotó, el otorgar costas con base en el artículo 46 del indicado Decreto resulta improcedente. Transcribió el ordinal 73.1 del CPC. El mismo contenido de la norma establece que se considerarán costas los honorarios de abogado, la indemnización de tiempo invertido y gastos indispensables del proceso; de lo cual, anotó, no existe prueba ni referencia en la sentencia cuestionada. Siendo que la parte ejecutante no aportó prueba alguna de que haya mediado inversión de dinero por concepto de honorarios de abogado, aunado a que el recurso lo interpuso una fundación que brinda el servicio en forma gratuita, anotó, el Juez tenía compelido otorgar monto alguno por concepto de costas del recurso de amparo, en la figura de honorarios. No se tiene prueba de que hayan sido cancelados, al no existir medio probatorio que demuestre la participación de profesional en derecho contratado bajo remuneración para la tramitación del recurso de amparo. Al momento de su ejecución, aseveró, no entra dentro de los presupuestos del numeral 46 del Decreto. Para recibir indemnización plena de un gasto, indicó, debe, necesariamente, demostrarse. Lo cual no puede cohonestarse por parte de esa representación. No se presentó prueba alguna de que mediara ese gasto. Por lo que es ahí donde se encuentra claramente marcado el yerro de la sentencia: otorgar el monto por concepto de costas del recurso de amparo como si ello fuera por honorarios, sin que haya una prueba ínfima de ello. Deben quedar claras las razones por las cuales se otorgan las costas a una persona vencedora en un proceso judicial. El magistrado de la Sala Constitucional, don Fernando Castillo Víquez, dijo, en múltiples ocasiones, ha sido claro en ordenar, tanto a la CCSS, cuando se realiza la satisfacción extraprocesal de las condenas de la Sala Constitucional; como a la jurisdicción contencioso-administrativa, de asegurarse de que los importes otorgados efectivamente lleguen a manos de los amparados. Transcribió, en lo de su interés, lo expuesto en la nota separada del voto de esa Sala no. 2016-012528. La sentencia cuestionada, manifestó, debió rechazar dicho extremo, pues, al tenerse por acreditado que la gestora del recurso de amparo fue una fundación sin fines de lucro, que gestiona a favor de usuarios de forma gratuita recursos de amparo; además de que no existe prueba aportada del gasto que tiene la fundación para tener, dentro de su planilla o staff, profesionales que formulen los recursos de amparo, o que por ese benemérito servicio les genere un costo, ese extremo no se puede otorgar, menos, concluyó, con sustento en el artículo 46 del Decreto Ejecutivo no. 41457 -JP. \n\nXVII. En torno a lo expuesto en el apartado anterior, precisa indicar lo siguiente. PRIMERO. El casacionista, en las páginas 16 y 17 del recurso señaló: “Por lo anterior, se tiene que la sentencia debió haber rechazado dicho extremo, toda vez que, al tener acreditado que la gestora del recurso de amparo es una fundación sin fines de lucro, que gestiona a favor de usuarios de forma gratuita recursos de amparo, amén de que no existe prueba que haya sido aportada al proceso del gasto que tiene la fundación para tener dentro de su planilla o staff profesionales que formulen los recursos de amparo, y/o que por este benemérito servicio les genere un costo, ese extremo no se puede otorgar, y menos con sustento en el artículo 46 del Arancel de honorarios por servicios profesionales de abogacía y notariado”, N° 41457 -JP.” Lo expuesto constituye el meollo de lo argumentado por el impugnante en la censura en estudio. Empero, distinto a lo afirmado, en la sentencia ejecutoria no se tuvo por acreditado, tampoco en la ahora cuestionada, que quien formuló el recurso de amparo fuera una fundación sin fines de lucro denominada “Fundación Derecho sin Fronteras”. Por el contrario, en el encabezado del fallo en ejecución se indicó: “Recurso de amparo que se tramita en expediente No. 23-018591-0007-CO, interpuesto por LEONARDO GÓMEZ SALAZAR, cédula de identidad 0108760664, a favor de JOHNNY FRANCISCO VALVERDE PORRAS, cédula de identidad 0108500565, contra la CAJA COSTARRICENSE DE SEGURO SOCIAL.” (Solo subrayado es suplido). Por su parte, como bien lo indicó el propio casacionista, el Juez de Ejecución, en el apartado IX de la sentencia ahora objetada, fue enfático al indicar que en “[…] en autos queda plenamente demostrado que el Lic. Gómez Salazar fue el profesional en Derecho encargado de interponer y tramitar el recurso de amparo, a favor del señor Valverde Porras y eso es suficiente para demostrar las labores del Abogado en sede judicial.” (Lo subrayado es suplido). Por lo tanto, al no haberse acreditado (en sede constitucional ni en ejecución de la sentencia) que quien gestionó el recurso de amparo fuera la indicada Fundación sin fines de lucro, de darse lo argüido, originaría el motivo de casación por violación de normas sustantivas previsto en el inciso a) del ordinal 138 del CPCA. Empero, lo argumentado por el impugnante es informal. No identificó la probanza con la cual se demuestra su dicho; señalando, con claridad y precisión, tal y como la técnica de la casación lo impone, según se expuso en el Considerando XIII de esta sentencia, al amparo de lo preceptuado en el ordinal 139 inciso 3) del CPCA, cómo fue indebidamente apreciada. Lo expuesto impone el rechazo de plano de la objeción en estudio.\n\nXVIII. Sin perjuicio de lo anterior y, a mayor abundamiento de razones, es menester indicar lo siguiente. SEGUNDO. esta Sala, desde vieja data, ha señalado la diferencia entre costas personales y honorarios de abogado, concluyendo que las costas personales le pertenecen a la parte, no al letrado. Al respecto, pueden consultare, mutatis mutandis, los fallos nos. 432-F-S1-2017 de las 09 horas 30 minutos del 20 de abril de 2017 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-950854); 515-F-S1-2018 de las 11 horas 20 minutos del 30 de mayo de 2018 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-892742); 28-F-S1-2024 de las 11 horas 05 minutos del 11 de enero (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1208396) y 297-F-S1-2024 de las 17 horas 27 minutos del 21 de marzo (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250); ambas del año 2024. TERCERO. El CPCA, en el ordinal 193 regula, de manera expresa, la imposición de las costas; al igual que lo hace el canon 73.1 del CPC. Por consiguiente, es la norma del CPCA la aplicable a esta lite. No obstante, esta disposición no regula, como sí lo hace la del CPC, qué se consideran costas. Ergo, este principio procesal, al igual que los contenidos en los ordinales 76.1 y 76.4 íbid, en virtud de la remisión efectuada por el artículo 220 del CPCA, es de aplicación a esta lite. En este sentido, dispone el precepto 73.1 del CPC: “[…] Se considerarán costas los honorarios de abogado, la indemnización del tiempo invertido por la parte en asistir a los actos del procedimiento en que fuera necesaria su presencia y los demás gastos indispensables del proceso.” (Lo subrayado es suplido). En este mismo orden de ideas, los preceptos 76.1 y 76.4 íbid indican: “76.1 Derecho a honorarios y fijación. Los honorarios de abogado pertenecen a este, con las excepciones establecidas por ley. Cuando la parte fuera abogada y haya actuado personalmente tendrá derecho a ellos. Salvo pacto en contrario, se fijarán en atención al trabajo, al estado y la trascendencia económica del proceso, con base en lo dispuesto en la Ley N.° 13, Ley Orgánica del Colegio de Abogados y Abogadas, de 28 de octubre de 1941, y el decreto de honorarios de abogados y notarios. […] 76.4 Fijación contractual de honorarios de abogado. Los abogados y sus clientes podrán fijar contractualmente el monto de los honorarios y sus modalidades de pago respetando los límites impuestos por la ley y el decreto respectivo. Dicha estipulación no afectará a las partes contrarias del proceso, para efectos de fijación de costas personales.” (Solo lo subrayado es suplido). A la luz de lo dispuesto en dichas normas, es claro que, para efectos de las costas, los honorarios de abogado deben calcularse con base en los límites legales y las tarifas establecidas en el Decreto respectivo, independientemente de cualquier acuerdo privado entre el abogado y su cliente. Esto implica que, en la liquidación de costas, no es necesario que la persona ejecutante demuestre el convenio que tiene con su abogado o el pago que le haya realizado, ya que la normativa prevé que el cálculo de ese extremo debe realizarse de acuerdo con el arancel o decreto respectivo, a fin de asegurar un criterio objetivo en la liquidación de costas. Así, si una parte contó con patrocinio letrado en la tramitación de una causa y obtuvo a su favor el pago de las costas, el importe que se reconocerá como honorarios de abogado será, necesariamente, el que se establezca en el “Arancel de honorarios por servicios profesionales de abogacía”, según las labores efectuadas. Consecuentemente, no resulta indispensable que se aporte una factura o comprobante de pago a favor del profesional en derecho para que proceda el reconocimiento de ese extremo. En esta lite, se insiste, el objetante no acreditó que don Johnny Valverde Porras hubiese carecido de patrocinio letrado durante la tramitación del proceso de amparo; o que lo fuera a título gratuito. Por el contrario, como se indicó, de la sentencia ejecutoria se determina que su apoderado especial judicial en este proceso de ejecución fue quien presentó el recurso de amparo a su favor ante la Sala Constitucional. Esto permite colegir que dicho profesional defendió los intereses del amparado en sede constitucional. Ergo, la falta de presentación de la factura o comprobante de pago que reclamó el recurrente no es suficiente para demeritar o desestimar el rubro de costas personales liquidado por la parte y reconocido expresamente en el fallo ejecutorio. Se reitera, porque el ejecutante contó con patrocinio letrado durante la tramitación del amparo y obtuvo a su favor el pago de las costas. Es decir, tiene derecho a que se le reconozca como costas el monto que, por concepto de honorarios de abogado, establece el arancel aplicable. Corolario, esta Sala no observa las infracciones legales aducidas y, por consiguiente, se impondrá el rechazo del embate.\n\nXIX. En la cuarta y última censura, página 17 del libelo, anunció el objetante interponerla por el motivo casacional por quebranto de normas sustantivas previsto en el inciso c) del artículo 138 del CPCA. Alegó aplicación indebida del canon 193 íbid. En la sentencia impugnada, dijo, el Juez de Ejecución otorgó las costas del proceso de ejecución de sentencia. Estimó, no existe motivo para exonerar a su mandante, a pesar de su oposición en cuanto a que la parte ejecutante no pudo fundamentar el daño moral subjetivo y no aportó prueba o sustento técnico que demostrara la existencia de un nexo causal entre lo ordenado en el voto ejecutorio y los rubros específicos que se pretenden ejecutar. El referido canon, dijo, establece que la parte vencida será exonerada del pago de las costas cuando, por la naturaleza de las cosas debatidas, haya existido motivo bastante para litigar. Reprodujo el apartado XI de la sentencia impugnada, denominado, “SOBRE LAS COSTAS DE LA EJECUCIÓN”. El Juez, anotó, sopesó tanto la condena en costas del recurso como el daño moral otorgado para justificar la no exoneración en los términos del inciso 2 del indicado artículo 193 ejúsdem. De haber valorado de manera adecuada la prueba, dijo, y los alcances de lo mencionado, habría arribado a la conclusión que no era procedente la condena del daño moral, ni monto alguno por concepto de costas del recurso de amparo. Razón para afirmar que el canon otorgado por costas de la ejecución es improcedente. El Juzgador, comentó, aplicó indebidamente el susodicho precepto 193 inciso 2) íbid, pues, dicha norma establece que la parte vencida podrá ser exonerada del pago de las costas cuando, por la naturaleza de las cuestiones debatidas, haya existido motivo suficiente para litigar. Tomando en consideración extremos meramente aritméticos, y solo los montos otorgados, alegó, representan un total de ₡231.000,00. Esto implica que, arguyó, del total pretendido, la parte ejecutante obtuvo un 48,07% -sin contar las costas que no se han fijado de la ejecución-, lo que acarrea, contrario sensu, que no obtuviera un 51,98% de lo que buscaba obtener. En consecuencia, alegó, se denota que su representada debía litigar. Logró, añadió, que la parte ejecutante no obtuviese el total de sus pretensiones. Por ello, se cuestionó ¿cómo no fue siquiera ínfimamente visualizado por el Juzgador, quien desechó la tesis de que su mandante tenía motivos suficientes para litigar? Máxime estando frente a una ejecución de sentencia de un derecho concedido en abstracto, donde se estaba ante un escenario de petitorias extremas, que implicaban que esa representación debía ejercer la defensa de los intereses institucionales. Si el Juez hubiera valorado lo anterior, expuso, habría determinado que su representada tenía motivos para litigar. Entre distintos elementos, señaló, se tienen los siguientes: 1) se otorgó apenas un 48.07% del total pretendido; 2) se rechazó un 51.98% del total solicitado; 3) se está ante una pretensión con evidente búsqueda de obtener extremos por encima de lo que se puede considerar paralelo a la razonabilidad; y 4) esta Sala, en la sentencia no. 1502-S1-2022, indicó que resulta irracional imponerle al fondo de contribución tripartito de la seguridad social y, a los demás asegurados beneficiados con dichos fondos, una indemnización adicional a quien ha consentido la espera y recibido, por tutela judicial, la atención médica requerida. Aunado a ello, brindó pautas para determinar si debe mediar o no indemnización, como lo es, si el tipo de patología del paciente remite o no a una emergencia, o bien, la conformación con la inclusión en una lista de espera e, incluso, la indemnización “in natura”. Es decir, su representada partió de posiciones desarrolladas por esta Sala para litigar en el proceso, lo cual le fue señalado al Juez, sin que lo tomara en consideración. Por lo anterior, argumentó, es evidente que esa representación debía litigar en el proceso. No conforme con ello, el Juez decidió condenar en costas a su mandante, dejándola en una clara posición de vulnerabilidad y desventaja, pues, el defender, incluso, la sostenibilidad financiera de la Institución, es claramente un motivo suficiente para litigar. Por ello, señaló, se puede deducir, de forma directa, clara y sencilla, que su representada tenía motivos suficientes para litigar, en vista de que se estaba protegiendo, de forma efectiva, la hacienda pública, en defensa de los pocos recursos que tiene. Se vio obligada a oponerse a la demanda, al considerar irrazonable y desproporcionada la cantidad solicitada por el ejecutante por concepto de daño moral subjetivo -₡300.000,00- circunstancia que llevó a que dicho monto fuera rechazado en sentencia y se redujera a ₡50.000,00. Habiéndose expuesto los motivos para recurrir tanto el rubro de daño moral como el de las costas del recurso de amparo, y encontrando asidero las razones para casar esos extremos, al acogerse el reclamo contra ellos, varía el sustento por el cual la autoridad judicial no exoneró a su representada. Razón que justifica el motivo para recurrir ese extremo. Llevando razón en los argumentos expuestos, y de haberse aplicado adecuadamente el artículo 193 inciso b) del CPCA, el Juez hubiera eximido a su mandante del pago de las costas del proceso de ejecución, dado que es evidente y manifiesto, además de simple constatación, anotó, el hecho de que se tenía motivo suficiente para litigar el presente proceso. Por lo que, concluyó, debe acogerse el presente agravio y casarse la sentencia.\n\nXX. En torno a lo expuesto en el Considerando anterior, es menester indicar PRIMERO. Luego de un estudio concienzudo del reparo en estudio, esta Sala arriba al convencimiento de que el recurrente invocó varias hipótesis disímiles entre sí, pero, por la manera como estructuró la objeción resultam indivisibles. En este sentido, en la página 18 del recurso señaló: “En tal sentido de haber valorado de manera adecuada la prueba, y los alcances de lo mencionado, habría arribado a la libre convicción, que no es procedente la condena del daño moral, ni monto alguno por concepto de costas del recurso de amparo, razón para afirmar que el canon otorgado por costas de la ejecución es improcedente.” Lo argüido, de darse, originaría el motivo casacional por quebranto de normas sustantivas previsto en el ordinal 138 inciso a) del CPCA, por la indebida apreciación probatoria. No obstante, resulta informal. El recurrente no individualizó medio de convicción alguno, explicando cómo fue transgredido por la sentencia objetada, tal y como la técnica de la casación lo impone, según ya se ha señalado. Por otro lado, en esa misma página 18 invocó la infracción, por errónea aplicación, del ordinal 193 inciso b) del CPCA, ya que, en su criterio, por la naturaleza de las cuestiones debatidas, a su mandante le asistía suficiente motivo para litigar. Ello por cuanto, según indicó, los montos otorgados al ejecutante ascienden a un total de ₡231.000,00. Es decir, un 48.02% de lo pretendido. Esto significa, acorde con su criterio, que su representada debía litigar en esta lite. Al respecto, lo indicado daría lugar al motivo casacional anunciado, previsto en el inciso c) del precepto 138 del CPCA. Luego, en las páginas 18 y 19 señaló: “[…] no se entiende cómo, no fue ni siquiera ínfimamente visualizado por el juez de primera instancia, quien, desecha la tesis de que mi representada sí tenía motivos suficientes para litigar el proceso de ejecución de sentencia, máxime estando frente a una ejecución de sentencia de un derecho concedido en abstracto, donde prácticamente se estaba ante un escenario de petitorias extremas, que implican que esta representación debiera ejercer sin discusión alguna, la defensa de los intereses institucionales. / Si el juez de instancia hubiera valorado lo anterior, habría determinado que mi representada tenía motivos de sobra para litigar el proceso judicial, toda vez que, entre distintos elementos, se tienen los siguientes: […]”. (Lo subrayado es suplido). En lo ahora expuesto, el recurrente aludió al motivo casacional por quebranto de normas procesales, previsto en el artículo 137 inciso 1) punto d) del CPCA: falta de motivación. Empero, lo argüido es informal, al omitir señalar la norma procesal conculcada, con la explicación clara y precisa de cómo sucedió la infracción, tal y como la técnica de la casación lo impone. Como ya fue expuesto en el apartado XVI de esta sentencia, la confusión puesta en evidencia, riñe con la técnica de la casación, la cual impone que los motivos del recurso deben indicarse de manera clara y precisa, con la fundamentación fáctica y jurídica del caso (precepto 139 inciso 3) del CPCA). Ergo, se impone el rechazo de la objeción en estudio. \n\nXXI. SEGUNDO. Sin perjuicio de lo antes expuesto y, a mayor abundamiento de razones, es menester indicar lo siguiente. En las páginas 19 y 20 indicó el recurrente: “Aunado a que, habiéndose expuesto los motivos para recurrir, tanto el canon del daño moral, como de las costas del recurso de amparo, encontrando asidero las razones para casar estos extremos, al acogerse el reclamo contra los mismos, varía el sustento por el cuál la autoridad judicial no exonera a mi representada, razón demás que justifica el motivo para recurrir este extremo. / Por lo que, llevando razón en los argumentos expuestos, y de haberse aplicado adecuadamente el artículo 193 inciso b) del Código Procesal Contencioso Administrativo, el juez de primera instancia hubiera eximido a mi representada del pago de costas de la ejecución, dado que es evidente y manifiesto, además de simple constatación, el hecho de que se tenía motivo suficiente para litigar el presente proceso, por lo que se estima que debe acogerse el presente agravio, y casarse la sentencia.” Lo expuesto no pasa de ser un alegato argumentativo ayuno de todo sustento fáctico y jurídico. Configura una expectativa del casacionista que, por las razones expuestas al estudiar cada agrario, no se configuró. Se brindaron los criterios por las cuales esta Sala estima la improcedencia de cada uno de ellos, motivo por el cual, distinto a lo argumentado, no ha variado el sustento para imponerle el reconocimiento de las costas del proceso de ejecución a la parte ejecutada.\n\nXXII. TERCERO. Acorde a lo expuesto en la contestación de la demanda, imágenes de la 31 a la 147 del expediente judicial electrónico, el apoderado general judicial de la CCSS alegó y solicitó que su mandante no debía ser condenada al pago del daño moral subjetivo, pues, el ejecutante no aportó elemento de juicio alguno -acorde a lo previsto en los cánones 180 inciso 1 del CPCA y 41.1 del CPC-, ni mencionó alguno que acreditara lo expuesto en la demanda, mucho menos, el fundamento para solicitar dicho extremo en el monto pretendido. Por el contrario, el Juzgador de Ejecución determinó la existencia del daño moral subjetivo en virtud de los hechos que sirvieron de base para el acogimiento del recurso de amparo, lo cual fue avalado por esta Cámara, según se expuso. Además, fijó su cuantía acorde a su prudente arbitrio y al amparo de los principios de razonabilidad y proporcionalidad, lo cual también fue compartido por este órgano decisor. De igual manera, se otorgó el monto peticionado por costas personales del recurso de amparo. También, se concedieron los réditos legales sobre los montos concedidos y las costas del proceso de ejecución, tal y como se solicitó. Corolario, distinto a lo expuesto por la recurrente, y como bien fue resuelto, se imponía condenar al pago de las costas del proceso de ejecución, según lo dispone el canon 193 del CPCA, al no concurrir ninguno de los motivos de exoneración previstos en esa norma. CUARTO. Tal y como se apuntó en el apartado XV de esta sentencia, lo indicado por la impugnante, tocante a la existencia de justicia restaurativa y la inexistencia de urgencia en la cita del amparado, el haberse consentido en la espera y la improcedencia del otorgamiento de una indemnización por concepto de daño moral subjetivo, ya fue objeto de análisis en los apartados del VI al XI de esta sentencia, por lo que, a fin de evitar reiteraciones innecesarias, se remite a lo ahí expresado.\n\nXXIII. En mérito de las razones indicadas, se impone el rechazo del recurso interpuesto. De conformidad con lo expuesto en el artículo 150 inciso 3) del CPCA, al no considerar esta Sala que al ente casacionista le asista motivo suficiente para recurrir, por las razones expuestas al analizarse cada agravio, se le impondrá el reconocimiento de las costas del recurso de casación, las cuales deberán liquidarse en la fase de ejecución de la sentencia, a fin de garantizar el derecho de defensa de la parte ejecutada, dándosele la audiencia respectiva de la liquidación que se presente (artículos 41 y 153 de la Constitución Política).\n\nXXIV. VOTO SALVADO DE LA MAGISTRADA ROJAS MORALES. Me apartó del criterio de mayoría en cuanto estima procedente condenar a la demandada al pago del daño moral subjetivo. Respecto de los daños y perjuicios que se derivan de un fallo de la Sala Constitucional, al declarar con lugar un recurso de amparo, conviene tener presente que, dada su naturaleza este tipo de sentencias contienen una condenatoria en abstracto, sin ninguna consideración fáctica, no prejuzga, por no haber sido objeto de análisis, sobre su existencia, ni su nexo de causalidad o cuantificación. Dicho Tribunal se limita a determinar la violación constitucional. Al ejecutar esos extremos debe establecerse la relación de causalidad entre lo declarado en abstracto y el asunto concreto. Así las cosas, el hecho de que la Sala Constitucional condene en abstracto al pago de daños y perjuicios, no trae aparejada una condenatoria automática a ejecutar, como mal parece entenderlo el Juez Ejecutor. Corresponde a los jueces encargados de resolver sobre la liquidación, valorar en cada caso concreto la existencia de mérito suficiente para conceder la indemnización peticionada. En esa dirección han de analizarse: las circunstancias particulares del caso, la posición de las partes, naturaleza, objeto y finalidad del resarcimiento, así como, los principios constitucionales de razonabilidad y proporcionalidad. Además, cuando el asunto verse sobre un supuesto daño moral subjetivo sufrido por una persona que enfrenta una falta de atención médica, como sucede en la especie, deviene indispensable el examen de aristas adicionales. En primer término, ha de valorarse el factor: urgencia, pues resulta evidente que no se encuentra en igual situación quien requiere, una atención urgente por parte de la CCSS, por ejemplo: aquel administrado que padece de un cáncer el cual avanza de manera irremediable, a quien presenta una dolencia, le ha sido prescrita una intervención quirúrgica o una cita médica sin carácter apremiante, en ambos casos el tiempo de espera para recibir el servicio médico no tiene el mismo resultado. Así tampoco, la afectación moral será de igual intensidad. Por otra parte, debe analizarse la inactividad del paciente por el trascurso del tiempo en la lista de espera (canon 30 inciso ch) de la Ley de la Jurisdicción Constitucional -LJC- y 38 del Código Procesal Contencioso Administrativo), la cual cesa cuando acude en amparo ante la Sala Constitucional o bien, a los tribunales de justicia, para reclamar la atención o el tratamiento médico que necesita (actividad administrativa). Tómese en cuenta, el trascurso del tiempo sin gestionar tiene en el ordenamiento jurídico costarricense consecuencias claras sobre la caducidad de la acción, aspecto valorable de oficio. No puede derivarse una ventaja pecuniaria de la inactividad, pues ello se enfrenta al principio de proporcionalidad en sentido estricto. En tercer lugar, ha de ponderarse la satisfacción que tiene la orden de un tribunal de justicia, mediante la cual se dispone la práctica de un acto médico o la entrega de medicamentos (aún sí surge en razón de una medida cautelar). Incluso, la más reciente jurisprudencia de la Sala Constitucional ha valorado la satisfacción generada a partir de la notificación del curso del amparo. Se trata de aquellos casos en que, con ocasión del amparo y al margen del tiempo trascurrido entre la interposición del recurso y la respuesta administrativa recibida, la autoridad recurrida reconoce al administrado la atención médica requerida (otorgando fecha cierta para una cirugía o consulta médica, brindando el medicamento necesitado, reprogramando una cita, etc). Casos, de última resolución vinculante erga omnes (según ordinal 13 de la LJC), en los que los Juzgadores Constitucionales han considerado improcedente condenar en costas, daños y perjuicios, resolviendo incluso sin condenatoria en esos aspectos; los que deben ser valorados por esta Cámara al pronunciarse sobre los procesos en curso. En ese sentido pueden consultarse, entre otras, las sentencia números: 2024-000017 de las 9 horas 15 minutos del 9 de enero de 2024, 2024-000026 de las 9 horas 15 minutos del 9 de enero de 2024 y 2024-006673 de las 9 horas 15 minutos del 8 de marzo de 2024. Valga destacar, otorgar el servicio médico requerido constituye una manifestación de justicia restaurativa, la que este Órgano Decisor debe valorar. La indemnización otorgada en infracción de los razonamientos enunciados se torna irrazonable y desproporcionada, máxime cuando en un sistema de seguridad social universal, como el costarricense, tales indemnizaciones las pagan todos los asegurados, inclusive aquellos desplazados por el ejecutante. Al examinar los aspectos descritos y el caso particular del señor Johnny Francisco Valverde Porras deviene improcedente indemnizar la afectación anímica concedida en sentencia. Consta en autos, el 24 de febrero de 2023, el Servicio de Neurocirugía del Hospital Monseñor Víctor Manuel Sanabria de Puntarenas, le expidió a don Johnny una solicitud de hospitalización para cirugía, sin fecha cierta. El 4 de agosto de 2023 acudió en amparo ante la Sala Constitucional, es decir; durante aproximadamente seis meses se mantuvo a la espera que se le programara la intervención. Hay que tomar en cuenta las posibilidades de la seguridad social en un área como la de Neurocirugía, en que no hay suficientes especialistas que atiendan la población, máxime que la cantidad de personas que requieren intervención en esa área va en aumento. Por otra parte, interesa advertir, aun y cuando el Hospital Monseñor Víctor Manuel Sanabria le extendió orden de hospitalización para cirugía, no lo hizo con carácter urgente. Aunado a lo anterior, es un hecho no controvertido que, como consecuencia del fallo constitucional el señor Valverde Porras recibió la atención médica requerida, toda vez que la intervención quirúrgica se realizó el 16 de noviembre de 2023 (así indicado en el oficio HMS-DG-0513-2024 del 14 de febrero 2024, emitido por el señor Randall Álvarez Juárez, Director General del Hospital Monseñor Sanabria). Es decir, el único tiempo de espera que soportó el ejecutante para recibir la atención necesitada fueron alrededor de tres meses, contados desde que interpuso el recurso de amparo el 4 de agosto de 2023 y hasta que se practicó la cirugía el 16 de noviembre siguiente. Incluso, ese plazo es menor si se toma en cuenta que el fallo ejecutoriado se notificó el 23 de agosto de 2023. Plazos de suyos razonables desde el punto de vista de la prestación de un servicio no urgente y ante la necesidad de cumplir los requisitos preoperatorios que trae aparejada toda intervención quirúrgica. Téngase presente, a partir de la interposición del amparo el ejecutante nunca fue sometido a una espera prolongada o indefinida. La atención médica la recibió en un plazo más que razonable (inclusive menor a los periodos de atención en la medicina privada). Sin obviar, que la cita de valoración le fue programada sin carácter de urgencia. Lo anterior dice de la inexistencia del daño liquidado. Valga acotar, en casos como el de estudio, no cabe duda, la satisfacción del usuario ya se generó, por lo tanto, deviene contrario a derecho otorgar una indemnización adicional a la recibida (valoración médica en derogación singular de la lista de espera). Lo anterior, lejos de causarle una afectación moral a la ejecutante, le otorgó un privilegio sobre los demás asegurados, lo cual desmerece el reclamo por daño moral planteado. Resulta irracional imponerle al fondo de contribución tripartito de la seguridad social y, a los demás asegurados beneficiados con dichos fondos, una indemnización adicional a quien ha recibido por tutela judicial la atención médica requerida. Por las razones indicadas, la indemnización concedida no se ajusta a criterios de razonabilidad y proporcionalidad (fijados por la propia Sala Constitucional). En mérito de lo expuesto, estima la suscrita, lo procedente era acoger los agravios primero y segundo del recurso interpuesto y en consecuencia, anular el fallo impugnado -solo- en cuanto reconoció el monto de ¢50.000,00 por concepto de daño moral subjetivo, para en su lugar, fallando por el fondo, rechazar dicho extremo.\n\nPOR TANTO\n\n Por mayoría, se declara sin lugar el recurso, con sus costas a cargo del ente casacionista, Caja Costarricense de Seguro Social, las cuales se liquidarán en la etapa de ejecución de sentencia. La magistrada Rojas Morales salva el voto para acoger el recurso en virtud de haberse configurado la justicia restaurativa. mja. \n\n \n\n \n\nRocío Rojas Morales\n\n \n\nDamaris Vargas Vásquez\n\n \n\nJorge Leiva Poveda\n\nCarlos Guillermo Zamora Campos\n\n \n\nIgnacio Jose Monge Dobles\n\n \n\n \n\nDocumento Firmado Digitalmente\n\n-- Código verificador --\n\n\n\n GRVXS1NVCFE61 \n\nTeléfonos: (506) 2295-3658 o 2295-3659, correo electrónico sala_primera@poder-judicial.go.cr",
"body_en_text": "**Review of the Document**\n\nExp. 23-004070-1028-CA\n\nRes. 000258-F-S1-2025\n\nFIRST CHAMBER OF THE SUPREME COURT OF JUSTICE. San José, at twelve hours twenty-two minutes on the twentieth of February, two thousand twenty-five.\n\nEnforcement process of the judgment issued by the Constitutional Chamber of the Supreme Court of Justice in an amparo appeal filed by LEONARDO GÓMEZ SALAZAR, attorney, holder of identity card number 108760664 and bar association number 17,049, in his capacity as special judicial representative of JOHNNY FRANCISCO VALVERDE PORRAS, operator, holder of identity card number 108500565 against the CAJA COSTARRICENSE DE SEGURO SOCIAL, with legal identification number 4-000-042147, represented by its unlimited-sum general judicial representative, Michael Montoya Jiménez, attorney, holder of identity card number 108930513 and bar association number 17,385. The general judicial representative of the executed entity filed a cassation appeal challenging judgment number 2024001065 at 07 hours 41 minutes on May 17, 2024, issued by the Juzgado Contencioso Administrativo y Civil de Hacienda of the Second Judicial Circuit of San José, comprised of judge José Andrés Cruz Tenorio.\n\nDrafted by Magistrate Leiva Poveda\n\n**CONSIDERANDO**\n\n**I.** The Constitutional Chamber of the Supreme Court of Justice, through judgment number 2023020609 at 09 hours 45 minutes on August 22, 2023, granted the amparo appeal filed by attorney Leonardo Gómez Salazar on behalf of Johnny Francisco Valverde Porras against the Caja Costarricense de Seguro Social (CCSS). Said appeal, filed before that Chamber on August 4, 2023, originated from the violation of the fundamental right to health. The protected party is a patient at the Hospital Monseñor Víctor Manuel Sanabria in Puntarenas. He was evaluated in the Neurosurgery Service of that hospital on February 2, April 23, and June 21, all of the dates in 2021; February 9 and October 21, both in 2022; and February 24 of 2023. He was diagnosed with HD C4-C5/C5-C6/C6-C7. It was documented: “L1 L2 DISC HERNIATION CANAL 10.3 MM WITHOUT FORAMINAL STENOSIS”, which requires surgical instrumentation\". On February 24, 2023, he was evaluated for the last time and a hospitalization request was issued \"for anterior cervical approach + discectomy C4-C5/C5-C6/C6-C7 + fusion with locked cage\". At the time the amparo appeal was filed, a date for the required surgical procedure had not been scheduled for Mr. Johnny. In this regard, that Chamber considered: “[…] this Chamber found a violation of the protected party’s fundamental right to health to be proven. It was demonstrated that he was placed on a surgical waiting list on February 24, 2023, and as of the date the respondent medical authority submitted its respective report – August 17, 2023 – almost 6 months of waiting and uncertainty regarding said intervention have elapsed. As such, this Constitutional Court considers it unreasonable to subject the protected party to an indefinite wait for the surgery he requires, especially when the ailment affecting him constantly interferes with his enjoyment of quality of life. Furthermore, the Administration must promptly and timely execute the necessary actions to safeguard the health and life of its users. Consequently, it is appropriate to grant the appeal with the order that, within a period of 3 months, counted from the notification of this judgment, the protected party undergo surgery at the respondent hospital, under the responsibility of his treating physician.” It ordered the acting Director General of the referred hospital to issue the pertinent orders and carry out the actions within the scope of their competencies, so that, within the indicated three-month period, counted from the notification of that judgment, the prescribed surgery be performed on the protected party. All this, under the criteria and responsibility of his treating physicians and if another medical cause does not prevent it. It warned that, according to the provisions of Article 71 of the Ley de la Jurisdicción Constitucional, imprisonment of three months to two years, or a fine of twenty to sixty days, will be imposed on anyone who receives an order that must be fulfilled or enforced, issued within an amparo appeal, and fails to fulfill or enforce it, provided the crime is not more severely penalized. It ordered the CCSS to pay the costs, damages, and losses caused by the facts that served as the basis for this declaration, which, it ordered, shall be liquidated in an enforcement of judgment proceeding of the contentious-administrative jurisdiction.\n\n**II.** In a brief uploaded to the electronic judicial file on December 20, 2023, at 12:49:27, images 02 to 26, attorney Gómez Salazar, in his capacity as special judicial representative of the executing party, Johnny Francisco Valverde Porras, submitted the corresponding liquidation to the court. He requested that the following items be granted: 1) the executed entity be ordered to pay the costs of the judgment enforcement process; 2) ₡181,500.00 for the personal costs of the amparo appeal; 3) ₡300,000.00 for subjective moral distress (daño moral subjetivo); and 4) the payment of statutory interest, from the moment the judgment becomes final until its effective payment. By resolution at 13 hours 51 minutes on January 17, 2024, images 28 and 29, the Judge, Giovanni Marchena Jara, admitted the claim. In a brief uploaded to the electronic judicial file on February 14, 2024, at 16:15:47, images 31 to 147, the CCSS's unlimited-sum general judicial representative, Montoya Jiménez, opposed the liquidation. He raised the defense of lack of right. In the now challenged judgment, judge José Andrés Cruz Tenorio ordered the CCSS to pay: 1) ₡50,000.00 for subjective moral distress; 2) ₡181,500.00 for the personal costs of the amparo appeal; 3) statutory interest on said amounts from the finality of that resolution until its effective payment; and 4) the costs of the judgment enforcement process and its accrued interest from the finality of the resolution fixing them until their cancellation. In disagreement, the general judicial representative of the CCSS filed a cassation appeal. In disagreement, the general judicial representative of the CCSS filed a cassation appeal. For its resolution, the brief uploaded to the virtual desktop of this Chamber on February 13, 2025, at 09:20:53, signed by attorney Gómez Salazar, was considered.\n\n**III.** In the first objection, page two of the brief, the appellant announced filing it based on the cassation ground of violation of substantive norms provided in subsection a) of canon 138 of the Código Procesal Contencioso Administrativo (CPCA): \"A cassation appeal for violation of substantive norms of the legal system shall also proceed, in the following cases: / a) When an improper assessment is attributed to the evidence or it has been pretermitted.\", due to the improper assessment of the enforceable judgment from the constitutional amparo appeal. He invoked the violation of canon 196 of the Ley General de la Administración Pública (LGAP). The challenged judgment, he noted, based its reasoning for granting subjective moral distress on a factual element, but without analyzing the aspects contained in this Chamber's line of rulings. He alluded to ruling no. 297-F-S1-2024 at 17 hours 27 minutes on March 21, 2024 (mentioned in the response to the claim). Within those aspects, he cited the determination of extreme need of the patient's case from a medical point of view (urgency), their consent to be on a waiting list, or the existence of physical harm. Likewise, he cited rulings nos.: 1502-S1-2022 at 11 hours 24 minutes on September 1; 1823-F-S1-2022 at 14 hours 26 minutes on August 4; 2429-F-S1-2022 at 14 hours 16 minutes on November 3; all three from the year 2022; and 28-F-S1-2024 at 11 hours 05 minutes on January 11, 2024. He reproduced, in what was of interest, the consideration in section VIII of the challenged ruling, titled \"ON THE MERITS OF THE MATTER,\" regarding the evidence to grant subjective moral distress. From the transcribed text, he alleged, it is observed that the Judge pointed out the conditions of the plaintiff and the legal-material situation arising from the amparo appeal, given that the executing party was placed in a disproportionate waiting period for evaluation and medical care, without the required service being provided. With the mere enforceability of a judgment, he noted, the Judge could determine that the Administration caused him \"emotional impairment (menoscabo emocional),\" without considering the factors of restorative justice, urgency, patient consent, which were brought to his attention in the response to the claim. He even added that the judge used the same template to justify his judgment against the CCSS. He requested that said resolutions be evaluated \"ad effectum videndi,\" since the Judge is acting contrary to what this Chamber has ordered. He transcribed the proven facts of the enforceable judgment. They make no reference whatsoever, he stated, to the worsening of the patient's condition, nor that he suffered \"emotional impairment.\" The challenged ruling, he indicated, directly violated the indicated numeral 196 of the LGAP, by having determined the existence of an injury (lesión) and harm, based on an enforceable judgment. That required, he asserted, technical proof to demonstrate it. This is aggravated, he affirmed, by the fact that, for the Judge, it is not sufficient that restorative justice was provided—medical care—even before the expiration of the period ordered by the Constitutional Chamber, since, for him, there was a violation of the fundamental right to health, and the care does not eliminate the Institution's obligation to compensate him for the untimely care. He copied a fragment of a judgment that does not coincide with the one challenged, as, in the reproduced text, it refers to the Optometry Service, which bears no relation to the protected party's condition. The objected ruling, he noted, violated said precept—196 of the LGAP, which provides that the harm must be effective, assessable, and individualizable, concerning a person or group. Starting from the judgment of the amparo appeal, due to the executing party's placement on a waiting list, he noted, there is no proof whatsoever of his emotional distress. Nor, he said, of the injury suffered. That legal concept, he pointed out, refers to harm, whether resulting from a lack of equivalence between what is given and received in an onerous contract, or from a crime where a person's body is diminished or violated; or an organic or functional disturbance of an individual. That is, he noted, the Judge, based on a simple enforceable judgment, validated and determined the existence of an injury to the patient, without specifying what type of injury, nor having technical proof to certify it, from any angle, which means the harm is neither real nor effective, directly violating the referred canon. The judicial authority, he indicated, did not consider the factors of restorative justice, urgency, patient consent, reiterated in this Chamber's case law. He cited—according to the order of presentation—judgments nos. 28-F-S1-2024 at 11 hours 05 minutes on January 11; 297-F-S1-2024 at 17 hours 27 minutes on March 21, both from 2024; 1502-F-S1-2022 at 11 hours 24 minutes on September 1; 1823-F-S1-2022 at 14 hours 26 minutes on August 4; and 2429-F-S1-2022; the three from 2022. He added a table where he set out, in his opinion, what was specified in each of those rulings. These resolutions, he stated, besides being public knowledge, were not weighed in the case under study, even though, he noted, those from 2022 were pointed out to the Judge, who must know that case law is a means for integrating, understanding, and applying the Law. However, he stated, with an \"animus\" to condemn, the Judge ignored that line of rulings and decided to condemn his represented party for an injury allegedly caused to the executing party, without having proof of that injury, apparently suffered, based solely on the enforcement of the amparo appeal and without weighing the scope of restorative justice, as this Chamber has contextualized it. If the Judge had duly analyzed the evidence, he asserted, he would have determined that an enforceable judgment is insufficient to determine the appropriateness of subjective moral distress. Even more so, considering that placing a person in a waiting period for medical consultations and procedures is not, \"per se,\" a sufficient reason to grant compensation. On this, he indicated that this Chamber established, in resolution no. 1502-S1-2022 at 11 hours 24 minutes on September 1, 2022, that regarding compensation for amparo appeals due to placement on waiting lists, it is irrational to impose on the tripartite social security contribution fund a compensation payment to someone who has consented to a wait for required medical care. This, he stated, was pointed out to the jurisdictional authority. However, he noted there is an \"animus\" to condemn the CCSS at all costs (and, of course, the contributors), without any support whatsoever from an evidentiary point of view. If the Judge had properly assessed the evidence, he pointed out, the reasoning of the ruling would be different. He concluded that it would have been determined that the evidence was insufficient to establish the existence of any type of harm.\n\n**IV.** Regarding the matters set forth in the preceding section, it is necessary to note the following. FIRST. It must be recalled that, in judgment enforcement processes in general, and mainly those issued by the Constitutional Chamber, the enforced matter must necessarily be constrained to what was resolved in the amparo judgment subject to enforcement. This Chamber has indicated that the judgment enforcement process seeks to materialize the abstract condemnation imposed on the losing party. If aspects different—or contrary—to the pronouncement giving rise to the enforcement are granted, or against persons who were not condemned, the principle of res judicata is violated. See, among other rulings of this deciding body: 383-2019 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-925036) and 309-2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1024927). Consequently, the oversight function of this Chamber is constrained to an objective comparison between the enforceable judgment and the appealed resolution. In this regard, resolutions nos. 82-A-S1-22 at 10 hours 06 minutes on January 26 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1072742) and 1984-F-S1-2022 at 11 hours 18 minutes on September 8, both from the year 2022 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112319), can also be consulted, among many others.\n\n**V.** As noted in Considerando I of this judgment, the Constitutional Chamber, in the ruling being enforced, granted the amparo appeal filed by the protected party, having deemed it proven that on February 24, 2023, he was evaluated, and the hospitalization request was issued at the Hospital Monseñor Sanabria for \"anterior cervical approach + discectomy c4-c5/c5-c6/c6-c7 + fusion with locked cages\". However, at the time the amparo appeal was filed, on August 4 of that year, no date had been scheduled for the required surgical procedure. Therefore, that Chamber considered the time elapsed up to that point, almost six months, to be disproportionate and violative of his fundamental right to health. Thus, it granted the amparo appeal and ordered both the acting Director General to issue the pertinent orders and carry out all actions within the scope of her competence, so that, within a period of three months from the notification of that judgment, the prescribed surgical intervention be performed on the protected party. As can be clearly inferred, the Constitutional Chamber granted the appeal because it considered the time the protected party had been on the waiting list was disproportionate and violated his fundamental right to health, considering his pathology. Precisely, the Enforcement Judge, in section VIII of the challenged judgment, adhering to what was resolved in the constitutional venue, considered in what is of interest: “[…] the alleged moral distress is not demonstrated in the constitutional venue, but rather in the stage we are dealing with, and since it concerns subjective moral distress, it can be proven through human presumptions and the prudent discretion of the Judge, provided its accreditation and quantification fully conform to the circumstantial elements of the generating event itself, an event which in this specific case is the fact of subjecting the protected party to an indefinite wait for the surgery he required. […] the record demonstrates the surgery that took place and, moreover, it is evident that Mr. Valverde Porras’ condition, although it caused him unbearable pain and affected the normal development of his daily life, was technically not urgent nor did it represent any immediate risk; however, what must be highlighted is that the violation of the fundamental right to health had already been configured, and both the medical care and the surgery in question were performed by order of the Constitutional Chamber, and the fact that the patient received care, even before the expiration of the period ordered by the Chamber, does not eliminate the institution's obligation to compensate him for the unreasonable waiting time (in the Chamber's view) on the corresponding list, before undergoing surgery. […] however, in accordance with the provisions of Articles 190, 196, and 197 of the Ley General de la Administración Pública, a causal link does exist between the conduct of the Hospital Monseñor Sanabria and the subjective moral distress, that is, between the unreasonable and indefinite waiting for the surgical intervention and the situations of anguish, insecurity, instability, and uncertainty caused to Mr. Valverde Porras, situations which, I reiterate, do not require direct evidence for their demonstration, as they can be proven through human presumptions. […] it has already been demonstrated that Mr. Valverde Porras’ condition, although it caused him pain and complications in his daily life, was not urgent; however, the fact that the care was not urgent was not an impediment nor a justification for the Constitutional Chamber to declare a violation of the fundamental right to health; hence, the event generating the Administration's liability did not depend on the urgency of the care, but rather was configured by the unreasonable delay in that care and the indefinite wait, which motivated the amparo appeal to be granted and is being enforced in this venue. […] it is more than evident that the harm and the negative feelings it generates arise from the unreasonable time on the waiting list (in the Chamber's view), and furthermore, I reiterate, subjective moral distress does not require direct evidence for its demonstration […] the fact of waiting so long for a surgical intervention for which a hospitalization request already existed caused the Constitutional Chamber to grant the amparo appeal, and therefore, this also caused negative feelings or situations in the plaintiff, which are compensated in this judgment. […] what the Constitutional Chamber analyzed in said appeal was the time elapsed between the hospitalization request for the corresponding surgery and the filing of the amparo appeal, and by that latter date, the harm had already occurred, and although note is taken of the surgical procedure performed and the restorative effects mentioned by the CCSS, the fact is that, in the Chamber's view, fundamental rights, especially the right to health, had already been violated.” The appellant did not challenge this basis for determining the existence of that harm in due form, as the technique of cassation imposes, in accordance with the provisions of Article 139, subsection 3) of the CPCA. He merely reiterated what had been stated since the response to the claim, namely that the enforceable judgment was insufficient for its accreditation. He did not question, clearly and precisely, the core of what the Enforcement Judge ordered regarding the existence of the causal link. He alluded to other issues, also raised in the response to the claim, such as restorative justice, urgency, and consent. However, it is insisted once more, without protesting the crux of what the Judge stated, concerning that the unlawful act determined by the Constitutional Chamber in the enforceable judgment is sufficient grounds to determine the existence of subjective moral distress (causal link), since this type of harm—subjective moral distress—is proven through human presumptions and the prudent discretion of the Judge, according to the facts analyzed in the constitutional venue. This deficiency means that what was argued is futile for the purpose of varying the decision.\n\n**VI.** Without prejudice to what was indicated in the previous section and, for greater abundance of reasons, the following must be pointed out. SECOND. The appellant insistently alluded to the fact that what he termed \"restorative justice\" operated in the sub júdice because the patient received the required medical care. In this regard, it must be noted that this Chamber, in previous matters, recognized its appropriateness regarding compensation for subjective moral distress for the violation of the fundamental right to health (as recognized by the Constitutional Chamber of the Supreme Court of Justice when granting the respective amparo appeal, due to the CCSS's delay in providing the medical service required by the administered person), when the CCSS provides the service within the period ordered in the constitutional venue. In this regard, judgments nos. 1502-S1-2022 at 11 hours 24 minutes on September 1 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112330), 2429-F-S1-2022 at 14 hours 16 minutes on November 3 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1123608), both from the year 2022; 28-F-S1-2024 at 11 hours 05 minutes on January 11, 297-F-S1-2024 at 17 hours 27 minutes on March 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250), 901-F-S1-2024 at 12 hours 31 minutes on July 4 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1240015), and 937 at 14 hours 51 minutes on July 10 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925); all from the year 2024, can be consulted. However, the current composition of this Chamber, after a new study, considers it necessary to reconsider this position. Undoubtedly, the provision of the service constitutes a rectification of the injured legal situation due to a failure of service. Even more so when it is necessary, as occurs with a pending health service. However, said reparation does not exclude, as the Enforcement Judge rightly indicated, the fact that the injured person may have suffered effects on their moral and patrimonial sphere while the abnormal conduct persisted due to the administrative dysfunction. If effective detriments (precepts 196 and 197 of the LGAP) specific to the particular case and derived from its specific characteristics are demonstrated, their existence being inferred, even through the \"in re ipsa\" intellectual process, despite the user having been jurisdictionally protected, their reparation is appropriate. That is, the service rectification does not exclude that the injured person suffers effects on their moral and patrimonial sphere while the abnormal conduct persists. If this occurred and was so proven, it is mandatory to impose the corresponding compensatory consequence, if requested by the person whose legal sphere was harmed. This is in accordance with the principle of full reparation for harm, which has constitutional and legal roots (canons 9, 41, 49 of the Constitution; 190 and 197 of the LGAP).\n\n**VII.** Within this line of thought, and regarding the existence and quantification of subjective moral distress, this Chamber, for a long time, has indicated that: \"IV. [...] it originates from the injury to an extra-patrimonial right. That is, it does not directly affect the patrimony. It presupposes an unjust disturbance of emotional conditions. It does not require direct proof and is left to the equitable assessment of the Judge. In the case of subjective moral distress, the courts are empowered to decree and quantify the condemnation. The legal nature of this type of harm does not oblige the liquidator to determine its existence because it pertains to their internal sphere. This is not a problem for psychiatrists or doctors. Its existence or non-existence must be understood because it belongs to the conscience. It is deduced through presumptions inferred from indications, since the unlawful generating event reveals the moral distress, because when the psyche, health, physical integrity, honor, intimacy, etc., are damaged, it is easy to infer the harm; therefore, it is said that proof of moral distress exists 'in re ipsa'. Nor must its value be proven because it has no concrete value. It is assessed discretionally. It is not, then, a matter of quantifying the suffering, as it is invaluable, but of fixing monetary compensation for its injury, the only mechanism available to the law, in order to repair, at least in part, the offense. For more detail on this aspect, consult, among others, from this collegiate body, rulings no. 112 already cited, no. 17 at 14 hours 30 minutes on February 21, 1996, and no. 41 at 14 hours 40 minutes on May 14, 1997. Its granting is not strictly subject to evidentiary factors (except those referring to the causal link), but to the prudence and objective discretion of the judge. However, its fixing is subject to the principles of reasonableness and proportionality, which must be assessed by the competent authority in each case, so that its quantification is in accordance with the Law and does not lead to excessive compensations that unjustifiably benefit one of the parties. That is, it must maintain a fair balance derived from the specific factual picture, a matter which must be weighed within the indicated limits.\" (Among many others, consult the judgment of that Chamber no. 468-F-S1-19 at 9 hours 45 minutes on May 30, 2019). In accordance with the foregoing, once the existence of the moral distress and its causal link with the cause of action alleged by the plaintiff are established—which is not contested by the appellant—the determination of the quantum depends on the equitable assessment of the Judge; for which purpose, the special circumstances of the case, as well as the constitutional principles of reasonableness and proportionality, must be considered.\" In this regard, judgment no. 1098-F-S1-2023 at 10 hours 09 minutes on July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1170686) can be consulted, among many others. That is, regarding subjective moral distress, its demonstration is \"in re ipsa,\" provided it is a consequence of an unlawful generating event or reason.\n\n**VIII.** In this litigation, the Constitutional Chamber, as already indicated, determined the unlawful conduct of the CCSS upon verifying the violation of the fundamental right to health of Mr. Johnny Francisco. The postponement of the required surgery was, at the time the constitutional judgment was issued, almost six months. Such a situation—unlawful act—in accordance with the maxims of logic, experience, and correct human understanding, as was resolved, is an adequate cause (causal link) of moral affliction, associated with anxiety, distress, frustration, and worry, due to the excessive time for care—as declared, it is insisted, in the constitutional venue—concerning a health situation which, \"per se,\" is a cause of concern for the person suffering from it, despite not having been diagnosed as urgent; but which caused severe pain, as indicated by the Judge. According to correct human understanding and experience, it is insisted, the existence of feelings such as those described above can be inferred \"in re ipsa,\" as the Enforcement Judge did, without the plaintiff having a legal duty to bear them, as they derive from an abnormal functioning of the Administration, so decreed, it is repeated once more, by the Constitutional Chamber. Ergo, contrary to what the appellant stated, its existence is determined, and, therefore, the propriety of its compensation.\n\n**IX.** Similarly, this Chamber has stated: \"VIII.-\n\n… In other instances, this court of cassation has had the opportunity to highlight the necessary “legal reasonableness” (razonabilidad jurídica) that these types of indemnities must maintain, for the verification of which the observance of a “reasonableness of equality” must be confirmed, which the Constitutional Chamber has defined as “…the type of legal assessment that assumes that equal antecedents must have equal consequences, without arbitrary exceptions” (e.g., rulings no. 5236-99 and 1354-2011). That is to say, to avoid inequitable and illegitimate treatment in the various matters in which the compensation for moral damages (daños morales) is discussed, it is essential to verify that the amounts awarded are not disproportionate when compared with those established in other similar matters. In this vein, the Chamber considers that the sum awarded is consistent with the intensity of the damage caused.” Judgment no. 760-F-S1-2023 of 13 hours 24 minutes of May 29, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1157835). In the same sense, one may consult, among others, rulings no. 1934-F-S1-2022 of 15 hours of August 12; 2654-F-S1-2022 of 10 hours 10 minutes of December 8 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1132117), both from the year 2022, and 1087-F-S1-2023 of 09 hours 36 minutes of July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1173505). Despite the fact that in the challenge under review the objector did not question the amount awarded for subjective moral damages, this Chamber considers the sum awarded, ₡50,000.00, to be reasonable and proportionate, taking into account the circumstances of this case and other similar matters. By way of example, the following precedents can be noted, in which this deciding body did not consider the sums awarded for the delay in providing the public health service unreasonable: No. 429-F-S1-2024 of 10 hours 41 minutes of May 3 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1229475), in which the Judge awarded ₡500,000.00; 937-F-S1-2024 of 14 hours 51 minutes of July 10 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925), in which it was set at ₡200,000.00; and 1302-F-S1-2024 of 16 hours 14 minutes of September 27, all from the year 2024 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1253306), in which the sum of ₡200,000.00 was awarded.\n\nX. THIRD. Likewise, the appellant alleged that, in the case of the amparo beneficiary (amparada), there was no urgency in performing the surgery. While it is true, as the Judge indicated, that the petitioner's ailment was not classified as medically urgent—even though it inflicted severe pain—it is also true that, as set forth in Section I of this judgment, it was the Constitutional Chamber itself, in the judgment being executed, that determined the urgency for the petitioner to undergo the required surgical procedure, ruling that it must be performed within three months from the notification of that ruling. Consequently, within the objective comparison that must prevail in these types of proceedings—enforcement of a constitutional judgment (ejecución de sentencia constitucional)—the issue of urgency is a precluded aspect, since, it bears repeating, it was determined and resolved as such by the Constitutional Court.\n\nXI. FOURTH. The challenger also argued that the amparo beneficiary acquiesced to or consented to remaining on the waiting list. Contrary to what was alleged, in this lite (lite) the existence of consent or tacitly consented act cannot be deemed, much less an express one, on the part of Mr. Valverde Porras. The recurso de amparo was filed on time. So much so that the Constitutional Chamber admitted it for processing and subsequently upheld it. This is independent of the time elapsed between the moment when the CCSS placed him on a waiting list and the filing of the amparo. Therefore, the petitioner demonstrated his disagreement with his stay on the waiting list, and said jurisdictional body upheld his claim.\n\nXII. In the second ground of disagreement, page nine of the appeal, the appellant announced that he was filing it on the cassation ground of violation of substantive norms (quebranto de normas sustantivas) provided for in subsection d) of numeral 138 of the CPCA: “d) When the judgment violates the norms or principles of Constitutional Law, among others, reasonableness, proportionality, legal certainty, and equality.” He invoked the postulate of reasonableness as being infringed. In the contested judgment, he said, the Enforcement Judge determined the reasonableness of the compensation because damage was caused to the petitioner and, as such, it is not sufficient that a restorative justice occurred. He reproduced, in what is relevant, what was considered in section VIII of the challenged ruling. The Judge, he noted, distinguished that the reprehensible conduct caused moral damage to the petitioner, and that was determined by the Constitutional Chamber. However, the text with which the enforcement of the recurso de amparo was promoted was all that was needed to reach that conclusion. The contested judgment, he said, left open the possibility to seek, unrestrictedly, double indemnities: the material type, by receiving medical care, and the pecuniary type, without any proof mediating thereof. The Judge, he indicated, with his analysis, violated the principle of reasonableness. The spirit of the CCSS, he noted, in accordance with precept 73 of the Political Constitution, is to guarantee the fundamental rights to life and health; without which, the other guarantees enshrined in the Magna Carta cannot be fully exercised. While, he pointed out, there are waiting lists or timeframes for fulfilling medical requirements, it is also true that granting a pecuniary compensation for placing a person on one of them, despite the absence of a medical criterion of urgency, implies that the amounts destined to guarantee the two aforementioned fundamental rights are diminished, which, clearly, he alleged, is irrational, since the contributing persons to the Enfermedad y Maternidad Insurance do so with the objective that a health service is provided and that resources are available to guarantee it. Not for compensation to be granted for placing a person on a waiting list, or for care to be scheduled within a reasonable waiting period. The Judge, he noted, straying from the principle of reasonableness, determined that the fact that the service was performed is insufficient to determine the existence of restorative justice in its entirety. Therefore, he noted, there must also be economic restitution. That is, he stated, it follows from the foregoing that a double compensation must always be granted when a person is placed on a waiting list, or was given a scheduled appointment exceeding a reasonable waiting time. However, he asserted, the truth is that this generates a privilege and unjust enrichment. He alluded to the judgments of this Chamber, according to their order of citation, No. 1502-S1-2022, 297-F-S1-2024, 28-F-S1-2024, and 1823-F-S1-2022. The objective of anyone who resorts to the Constitutional Chamber, he said, is to have a surgical procedure performed, or to be provided with medical care. They seek, he added, the restoration of their health, not compensation. This, he argued, can lead to a reduction in the health service's resources, which are necessary for equipment improvements, payment for medications, and instruments to adequately provide the health service through trained professionals. Said principle was directly violated, he said, by awarding a compensatory amount arguing that the medical service having been provided is not sufficient, because waiting so long for the medical procedure to be performed causes negative feelings or situations in the petitioner that deserve compensation. A conclusion reached solely with the text of the enforcement. The Judge violated said principle of reasonableness, since, despite being clear that restorative justice had occurred, he granted a pecuniary amount under the premise that it is not sufficient that the procedure was performed; rather, a person on a waiting list or exceeding a reasonable waiting period for medical procedures to be performed or for care deserves double compensation, which generates a privilege and unjust enrichment. It was not weighed that a privilege was granted to him over the other insured persons, who were overtaken by the amparo beneficiary on the waiting list. This was previously analyzed by this Chamber, he noted, in judgment No. 1502-S1-2022, which he reproduced in what was relevant. Also, in No. 297-F-S1-2024 of 17 hours 27 minutes of March 21, 2024, which he also copied as pertinent. That situation, he pointed out, presented to the Judge, was directly overlooked and, he said, even evidences, in some way, a possible existence of an “animus” to condemn his client under any scenario. It is, he alleged, contrary to the principle of reasonableness, since, besides diminishing the resources available to provide the health service, it grants a privileged position to the person who received the required care at the expense of those who collaborate to provide an adequate health service. Therefore, he concluded, awarding compensation for moral damages becomes a violation of the principle of reasonableness.\n\nXIII. Regarding what was indicated in the preceding Considerando, the following must be stated. FIRST. The objector forgot that this procedural instance does not correspond to an ordinary appeal (such as an apelación). Nor is it sufficient to express a series of general and merely argumentative disagreements. It is essential to contrast what was decided with the infraction that, in his opinion, took place. In this regard, numeral 139 subsection 3 of the CPCA provides a necessary substantive requirement, both for the admissibility of the appeal and for its subsequent evaluation on the merits. This refers to the appeal's motivation, which, given the characteristics of cassation, must be clear and precise. In this sense, it must contain, as stipulated by the precept under comment, the factual and legal foundation of the case. Factual, to the extent that it shows disagreement with the facts that have been held as proven or unproven (which leads to the weighing of evidence), or with the circumstances that occurred in the violation of procedural norms. Legal, when it concerns an issue raised about the application, omission, or incorrect interpretation of any norm that makes up the legal framework, including, of course, the principles of constitutional rank, or that which also operates by reflexive or indirect effect, after the facts of the contested judgment are modified. In both procedural and evidentiary infractions, the legal reasons (always necessary) may concur with factual ones and, in that sense, the referenced foundations must be directed in both aspects, under penalty of inadmissibility. Moreover, it is necessary to clarify that the legal foundation exempts, by express legal mandate, the indication of those canons relating to the value of the improperly appraised evidence. Similarly, it is unnecessary to cite the norms that the lower court erroneously used and mentioned to issue and justify its decision, because they are already contained in the contested ruling itself. And of course, it is not at all essential to cite the precepts that establish the requirements, deadlines, and basic rules for the admission of the appeal. Rather than citing the latter, what is essential is that they are fulfilled, that they are put into practice when preparing and filing the cassation. Thus, the foundation required by law can be understood, roughly, as that technical-legal argumentation in which a series of articles or legal rules are mentioned, interwoven or concatenated with each other and reasonably linked in a double perspective: with the arguments of the appeal and with the judgment under attack. To the extent that a set of legal norms (or, if applicable, a single one) is cited, relevant and clearly linked to the contested judgment (whether in its factual or legal basis) and the appeal arguments, there is legal foundation. Jurisprudential additions or eventual doctrinal citations will sometimes reinforce the allegations made but, generally, do not constitute their essence. As this Chamber has already indicated when interpreting the referenced article 139, “it is required that the appeal have a minimum legal foundation … the reasons on which it bases its petition must be explained, combating the legal arguments of the appealed judgment and recording, at least, some normative reference that supports it” (Resolution no. 318-A-2008, of 14 hours 25 minutes of May 8, 2008). The foundation is, therefore, unrelated to the confused display of norms and allegations; to the mixture of unintelligible arguments or the simple exposition of opinions on the appropriateness or justice of the case, or to the recounting of the errors considered to have been committed in the appealed judgment, without support in norms or legal criteria. Hence, if the appeal completely omits that technical-normative relationship referred to, or if the one made is manifestly and evidently impertinent or disconnected from the case, it must be understood that it lacks “total legal foundation”, and therefore, fails to meet the necessary requirement established in numeral 139.3, which is sanctioned with outright rejection, according to the provisions of Article 140 subsection c) of the same Code of Procedure. Likewise, this Chamber has repeatedly indicated that for an appeal to pass the admission control, in addition to a sufficient statement of reasons, the corresponding mention and linkage with the contested judgment of the applicable norms that are deemed infringed is necessary. In this sense, one may consult, among other resolutions, No. 677-A-S1-2021 of 09 hours 40 minutes of March 25, 2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1029345); 755-A-S1-2022 of 10 hours 55 minutes of March 29 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1082042); and 1663-A-S1-2022 of 10 hours 05 minutes of July 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112340), both from the year 2022.\n\nXIV. Along this line of thought, after a meticulous study of the objection under review, this Chamber determines that the cassation appellant alleged several dissimilar hypotheses, but, due to the way it was structured, they are inseparable from each other. In this sense, on pages 10 and 11 of the appeal, he indicated: “It is observed in the paragraph copied above that the Judge distinguishes that the reproached conduct caused moral damage to the plaintiff [sic], and that was determined by the Constitutional Chamber, however, the text with which the enforcement of the recurso de amparo is promoted was all that was needed to reach that conclusion. […] waiting so long for the medical procedure to be performed causes negative feelings or situations in the plaintiff, which deserve compensation, a conclusion reached solely with the enforcement text.” (Underlining supplied). If that which is criticized were to occur, it would give rise to the cassation ground of violation of substantive norms (quebranto de normas sustantivas) provided for in subsection a) of canon 138 of the CPCA, by virtue of the alleged improper assessment of the judgment being executed. However, what is argued is informal. The appellant omitted to indicate the substantive norms that were violated by the alleged excess, with a clear and precise explanation of how the transgression occurred, as required by cassation technique, as set forth in the previous section, in accordance with what is indicated in numeral 139 subsection 3) ibid. On page 10 he added: “Let this Honorable First Chamber note that the first instance judgment practically leaves open the possibility to unrestrictedly seek double indemnities, the material type, by receiving medical care, and the pecuniary type, without any proof mediating thereof.” (Only the highlighting is from the original). What is now alleged would give rise to the cassation ground for violation of procedural norms (violación de normas procesales) provided for in subsection 1) point d) of canon 137 ibidem: lack of reasoning (falta de motivación). However, as was the case with the previous point, what is argued is informal because the challenger did not indicate, with due rigor, the procedural norms that were violated, with a clear and precise explanation of how the infraction occurred. Then, on pages 11 and 12, he stated: “In addition to the foregoing, the first instance judge, straying from the principle of reasonableness, determines that the fact that the service was provided is insufficient to speak of restorative justice in its entirety, and that therefore there must also be economic restitution […] In that sense, the first instance judge directly violates the principle of reasonableness by awarding a compensatory amount, maintaining that it is not sufficient that the medical service was provided, given that waiting so long for the medical procedure to be performed causes negative feelings or situations in the plaintiff [sic], which deserve compensation, a conclusion reached solely with the enforcement text. / Regarding this, the judge violates the principle of reasonableness, since, despite being clear that restorative justice occurred, he grants a pecuniary amount, under the premise that it is not sufficient that the procedure was performed or that care was provided, but rather that a person on a waiting list and/or exceeding a reasonable waiting period for medical procedures to be performed or for care deserves double compensation, which generates a privilege and unjust enrichment. Besides not weighing that a privilege is granted to him over the other insured persons, who were overtaken by the amparo beneficiary on the waiting list. […] This situation, which as can be inferred was presented to the judge, was directly overlooked and even evidences, in some way, a possible existence, it is reiterated, of an animus to condemn under any scenario, which is reiterated to be contrary to the principle of reasonableness, since this, besides diminishing the resources available to the Institution to provide the health service, grants a privileged position to the person who received the required care at the expense of those who collaborate to provide an adequate health service.” (Highlighting is from the original). What is now set forth would give rise to the announced cassation ground for violation of substantive norms, for the alleged breach of the constitutional principle of reasonableness. The evident ambiguity conflicts with cassation technique, which requires that the grounds of the appeal must be indicated clearly and precisely, with the factual and legal foundation of the case (precept 139 subsection 3) of the CPCA). Ergo, the rejection of the objection under review is required.\n\nXV. SECOND. What was argued by the challenger, concerning that restorative justice occurred in this lite (support for alleging the violation of the principle of reasonableness), the non-existence of urgency in the appointment of the amparo beneficiary, his consent to remain on a waiting list, and the inappropriateness of granting compensation for subjective moral damages, was already the subject of analysis in sections VI through XI of this judgment, so that, in order to avoid unnecessary reiterations, reference is made to what was expressed therein.\n\nXVI. In the third objection, page 13 of the appeal, the appellant announced that he was filing it on the cassation ground of violation of substantive norms (quebranto de normas sustantivas) provided for in subsection c) of canon 138 of the CPCA: “c) When a legal norm has been applied or interpreted improperly or has been left unapplied.” He invoked the infringement of ordinal 46 of Decreto Ejecutivo No. 41457-JP of October 17, 2018, “Arancel de honorarios por servicios profesionales de abogacía y notariado” and 73.1 of the Código Procesal Civil (CPC). Regarding the personal costs (costas personales) of the recurso de amparo, he said, the Enforcement Judge opted to award them. This, despite being certain that legal representation is not required to file a recurso de amparo. He even added that the recurso de amparo being executed was filed by a non-profit foundation. He maintained that the right was granted in the resolution itself issued by the Constitutional Chamber. He transcribed what was stated in Considerando IX of the contested ruling, titled “SOBRE LAS COSTAS DEL AMPARO”. Despite the fact that the recurso de amparo, he pointed out, was presented through a non-profit foundation that, according to its advertising, promotes the filing of recursos de amparo free of charge, and that it did not generate any expense for the amparo beneficiary that has been proven, he took the determination to award that amount. It is clear, he indicated, that it was the “Fundación Derecho sin Fronteras” that filed the recurso de amparo, using, for this purpose, the generalized template with which it has filed more than 4,000 recursos de amparo—according to its own statement, published on its page—which it manages free of charge. The same principle of gratuity, he stated, must apply to the case, since, as a non-profit foundation, favoring a user by advancing their appointment, surgery, and other medical procedures provided by the CCSS is sufficient for its stigma. He agreed with the judicial authority, he asserted, that a legal professional participated in the accompaniment of the template's formulation. However, he said, the petition was made through a non-profit foundation, filing the appeal free of charge. Consequently, given that the principle of gratuity applies to the filing of the recurso de amparo, and the foundation is a promoter of the same principle, coupled with the premise that there is no evidence whatsoever of expense on the part of the amparo beneficiary, nor an invoice presented by the lawyer to the non-profit foundation, the appropriate course was exoneration from costs. The contested judgment, he alleged, improperly applied Article 46 of Decreto Ejecutivo No. 41457-JP. There is no evidence in the case file, he asserted, proving that the presentation, formulation, and processing of the recurso de amparo generated a cost for the petitioner. It is certain, he indicated, that the foundation that filed the appeal managed it free of charge, therefore, awarding that compensation is not appropriate, especially since there is no proof of any expense. Therefore, he affirmed, the petition is covered by the principle of gratuity. The recurso de amparo was presented by a foundation through its legal department. A petition made free of charge, as they advertise, and there is no evidence in the case file demonstrating any expense or charge or salary paid by the professional on the foundation's payroll. Even more reason, he said, to affirm that the foundation promotes the well-being of the population without expecting anything in return. It was the Fundación Derecho Sin Fronteras that processed the recurso de amparo, so it is inappropriate to award attorney fees (honorarios) under the protection of the provisions of Article 46 of the referenced Decreto No. 41457 -JP. He reproduced, as pertinent, the first precept of that regulatory body. According to that text, he indicated, the application of that Arancel de honorarios would be valid insofar as the professional provides services for the payment of a fee. In this lite, he commented, besides the appeal being formulated by a foundation, there is no evidence proving the charging of attorney fees for the study, analysis, drafting, and processing of the recurso de amparo. He even added that the premise upheld by the foundation that promoted the appeal is that it is provided free of charge. He considered there to be no attorney fees to be paid for the formulation of the appeal because the petition was made by a non-profit foundation, which uses the same template—more than 4,000 cases—and provides the service free of charge. For that reason, he noted, awarding costs based on Article 46 of the indicated Decreto is inappropriate. He transcribed ordinal 73.1 of the CPC. The very content of the norm establishes that attorney fees, compensation for time invested, and indispensable expenses of the process shall be considered costs; for which, he noted, there is no proof or reference in the contested judgment. Given that the petitioner provided no proof whatsoever that money was invested for attorney fees, coupled with the fact that the appeal was filed by a foundation that provides the service free of charge, he noted, the Judge was compelled not to award any amount for costs of the recurso de amparo, under the concept of attorney fees. There is no proof that they were paid, as there is no means of proof demonstrating the participation of a legal professional contracted for remuneration for the processing of the recurso de amparo. At the time of its enforcement, he asserted, it does not fit within the assumptions of numeral 46 of the Decreto. To receive full compensation for an expense, he indicated, it must necessarily be demonstrated. Which cannot be condoned by this representation. No proof whatsoever was presented that such an expense occurred. So it is there that the error of the judgment is clearly marked: awarding the amount for costs of the recurso de amparo as if it were for attorney fees, without there being the slightest proof of it. The reasons why costs are awarded to a winning party in a judicial process must be clear. The Constitutional Chamber magistrate, Mr. Fernando Castillo Víquez, he said, has been clear on multiple occasions in ordering both the CCSS, when extra-procedural satisfaction of the Constitutional Chamber's condemnations is made, and the contentious-administrative jurisdiction, to ensure that the amounts awarded actually reach the hands of the amparo beneficiaries. He transcribed, in what is relevant, what was set forth in the separate note of that Chamber's vote No. 2016-012528. The contested judgment, he stated, should have rejected that amount, because, having been proven that the petitioner of the recurso de amparo was a non-profit foundation, which manages recursos de amparo free of charge for users, in addition to there being no evidence provided of the expense the foundation incurs for having professionals on its payroll or staff who formulate the recursos de amparo, or that this meritorious service generates a cost for them, that amount cannot be awarded, much less, he concluded, with support in Article 46 of Decreto Ejecutivo No. 41457 -JP.\n\nXVII. Regarding what was set forth in the previous section, the following must be stated. FIRST. The cassation appellant, on pages 16 and 17 of the appeal, pointed out: “Therefore, it follows that the judgment should have rejected that amount, since, having proven that the petitioner of the recurso de amparo is a non-profit foundation that manages recursos de amparo free of charge for users, besides there being no evidence provided to the process of the expense the foundation incurs for having professionals on its payroll or staff who formulate the recursos de amparo, and/or that this meritorious service generates a cost for them, that amount cannot be awarded, much less with support in Article 46 of the Arancel de honorarios por servicios profesionales de abogacía y notariado”, No. 41457 -JP.” The foregoing constitutes the core of what was argued by the challenger in the criticism under review. However, contrary to what was affirmed, neither in the judgment being executed, nor in the one now contested, was it proven that the party who formulated the recurso de amparo was a non-profit foundation called “Fundación Derecho sin Fronteras”. On the contrary, the heading of the ruling under execution indicated: “Recurso de amparo processed in case file No. 23-018591-0007-CO, filed by LEONARDO GÓMEZ SALAZAR, identity card 0108760664, on behalf of JOHNNY FRANCISCO VALVERDE PORRAS, identity card 0108500565, against the CAJA COSTARRICENSE DE SEGURO SOCIAL.” (Only underlining supplied). Moreover, as the cassation appellant himself well indicated, the Enforcement Judge, in section IX of the judgment now contested, was emphatic in indicating that “… in the case file, it is fully demonstrated that Lic. Gómez Salazar was the legal professional responsible for filing and processing the recurso de amparo on behalf of Mr. Valverde Porras and that is sufficient to demonstrate the work of the Attorney in court.” (Underlining supplied). Therefore, since it was not proven (neither before the Constitutional Chamber nor in the enforcement of the judgment) that the party who processed the recurso de amparo was the indicated non-profit Foundation, if what was argued were to occur, it would give rise to the cassation ground for violation of substantive norms provided for in subsection a) of ordinal 138 of the CPCA. However, what was argued by the challenger is informal.\n\nHe did not identify the evidence demonstrating his assertion; nor did he clearly and precisely indicate, as required by cassation technique, as set forth in Considerando XIII of this judgment, under the provision of Article 139(3) of the CPCA, how it was improperly assessed. The foregoing mandates the outright dismissal of the objection under review.\n\nXVIII. Notwithstanding the above and, for greater abundance of reasons, it is necessary to state the following. SECOND. This Chamber has long distinguished between personal costs (costas personales) and attorney’s fees, concluding that personal costs belong to the party, not the attorney. In this regard, see, mutatis mutandis, rulings no. 432-F-S1-2017 of 09:30 hours on April 20, 2017 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-950854); 515-F-S1-2018 of 11:20 hours on May 30, 2018 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-892742); 28-F-S1-2024 of 11:05 hours on January 11 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1208396) and 297-F-S1-2024 of 17:27 hours on March 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250); both from the year 2024. THIRD. The CPCA, in Article 193, expressly regulates the imposition of costs; as does canon 73.1 of the CPC. Consequently, the CPCA rule is the one applicable to this lite. However, this provision does not regulate, as the CPC does, what is considered costs. Ergo, this procedural principle, like those contained in Articles 76.1 and 76.4 ibidem, by virtue of the referral made by Article 220 of the CPCA, is applicable to this lite. In this sense, Article 73.1 of the CPC provides: “[…] Attorney’s fees, compensation for the time spent by the party attending procedural acts where their presence was necessary, and other indispensable expenses of the process shall be considered costs.” (The underlining is supplied). In the same vein, Articles 76.1 and 76.4 ibidem state: “76.1 Right to fees and setting. Attorney’s fees belong to the attorney, with the exceptions established by law. When the party is an attorney and has acted personally, they shall be entitled to them. Unless otherwise agreed, they shall be set according to the work, the status, and the economic significance of the case, based on the provisions of Law No. 13, Ley Orgánica del Colegio de Abogados y Abogadas, of October 28, 1941, and the decree on attorneys’ and notaries’ fees. […] 76.4 Contractual setting of attorney’s fees. Attorneys and their clients may contractually set the amount of fees and their payment methods, respecting the limits imposed by the law and the respective decree. Said stipulation shall not affect the opposing parties in the process, for the purposes of setting personal costs.” (Only the underlining is supplied). In light of these rules, it is clear that, for purposes of costs, attorney’s fees must be calculated based on the legal limits and rates established in the respective Decree, regardless of any private agreement between the attorney and their client. This implies that, in the settlement of costs (liquidación de costas), it is not necessary for the executing party to prove the agreement they have with their attorney or the payment they have made to them, since the regulations provide that the calculation of this item must be made according to the respective tariff or decree, to ensure an objective criterion in the settlement of costs. Thus, if a party had legal representation in the processing of a case and obtained in its favor the payment of costs, the amount to be recognized as attorney’s fees will necessarily be that established in the “Tariff of Fees for Professional Legal Services,” according to the work performed. Consequently, it is not essential to provide an invoice or proof of payment to the legal professional for the recognition of that item to proceed. In this lite, it is reiterated, the objector did not prove that Mr. Johnny Valverde Porras lacked legal representation during the processing of the amparo; or that it was provided free of charge. On the contrary, as indicated, from the enforcement judgment it is determined that his special judicial representative in this enforcement process was the one who filed the amparo on his behalf before the Sala Constitucional. This allows us to infer that said professional defended the interests of the protected party in the constitutional venue. Ergo, the failure to present the invoice or payment receipt claimed by the appellant is not sufficient to detract from or dismiss the item for personal costs settled by the party and expressly recognized in the enforcement ruling. It is reiterated, because the executing party had legal representation during the processing of the amparo and obtained in its favor the payment of costs. That is, they are entitled to have recognized as costs the amount established by the applicable tariff for attorney’s fees. Consequently, this Chamber observes no legal violations alleged and, therefore, the dismissal of the challenge will be imposed.\n\nXIX. In the fourth and final censure, page 17 of the brief, the objector announced its filing on the cassation ground for violation of substantive rules provided in Article 138(c) of the CPCA. He alleged improper application of canon 193 ibidem. In the challenged judgment, he said, the Enforcement Judge granted the costs of the execution of judgment process. He considered there was no reason to exonerate his principal, despite his opposition insofar as the executing party could not substantiate the subjective moral damages and did not provide proof or technical support demonstrating the existence of a causal link between what was ordered in the enforcement vote and the specific items sought to be enforced. The referenced canon, he said, establishes that the losing party shall be exonerated from paying costs when, due to the nature of the matters debated, there was sufficient reason to litigate. He reproduced section XI of the challenged judgment, entitled, “ON THE COSTS OF THE ENFORCEMENT PROCEEDING.” The Judge, he noted, weighed both the costs award from the amparo and the moral damages granted to justify non-exoneration under the terms of Article 193(2) ejusdem. Had the evidence been properly assessed, he said, and the scope of the aforementioned, he would have concluded that the awarding of moral damages, nor any amount for costs of the amparo, was not appropriate. Reason to affirm that the canon granted for enforcement costs is improper. The Judge, he commented, improperly applied the aforementioned Article 193(2) ibidem, as that rule establishes that the losing party may be exonerated from paying costs when, due to the nature of the issues debated, there was sufficient reason to litigate. Taking into consideration purely arithmetic extremes, and only the amounts awarded, he alleged, they represent a total of ₡231,000.00. This implies, he argued, that of the total sought, the executing party obtained 48.07% - without counting the costs that have not yet been set for the enforcement - which entails, a contrario sensu, that they did not obtain 51.98% of what they sought to obtain. Consequently, he alleged, it is evident that his represented entity had reason to litigate. He added that it achieved that the executing party did not obtain the totality of its claims. Therefore, he questioned, how was it not even minimally visualized by the Judge, who dismissed the thesis that his principal had sufficient reasons to litigate? Especially being faced with an execution of judgment of a right granted in the abstract, where they were facing a scenario of extreme petitions, which implied that this representation had to exercise the defense of institutional interests. If the Judge had assessed the above, he stated, he would have determined that his principal had reasons to litigate. Among various elements, he pointed out, are the following: 1) only 48.07% of the total sought was granted; 2) 51.98% of the total requested was denied; 3) this is a claim with an evident search to obtain extremes beyond what can be considered parallel to reasonableness; and 4) this Chamber, in judgment no. 1502-S1-2022, indicated that it is irrational to impose on the tripartite contribution fund of social security and on the other insured persons benefiting from those funds, additional compensation on someone who has consented to the wait and received, through judicial protection, the required medical attention. Added to this, it provided guidelines to determine whether compensation should or should not be awarded, such as whether the patient’s type of pathology constitutes an emergency or not, or the conformity with inclusion on a waiting list and, even, “in natura” compensation. That is, his principal based its litigation in the process on positions developed by this Chamber, which was pointed out to the Judge without him taking it into consideration. For the above, he argued, it is evident that this representation had to litigate in the process. Not satisfied with that, the Judge decided to order his principal to pay costs, placing it in a clear position of vulnerability and disadvantage, as defending, even, the financial sustainability of the Institution, is clearly a sufficient reason to litigate. Therefore, he pointed out, it can be deduced, directly, clearly, and simply, that his principal had sufficient reasons to litigate, given that it was effectively protecting the public treasury, in defense of the few resources it has. It was forced to oppose the lawsuit, considering the amount requested by the executing party for subjective moral damages -₡300,000.00- unreasonable and disproportionate, a circumstance that led to said amount being rejected in the judgment and reduced to ₡50,000.00. Having set forth the reasons for challenging both the moral damages item and the costs of the amparo, and the reasons for quashing those extremes having merit, upon upholding the claim against them, the basis upon which the judicial authority did not exonerate its principal varies. Reason that justifies the motive to challenge that extreme. Being correct in the arguments presented, and had Article 193(b) of the CPCA been properly applied, the Judge would have exempted its principal from paying the costs of the enforcement process, given that the fact of having sufficient reason to litigate the present process is evident and manifest, besides simple verification, he noted. Therefore, he concluded, this grievance must be upheld and the judgment quashed.\n\nXX. Regarding the points made in the foregoing Considerando, it is necessary to state FIRST. After a thorough study of the objection under review, this Chamber arrives at the conviction that the appellant invoked several hypotheses dissimilar to each other, but, due to the way the objection was structured, they are indivisible. In this sense, on page 18 of the appeal he stated: “In that sense, had the evidence and the scope of the aforementioned been properly assessed, he would have arrived at the free conviction that the awarding of moral damages, nor any amount for costs of the amparo, is not appropriate, reason to affirm that the canon granted for enforcement costs is improper.” The argument made, if it were to occur, would give rise to the cassation ground for violation of substantive rules provided in Article 138(a) of the CPCA, for improper evidentiary assessment. However, it is informal. The appellant did not identify any evidentiary element, explaining how it was violated by the objected judgment, as required by cassation technique, as has already been pointed out. On the other hand, on that same page 18 he invoked the violation, by erroneous application, of Article 193(b) of the CPCA, since, in his opinion, due to the nature of the issues debated, his principal had sufficient reason to litigate. This because, as he indicated, the amounts awarded to the executing party total ₡231,000.00. That is, 48.07% of what was sought. This means, according to his criterion, that his principal had to litigate in this lite. In this regard, what was indicated would give rise to the announced cassation ground, provided in section (c) of Article 138 of the CPCA. Then, on pages 18 and 19 he stated: “[…] it is not understood how it was not even minimally visualized by the first instance judge, who dismisses the thesis that my principal did have sufficient reasons to litigate the execution of judgment process, especially being faced with an execution of judgment of a right granted in the abstract, where they were practically facing a scenario of extreme petitions, which imply that this representation had to exercise, without any discussion, the defense of institutional interests. / Had the judge of instance assessed the above, he would have determined that my principal had more than enough reasons to litigate the judicial process, since, among various elements, the following exist: […]”. (The underlining is supplied). In what has now been set forth, the appellant alluded to the cassation ground for violation of procedural rules, provided in Article 137(1)(d) of the CPCA: lack of reasoning. However, the argument is informal, as it omits to indicate the specific procedural rule violated, with a clear and precise explanation of how the violation occurred, as required by cassation technique. As already set forth in section XVI of this judgment, the confusion evidenced conflicts with cassation technique, which requires that the grounds for the appeal must be indicated clearly and precisely, with the factual and legal basis of the case (Article 139(3) of the CPCA). Ergo, the dismissal of the objection under review is mandated.\n\nXXI. SECOND. Notwithstanding the foregoing and, for greater abundance of reasons, it is necessary to state the following. On pages 19 and 20, the appellant indicated: “Added to the fact that, having set forth the reasons for challenging both the canon for moral damages and the costs of the amparo, and the reasons for quashing these extremes having merit, upon upholding the claim against them, the basis upon which the judicial authority did not exonerate my principal varies, a further reason that justifies the motive to challenge this extreme. / Therefore, being correct in the arguments presented, and had Article 193(b) of the Código Procesal Contencioso Administrativo been properly applied, the first instance judge would have exempted my principal from paying costs of the enforcement, given that the fact of having sufficient reason to litigate the present process is evident and manifest, besides simple verification, and therefore it is considered that this grievance must be upheld, and the judgment quashed.” The foregoing amounts to nothing more than an argumentative allegation devoid of any factual and legal support. It constitutes an expectation by the cassation appellant that, for the reasons explained when studying each grievance, did not materialize. The criteria were provided for which this Chamber finds each of them improper, reason why, contrary to what was argued, the basis for ordering the executed party to pay the costs of the enforcement process has not varied.\n\nXXII. THIRD. According to what was set forth in the response to the lawsuit, images 31 to 147 of the electronic judicial file, the general judicial representative of the CCSS alleged and requested that its principal should not be ordered to pay subjective moral damages, because the executing party provided no element of judgment whatsoever - in accordance with the provisions of canons 180(1) of the CPCA and 41.1 of the CPC - nor did they mention any to support what was stated in the lawsuit, much less the basis for requesting that extreme in the amount sought. On the contrary, the Enforcement Judge determined the existence of subjective moral damages by virtue of the facts that served as the basis for upholding the amparo, which was endorsed by this Chamber, as explained. In addition, he set its amount according to his prudent discretion and under the principles of reasonableness and proportionality, which was also shared by this decision-making body. Likewise, the amount requested for personal costs of the amparo was awarded. Also, the legal interest on the awarded amounts and the costs of the enforcement process were granted, as requested. Consequently, contrary to what was stated by the appellant, and as was correctly resolved, ordering the payment of the costs of the enforcement process was mandated, as provided by canon 193 of the CPCA, since none of the grounds for exoneration provided in that rule were present. FOURTH. As noted in section XV of this judgment, what was indicated by the appellant regarding the existence of restorative justice and the lack of urgency in the protected party’s appointment, the consent to the wait, and the impropriety of granting compensation for subjective moral damages, was already analyzed in sections VI to XI of this judgment, so, to avoid unnecessary reiteration, the reader is referred to what is stated there.\n\nXXIII. By virtue of the reasons indicated, the dismissal of the appeal filed is mandated. In accordance with Article 150(3) of the CPCA, as this Chamber does not consider that the cassation appellant had sufficient reason to appeal, for the reasons set forth when analyzing each grievance, it shall be ordered to pay the costs of the cassation appeal, which must be settled (liquidarse) in the judgment enforcement phase, in order to guarantee the right of defense of the executed party, providing them the respective opportunity to be heard regarding the settlement presented (Articles 41 and 153 of the Constitución Política).\n\nXXIV. DISSENTING VOTE OF MAGISTRATE ROJAS MORALES. I depart from the majority opinion insofar as it finds it appropriate to order the defendant to pay subjective moral damages. Regarding the damages (daños y perjuicios) arising from a ruling of the Sala Constitucional, when it declares an amparo to be well-founded, it is worth bearing in mind that, given their nature, these types of judgments contain an award in the abstract, without any factual consideration; they do not pre-judge, because they were not subject to analysis, their existence, their causal link, or quantification. Said Court merely determines the constitutional violation. When enforcing those extremes, the causal relationship must be established between what was declared in the abstract and the specific matter. Thus, the fact that the Sala Constitucional orders in the abstract the payment of damages, does not entail an automatic award to be enforced, as the Enforcement Judge seems to mistakenly understand it. It is the responsibility of the judges tasked with resolving the settlement (liquidación) to assess, in each specific case, the existence of sufficient merit to grant the requested compensation. In this direction, the following must be analyzed: the particular circumstances of the case, the position of the parties, the nature, object, and purpose of the compensation, as well as the constitutional principles of reasonableness and proportionality. Furthermore, when the matter concerns alleged subjective moral damages suffered by a person facing a lack of medical attention, as in the present case, the examination of additional aspects becomes essential. First, one must assess the urgency factor, because it is evident that the person requiring urgent attention from the CCSS, for example, an administered person suffering from a cancer that progresses irremediably, is not in the same situation as someone who presents a condition for which a surgical intervention or a non-urgent medical appointment has been prescribed; in both cases, the waiting time to receive the medical service does not have the same result. Neither will the moral injury be of the same intensity. On the other hand, the patient's inactivity over the course of time on the waiting list must be analyzed (canon 30(ch) of the Ley de la Jurisdicción Constitucional - LJC - and 38 of the Código Procesal Contencioso Administrativo), which ceases when they file an amparo before the Sala Constitucional or, alternatively, before the courts of justice, to claim the necessary medical attention or treatment (administrative activity). It must be taken into account that the passage of time without taking action has clear consequences in the Costa Rican legal system regarding the expiration of the action, an aspect that can be considered ex officio. A pecuniary advantage cannot be derived from inactivity, as this conflicts with the principle of proportionality in the strict sense. Third, the satisfaction provided by a court order arranging the performance of a medical act or the delivery of medication must be weighed (even if it arises from a precautionary measure). Indeed, the most recent jurisprudence of the Sala Constitucional has valued the satisfaction generated from the notification of the amparo’s processing. These are cases where, on the occasion of the amparo and irrespective of the time elapsed between the filing of the appeal and the administrative response received, the appealed authority recognizes the required medical attention for the administered person (setting a fixed date for surgery or a medical consultation, providing the needed medication, rescheduling an appointment, etc.). Cases of latest binding resolution erga omnes (according to Article 13 of the LJC), in which the Constitutional Judges have considered the ordering of costs and damages improper, resolving even without an award on these aspects; these must be assessed by this Chamber when ruling on ongoing processes. In that regard, see, among others, judgments numbers: 2024-000017 of 9:15 hours on January 9, 2024, 2024-000026 of 9:15 hours on January 9, 2024, and 2024-006673 of 9:15 hours on March 8, 2024. It is worth noting that providing the required medical service constitutes a manifestation of restorative justice, which this Decision-Making Body must assess. Compensation granted in violation of the stated reasoning becomes unreasonable and disproportionate, especially when, in a universal social security system like Costa Rica’s, such compensation is paid by all insured persons, including those displaced by the executing party. Upon examining the described aspects and the particular case of Mr. Johnny Francisco Valverde Porras, compensating the emotional injury granted in the judgment becomes improper. It is on record that on February 24, 2023, the Neurosurgery Service of the Hospital Monseñor Víctor Manuel Sanabria de Puntarenas issued Mr. Johnny a hospitalization request for surgery, without a fixed date. On August 4, 2023, he filed an amparo before the Sala Constitucional, meaning he remained waiting for the intervention to be scheduled for approximately six months. One must consider the capacities of social security in an area such as Neurosurgery, where there are insufficient specialists to serve the population, especially since the number of people requiring intervention in that area is increasing. Moreover, it is pertinent to note, even though the Hospital Monseñor Víctor Manuel Sanabria issued a hospitalization order for surgery, it did not do so with an urgent character. In addition to the above, it is an undisputed fact that, as a consequence of the constitutional ruling, Mr. Valverde Porras received the required medical attention, since the surgical intervention was performed on November 16, 2023 (as indicated in official letter HMS-DG-0513-2024 of February 14, 2024, issued by Mr. Randall Álvarez Juárez, Director General of Hospital Monseñor Sanabria). That is, the only waiting time the executing party endured to receive the needed attention was approximately three months, counted from the filing of the amparo on August 4, 2023, until the surgery was performed on November 16 following. This period is even shorter if one considers that the enforcement ruling was notified on August 23, 2023. Periods that are, in themselves, reasonable from the viewpoint of providing a non-urgent service and given the need to meet the preoperative requirements that any surgical intervention entails. Bear in mind, from the moment the amparo was filed, the executing party was never subjected to a prolonged or indefinite wait. The medical attention was received within a more than reasonable timeframe (even shorter than waiting periods in private medicine). Without overlooking that the assessment appointment was scheduled without an urgent character. The foregoing attests to the nonexistence of the damages settled. It is worth noting, in cases like the one under review, there is no doubt, the user’s satisfaction has already been generated, therefore, granting additional compensation to what has been received (medical assessment in singular derogation from the waiting list) becomes contrary to law. Far from causing the executing party moral injury, it granted him a privilege over the other insured persons, which diminishes the moral damages claim filed. It is irrational to impose on the tripartite contribution fund of social security and on the other insured persons benefiting from those funds, additional compensation on someone who has received, through judicial protection, the required medical attention. For the reasons indicated, the compensation granted does not conform to criteria of reasonableness and proportionality (established by the Sala Constitucional itself). By virtue of the foregoing, the undersigned considers that the proper course was to uphold the first and second grievances of the filed appeal and, consequently, annul the challenged judgment - only - insofar as it recognized the amount of ¢50,000.00 for subjective moral damages, to instead, ruling on the merits, reject that extreme.\n\nPOR TANTO\n\nBy majority vote, the appeal is declared without merit, with its costs payable by the cassation appellant entity, Caja Costarricense de Seguro Social, which shall be settled (se liquidarán) in the judgment enforcement stage. Magistrate Rojas Morales issues a dissenting vote and would uphold the appeal by virtue of restorative justice having been configured. mja.\n\nRocío Rojas Morales\n\nDamaris Vargas Vásquez\n\nJorge Leiva Poveda\n\nCarlos Guillermo Zamora Campos\n\nIgnacio Jose Monge Dobles\n\nDigitally Signed Document\n-- Verification code --\n\n\n GRVXS1NVCFE61 \n\nTelephones: (506) 2295-3658 or 2295-3659, email sala_primera@poder-judicial.go.cr\n\nExp. 23-004070-1028-CA\n\nRes. 000258-F-S1-2025\n\n**SALA PRIMERA DE LA CORTE SUPREMA DE JUSTICIA.** San José, at twelve hours twenty-two minutes on the twentieth of February of two thousand twenty-five.\n\nEnforcement proceeding of the judgment issued by the Constitutional Chamber of the Supreme Court of Justice in the amparo appeal filed by **LEONARDO GÓMEZ SALAZAR**, attorney, holder of identity card number 108760664 and bar association number 17.049, in his capacity as special judicial representative of **JOHNNY FRANCISCO VALVERDE PORRAS**, operator, holder of identity card number 108500565, **against** the **CAJA COSTARRICENSE DE SEGURO SOCIAL**, with legal entity identification number 4-000-042147, represented by its general judicial representative without sum limit, Michael Montoya Jiménez, attorney, holder of identity card number 108930513 and bar association number 17.385. The general judicial representative of the enforced entity filed a cassation appeal challenging judgment number 2024001065 from 07 hours 41 minutes on May 17, 2024, issued by the Juzgado Contencioso Administrativo y Civil de Hacienda of the Second Judicial Circuit of San José, composed of Judge José Andrés Cruz Tenorio.\n\n**Judge Leiva Poveda drafts**\n\n**CONSIDERING**\n\n**I.** The Constitutional Chamber of the Supreme Court of Justice, through judgment number 2023020609 at 09 hours 45 minutes on August 22, 2023, upheld the amparo appeal filed by attorney Leonardo Gómez Salazar on behalf of Johnny Francisco Valverde Porras against the Caja Costarricense de Seguro Social (CCSS). Said appeal, filed before that Chamber on August 4, 2023, originated from a violation of the fundamental right to health. The amparo beneficiary is a patient at the Hospital Monseñor Víctor Manuel Sanabria in Puntarenas. He was evaluated in the Neurosurgery Service of that Hospital on February 2, April 23, June 21, all three dates in the year 2021; February 9, October 21, both in 2022, and February 24, 2023. He was diagnosed with HD C4-C5/C5-C6/C6-C7. The following was documented: “*HERNIA DE DISCO L1 L2 CANAL 10.3 MM SIN ESTENOSIS FORAMINAL*”, which requires surgical instrumentation. On February 24, 2023, he was evaluated for the last time and a hospitalization request was issued “*for anterior cervical approach + discectomy C4-C5/C5-C6/C6-C7 + fusion with locked cage*”. At the time the amparo appeal was filed, a date for performing the required surgical procedure had not been scheduled for Mr. Johnny. In this regard, that Chamber considered: “[…] *this Chamber deemed a violation of the amparo beneficiary's fundamental right to health to have been proven. For it was demonstrated that he was placed on a surgical waiting list as of February 24, 2023, and by the date on which the respondent medical authority submitted its respective report – August 17, 2023 – almost 6 months of waiting and uncertainty regarding said intervention have elapsed*.\n\nIt is thus that this Constitutional Court considers it unreasonable to subject the amparo claimant to an indefinite wait for the surgery he requires, even more so when the affliction that affects him constantly interferes [sic] with his enjoyment of quality of life. Furthermore, the Administration must promptly and timely execute the necessary actions to safeguard the health and life of its users. Consequently, the appropriate course is to declare the amparo action with merit, with the order that, within a period of 3 months, counted from the notification of the judgment, the amparo claimant undergo the surgical intervention at the respondent hospital, under the responsibility of his treating physician.” It ordered the Acting Director General of the aforementioned Hospital to issue the pertinent orders and carry out the actions within her scope of authority, so that, within the indicated three-month period, counted from the notification of that judgment, the prescribed surgery be performed on the amparo claimant. All of this, under the criteria and responsibility of his treating physicians and provided no other medical cause prevents it. It warned her that, in accordance with the provisions of article 71 of the Ley de la Jurisdicción Constitucional, a prison sentence of three months to two years or a fine of twenty to sixty days will be imposed on anyone who receives an order that must be complied with or enforced, issued within an amparo proceeding, and does not comply with it or enforce it, provided the crime is not more severely punished. It ordered the CCSS to pay the costs, damages, and losses caused by the facts that served as the basis for that declaration, which, it ordered, will be determined in the sentence execution phase of the contentious-administrative proceeding.\n\nII. In a brief uploaded to the electronic judicial file on December 20, 2023, at 12:49:27, images 02 through 26, Mr. Gómez Salazar, in his capacity as special judicial attorney-in-fact for the plaintiff, Johnny Francisco Valverde Porras, submitted the corresponding statement of claim. He requested that the following items be granted: 1) the defendant entity be ordered to pay the costs of the sentence execution proceeding; 2) ₡181,500.00 for the personal costs of the amparo proceeding; 3) ₡300,000.00 for subjective moral damages; and 4) payment of statutory interest, from the moment the judgment became final until its effective payment. By resolution at 13:51 on January 17, 2024, images 28 and 29, the Judge, Giovanni Marchena Jara, admitted the claim. In a brief uploaded to the electronic judicial file on February 14, 2024, at 16:15:47, images 31 through 147, the CCSS's general judicial attorney-in-fact without sum limit, Montoya Jiménez, opposed the statement of claim. He raised the defense of lack of right. In the judgment now challenged, the judge, José Andrés Cruz Tenorio, ordered the CCSS to pay: 1) 50,000.00 for subjective moral damages, 2) 181,500.00 for the personal costs of the amparo proceeding; 3) statutory interest on said amounts from the date this ruling becomes final until its effective payment, and 4) the costs of the sentence execution proceeding and its interest from the date the ruling setting them becomes final until their cancellation. Disagreeing, the CCSS's general judicial attorney-in-fact filed a cassation appeal. For its resolution, the brief uploaded to the virtual desktop of this Chamber on February 13, 2025, at 09:20:53, signed by Mr. Gómez Salazar, was considered.\n\nIII. In the first objection, page two of the petition, the appellant announced filing it on the cassation ground for violation of substantive norms provided for in subsection a) of canon 138 of the Código Procesal Contencioso Administrativo (CPCA): “The cassation appeal shall also be admissible for violation of substantive norms of the legal system, in the following cases: / a) When an improper weighing is attributed to the evidence or it has been pretermitted.”, for the improper weighing of the executory judgment of the constitutional decision in the amparo proceeding. He invoked the violation of canon 196 of the Ley General de la Administración Pública (LGAP). The challenged judgment, he pointed out, based its reasoning for granting subjective moral damages on a factual aspect, but without analyzing the edges contained in the line of this Chamber. He alluded to ruling no. 297-F-S1-2024 from 17:27 on March 21, 2024 (mentioned in the response to the claim). Within those aspects, he cited the determination of extreme necessity of the patient's case from a medical point of view (urgency), his consent to be on a waiting list or, rather, the existence of physical harm. Similarly, he cited rulings nos.: 1502-S1-2022 from 11:24 on September 1st; 1823-F-S1-2022 from 14:26 on August 4th; 2429-F-S1-2022 from 14:16 on November 3rd; all three from the year 2022; and 28-F-S1-2024 from 11:05 on January 11, 2024. He reproduced, in what was of interest to him, the reasoning in Section VIII of the challenged ruling, called “ON THE MERITS OF THE CASE”, regarding the evidence to grant subjective moral damages. From what was transcribed, he alleged, it is observed that the Judge specified the conditions of the plaintiff and the juridical-material situation arising from the amparo proceeding, since the plaintiff was placed in a disproportionate waiting period for his assessment and medical care, without the required service being provided. With the mere executory judgment of a sentence, he noted, he was able to determine that the Administration caused him “an emotional detriment,” without taking into account the factors of restorative justice, urgency, or the patient's condition, which were pointed out to him in the response to the claim.\n\nHe added that he even used the same template to justify his ruling against the CCSS. He requested that those resolutions be examined *ad effectum videndi*, because the Judge is acting contrary to what has been ordered by this Chamber. He transcribed the proven facts of the enforceable judgment. They make no reference whatsoever, he stated, to the worsening of the patient's condition, nor that he suffered \"an emotional impairment\". The challenged ruling, he indicated, directly violated the aforementioned numeral 196 of the LGAP, by having determined the existence of a lesion (lesión), and of damage (daño), with an enforceable judgment. To do so, he asserted, required technical proof to demonstrate it. This is aggravated, he affirmed, by the fact that, for the Judge, it is not enough that restorative justice occurred—the medical care—even before the expiration of the deadline ordered by the Constitutional Chamber, since, for him, there was a lesion (lesión) to the fundamental right to health, and the care does not eliminate the Institution's obligation to indemnify him for the untimely care. He copied a fragment of a ruling that does not coincide with the challenged one, because, in the reproduced text, it refers to the Optometry Service, which bears no relation to the petitioner’s ailment. The objected ruling, he noted, violated said precept—196 of the LGAP, which provides that the damage must be effective, assessable, and individualizable, in relation to a person or group—. Starting from the amparo appeal judgment, because the enforcing party was placed on a waiting list, he pointed out, there is no proof whatsoever of his internal distress. Nor, he said, of the lesion (lesión) suffered. Said legal concept, he noted, corresponds to a damage, either as a result of the lack of equivalence between what is given and what is received, in an onerous title, or from a crime, where a person's body is impaired or transgressed; or, an organic or functional disturbance of an individual. That is, he remarked, the Judge, from a simple enforceable judgment, validated and determined the existence of a lesion (lesión) in the patient, without specifying what type of lesion (lesión), nor having technical proof that accredits it as such, from any standpoint, which results in the damage not being real or effective, directly violating the referred canon. The judicial authority, he indicated, did not take into account the factors of restorative justice, urgency, the patient's condition, reiterated in the jurisprudence of this Chamber. He cited—according to the order of presentation—ruling nos. 28-F-S1-2024 at 11 hours 05 minutes of January 11; 297-F-S1-2024 at 17 hours 27 minutes of March 21, both of the year 2024; 1502-F-S1-2022 at 11 hours 24 minutes of September 1; 1823-F-S1-2022 at 14 hours 26 minutes of August 4; and 2429-F-S1-2022; the three from the year 2022. he added a table in which he set out, in his opinion, what was detailed in each of those rulings. Those resolutions, he stated, in addition to being public knowledge, were not weighed in the case under study, although, he noted, those from the year 2022 were specifically pointed out to the Judge, who must know that jurisprudence is a means to integrate, understand, and apply the Law. However, he explained, with an *animus* to condemn, he ignored that line and decided to condemn his represented party for a lesion (lesión) caused to the enforcing party, according to his understanding, without having proof of that lesion (lesión), apparently suffered, solely with the enforcement of the amparo appeal and without weighing the scope of restorative justice, as this Chamber has contextualized. If the Judge had duly analyzed the evidence, he asserted, he would have determined that an enforceable judgment is insufficient to determine the appropriateness of subjective moral damages (daño moral subjetivo). Especially, taking into consideration that placing a person on a waiting period to perform medical consultations and procedures is not, *per se*, sufficient reason to award compensation. On that point, he indicated, this Chamber established, in resolution no. 1502-S1-2022 at 11 hours 24 minutes of September 1, 2022, that regarding compensation for amparo appeals for placement on waiting lists, it is irrational to impose on the tripartite social security contribution fund a compensation payment to someone who has consented to a wait for the required medical care. This, he explained, was pointed out to the jurisdictional authority. However, he denoted that there exists an *animus* to condemn the CCSS at all costs (and of course, the contributors), without any basis whatsoever from the evidentiary point of view. If the Judge had adequately assessed the evidence, he pointed out, the reasoning of the ruling would be different. It would have been determined, he concluded, that the evidence was insufficient to establish the existence of damage of any type.\n\n**IV.** Regarding what was set forth in the preceding section, the following must be noted. **FIRST.** It must be remembered that, in enforcement proceedings in general and, principally, those issued by the Constitutional Chamber, what is enforced must necessarily be constrained to what was resolved in the amparo ruling giving rise to the enforceable judgment. This Chamber has indicated that the enforcement proceeding seeks to materialize the abstract condemnation imposed on the losing party. If aspects different—or contrary—to the pronouncement giving rise to the enforcement are granted, or if they are granted against persons who were not condemned, res judicata is violated. See, among other rulings of this decision-making body: 383-2019 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-925036) and 309-2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1024927). Consequently, the oversight function of this Chamber is constrained to an objective comparison between the enforceable ruling and the appealed resolution. In this sense, one may also consult, among many others, resolutions nos. 82-A-S1-22 at 10 hours 06 minutes of January 26 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1072742) and 1984-F-S1-2022 at 11 hours 18 minutes of September 8, both of the year 2022 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112319).\n\n**V.**\n\nAs noted in Considerando I of this judgment, the Constitutional Chamber (Sala Constitucional), in the ruling being executed, granted the amparo appeal (recurso de amparo) filed by the protected party, it having been proven that on February 24, 2023, he was evaluated, and the request for hospitalization was issued at the Hospital Monseñor Sanabria for “anterior cervical approach + discectomy C4-C5/C5-C6/C6-C7 + fusion with locked cages”. However, at the time the amparo appeal was filed, on August 4 of that year, a date for the required surgical procedure had not been scheduled. Therefore, said Chamber considered that the time elapsed up to that point, almost six months, was disproportionate and violated his fundamental right to health. Therefore, it granted the amparo appeal and ordered both the Acting General Director to issue the pertinent orders and carry out all actions within the scope of her competence, so that, within a period of three months, counted from the notification of that judgment, the prescribed surgery be performed on the protected party. As can be clearly inferred, the Constitutional Chamber granted the appeal because it considered that the time the protected party spent on the waiting list was disproportionate and violated his fundamental right to health, considering his pathology. Precisely, the Execution Judge, in Section VIII of the contested judgment, adhering to what was resolved in the constitutional venue, considered, in what is of interest: “[…] the alleged moral damages (daño moral) are not proven in the constitutional venue, but rather in the stage at hand, and since this is subjective moral damages (daño moral subjetivo), it can be proven through human presumptions and the prudent discretion of the Judge, however, its proof and quantification must fully conform to the circumstantial elements of the very generating event, an event which, in the specific case, is the act of subjecting the protected party to an indefinite wait for the surgery he required to be performed. […] the record demonstrates the surgery was carried out and furthermore, it is evident that Mr. Valverde Porras’ condition, although it caused him unbearable pain and affected the normal development of his daily life, was technically not urgent nor did it represent any immediate risk; however, what must be emphasized is that the violation of the fundamental right to health had already been configured and both the medical attention and the surgery in question were performed by order of the Constitutional Chamber, and the fact that the patient received attention, even before the expiration of the deadline ordered by the Chamber, does not eliminate the institution's obligation to compensate him for the unreasonable waiting time (in the Chamber's opinion) on the corresponding list, before being surgically intervened. […] however, pursuant to the provisions of articles 190, 196, and 197 of the General Public Administration Act (Ley General de la Administración Pública), there is indeed a causal link (relación de causalidad) between the conduct of the Hospital Monseñor Sanabria and the subjective moral damages, that is, between the unreasonable and indefinite wait for the surgery and the situations of anguish, insecurity, instability, and uncertainty caused to Mr. Valverde Porras, situations which, I reiterate, do not require direct evidence for their demonstration, since they can be proven through human presumptions. […] it has already been demonstrated that Mr. Valverde Porras’ condition, although it caused him pain and complications in his daily life, was not urgent; however, the fact that the attention was not urgent was neither an impediment nor a justification for the Constitutional Chamber to declare the violation of the fundamental right to health, hence the generating event of the Administration's liability did not depend on the urgency of the attention, but rather it was configured by the unreasonable period in that attention and by the indefinite wait, which motivated the amparo appeal to be granted and executed in this venue. […] it is more than evident that the damage and the negative feelings it generates arise from the unreasonable time on the waiting list (in the Chamber's opinion), and furthermore, I reiterate, subjective moral damages do not require direct evidence for their demonstration […] the fact of waiting so long for a surgery for which a hospitalization request already existed, caused the Constitutional Chamber to grant the amparo appeal, and therefore, that also caused negative feelings or situations in the plaintiff, which are compensated in this judgment. […] what the Constitutional Chamber analyzed in said appeal was the time elapsed between the hospitalization request for the corresponding surgery and the filing of the amparo appeal, and by that latter date, the damage had already been produced, and although note is taken of the surgical procedure performed and the restorative effects mentioned by the CCSS, the truth is that, in the Chamber's opinion, fundamental rights, especially the right to health, had already been violated.” The appellant did not challenge that basis for determining the existence of that damage in due form, as the cassation technique requires of him, in accordance with the provisions of Article 139(3) of the CPCA. He merely reiterated what was stated since the response to the complaint (contestación de la demanda), to the effect that the executory judgment (sentencia ejecutoria) was insufficient for its proof. He did not question, clearly and precisely, the crux of what the Execution Judge (Juzgador de Ejecución) ordered regarding the existence of the causal link. He alluded to other topics, also raised in the response to the complaint, such as restorative justice, urgency, and consent. However, it is insisted once more, without challenging the heart of what the Judge stated, concerning that the unlawful act determined by the Constitutional Chamber in the executory judgment is sufficient reason to determine the existence of subjective moral damages (causal link), for this type of damage—subjective moral—is proven with human presumptions and the prudent discretion of the Judge, in accordance with the facts analyzed in the constitutional venue.\n\nThis deficiency renders the argument futile for the purpose of varying the decision reached.\n\n**VI.** Without prejudice to the foregoing section and, for greater abundance of reasons, the following must be noted. **SECOND.** The appellant, insistently, alluded to the fact that what he termed “restorative justice” operated in this case, because the patient was provided the required medical care. In this regard, this Chamber, in previous matters, has recognized its applicability in the area of compensation for subjective non-material damage (daño moral subjetivo) due to the violation of the fundamental right to health (as recognized by the Constitutional Chamber of the Supreme Court of Justice upon granting the corresponding amparo appeal, due to the CCSS's delay in providing the medical service required by the administered person), when the CCSS provides the service within the term ordered in the constitutional venue. In this regard, judgments nos. 1502-S1-2022 of 11 hours 24 minutes on September 1st (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112330), 2429-F-S1-2022 of 14 hours 16 minutes on November 3rd (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1123608), both from the year 2022; 28-F-S1-2024 of 11 hours 05 minutes on January 11th (), 297-F-S1-2024 of 17 hours 27 minutes on March 21st (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250), 901-F-S1-2024 of 12 hours 31 minutes on July 4th (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1240015) and 937 of 14 hours 51 minutes on July 10th (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925); all from the year 2024, may be consulted. However, the current composition of this Chamber, after a new study, considers it necessary to reconsider that position. Undoubtedly, it is a vindication of the injured legal situation, by the lack of service, that the service be provided. Even more so, when necessary, as occurs with a pending health service. However, said reparation does not exclude, as the Enforcement Judge rightly indicated, that the injured person suffered affectations in their moral and patrimonial sphere while the abnormal conduct persisted due to the administrative dysfunction. If effective impairments (precepts 196 and 197 of the LGAP) specific to the particular case and derived from its particular characteristics are demonstrated, with their existence being inferred, even through the intellectual process “in re ipsa,” despite the user having been judicially protected, their reparation is appropriate. That is, the service rectification does not exclude that the injured person suffers affectations in their moral and patrimonial sphere while the abnormal conduct persists. If that occurred and was thus proven, it is mandatory to impose the corresponding compensatory consequence, if requested by the person whose legal sphere was damaged. This is so in accordance with the principle of full reparation of damage, which has constitutional and legal roots (constitutional canons 9, 41, 49; 190 and 197 of the LGAP).\n\n**VII.** Within this line of thought, and regarding the existence and quantification of subjective non-material damage, this Chamber, for a long time, has indicated that: “**IV.** [...] it originates from the injury to an extra-patrimonial right. That is, it does not directly impact the patrimony. It supposes an unjust disturbance of the emotional conditions. It does not require direct proof and is left to the equitable assessment of the Judge. If it concerns subjective non-material damage, the courts are empowered to decree and quantify the award. The legal nature of this type of damage does not obligate the liquidator to determine its existence because it belongs to its internal sphere. This is not a problem for psychiatrists or doctors. One must understand its existence or not because it belongs to conscience. It is deduced through presumptions inferred from circumstantial evidence, since the unlawful generating fact reveals the non-material damage, because when the psyche, health, physical integrity, honor, intimacy, etc., are damaged, it is easy to infer the damage, which is why it is said that proof of non-material damage exists ‘in re ipsa.’ Neither must its value be proven because it has no concrete value. It is valued prudentially. It is not, then, a matter of quantifying suffering, as it is inestimable, but of fixing a monetary compensation for its injury, the only mechanism to which law can resort, so as to repair, at least in part, its offense. For greater detail on this aspect, one may consult, among others, from this collegiate body, rulings no. 112 already cited, no. 17 of 14 hours 30 minutes on February 21, 1996, and no. 41 of 14 hours 40 minutes on May 14, 1997. Its granting does not have a strict attachment to evidentiary factors (except those referring to the causal link), but to the prudence and objective discretion of the judge. However, its determination is subject to the principles of reasonableness and proportionality, which must be assessed by the competent authority in each case, so that its quantification is in accordance with Law and does not lead to excessive indemnities that unjustifiably benefit one of the parties. That is, it must maintain a just balance derived from the specific factual picture, a matter that must be pondered within the indicated limits.” (Among many others, judgment of this Chamber no. 468-F-S1-19 of 9 hours 45 minutes on May 30, 2019, may be consulted). In accordance with the foregoing, once the existence of the non-material damage and its causal link with the cause of action alleged by the plaintiff are established—which is not objected to by the appellant—the determination of the quantum depends on the equitable assessment of the Judge; for which, special circumstances of the case, as well as the constitutional principles of reasonableness and proportionality, must be considered. In this regard, judgment no. 1098-F-S1-2023 of 10 hours 09 minutes on July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1170686), among many others, may be consulted. That is, it is with respect to subjective non-material damage that its demonstration is “in re ipsa,” provided that it is a consequence of an unlawful generating fact or motive.\n\n**VIII.** In this litigation, the Constitutional Chamber, as has already been indicated, determined the unlawful conduct of the CCSS by verifying the violation of the fundamental right to health of Mr. Johnny Francisco.\n\nThe postponement of the required surgery was, at the time the constitutional judgment was handed down, almost six months. Such a situation—an unlawful act—according to the maxims of logic, experience, and correct human understanding, as was resolved, is an adequate cause (causal link) of moral distress (aflicción moral), associated with anxiety, annoyance, frustration, and worry, due to the excessive waiting time for care—as declared, it is insisted, at the constitutional level—of a health situation that, “per se,” is a cause of concern for the person suffering from it, even though it was not diagnosed as urgent; but which generated severe pain, as indicated by the Judge. In accordance with correct human understanding and experience, it is insisted, the existence of feelings such as those described above can be inferred “in re ipsa,” as the Execution Judge did, without the person having the legal duty to endure them, since they derive from an abnormal functioning of the Administration, as decreed, it is repeated once more, by the Constitutional Chamber. Ergo, contrary to what was indicated by the appellant, its existence is determined and, therefore, the propriety of its compensation.\n\n**IX.** Likewise, this Chamber has stated: “***VIII.*** *[…] On other occasions, this cassation body (órgano de casación) has had the opportunity to highlight the necessary “legal reasonableness” (razonabilidad jurídica) that such indemnifications must observe, for the verification of which compliance with a “reasonableness of equality” (razonabilidad de igualdad) must be verified, which the Constitutional Chamber has defined as “…the type of legal assessment that starts from the premise that equal antecedents must have equal consequences, without arbitrary exceptions” (e.g., Votos 5236-99 and 1354-2011). That is to say, to avoid inequitable and illegitimate treatment in the various matters where the compensation of moral damages (daños morales) is discussed, it is essential to verify that the amounts recognized are not disproportionate when compared to those established in other similar matters. In this vein, the Chamber considers that the sum granted conforms to the intensity of the harm (daño) caused.*” Judgment no. 760-F-S1-2023 of 1:24 p.m. on May 29, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1157835). In the same sense, the following rulings, among others, can be consulted: nos. 1934-F-S1-2022 of 3:00 p.m. on August 12; 2654-F-S1-2022 of 10:10 a.m. on December 08 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1132117), both from the year 2022, and 1087-F-S1-2023 of 9:36 a.m. on July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1173505). Even though in the objection under review the challenger did not question the amount granted for subjective moral harm, this Chamber considers that the sum granted, ₡50,000.00, is reasonable and proportionate, considering the circumstances of this case and other similar matters. By way of example, the following precedents can be pointed out, where this decision-making body did not consider unreasonable the sums granted for the delay in the provision of the public health service, nos. 429-F-S1-2024 of 10:41 a.m. on May 03 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1229475), in which the adjudicator granted ₡500,00.00; 937-F-S1-2024 of 2:51 p.m. on July 10 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925), in which it was set at ₡200,000.00; and 1302-F-S1-2024 of 4:14 p.m. on September 27, all from the year 2024 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1253306), in which the sum of ₡200,000.00 was granted.\n\n**X. THIRD.** Likewise, the appellant argued that, in the case of the amparo beneficiary, there was no urgency in performing the surgery. While it is true, as the Judge pointed out, that the petitioner's ailment was not classified as medically urgent—even though it inflicted severe pain—it is also true that, as stated in section I of this judgment, it was the Constitutional Chamber itself, in the final judgment, that determined the urgency of performing the required surgical procedure on the petitioner, ordering that it should be carried out within a period of three months from the notification of that ruling. Consequently, within the objective comparison that must prevail in this type of process—enforcement of a constitutional judgment—the issue of urgency is a precluded aspect, because, it is repeated, it was so determined and resolved by the Constitutional Court.\n\n**XI. FOURTH.** The challenger also alleged that the amparo beneficiary acquiesced or consented to remaining on the waiting list. Contrary to what was alleged, in this dispute, the existence of tacit consent or an agreed act, much less an express one, by Mr. Valverde Porras cannot be deemed to exist. The amparo appeal was filed on time. So much so that the Constitutional Chamber admitted it for processing and, subsequently, granted it. This is regardless of the time elapsed between the moment when the CCSS placed him on the waiting list and the filing of the amparo. Therefore, the petitioner showed his disagreement with his continued presence on the waiting list, and that jurisdictional body (órgano jurisdiccional) ruled in his favor.\n\n**XII.** In the **second** ground for disagreement, page nine of the appeal, the appellant announced his intention to file it based on the cassation ground for violation of substantive norms provided for in subsection d) of article 138 of the CPCA: “***d)** When the judgment violates the norms or principles of Constitutional Law, among others, reasonableness, proportionality, legal certainty (seguridad jurídica), and equality.*” He invoked a violation of the postulate of reasonableness. In the objected judgment, he said, the Execution Judge determined the reasonableness of the compensation, since harm (daño) was caused to the petitioner and, as such, it is not enough that there was restorative justice. He reproduced, in what was of interest to him, what was considered in section VIII of the questioned ruling. The Judge, he noted, distinguished that the reproached conduct generated moral harm (daño moral) to the petitioner, and that was determined at the Constitutional level. However, to reach that conclusion, the text with which the enforcement of the amparo appeal was initiated was sufficient for him. The contested judgment, he said, left open the possibility of seeking, in an unrestricted manner, double indemnifications: one of a material type, by receiving medical care, and a pecuniary one, without any evidence whatsoever mediating therefor.\n\nThe Judge, by his analysis, violated the principle of reasonableness. The spirit of the CCSS, he noted, in accordance with precept 73 of the Political Constitution, is to guarantee the fundamental rights to life and health; without which, the other guarantees enshrined in the Magna Carta cannot be fully exercised. Although, he pointed out, there are waiting lists or waiting periods for carrying out medical requirements; it is also true that granting a pecuniary indemnification for placing a person on one of them, despite there being no medical urgency criterion, implies that the amounts destined to guarantee the two aforementioned fundamental rights are diminished, which, by all accounts, he alleged, is irrational, since the contributing persons to the Sickness and Maternity Insurance do so with the objective that a health service be provided and that resources be available to guarantee it. Not for indemnifications to be granted for placing a person on a waiting list, or for appointments to be set within a reasonable waiting period. The Adjudicator, he noted, straying from the principle of reasonableness, determined that the fact that the service had been performed was insufficient to establish the existence of complete restorative justice. Therefore, he noted, there must also be economic compensation. That is, he stated, it follows from the foregoing that he determined that a double indemnification must always be involved when a person is placed on a waiting list, or has been given a scheduled appointment exceeding a reasonable waiting time. However, he affirmed, the truth is that this generates a privilege and unjust enrichment without any cause. He alluded to the judgments of this Chamber, according to its citation order, nos. 1502-S1-2022, 297-F-S1-2024, 28-F-S1-2024 and 1823-F-S1-2022. The objective of those who appeal to the Constitutional Chamber, he said, is to have a surgical procedure performed, or to be provided medical attention. They seek, he added, the restoration of their health, not an indemnification. This, he argued, can lead to a reduction in the health service’s resources, necessary for equipment improvements, payment for medications, and instruments to adequately provide the health service, through professionals prepared for it. This principle was directly violated, he said, by granting an indemnification component, alleging that it is not enough that the medical service was provided, since the fact of waiting so long for the medical procedure to be performed causes negative feelings or situations in the enforcing party that merit an indemnification. A conclusion arrived at solely from the text of the execution. The Judge transgressed said principle of reasonableness, since, despite being clear that restorative justice occurred, he granted a pecuniary amount, under the premise that it is not sufficient that the procedure was performed; rather, a person who is on a waiting list or exceeds a reasonable waiting period to have medical procedures performed or to be attended, deserves a double indemnification, which generates a privilege and unjust enrichment without any cause. It was not weighed that a privilege was granted to him over the other insured persons, who are surpassed by the protected person on the waiting list. This was previously analyzed by this Chamber, he noted, in judgment no. 1502-S1-2022, which he reproduced in its relevant parts. Also, in no. 297-F-S1-2024 at 5:27 p.m. on March 21, 2024, which he also copied as pertinent. This situation, he indicated, presented to the Adjudicator, was directly disregarded and, he even said, evidence, in some form, of a possible existence of an \"animus\" to condemn his principal under any scenario. It is, he alleged, contrary to the principle of reasonableness, since, in addition to diminishing the resources available to provide the health service; it grants a position of privilege to the person who received the required attention at the expense of those who collaborate to provide an adequate health service. Therefore, he concluded, granting an indemnification for moral damages (daño moral) becomes a violation of the principle of reasonableness.\n\nXIII. Regarding what was indicated in the preceding Considerando, it is necessary to indicate the following. FIRST. The objector forgot that this procedural instance does not correspond to an ordinary appeal (such as an appeal). Nor is it sufficient to express a series of general and merely argumentative disagreements. It is necessary to contrast what was decided with the infraction that, in his opinion, took place. In this regard, numeral 139, subsection 3 of the CPCA requires a necessary material requirement, both for the admissibility of the cassation appeal (recurso) and for its subsequent evaluation on the merits. It concerns the motivation of the cassation appeal which, due to the characteristics of cassation, must be clear and precise. In this sense, it must contain, as stipulated by the precept under comment, the factual and legal foundation of the case. Factual, to the extent that one shows disagreement with the facts that have been considered proven or unproven (which leads to the weighing of the evidence), or with the circumstances that occurred in the violation of procedural rules. Legal, when it concerns a problem raised about the application, omission, or improper interpretation of any norm that makes up the block of legality, including, of course, constitutional principles, or that which also operates by reflexive or indirect effect, after the facts of the appealed judgment are modified. Both in the procedural infraction and in the evidentiary one, the factual reasons may concur, along with the legal reasons (always necessary), and in that sense, the referenced foundations must be directed in both aspects, under penalty of inadmissibility. Furthermore, it is necessary to clarify that from the legal foundation, by express legal mandate, the indication of those canons relative to the value of the poorly appreciated evidentiary element or elements is exempted. Likewise, it is unnecessary to cite the norms that the jurisdictional body of instance erroneously used and mentioned to issue and reason its decision, because they are contained in the same appealed ruling. And of course, it is not at all indispensable to cite the precepts that establish the requirements, deadlines, and basic rules for the admission of the cassation appeal. Before the citation of these latter ones, what is essential is that they be fulfilled, that they be put into practice at the time of drafting and filing the cassation appeal. Thus, the foundation ordered by law can be understood, roughly, as that technical-legal argumentation in which a series of articles or legal rules are mentioned, intertwined or concatenated with each other and reasonably linked in a double perspective: with the arguments of the cassation appeal and with the judgment being attacked. To the extent that a set of legal norms (or if applicable, a single one of them) is cited, pertinent and clearly linked to the contested judgment (whether in its factual or legal basis) and the arguments of the cassation appeal, there is legal foundation. Jurisprudential additions or eventual doctrinal citations will sometimes reinforce the allegations made, but generally do not constitute their essence. As this Chamber has already indicated interpreting the referenced article 139, \"it is required that the cassation appeal have a minimum legal foundation ... the reasons on which it bases its action must be explained, combating the legal arguments of the appealed judgment and setting forth, at least, some normative reference that gives it support\" (Resolution no. 318-A-2008, at 2:25 p.m. on May 8, 2008).\n\nThe legal basis is, therefore, foreign to a confused display of rules and allegations; to a mix of unintelligible arguments or the simple exposition of opinions on the appropriateness or justice of the case, or, likewise, to a recounting of the mistakes considered to have been made in the appealed judgment, without support in legal rules or criteria. Hence, if the appeal completely omits that technical-normative relationship to which reference has been made, or the one it makes is manifestly and evidently impertinent or disconnected from the case, it must be understood that it lacks \"total legal basis\" (\"total fundamentación jurídica\"), and therefore, fails to comply with the necessary requirement established in numeral 139.3, which is sanctioned with outright rejection, pursuant to the provisions of article 140, subsection c) of the same procedural code (Código de rito). This Chamber, likewise, has repeatedly indicated that for an appeal to pass the admission review, it requires, in addition to a sufficient exposition of grounds, the corresponding mention and linking of the applicable rules deemed infringed with the judgment under challenge. In this regard, among other resolutions, nos. 677-A-S1-2021 of 09 hours 40 minutes on March 25, 2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1029345); 755-A-S1-2022 of 10 hours 55 minutes on March 29 of March (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1082042); and 1663-A-S1-2022 of 10 hours 05 minutes on July 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112340), both from the year 2022, may be consulted.\n\n**XIV.** In this line of thought, after a conscientious study of the objection under review, this Chamber determines that the appellant (casacionista) alleged several dissimilar hypotheses, but, due to the way it was structured, they are inseparable from each other. In this regard, on pages 10 and 11 of the appeal, he indicated: “*It is observed in the paragraph copied above that the Judge distinguishes that the reproached conduct caused moral damage to the plaintiff, and that was determined in the Constitutional Court, however, he only needed the text with which the amparo appeal was filed to reach that conclusion.* […] *the fact of waiting so long for the medical procedure to be performed causes negative feelings or situations in the plaintiff, which deserve compensation, a conclusion he reached solely with the text of the filing.*” (The underlining is supplied). If what was reproached were to occur, it would give rise to the cassation ground for violation of substantive rules provided for in subsection a) of canon 138 of the CPCA, by virtue of the alleged improper assessment of the final judgment (sentencia ejecutoria). However, the argument is informal. The appellant omitted to indicate the substantive rules that were violated by the alleged excess, with a clear and precise explanation of how the transgression occurred, just as the technique of cassation requires, as set forth in the previous section, pursuant to the provisions of numeral 139, subsection 3) ibid. On page 10, he added: “*Note, by the honorable First Chamber (Sala Primera), that the first-instance judgment practically leaves open the possibility of unrestrainedly obtaining double compensation, that of a material nature, by receiving medical care, and that of a pecuniary nature, without any proof whatsoever thereof.*” (Only the bolded text is original). What is now alleged would give rise to the cassation ground for violation of procedural rules provided for in subsection 1) point d) of canon 137 ibidem: lack of reasoning (falta de motivación). However, as happened with the previous one, the argument is informal, since the challenger (impugnante) did not indicate, with the due rigor, the procedural rules (normas adjetivas) that were transgressed, with a clear and precise explanation of how the infraction occurred. Then, on pages 11 and 12, he stated: “*In addition to the above, the first-instance judge, departing from the principle of reasonableness (principio de razonabilidad), determines that the fact that the service was provided is insufficient to speak of full restorative justice, and that therefore there must also be economic redress* […] *In that sense, the first-instance judge directly violates the principle of reasonableness, by granting a compensatory item, holding that it is not sufficient that the medical service was provided, given that the fact of waiting so long for the medical procedure to be performed causes negative feelings or situations in the plaintiff, which deserve compensation, a conclusion he reached solely with the text of the filing.* / *On this, the judge violates the principle of reasonableness, given that despite having clarity that a restorative justice took effect, he grants a pecuniary amount, under the premise that it is not sufficient that the procedure was performed on him, or that he was attended to, but rather that a person who is on a waiting list and/or who exceeds a reasonable waiting period for medical procedures to be performed or to be attended to, deserves double compensation, which generates a privilege and unjust enrichment without any cause. In addition to the fact that he does not weigh that a privilege is granted over the other insured persons, who were overtaken by the person protected by the amparo, on the waiting list.* […] *This situation, which as can be inferred, was presented to the judge, was directly disregarded, and even, some possible existence, it is reiterated, of an animus to convict under any scenario is evidenced, which is reiterated, is contrary to the principle of reasonableness, since this, in addition to depleting the resources available to the Institution (Institución) to provide the health service, grants a position of privilege to the person who received the required care, at the expense of those who collaborate to provide an adequate health service.*” (The bolded text is original). What is now set forth would give rise to the announced cassation ground for violation of substantive rules, for the alleged violation of the constitutional principle of reasonableness.\n\nThe ambiguity highlighted conflicts with the technique of cassation (casación), which requires that the grounds for the appeal be stated clearly and precisely, with the factual and legal basis of the case (precept 139(3) of the CPCA). Therefore, the objection under consideration must be dismissed.\n\n**XV. SECOND.** The appellant’s arguments regarding whether restorative justice (justicia restaurativa) operated in this dispute (grounds for alleging a violation of the principle of reasonableness), the absence of urgency in the protected party’s appointment, her consent to remain on a waiting list, and the impropriety of granting compensation for subjective moral damages (daño moral subjetivo), were already analyzed in sections VI through XI of this judgment. Thus, to avoid unnecessary repetition, the Court refers to what was stated therein.\n\n**XVI.** In the **third** objection, on page 13 of the appeal, the appellant announced that he was bringing it on the cassation ground of breach of substantive norms, provided for in subsection c) of article 138 of the CPCA: “***c)** When a legal norm has been improperly applied or interpreted, or has not been applied.*” He alleged the violation of articles 46 of Decreto Ejecutivo no. 41457-JP of October 17, 2018, “Arancel de honorarios por servicios profesionales de abogacía y notariado,” and 73.1 of the Código Procesal Civil (CPC). Regarding the personal costs of the amparo (recurso de amparo) appeal, he stated that the Enforcement Judge opted to grant them. This, despite being certain that legal representation is not required to file an amparo appeal. He even added that the amparo appeal being enforced was filed by a non-profit foundation. He argued that the right was granted in the decision itself issued by the Sala Constitucional. He transcribed what was stated in Considerando IX of the contested ruling, entitled “*SOBRE LAS COSTAS DEL AMPARO*.” He indicated that although the amparo appeal was filed through a non-profit foundation, which, according to its own publicity, promotes the filing of amparo appeals free of charge, and which did not generate any expense for the protected party that had been demonstrated, the determination was made to grant this item. He indicated that it is clear that it was the “Fundación Derecho sin Fronteras” who filed the amparo appeal, using, for this purpose, the generalized template with which it has filed more than 4,000 amparo appeals—according to its own statements and the publicity on its website—which it handles free of charge. The same principle of gratuity, he stated, must be applied to the case, since, as a non-profit foundation, favoring a user by advancing their appointment, surgery, and other medical procedures provided by the CCSS is sufficient for its purposes. He agreed with the judicial authority, he asserted, that a legal professional participated in drafting the template. However, he stated, the proceeding was filed through a non-profit foundation, filing the appeal free of charge. Consequently, given that the principle of gratuity applies to the filing of an amparo appeal and the foundation promotes that same principle, coupled with the premise that there is no proof whatsoever of any expense by the protected party, nor any invoice presented by the lawyer to the non-profit foundation, the appropriate action was exoneration from costs. The contested judgment, he alleged, improperly applied article 46 of Decreto Ejecutivo no. 41457-JP. There is no evidence in the case file, he asserted, proving that the filing, formulation, and processing of the amparo appeal generated any cost for the enforcing party. It is certain, he indicated, that the foundation that filed the appeal handled it free of charge, and therefore, it is improper to grant that compensation, given that there is also no proof of any expense. Therefore, he affirmed, the proceeding is covered by the principle of gratuity. The amparo appeal was filed by a foundation through its legal department. A proceeding that was done free of charge, as they advertise, and there is no evidence in the case file demonstrating any expense, charge, or salary paid by the professional from the foundation’s payroll. All the more reason, he stated, to affirm that the foundation promotes the well-being of the population without expecting anything in return. It was the Fundación Derecho Sin Fronteras that handled the amparo appeal, making it improper to award fees under the provisions of article 46 of the aforementioned Decreto no 41457-JP. He reproduced, to the extent relevant, the first precept of that regulatory body. In accordance with that text, he indicated, the application of that fee schedule (Arancel de honorarios) would be valid insofar as the professional renders a service for the payment of a fee. In this dispute, he commented, in addition to the appeal being formulated by a foundation, there is no evidence proving the collection of fees for the study, analysis, drafting, and processing of the amparo appeal. He even added that the premise sustained by the foundation that promoted the appeal is that it provides the service free of charge. He considered that, as there are no fees to be paid for the formulation of the appeal—since the proceeding was done by a non-profit foundation, which uses the same template (more than 4,000 cases)—and that the service is provided free of charge, awarding costs based on article 46 of the indicated Decree is therefore improper. He transcribed article 73.1 of the CPC. The very content of the norm establishes that attorney’s fees, compensation for time invested, and indispensable expenses of the process shall be considered as costs (costas); for which, he noted, there is no proof or reference in the contested judgment. Given that the enforcing party provided no proof whatsoever that an investment of money in attorney’s fees was involved, coupled with the fact that the appeal was filed by a foundation that provides the service free of charge, he noted, the Judge was not compelled to award any amount for costs of the amparo appeal, in the form of fees. There is no proof that they were paid, as there is no evidentiary means demonstrating the participation of a legal professional hired under remuneration for the processing of the amparo appeal. At the time of its enforcement, he asserted, it does not fall within the parameters of article 46 of the Decree. To receive full compensation for an expense, he indicated, it must necessarily be demonstrated. Which this representation cannot condone. No proof whatsoever was presented that such expense occurred.\n\nIt is therefore here that the error of the judgment is clearly marked: granting the amount for costs (costas) of the amparo appeal as if it were for fees (honorarios), without there being even the slightest proof thereof. The reasons for which costs are awarded to a prevailing party in a judicial process must be clear. The magistrate of the Constitutional Chamber (Sala Constitucional), Mr. Fernando Castillo Víquez, stated, on multiple occasions, he has been clear in ordering, both the CCSS, when extra-procedural satisfaction of the Constitutional Chamber's condemnations is carried out; and the contentious-administrative jurisdiction, to ensure that the amounts granted actually reach the hands of the protected parties. He transcribed, as relevant, what was set forth in the separate note of that Chamber's vote no. 2016-012528. The questioned judgment, he stated, should have rejected this aspect, since, having taken as proven that the promoter of the amparo appeal was a non-profit foundation, which manages amparo appeals on behalf of users free of charge; in addition to there being no evidence provided of the expense the foundation has to keep, within its payroll or staff, professionals who file the amparo appeals, or that this meritorious service generates a cost for them, this aspect cannot be granted, least of all, he concluded, based on Article 46 of Executive Decree No. 41457 -JP.\n\n**XVII.** Regarding what was set forth in the previous section, the following must be noted. **FIRST.** The appellant for cassation (casacionista), on pages 16 and 17 of the appeal, pointed out: “*For the foregoing reasons, the judgment should have rejected said aspect, since, having taken as proven that the promoter of the amparo appeal is a non-profit foundation, which manages amparo appeals on behalf of users free of charge, besides there being no evidence provided to the process of the expense the foundation has to keep within its payroll or staff professionals who file the amparo appeals, and/or that this meritorious service generates a cost for them, this aspect cannot be granted, and least of all based on Article 46 of the Fee Schedule for Professional Legal and Notarial Services (Arancel de honorarios por servicios profesionales de abogacía y notariado)*, *No. 41457 -JP.*” The foregoing constitutes the core of what was argued by the challenger in the censure under review. However, unlike what was stated, in the enforceable judgment it was not taken as proven, nor in the one now questioned, that the person who filed the amparo appeal was a non-profit foundation named “*Fundación Derecho sin Fronteras*”. On the contrary, the heading of the judgment under enforcement indicated: “*Amparo appeal processed in case file No.* **23-018591-0007-CO**, *filed by* **LEONARDO GÓMEZ SALAZAR**, *identity card 0108760664, on behalf of* **JOHNNY FRANCISCO VALVERDE PORRAS**, *identity card 0108500565, against the* **CAJA COSTARRICENSE DE SEGURO SOCIAL** *.*” (Only underlining is supplied). For his part, as the appellant for cassation himself well indicated, the Enforcement Judge (Juez de Ejecución), in section IX of the judgment now objected to, was emphatic in indicating that in “[…] *the case records fully demonstrate that Lic. Gómez Salazar was the legal professional in charge of filing and processing the amparo appeal, on behalf of Mr. Valverde Porras and that is sufficient to demonstrate the Attorney's work in the judicial venue.*” (The underlining is supplied). Therefore, since it was not proven (in the constitutional venue or in enforcement of the judgment) that the one who managed the amparo appeal was the indicated non-profit Foundation, if what was argued were to occur, it would give rise to the ground for cassation for violation of substantive norms provided for in subparagraph a) of article 138 of the CPCA. However, what was argued by the challenger is informal. He did not identify the evidence with which his statement is demonstrated; pointing out, with clarity and precision, just as cassation technique imposes, as set forth in Considering XIII of this judgment, under the protection of what is prescribed in article 139 subsection 3) of the CPCA, how it was improperly assessed. The foregoing mandates the outright rejection of the objection under review.\n\n**XVIII.** Notwithstanding the foregoing and, for greater abundance of reasons, it is necessary to indicate the following. **SECOND.** this Chamber, for a long time, has pointed out the difference between personal costs (costas personales) and attorney's fees (honorarios de abogado), concluding that personal costs belong to the party, not to the attorney. In this regard, the following judgments can be consulted, mutatis mutandis: nos. 432-F-S1-2017 of 09 hours 30 minutes of April 20, 2017 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-950854); 515-F-S1-2018 of 11 hours 20 minutes of May 30, 2018 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-892742); 28-F-S1-2024 of 11 hours 05 minutes of January 11 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1208396) and 297-F-S1-2024 of 17 hours 27 minutes of March 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250); both from the year 2024. **THIRD.** The CPCA, in article 193, expressly regulates the imposition of costs (costas); just as canon 73.1 of the CPC does. Consequently, it is the CPCA norm that is applicable to this litigation. However, this provision does not regulate, as the CPC's does, what is considered costs. Ergo, this procedural principle, just like those contained in articles 76.1 and 76.4 ibid, by virtue of the remission made by article 220 of the CPCA, is applicable to this litigation. In this sense, precept 73.1 of the CPC provides: “[…] *Attorney's fees shall be considered costs, the compensation for the time invested by the party in attending the procedural acts where their presence was necessary and the other indispensable expenses of the process.*” (The underlining is supplied). In this same line of thought, precepts 76.1 and 76.4 ibid indicate: “***76.1 Right to fees and setting.** Attorney's fees belong to the attorney, with the exceptions established by law. When the party is an attorney and has acted personally, they shall be entitled to them. Unless agreed otherwise, they shall be set in consideration of the work, the status and economic significance of the process, based on the provisions of Law No. 13, Organic Law of the Bar Association (Ley Orgánica del Colegio de Abogados y Abogadas), of October 28, 1941, and the decree on fees of attorneys and notaries.* […] ***76.4 Contractual setting of attorney's fees.** Attorneys and their clients may contractually set the amount of fees and their payment terms respecting the limits imposed by the law and the respective decree. Such stipulation shall not affect the opposing parties to the process, for purposes of setting personal costs.*” (Only the underlined is supplied). In light of what is provided in said norms, it is clear that, for purposes of costs, attorney's fees must be calculated based on the legal limits and the rates established in the respective Decree, independently of any private agreement between the attorney and their client.\n\nThis implies that, in the settlement of costs (liquidación de costas), it is not necessary for the executing party to prove the agreement they have with their attorney or the payment made to them, since the regulations provide that the calculation of that item must be made in accordance with the applicable tariff or decree, in order to ensure an objective criterion in the settlement of costs. Thus, if a party had legal representation (patrocinio letrado) during the processing of a case and obtained an award of costs in their favor, the amount to be recognized as attorney's fees will necessarily be that established in the \"Tariff of Fees for Professional Legal Services\" (\"Arancel de honorarios por servicios profesionales de abogacía\"), according to the work performed. Consequently, it is not essential to provide an invoice or proof of payment to the legal professional for the recognition of that item to proceed. In this litigation (lite), it is insisted, the objector did not prove that Mr. Johnny Valverde Porras lacked legal representation during the processing of the amparo proceeding; or that it was provided on a pro bono basis. On the contrary, as indicated, it is determined from the enforceable judgment that his special judicial representative in this enforcement proceeding was the one who filed the amparo action on his behalf before the Constitutional Chamber. This allows one to infer that said professional defended the interests of the protected party in the constitutional venue. Therefore, the failure to present the invoice or proof of payment claimed by the appellant is not sufficient to diminish or dismiss the item of personal costs (costas personales) settled by the party and expressly recognized in the enforceable judgment. It is reiterated, because the executing party had legal representation during the processing of the amparo and obtained an award of costs in their favor. That is, they have the right to be recognized for costs the amount established by the applicable tariff for attorney's fees. As a corollary, this Chamber does not observe the alleged legal infractions and, consequently, the rejection of the challenge will be imposed.\n\n**XIX.** In the **fourth** and final objection, page 17 of the complaint, the objector announced its filing on the cassation ground of violation of substantive norms provided for in subsection c) of Article 138 of the CPCA. He alleged improper application of canon 193 ibid. In the challenged judgment, he said, the Enforcement Judge granted the costs of the judgment enforcement proceeding. He considered there is no reason to exonerate his client, despite his opposition that the executing party could not substantiate the subjective moral damages (daño moral subjetivo) and did not provide proof or technical support demonstrating the existence of a causal link between what was ordered in the enforceable decision (voto ejecutorio) and the specific items sought to be enforced. The aforementioned canon, he said, establishes that the losing party shall be exonerated from paying costs when, due to the nature of the matters debated, there was sufficient reason to litigate. He reproduced section XI of the challenged judgment, entitled, \"*ON THE COSTS OF THE ENFORCEMENT*\" (“*SOBRE LAS COSTAS DE LA EJECUCIÓN*”). The Judge, he noted, weighed both the costs award from the appeal and the moral damages granted to justify the non-exoneration under the terms of subsection 2 of the indicated article 193 ejúsdem. Had the evidence been properly assessed, he said, and the scope of the foregoing, he would have reached the conclusion that the award of moral damages was not appropriate, nor any amount for the costs of the amparo action. Reason to affirm that the canon granted for the costs of the enforcement is improper. The Judge, he commented, improperly applied the aforementioned precept 193 subsection 2) ibid, since that norm establishes that the losing party may be exonerated from the payment of costs when, due to the nature of the matters debated, there was sufficient reason to litigate. Taking into consideration purely arithmetic grounds, and only the amounts granted, he alleged, they represent a total of ₡231,000.00. This implies, he argued, that of the total sought, the executing party obtained 48.07% -not counting the costs of the enforcement that have not been set-, which results, *contrario sensu*, in them not obtaining 51.98% of what they sought to obtain. Consequently, he alleged, it is denoted that his client had to litigate. He achieved, he added, that the executing party did not obtain the totality of its claims. Therefore, he questioned: how was this not even minimally visualized by the Judge, who dismissed the thesis that his client had sufficient reasons to litigate? Especially being faced with a judgment enforcement of a right granted in the abstract, where they were in a scenario of extreme petitions, which implied that this representation had to exercise the defense of institutional interests. If the Judge had assessed the above, he stated, he would have determined that his client had reasons to litigate. Among different elements, he pointed out, are the following: **1)** only 48.07% of the total sought was granted; **2)** 51.98% of the total requested was rejected; **3)** it is a claim with an evident search to obtain items above what can be considered parallel to reasonableness; and **4)** this Chamber, in judgment no. 1502-S1-2022, indicated that it is irrational to impose on the tripartite social security contribution fund and on the other insured parties benefited from said funds, additional compensation for someone who has consented to the wait and received, through judicial protection, the required medical attention. In addition to that, it provided guidelines to determine whether or not compensation should occur, such as whether the type of pathology of the patient refers to an emergency or not, or the conformity with inclusion on a waiting list and, even, compensation \"*in natura*\". That is, his client started from positions developed by this Chamber to litigate in the proceeding, which was pointed out to the Judge, without him taking it into consideration. From the foregoing, he argued, it is evident that this representation had to litigate in the proceeding. Not satisfied with this, the Judge decided to order his client to pay costs, leaving it in a clear position of vulnerability and disadvantage, since defending, even, the financial sustainability of the Institution, is clearly a sufficient reason to litigate. For this, he pointed out, it can be deduced, directly, clearly, and simply, that his client had sufficient reasons to litigate, given that the public treasury was being effectively protected, in defense of the few resources it has. It was forced to oppose the claim, considering the amount requested by the executing party for subjective moral damages unreasonable and disproportionate -₡300,000.00- a circumstance that led to said amount being rejected in the judgment and reduced to ₡50,000.00. Having exposed the reasons to challenge both the moral damages item and the costs of the amparo action, and finding support for the reasons to overturn those items, by accepting the claim against them, the basis on which the judicial authority did not exonerate his client varies. A reason that justifies the ground to challenge that item.\n\nBased on the arguments presented, and if Article 193 subsection b) of the CPCA had been properly applied, the Judge would have exempted his client from paying the costs of the enforcement proceeding, given that it is evident and manifest, besides being a simple verification, he noted, the fact that there was sufficient reason to litigate this process. Therefore, he concluded, this grievance should be upheld and the judgment overturned.\n\n**XX.** Regarding the foregoing Considerando, it is necessary to indicate **FIRST.** After a thorough study of the objection under review, this Chamber reaches the conviction that the appellant invoked several mutually dissimilar hypotheses, but, due to the way he structured the objection, they are indivisible. In this sense, on page 18 of the appeal he stated: “*In this regard, had the evidence been properly assessed, and the scope of what was mentioned, he would have arrived at the free conviction that the award of non-pecuniary damages is not appropriate, nor any amount for the costs of the amparo appeal, reason to affirm that the amount granted for the enforcement proceeding costs is improper.*” What was argued, if true, would give rise to the cassation ground for violation of substantive norms provided for in article 138 subsection a) of the CPCA, due to improper evidentiary assessment. However, it is informal. The appellant did not identify any piece of evidence, explaining how it was violated by the objected ruling, as the cassation technique requires, as has already been indicated. On the other hand, on that same page 18, he invoked the violation, by erroneous application, of article 193 subsection b) of the CPCA, since, in his opinion, due to the nature of the debated issues, his client had sufficient reason to litigate. This is because, according to what he indicated, the amounts granted to the enforcing party total ₡231,000.00. That is, 48.02% of what was claimed. This means, according to his criterion, that his represented party should litigate in this dispute. In this regard, what was indicated would give rise to the announced cassation ground, provided for in subsection c) of precept 138 of the CPCA. Then, on pages 18 and 19 he indicated: “[…] *it is not understood how, it was not even minimally visualized by the trial judge, who dismisses the thesis that my represented party did have sufficient reasons to litigate the sentence enforcement proceeding, especially when facing the enforcement of a sentence for a right granted in the abstract, where we were practically before a scenario of extreme petitions, which mean that this representation must exercise, without any discussion, the defense of institutional interests.* **/***If the trial judge had assessed the foregoing, he would have determined that my represented party had more than enough reasons to litigate the judicial process, since, among different elements, there are the following:* […]”. (The underlining is supplied). In what is now presented, the appellant alluded to the cassation ground for violation of procedural norms, provided for in Article 137 subsection 1) point d) of the CPCA: lack of reasoning. However, what was argued is informal, by omitting to indicate the procedural norm violated, with a clear and precise explanation of how the violation occurred, as the cassation technique requires. As was already stated in section XVI of this judgment, the confusion revealed conflicts with the cassation technique, which requires that the grounds for the appeal must be indicated clearly and precisely, with the factual and legal basis of the case (precept 139 subsection 3) of the CPCA). Therefore, the rejection of the objection under study is imposed.\n\n**XXI. SECOND.** Notwithstanding the foregoing and, for greater abundance of reasons, it is necessary to indicate the following. On pages 19 and 20 the appellant indicated: “*Added to that, having presented the reasons to appeal, both the item for non-pecuniary damages and the costs of the amparo appeal, finding support for the reasons to overturn these items, upon upholding the claim against them, the basis on which the judicial authority does not exonerate my represented party varies, an additional reason that justifies the grounds to appeal this item.* **/***Therefore, having reason in the arguments presented, and if Article 193 subsection b) of the Code of Administrative Contentious Procedure had been properly applied, the trial judge would have exempted my represented party from paying the enforcement proceeding costs, given that it is evident and manifest, besides being a simple verification, the fact that there was sufficient reason to litigate this process, for which it is estimated that this grievance should be upheld, and the judgment overturned.*”. The foregoing is nothing more than an argumentative allegation devoid of any factual and legal support. It constitutes an expectation of the cassation appellant that, for the reasons presented when studying each grievance, was not realized. The criteria for which this Chamber deems the inadmissibility of each of them were provided, a reason why, contrary to what was argued, the basis for imposing the recognition of the enforcement proceeding costs on the defendant party has not varied.\n\n**XXII. THIRD.** According to what was presented in the response to the lawsuit, images 31 to 147 of the electronic judicial file, the general judicial attorney of the CCSS argued and requested that his client should not be ordered to pay subjective non-pecuniary damages, since the enforcing party did not provide any element of judgment—in accordance with the provisions of canons 180 subsection 1 of the CPCA and 41.1 of the CPC—nor did he mention any that would prove what was stated in the lawsuit, much less the basis for requesting said item in the amount claimed. On the contrary, the Enforcement Judge determined the existence of subjective non-pecuniary damages by virtue of the facts that served as the basis for the upholding of the amparo appeal, which was endorsed by this Chamber, as indicated. Furthermore, he set its amount in accordance with his sound discretion and under the principles of reasonableness and proportionality, which was also shared by this decision-making body. Likewise, the amount requested for the personal costs of the amparo appeal was granted. Also, the legal interest on the granted amounts and the costs of the enforcement proceeding were awarded, exactly as requested.\n\nCorollary, contrary to what was stated by the appellant, and as was correctly resolved, it was proper to order the payment of the costs of the execution proceeding, as provided by canon 193 of the CPCA, since none of the grounds for exoneration set forth in that rule are present. FOURTH. As noted in section XV of this judgment, what was stated by the challenger regarding the existence of restorative justice and the lack of urgency in the scheduling of the amparo petitioner's appointment, the fact of having consented to the wait, and the impropriety of granting compensation for subjective moral damage (daño moral subjetivo), was already the subject of analysis in sections VI through XI of this judgment; therefore, in order to avoid unnecessary reiterations, the Court refers to what was expressed therein.\n\nXXIII. By virtue of the reasons indicated, the rejection of the filed appeal is proper. In accordance with the provisions of article 150, subsection 3) of the CPCA, since this Chamber does not consider that the cassation appellant has sufficient grounds to appeal, for the reasons set forth when analyzing each grievance, it shall be ordered to pay the costs of the cassation appeal (recurso de casación), which must be calculated in the judgment execution phase, in order to guarantee the right of defense of the party against whom execution is sought, by granting it the respective hearing on the calculation of costs that is submitted (articles 41 and 153 of the Political Constitution).\n\nXXIV. DISSENTING VOTE OF JUDGE ROJAS MORALES. I diverge from the majority opinion insofar as it deems it appropriate to order the defendant to pay for subjective moral damage. Regarding the damages (daños y perjuicios) deriving from a ruling of the Constitutional Chamber, when granting an amparo appeal (recurso de amparo), it is important to bear in mind that, given their nature, these types of judgments contain an abstract condemnation, without any factual consideration; they do not prejudge, since they have not been the subject of analysis, their existence, causal link, or quantification. Said Court merely determines the constitutional violation. When enforcing these aspects, the causal relationship between what was declared in the abstract and the specific matter must be established. This being the case, the fact that the Constitutional Chamber abstractly orders the payment of damages does not entail an automatic, enforceable condemnation, as the Executing Judge seems to wrongly understand it. It is incumbent upon the judges responsible for resolving the calculation of damages to assess, in each specific case, the existence of sufficient merit to grant the requested compensation. In this regard, the following must be analyzed: the particular circumstances of the case, the position of the parties, the nature, purpose, and objective of the remedy, as well as the constitutional principles of reasonableness and proportionality. Furthermore, when the matter concerns an alleged subjective moral damage suffered by a person facing a lack of medical care, as occurs in the present case, the examination of additional facets becomes indispensable. In the first place, the factor of urgency must be assessed, since it is evident that a person requiring urgent care from the CCSS is not in the same situation, for example: an individual suffering from a cancer that is progressively worsening irremediably, versus a person who has an ailment for which a surgical intervention or a medical appointment without a pressing character has been prescribed; in both cases, the waiting time to receive the medical service does not have the same result. Likewise, the moral harm will not be of the same intensity either. On the other hand, the inactivity of the patient must be analyzed during the passage of time on the waiting list (canon 30, subsection ch) of the Constitutional Jurisdiction Law -LJC- and 38 of the Contentious Administrative Procedure Code), which ceases when the patient files an amparo before the Constitutional Chamber or, alternatively, before the courts of justice, to demand the medical care or treatment necessary (administrative activity). It should be taken into account that, in the Costa Rican legal system, the passage of time without taking action has clear consequences regarding the expiry of the action, an aspect that can be assessed ex officio. A pecuniary advantage cannot be derived from inactivity, as this conflicts with the principle of proportionality in the strict sense. Thirdly, the satisfaction derived from the order of a court of justice, through which the performance of a medical act or the delivery of medications is ordered (even if it arises from a precautionary measure), must be weighed. Even the most recent jurisprudence of the Constitutional Chamber has assessed the satisfaction generated from the notification of the processing of the amparo. This refers to those cases in which, on the occasion of the amparo and regardless of the time elapsed between the filing of the appeal and the administrative response received, the respondent authority provides the individual with the required medical care (granting a fixed date for surgery or a medical consultation, supplying the needed medication, rescheduling an appointment, etc.). Cases of the latest erga omnes binding resolution (according to article 13 of the LJC), in which the Constitutional Judges have considered it improper to order costs, damages, and losses, resolving even without a condemnation in those aspects; which must be assessed by this Chamber when ruling on ongoing proceedings. In this regard, the following judgment numbers may be consulted, among others: 2024-000017 of 9:15 a.m. on January 9, 2024, 2024-000026 of 9:15 a.m. on January 9, 2024, and 2024-006673 of 9:15 a.m. on March 8, 2024. It is worth emphasizing that providing the required medical service constitutes a manifestation of restorative justice, which this Deciding Body must assess. The compensation granted in violation of the stated reasoning becomes unreasonable and disproportionate, especially when, in a universal social security system, such as Costa Rica's, such compensations are paid by all insured persons, including those displaced by the plaintiff. Upon examining the aspects described and the specific case of Mr. Johnny Francisco Valverde Porras, it is improper to compensate the emotional harm granted in the judgment. It is evident in the case file that, on February 24, 2023, the Neurosurgery Service of the Monseñor Víctor Manuel Sanabria Hospital in Puntarenas issued to Mr. Johnny a hospitalization request for surgery, without a fixed date. On August 4, 2023, he filed an amparo before the Constitutional Chamber, meaning that for approximately six months he remained waiting for the intervention to be scheduled. One must take into account the possibilities of social security in an area such as Neurosurgery, where there are not enough specialists to serve the population, especially since the number of people requiring intervention in this area is increasing. Moreover, it is of interest to note that, even though the Monseñor Víctor Manuel Sanabria Hospital issued him a hospitalization order for surgery, it did so on a non-urgent basis. Added to the above, it is an uncontested fact that, as a consequence of the constitutional ruling, Mr. Valverde Porras received the required medical care, since the surgical intervention was performed on November 16, 2023 (as indicated in official communication HMS-DG-0513-2024 of February 14, 2024, issued by Mr. Randall Álvarez Juárez, General Director of the Monseñor Sanabria Hospital). That is, the only waiting time the plaintiff endured to receive the needed care was approximately three months, counted from when he filed the amparo appeal on August 4, 2023, until the surgery was performed on the following November 16. This period is even shorter if one considers that the final and enforceable judgment was notified on August 23, 2023.\n\nTimeframes that are reasonable from the standpoint of providing a non-urgent service and given the need to fulfill the preoperative requirements entailed by any surgical intervention. It should be noted that, from the filing of the amparo, the plaintiff was never subjected to a prolonged or indefinite wait. The medical attention was received within a more than reasonable period (even shorter than care timelines in private medicine). Without overlooking that the assessment appointment was scheduled on a non-urgent basis. The foregoing speaks to the nonexistence of the damages claimed. It is worth noting, in cases such as the one under study and without a doubt, the user's satisfaction was already achieved; therefore, it becomes contrary to law to award additional compensation beyond what was received (a medical assessment that uniquely bypassed the waiting list (lista de espera)). The foregoing, far from causing moral harm to the plaintiff, granted her a privilege over the other insured persons, which diminishes the claim for moral damages (daño moral) raised. It is irrational to impose on the tripartite contribution fund of social security, and on the other insured persons who benefit from those funds, an additional compensation payment to someone who has already received the required medical attention through judicial protection. For the reasons indicated, the compensation granted does not conform to criteria of reasonableness and proportionality (established by the Constitutional Chamber (Sala Constitucional) itself). By virtue of the foregoing, the undersigned considers that the appropriate course of action was to uphold the first and second grievances of the appeal filed and, consequently, to annul the contested ruling —only— insofar as it recognized the amount of ¢50,000.00 for subjective moral damages (daño moral subjetivo), in order to instead, ruling on the merits, reject that claim.\n\nPOR TANTO\n\nBy majority vote, the appeal is declared without merit (sin lugar), with its costs to be borne by the appellant, Caja Costarricense de Seguro Social, which shall be calculated in the sentence execution stage.\n\nMagistrate Rojas Morales issues a dissenting vote to grant the appeal by virtue of restorative justice having been configured. mja.\n\nRocío Rojas Morales\n\nDamaris Vargas Vásquez\n\nJorge Leiva Poveda\n\nCarlos Guillermo Zamora Campos\n\nIgnacio Jose Monge Dobles\n\nDigitally Signed Document\n-- Verification Code --\n\nGRVXS1NVCFE61\nTelephones: (506) 2295-3658 or 2295-3659, email sala_primera@poder-judicial.go.cr\n\nThat process seeks to materialize the abstract judgment imposed on the losing party. If aspects different from or contrary to the procedure giving rise to the execution are granted, or if they are granted against persons who were not convicted, res judicata (cosa juzgada) is violated. See resolutions 383-2019 and 309-2021 of the First Chamber. Consequently, the supervisory function of this Chamber is limited to an objective comparison between the final judgment and the resolution under appeal. See resolutions 82-2022 and 1984-2022 of the First Chamber (voto 258-F-2025).\n\nChange of jurisprudential criterion regarding restorative justice (see resolutions 1502-2022, 2429-2022, 28-2024, 297-2024, 901-2024, and 937-2024). It involves a vindication of the injured legal situation, due to a failure of service, which must be provided. Even more so, when it becomes necessary, as occurs with pending health service. However, said reparation does not exclude that the injured person has suffered harm to their moral and pecuniary spheres while the abnormal conduct persisted due to the administrative dysfunction. If effective detriments are demonstrated (precepts 196 and 197 of the General Public Administration Act (Ley General de la Administración Pública, LGAP)), their reparation is warranted. That is, the corrective service does not exclude that the injured person suffers harm to their moral and pecuniary spheres while the abnormal conduct persists (principle of full reparation of harm (principio de reparación integral del daño), articles 9, 41, and 49 of the Political Constitution, 190 and 197 of the LGAP) (Voto 258-F-2025).\n\nAnalysis regarding the existence (causal link (nexo causal)), demonstration (in re ipsa), and quantification (legal reasonableness (razonabilidad jurídica) and reasonableness of equality (razonabilidad de igualdad)) of subjective non-pecuniary damage (daño moral subjetivo). See resolutions 112-1996, 41-1997, 468-2019, and 1098-2023 of the First Chamber. The Constitutional Chamber granted an amparo appeal against the Costa Rican Social Security Fund, for violating the fundamental right to health of the protected person, given that a disproportionate period of nearly six months of indefinite waiting had elapsed for the required herniated disc surgery to be performed; even more so, when the condition affected their quality of life. It ordered the entity to perform the prescribed surgical intervention within a period of three months from the notification of the judgment. In the judgment execution proceeding, the Court ordered the judgment debtor to pay a sum for subjective non-pecuniary damage. This Chamber considers that, despite the diagnosis not being classified as urgent (but it was so determined and resolved by the Constitutional Court), it generated severe pain, and the postponement of the surgery —an unlawful act—, according to logic, experience, and correct human understanding, is an adequate cause (causal link) of moral affliction associated with anxiety, discomfort, frustration, and worry due to the excessive waiting time for care —declared in the constitutional venue—. Ergo, its existence can be inferred \"in re ipsa,\" and, therefore, its compensation. On the other hand, the objector did not challenge the amount awarded. However, this Chamber considers it reasonable and proportionate, considering the circumstances of this case and other similar matters (legal reasonableness). See resolutions 429-2024, 937-2024, and 1302-2024 of the First Chamber. Finally, the existence of tacit or express consent of the amparo petitioner cannot be considered, since they showed their disagreement with their continued presence on the waiting list, a point on which the Constitutional Chamber found in their favor (voto 258-F-2025).\n\nNecessary \"legal reasonableness\" (razonabilidad jurídica) that indemnities must maintain, for the verification of which compliance with a \"reasonableness of equality\" (razonabilidad de igualdad) must be observed, which the Constitutional Chamber has defined as \"the type of legal assessment that presumes that equal precedents must have equal consequences, without arbitrary exceptions\" (resolutions 5236-1999 and 1354-2011). That is, to avoid inequitable and illegitimate treatment in the various matters in which compensation for non-pecuniary damages is discussed, it is necessary to verify that the amounts recognized are not disproportionate when compared with those established in other similar cases. See resolutions 1934-2022, 2654-2022, 760-2023, and 1087-2023 of the First Chamber (voto 258-F-2025).\n\nIn the present constitutional execution proceeding, the Court accredited subjective non-pecuniary damage against the judgment debtor. However, this Chamber observes that the appellant did not challenge that basis for determining the existence of that damage in the proper form, as required by the cassation technique (mandate 139.3 of the Contentious-Administrative Procedure Code). They did not clearly and precisely challenge the core of what was ordered by the Execution Judge regarding the existence of the causal link. Such deficiency renders the arguments futile for the purpose of modifying what was resolved. Another reproach would give rise to the cassation ground for breach of substantive norms (ordinal 138.a ibidem), for an allegedly improper assessment of the final judgment. However, the argument is informal, because it omits pointing out the substantive norms that were breached by the alleged excess, with a clear and precise explanation of how the transgression occurred. They accuse a cassation ground for violation of procedural rules, namely lack of reasoning (norm 137.1.d ibidem), without indicating the adjective rules that were violated, with a clear and precise explanation of how the infraction occurred. Another reproach is ambiguous. If another argument were to be raised, it would give rise to the cassation ground for violation of substantive norms (numeral 138.a ibidem), but it is informal, because the evidence demonstrating their claim was not identified, clearly and precisely stating how it was improperly assessed (voto 258-F-2025).\n\nNumeral 139.3 of the Contentious-Administrative Procedure Code provides for the factual and legal reasoning of the cassation appeal, as a material requirement necessary for its admissibility and for its subsequent evaluation on the merits. See resolutions 318-2008, 677-2021, 755-2022, and 1663-2022 of the First Chamber (voto 258-F-2025).\n\nDifference between personal costs (costas personales) and attorney's fees. The former belong to the party, not to the lawyer.\n\nSee rulings 432-2017, 515-2018, 28-2024, and 297-2024 of the First Chamber (Sala Primera) (voto 258-F-2025).\n\nIn light of articles 193 of the Contentious-Administrative Procedural Code (Código Procesal Contencioso Administrativo), 73.1, 76.1 and 4 of the Civil Procedural Code (Código Procesal Civil), for purposes of costs (costas), attorney fees (honorarios de abogado) must be calculated based on the legal limits and the rates established in the respective Decree, regardless of any private agreement between the attorney and their client. This implies that, in the liquidation of costs, it is not necessary for the executing party (persona ejecutante) to prove the agreement they have with their attorney or the payment they may have made, since the regulations provide that the calculation of this item must be carried out in accordance with the tariff or respective decree, in order to ensure an objective criterion in the liquidation of costs. Consequently, it is not essential to provide an invoice or proof of payment in favor of the legal professional for the recognition of that item to proceed (voto 258-F-2025).\n\nPursuant to article 150.3 of the Contentious-Administrative Procedural Code, since this Chamber does not consider that the appellant (casacionista) has sufficient reason to appeal, the recognition of the costs of the cassation appeal (recurso de casación) is imposed upon them, which must be liquidated in the sentence execution phase (fase de ejecución de la sentencia), in order to guarantee the right of defense of the executed party (parte ejecutada), granting them the respective hearing on the liquidation presented (articles 41 and 153 of the Political Constitution (Constitución Política)) (voto 258-F-2025).\n\nSan José, at twelve hours twenty-two minutes on the twentieth of February, two thousand twenty-five.\n\nExecution proceeding of the judgment issued by the Constitutional Chamber of the Supreme Court of Justice in the amparo appeal filed by **LEONARDO GÓMEZ SALAZAR**, attorney, holder of identity card number 108760664 and bar association number 17.049, in his capacity as special judicial representative of **JOHNNY FRANCISCO VALVERDE PORRAS**, operator, holder of identity card number 108500565, **against** the **CAJA COSTARRICENSE DE SEGURO SOCIAL**, with legal entity number 4-000-042147, represented by its general judicial representative without limit of amount, Michael Montoya Jiménez, attorney, holder of identity card number 108930513 and bar association number 17.385. The general judicial representative of the executed entity filed a cassation appeal challenging judgment number 2024001065 of 07 hours 41 minutes on May 17, 2024, issued by the Juzgado Contencioso Administrativo y Civil de Hacienda of the Second Judicial Circuit of San José, composed of Judge José Andrés Cruz Tenorio. \n\n**Drafted by Judge Leiva Poveda**\n\n**CONSIDERANDO**\n\n**I.** The Constitutional Chamber of the Supreme Court of Justice, through judgment number 2023020609 of 09 hours 45 minutes on August 22, 2023, granted the amparo appeal filed by attorney Leonardo Gómez Salazar on behalf of Johnny Francisco Valverde Porras against the Caja Costarricense de Seguro Social (CCSS). This appeal, filed before that Chamber on August 4, 2023, originated from the violation of the fundamental right to health. The protected party is a patient at the Hospital Monseñor Víctor Manuel Sanabria in Puntarenas. He was evaluated in the Neurosurgery Service of that Hospital on February 2, April 23, June 21, all dates in 2021; February 9, October 21, both in 2022, and February 24, 2023. He was diagnosed with HD C4-C5/C5-C6/C6-C7. It was documented: \"*L1-L2 DISC HERNIATION CANAL 10.3 MM WITHOUT FORAMINAL STENOSIS, which requires surgical instrumentation*\". On February 24, 2023, he was evaluated for the last time and a hospitalization request was issued \"*for anterior cervical approach + discectomy C4-C5/C5-C6/C6-C7 + fusion with locked cage*\". At the time the amparo appeal was filed, no date had been scheduled for Mr. Johnny to undergo the required surgical procedure. In this regard, that Chamber considered: \"[…] *this Chamber found a violation of the protected party's fundamental right to health to be proven. For it was demonstrated that he was placed on a surgical waiting list as of February 24, 2023, and as of the date the respondent medical authority rendered its respective report -August 17, 2023- almost 6 months of waiting and uncertainty regarding said intervention have passed. Thus, this Constitutional Court considers it unreasonable to subject the protected party to an indefinite wait for the surgery he requires, even more so when the ailment afflicting him constantly interferes with [sic] his enjoyment of quality of life. Furthermore, the Administration must promptly and timely execute the necessary actions to safeguard the health and life of its users. Consequently, it is appropriate to grant the appeal, with the order that, within a period of 3 months from the notification of the judgment, the protected party undergo surgery at the respondent hospital, under the responsibility of his treating physician.*\" It ordered the Acting General Director of the aforementioned Hospital to issue the pertinent orders and carry out the actions within her scope of authority, so that, within the indicated three-month period from the notification of that judgment, the surgery prescribed for the protected party be performed. All of this, under the criteria and responsibility of his treating physicians and if no other medical cause prevents it. It warned her that, pursuant to the provisions of Article 71 of the Ley de la Jurisdicción Constitucional, imprisonment of three months to two years, or a fine of twenty to sixty days, will be imposed on anyone who receives an order that must be complied with or enforced, issued within an amparo appeal, and fails to comply with it or fails to enforce it, provided the offense is not more severely punished. It condemned the CCSS to pay the costs, damages, and losses caused by the facts that served as the basis for that declaration, which, it ordered, shall be liquidated in the execution of the judgment in the administrative litigation jurisdiction.\n\n**II.** In a document uploaded to the electronic judicial file on December 20, 2023, at 12:49:27, images 02 to 26, attorney Gómez Salazar, in his capacity as special judicial representative of the executing party, Johnny Francisco Valverde Porras, submitted the corresponding liquidation to the court. He requested the following items be accepted: **1)** that the executed entity be ordered to pay the costs of the execution proceeding; **2)** ₡181,500.00 for the personal costs of the amparo appeal; **3)** ₡300,000.00 for subjective moral damages (daño moral subjetivo); and **4)** the payment of legal interest, from the moment the judgment became final until its effective payment. By resolution at 13 hours 51 minutes on January 17, 2024, images 28 and 29, the Judge, Giovanni Marchena Jara, admitted the claim. In a document uploaded to the electronic judicial file on February 14, 2024, at 16:15:47, images 31 to 147, the general judicial representative without limit of amount of the CCSS, Montoya Jiménez, opposed the liquidation. He raised the defense of lack of right.\n\nIn the judgment now under challenge, the judge, José Andrés Cruz Tenorio, ordered the CCSS to pay: 1) 50,000.00 for subjective moral damages (daño moral subjetivo), 2) 181,500.00 for the personal costs of the amparo action; 3) legal interest on said amounts from the finality of that decision until effective payment, and 4) the costs of the judgment enforcement proceeding and their yields from the finality of the decision fixing them until their cancellation. Disagreeing, the CCSS's general judicial representative filed a cassation appeal. For its resolution, the brief uploaded to this Chamber's virtual desktop on February 13, 2025 at 09:20:53, signed by attorney Gómez Salazar, was considered.\n\nIII. In the first objection, page two of the pleading, the appellant announced that he was filing it on the cassation ground of violation of substantive norms provided for in subsection a) of canon 138 of the Código Procesal Contencioso Administrativo (CPCA): \"The cassation appeal shall also lie for violation of substantive norms of the legal system, in the following cases: / a) When evidence is attributed improper valuation or has been pretermitted.\", for the improper valuation of the final judgment of the constitutional amparo decision. He invoked the violation of canon 196 of the Ley General de la Administración Pública (LGAP). The challenged judgment, he pointed out, based its argument for granting subjective moral damages (daño moral subjetivo) on a factual point, but without analyzing the aspects contained in this Chamber's line of rulings. He alluded to decision no. 297-F-S1-2024 of 17 hours 27 minutes of March 21, 2024 (mentioned in the response to the complaint). Within those aspects, he cited the determination of extreme necessity of the patient's case from a medical point of view (urgency), their consent to being on a waiting list, or, alternatively, the existence of physical harm. Likewise, he cited decisions nos.: 1502-S1-2022 of 11 hours 24 minutes of September 1; 1823-F-S1-2022 of 14 hours 26 minutes of August 4; 2429-F-S1-2022 of 14 hours 16 minutes of November 3; all three from the year 2022; and 28-F-S1-2024 of 11 hours 05 minutes of January 11, 2024. He reproduced, in what was of interest to him, what was considered in section VIII of the challenged judgment, called \"ON THE MERITS OF THE MATTER,\" regarding the evidence to grant subjective moral damages (daño moral subjetivo). From the transcribed portion, he alleged, it is observed that the Judge specified the conditions of the plaintiff and the legal-material situation that arose regarding the amparo action, as the enforcement creditor had been placed on a disproportionate waiting period for their medical assessment and care, without the required service being provided. With the simple finality of a judgment, he noted, the Judge was able to determine that the Administration caused them \"an emotional impairment (menoscabo emocional),\" without taking into account the factors of restorative justice, urgency, patient's conformation, which were pointed out to the Judge in the response to the complaint. He even added that the Judge used the same template to justify his sanction against the CCSS. He requested that said decisions be evaluated \"ad effectum videndi,\" because the Judge is acting contrary to what this Chamber has ordered. He transcribed the proven facts of the final judgment. They make no reference whatsoever, he stated, to the worsening of the patient's condition, nor that they suffered \"an emotional impairment (menoscabo emocional).\" The challenged judgment, he indicated, directly violated the aforementioned numeral 196 of the LGAP, by having determined the existence of an injury (lesión), and of damage (daño), with a final judgment. To do so, he asserted, required technical proof demonstrating it. This is aggravated, he affirmed, by the fact that, for the Judge, it is not sufficient that restorative justice—medical care—had occurred, even before the expiration of the deadline ordered by the Constitutional Chamber, since, for him, there was an injury (lesión) to the fundamental right to health, and the care does not eliminate the Institution's obligation to compensate him for the untimely care. He copied a fragment of a judgment that does not coincide with the one challenged, because, in what was reproduced, it alludes to the Optometry Service, which bears no relation to the protected person's ailment. The objected judgment, he noted, violated said precept—196 of the LGAP, which provides that the damage (daño) must be effective, assessable, and individualizable, in relation to a person or group—. Starting from the amparo judgment, because the enforcement creditor was placed on a waiting list, he pointed out, there is no proof whatsoever of their impact on their internal state. Nor, he said, of the injury (lesión) suffered. That legal concept, he indicated, corresponds to damage (daño), whether as a product of the lack of equivalence between what is given and what is received, in an onerous title, or from a crime, where a person's body is diminished or transgressed; or, an organic or functional disturbance of an individual. That is to say, he noted, the Judge, from a simple final judgment, validated and determined the existence of an injury (lesión) in the patient, without specifying what type of injury (lesión), nor having technical proof that accredits it, from any angle, which entails that the damage (daño) is not real nor effective, directly violating the referenced canon. The judicial authority, he indicated, did not take into account the factors of restorative justice, urgency, patient's conformation, reiterated in this Chamber's jurisprudence.\n\nHe cited—in the order of presentation—rulings nos. 28-F-S1-2024 of 11:05 a.m. on January 11; 297-F-S1-2024 of 5:27 p.m. on March 21, both from the year 2024; 1502-F-S1-2022 of 11:24 a.m. on September 1; 1823-F-S1-2022 of 2:26 p.m. on August 4; and 2429-F-S1-2022; the last three from the year 2022. He added a table in which he set out, in his opinion, what each of those rulings specified. Those decisions, he stated, besides being of public knowledge, were not weighed in the case under study, even though, he noted, those from the year 2022 were pointed out to the Judge, who must know that case law is a means to integrate, understand, and apply the Law. However, he argued, with an “animus” to convict, he ignored said line and decided to convict his client for an injury caused to the executing party, according to his understanding, without having proof of that injury, apparently suffered, merely by the filing of the recurso de amparo and without weighing the scope of restorative justice, as this Chamber has contextualized it. If the Judge had duly analyzed the evidence, he asserted, he would have determined that an enforceable judgment is insufficient to determine the applicability of a subjective non-pecuniary damage (daño moral subjetivo). Especially, taking into consideration that placing a person on a waiting period to perform medical consultations and procedures is not, “per se”, sufficient grounds to award compensation. On that point, he indicated, this Chamber established, in ruling no. 1502-S1-2022 of 11:24 a.m. on September 1, 2022, that, regarding compensation for recurso de amparo for placement on waiting lists, it is irrational to impose on the tripartite contribution fund of social security compensation to someone who has consented to a wait for the required medical care. That, he argued, was pointed out to the jurisdictional authority. However, he indicated that there exists an “animus” to convict the CCSS at all costs (and of course, the contributors), without any substantive basis from an evidentiary standpoint. If the Judge had adequately assessed the evidence, he noted, the reasoning of the ruling would be different. It would have been determined, he concluded, that the evidence was insufficient to establish the existence of damage of any kind.\n\nIV. Regarding what was stated in the previous section, the following must be noted. FIRST. It must be remembered that, in judgment enforcement proceedings in general and, principally, those issued by the Constitutional Chamber (Sala Constitucional), what is enforced must necessarily be constrained to what was resolved in the amparo judgment that is the subject of the enforcement. This Chamber has indicated that the judgment enforcement proceeding seeks to materialize the abstract condemnation imposed on the losing party. If aspects different from—or contrary to—the pronouncement that gives rise to the enforcement, or against persons who were not condemned, are granted, res judicata (cosa juzgada) is violated. See, among other rulings of this deciding body: 383-2019 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-925036) and 309-2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1024927). Consequently, the oversight function of this Chamber is constrained to an objective comparison between the enforceable judgment and the appealed resolution. In this regard, one may also consult, among many others, rulings nos. 82-A-S1-22 of 10:06 a.m. on January 26 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1072742) and 1984-F-S1-2022 of 11:18 a.m. on September 8, both from the year 2022 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112319).\n\nV. As was noted in Considering I of this judgment, the Constitutional Chamber (Sala Constitucional), in the ruling being enforced, granted the recurso de amparo filed by the protected party (amparado), it having been verified that on February 24, 2023, he was evaluated, issuing the hospitalization request at Hospital Monseñor Sanabria for “anterior cervical approach + discectomy c4-c5/c5-c6/c6-c7 + fusion with locked cages” (“abordaje cervical anterior + discectomía c4-c5/c5-c6/c6-c7 + fusión con cage bloqueados”). However, at the time of filing the recurso de amparo on August 4 of that year, no date had been scheduled for the required surgical procedure. Therefore, said Chamber considered that the time elapsed up to that point, almost six months, was disproportionate and violated his fundamental right to health. Therefore, it granted the recurso de amparo and ordered both the Acting General Director to issue the pertinent orders and carry out all actions within the scope of her authority, so that, within a period of three months, counted from the notification of that judgment, the prescribed surgical intervention be performed on the protected party (amparado). As can be clearly inferred, the Constitutional Chamber (Sala Constitucional) granted the recurso because it considered that the time the protected party (amparado) had spent on the waiting list was disproportionate and violated his fundamental right to health, considering his pathology.\n\nPrecisely, the Execution Judge, in section VIII of the questioned judgment, adhering to what was resolved in the constitutional venue, considered of interest: “[…] the alleged non-material damage (daño moral) is not demonstrated in the constitutional venue, but rather in the stage before us, and since this is subjective non-material damage (daño moral subjetivo), it can be accredited through human presumptions and the prudent judgment of the Adjudicator, provided, however, that its accreditation and quantification must fully conform to the circumstantial elements of the very generating event, an event which in the [sic] specific case, is the act of subjecting the protected party to an indefinite wait for the surgery he required. […] the record demonstrates the surgery that was carried out, and furthermore, it is evident that Mr. Valverde Porras's ailment, although it caused him unbearable pain and affected the normal development of his daily life, was technically not urgent nor did it represent any immediate risk; however, what must be highlighted is that the injury to the fundamental right to health had already been configured, and both the medical care and the surgery in question were performed by order of the Constitutional Chamber, and the fact that the patient was given care, even before the expiration of the deadline ordered by the Chamber, does not eliminate the obligation the institution has to compensate him for the unreasonable waiting time (in the Chamber's opinion) on the corresponding list, before undergoing surgery. […] nevertheless, pursuant to the provisions of articles 190, 196, and 197 of the General Public Administration Act (Ley General de la Administración Pública), a causal link does exist between the conduct of Hospital Monseñor Sanabria and the subjective non-material damage, that is, between the unreasonable and indefinite wait for the surgical intervention and the situations of anguish, insecurity, instability, and uncertainty caused to Mr. Valverde Porras, situations which, I reiterate, do not require direct evidence for their demonstration, since they can be accredited through human presumptions. […] it has already been demonstrated that Mr. Valverde Porras's ailment, although generating pain and complications in his daily life, was not urgent; however, the fact that the care was not urgent was neither an impediment nor a justification for the Constitutional Chamber to declare a violation of the fundamental right to health; hence, the generating event of the Administration's liability did not depend on the urgency of the care, but rather is configured by the unreasonable period in said care and by the indefinite wait, which motivated the amparo appeal (recurso de amparo) being granted and being executed in this venue. […] it is more than evident that damage [sic] and the negative feelings this generates arise from the unreasonable time on the waiting list (in the Chamber's opinion), and furthermore, I reiterate, subjective non-material damage does not require direct evidence for its demonstration […] the fact of waiting so long for a surgical intervention for which a hospitalization request already existed caused the Constitutional Chamber to grant the amparo appeal and, therefore, that also caused negative feelings or situations in the plaintiff, which are compensated in this judgment. […] what the Constitutional Chamber analyzed in said appeal was the time elapsed between the hospitalization request for the corresponding surgery and the filing of the amparo appeal, and by that latter date, the damage had already occurred, and although note is taken of the surgical procedure performed and the restorative effects mentioned by the CCSS, the truth is that, in the Chamber's opinion, fundamental rights had already been violated, especially the right to health.” The appellant did not object to said basis for determining the existence of that damage in due form, as the technique of cassation imposes, in accordance with the provisions of article 139, subsection 3) of the CPCA. He limited himself to reiterating what was set forth since the response to the complaint, to the effect that the executory judgment was insufficient for its accreditation. He did not question, in a clear and precise manner, the crux of what the Execution Judge ordered regarding the existence of the causal link. He alluded to other topics, also set forth in the response to the complaint, such as restorative justice, urgency, and consent. However, it is insisted once again, without challenging the crux of what the Adjudicator stated, concerning that the unlawful act determined by the Constitutional Chamber in the executory judgment is sufficient ground to determine the existence of subjective non-material damage (causal link), since this type of damage—subjective non-material damage—is accredited through human presumptions and the prudent judgment of the Adjudicator, according to the facts analyzed in the constitutional venue. Such deficiency renders the arguments futile for the purpose of varying what was resolved.\n\n**VI.** Without prejudice to what was indicated in the preceding section and, for greater abundance of reasons, it is imperative to note the following. **SECOND.** The appellant for cassation, insistently, alluded to the fact that what he called “restorative justice” operated in the sub judice, because the patient was provided the required medical care. In this regard, it is necessary to point out that this Chamber, in previous matters, recognized its applicability in the matter of compensation for subjective non-material damage due to the infringement of the fundamental right to health (as recognized by the Constitutional Chamber of the Supreme Court of Justice upon granting the respective amparo appeal, due to the CCSS's delay in providing the medical service required by the administered person), when the CCSS renders the service within the deadline ordered in the constitutional venue. In this regard, see judgments nos.\n\n1502-S1-2022 of 11:24 a.m. on September 1 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112330), 2429-F-S1-2022 of 2:16 p.m. on November 3 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1123608), both from the year 2022; 28-F-S1-2024 of 11:05 a.m. on January 11 (), 297-F-S1-2024 of 5:27 p.m. on March 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250), 901-F-S1-2024 of 12:31 p.m. on July 4 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1240015) and 937 of 2:51 p.m. on July 10 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925); all from the year 2024. However, the current composition of this Chamber, after further study, considers it necessary to reconsider that position. Without a doubt, it involves a vindication of the injured legal situation, due to a failure of the service to be provided. Even more so when it becomes necessary, as occurs with a pending health service. Nevertheless, said reparation does not exclude, as the Enforcement Judge correctly indicated, that the harmed person suffered impairments in their moral and pecuniary spheres while the abnormal conduct persisted due to the administrative dysfunction. If effective impairments (articles 196 and 197 of the LGAP) specific to the particular case and derived from its particular characteristics are demonstrated, inferring their existence even through the intellectual process “in re ipsa”, despite the user having been granted jurisdictional protection, their reparation is appropriate. That is, the service-related rectification does not exclude the fact that the harmed person suffers impairments in their moral and pecuniary spheres while the abnormal conduct persists. If that occurred and was so proven, it is mandatory to impose the corresponding compensatory consequence, if it was requested by the person whose legal sphere was damaged. This is so in accordance with the principle of integral reparation for damage (daño), which has constitutional and legal roots (articles 9, 41, 49 of the Constitution; 190 and 197 of the LGAP).\n\nVII. Within this line of thought, and regarding the existence and quantification of subjective moral damage (daño moral subjetivo), this Chamber, for a long time, has indicated that: “IV. [...] it stems from the injury to an extra-patrimonial right. That is, it does not directly affect one’s pecuniary sphere. It entails an unjust disturbance of one’s mental conditions. It does not require direct proof and is left to the equitable assessment of the Judge. In the case of subjective moral damage (daño moral subjetivo), the courts are empowered to decree and quantify the award. The legal nature of this type of damage (daño) does not oblige the liquidator to determine its existence because it belongs to one’s internal sphere. This is not a matter for psychiatrists or doctors. Its existence or non-existence must be understood because it pertains to consciousness. It is deduced through presumptions inferred from circumstantial evidence, since the unlawful generating event reveals the moral damage (daño moral), because when the psyche, health, physical integrity, honor, intimacy, etc., are damaged, it is easy to infer the damage (daño), which is why it is said that the proof of moral damage (daño moral) exists ‘in re ipsa’. Its value also need not be proven because it has no specific value. It is valued prudentially. It is not, then, about quantifying suffering, as it is inappreciable, but rather about setting a monetary compensation for its injury, the only mechanism to which the law can turn, in order to repair, at least in part, the offense. For further detail on this aspect, one may consult, among others, from this collegiate body, rulings no. 112 already cited, no. 17 of 2:30 p.m. on February 21, 1996, and no. 41 of 2:40 p.m. on May 14, 1997. Its granting is not strictly tied to evidentiary factors (except those referring to the causal link), but rather to the prudence and objective discretion of the judge. However, its determination is subject to the principles of reasonability and proportionality, which must be assessed by the competent authority in each case, so that its quantification is lawful and does not lead to excessive compensation that unjustifiably benefits one of the parties. That is, it must maintain a just balance derived from the specific factual scenario, a matter that must be weighed within the indicated limits.” (Among many others, one may consult the judgment of this Chamber no. 468-F-S1-19 of 9:45 a.m. on May 30, 2019). According to the foregoing, once the existence of moral damage (daño moral) and its causal link with the cause of action alleged by the plaintiff have been established —which is not contested by the appellant—, the determination of the *quantum* depends on the equitable assessment of the Judge; for which purpose, attention must be paid to the special circumstances of the case, as well as to the constitutional principles of reasonability and proportionality.” In this regard, one may consult, among many others, judgment no. 1098-F-S1-2023 of 10:09 a.m. on July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1170686). That is, it is regarding subjective moral damage (daño moral subjetivo) that its demonstration is “in re ipsa”, provided it is a consequence of an unlawful generating event or motive.\n\nVIII. In this dispute, the Constitutional Chamber (Sala Constitucional), as has already been indicated, determined the unlawful conduct of the CCSS upon verifying the breach of the fundamental right to health of Mr. Johnny Francisco. The postponement of the required surgery was, at the time the constitutional judgment was issued, almost six months. Such a situation —an unlawful act (hecho antijurídico)—, in accordance with the rules of logic, experience, and correct human understanding, as was resolved, is an adequate cause (causal link) of moral affliction, associated with anxiety, discomfort, frustration, and worry, due to the excessive waiting time for care —so declared, it is insisted, in the constitutional venue— for a health situation that, \"per se\", is a cause of concern for the person suffering from it, even though it was not diagnosed as urgent; but which generated severe pain, as the Judge indicated. In accordance with correct human understanding and experience, it is insisted, one can deduce, \"in re ipsa\", as the Enforcement Judge did, the existence of feelings such as those described above, without him having the legal duty to endure them, since they derive from an abnormal functioning of the Administration, so decreed, it is repeated once more, by the Constitutional Chamber (Sala Constitucional).\n\nTherefore, contrary to what the appellant indicated, its existence is determined and, consequently, the appropriateness of its compensation is established.\n\n**IX.** Likewise, this Chamber has stated: “***VIII.*** […] *On other occasions, this appellate body has had the opportunity to highlight the necessary “legal reasonableness” that this type of compensation must maintain, for the verification of which compliance with a “reasonableness of equality” must be confirmed, which the Constitutional Chamber has defined as “… the type of legal assessment that starts from the premise that equal antecedents must have equal consequences, without arbitrary exceptions” (e.g., Votos no. 5236-99 and 1354-2011). That is to say, to avoid inequitable and illegitimate treatment in the various matters in which compensation for moral damages (daños morales) is discussed, it is necessary to verify that the amounts awarded are not disproportionate when compared with those established in other similar matters. In that vein, this Chamber considers that the sum granted conforms to the intensity of the harm caused.*” Judgment no. 760-F-S1-2023 of 13 hours 24 minutes of May 29, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1157835). In the same sense, one may consult, among others, rulings nos. 1934-F-S1-2022 of 15 hours of August 12; 2654-F-S1-2022 of 10 hours 10 minutes of December 08 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1132117), both from the year 2022 and 1087-F-S1-2023 of 09 hours 36 minutes of July 5, 2023 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1173505). Although in the objection under study the objector did not question the amount awarded for subjective moral damages (daño moral subjetivo), this Chamber considers the sum granted, ₡50,000.00, to be reasonable and proportionate, considering the circumstances of this case and other similar matters. By way of example, the following precedents can be pointed out, in which this deciding body did not consider unreasonable the sums awarded for the delay in the provision of the public health service, nos. 429-F-S1-2024 of 10 hours 41 minutes of May 3 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1229475), where the Adjudicator awarded ₡500.00,00; 937-F-S1-2024 of 14 hours 51 minutes of July 10, (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1239925), where it was set at ₡200,000.00; and 1302-F-S1-2024 of 16 hours 14 minutes of September 27, all from the year 2024 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1253306), where the sum of ₡200,000.00 was granted.\n\n**X.** **THIRD.** Likewise, the appellant alleged that, in the case of the amparo petitioner, there was no urgency in performing the surgery. While it is true, as the Adjudicator pointed out, that the plaintiff's condition was not medically classified as urgent—despite inflicting severe pain—it is also true that, as set forth in section I of this judgment, it was the Constitutional Chamber itself, in the enforceable judgment, that determined the urgency for the plaintiff to undergo the required surgical procedure, ordering that it be performed within a period of three months from the notification of that ruling. Consequently, within the objective comparison that must prevail in this type of process—execution of constitutional judgments (ejecución de sentencia constitucional)—the issue of urgency is a precluded aspect, since, it is repeated, it was so determined and resolved by the Constitutional Court.\n\n**XI.** **FOURTH.** The challenger also argued that the amparo petitioner acquiesced or consented to remaining on the waiting list. Contrary to what was alleged, in this dispute the existence of tacit consent or an act of consent, much less express consent, on the part of Mr. Valverde Porras cannot be deemed to exist. The recurso de amparo was filed in time. So much so that the Constitutional Chamber admitted it for processing and subsequently granted it. This is independent of the time elapsed between the moment the CCSS placed him on the waiting list and the filing of the amparo. Therefore, the plaintiff demonstrated his disagreement with his permanence on the waiting list, and said jurisdictional body agreed with him.\n\n**XII.** In the **second** ground of disagreement, page nine of the appeal, the appellant announced he would file it based on the cassation ground for violation of substantive norms provided for in subsection d) of numeral 138 of the CPCA: “***d)** When the judgment violates the norms or principles of Constitutional law, among others, reasonableness, proportionality, legal certainty (seguridad jurídica), and equality.*” He invoked the infringement of the postulate of reasonableness. In the contested judgment, he said, the Execution Judge (Juzgador de Ejecución) determined the reasonableness of the compensation, since the plaintiff was caused harm and, as such, it is not sufficient that a restorative justice has occurred. He reproduced, insofar as it interested him, what was considered in section VIII of the questioned ruling. The Judge, he noted, distinguished that the reproached conduct generated moral damages (daño moral) to the plaintiff, and that was determined in the Constitutional venue. However, the text with which the execution of the recurso de amparo was promoted was enough for him to reach that conclusion. The appealed judgment, he said, left open the possibility to seek, unrestrictedly, double compensation: the material type, by receiving medical attention, and the pecuniary one, without any evidence whatsoever mediating on this. The Judge, he indicated, with his analysis, violated the principle of reasonableness. The spirit of the CCSS, he noted, in accordance with precept 73 of the Political Constitution, is to guarantee the fundamental rights to life and health; without which, the other guarantees enshrined in the Magna Carta cannot be fully exercised. While, he pointed out, there are waiting lists or periods to perform medical requirements; it is also true that granting pecuniary compensation for placing a person on one of them, despite there being no medical urgency criterion, implies that the amounts destined to guarantee the two referred fundamental rights are diminished, which, by all lights, he alleged, is irrational, since the contributing persons to the Health and Maternity Insurance do so with the objective that a health service is provided and that there are resources to guarantee it. Not so that compensation is granted for placing a person on a waiting list, or that the treatments are set within a reasonable waiting period. The Adjudicator, he noted, straying from the principle of reasonableness, determined that the fact that the service provision had been performed was insufficient to determine the existence of a complete restorative justice.\n\nFor this reason, he noted, there must also be economic compensation. That is, he explained, it follows from the foregoing that a double indemnification must always be involved when a person is placed on a waiting list, or has been given a scheduled appointment exceeding a reasonable waiting time. However, he stated, the truth is that this generates a privilege and unjust enrichment without any cause. He alluded to the judgments of this Chamber, in order of citation, nos. 1502-S1-2022, 297-F-S1-2024, 28-F-S1-2024, and 1823-F-S1-2022. The objective of a person who resorts to the Constitutional Chamber (Sala Constitucional), he said, is to have a surgical procedure performed, or to receive medical care. He seeks, he added, the restoration of his health, not compensation. This, he argued, could entail a reduction in the health service's resources, which are necessary for equipment improvements, payment for medications, and instruments to adequately provide the health service through professionals trained for that purpose. This principle was directly violated, he said, by granting a compensatory award (extremo indemnizatorio) when it was argued that it is not enough that the medical service was provided, because the fact of waiting so long for the medical procedure to be performed causes negative feelings or situations in the petitioner that merit compensation. A conclusion reached based solely on the text of the writ of execution (ejecución). The Judge violated said principle of reasonableness (razonabilidad), given that, although he was clear that restorative justice had occurred, he granted a pecuniary amount, under the premise that it is not enough that the procedure was performed; rather, a person who is on a waiting list or exceeds a reasonable waiting time for medical procedures to be performed or to receive care, deserves a double compensation, which generates a privilege and unjust enrichment without any cause. It was not weighed that a privilege was granted over the other insured persons, who are bypassed by the person protected under the waiting list. This was previously analyzed by this Chamber, he noted, in judgment no. 1502-S1-2022, which he reproduced in the relevant parts. Also, in no. 297-F-S1-2024 of 17:27 on March 21, 2024, which he also copied in the relevant parts. That situation, he pointed out, presented to the Adjudicator, was directly disregarded and, indeed, he said, it evidences, in some way, a possible existence of an \"animus\" to condemn his client under any scenario. It is, he alleged, contrary to the principle of reasonableness (razonabilidad), because, in addition to reducing the resources available to provide the health service, it grants a position of privilege to the person who received the required care at the expense of those who collaborate to provide an adequate health service. Therefore, he concluded, granting compensation for moral damages (daño moral) becomes a violation of the principle of reasonableness (razonabilidad).\n\nXIII. Regarding what was indicated in the preceding Considerando, the following must be stated. FIRST. The objector forgot that this procedural instance does not correspond to an ordinary appeal (recurso ordinario) (such as apelación). Nor is it sufficient to express a series of general and merely argumentative disagreements. It is necessary to contrast what was decided with the infraction that, in his opinion, took place. In this regard, numeral 139, subsection 3 of the CPCA provides for a material requirement, necessary both for the admissibility of the appeal and for its subsequent evaluation on the merits. This is the grounds for the appeal (motivación del recurso) which, due to the characteristics of cassation (casación), must be clear and precise. In this sense, it must contain, as provided by the precept under discussion, the factual and legal grounds (fundamentación fáctica y jurídica) of the case. Factual, insofar as it shows disagreement with the facts that have been considered proven or unproven (which leads to the weighing of the evidence), or with the circumstances that occurred in the violation of procedural rules. Legal, when it involves a problem raised concerning the application, omission, or incorrect interpretation of any norm that forms part of the legal framework (bloque de juricidad), including, of course, principles of constitutional rank, or that which also operates by reflexive or indirect effect, after the facts of the appealed judgment are modified. In both procedural infraction and evidentiary infraction, alongside the legal reasons (always necessary), those of a factual nature may concur, and in that sense, the grounds of reference must be directed on both fronts, under penalty of inadmissibility. For its part, it is necessary to clarify that from the legal grounds, the indication of those canons related to the value of the evidentiary element or elements poorly assessed is exempted by express legal mandate. Similarly, it is unnecessary to cite the norms that the trial court body erroneously used and mentioned to issue and reason its decision, because they appear in the appealed ruling itself. And of course, it is not at all essential to cite the precepts that establish the basic requirements, deadlines, and rules for the admissibility of the appeal. Rather than the citation of these latter, what is essential is that they be fulfilled, that they be put into practice at the time of drafting and filing the cassation. Thus, the grounds required by law can be understood, roughly, as that technical-legal argumentation in which a series of articles or legal rules are mentioned, intertwined or concatenated with each other and reasonably linked in a double perspective: with the arguments of the appeal and with the judgment being attacked. To the extent that a set of legal norms (or, if applicable, a single one) is cited, pertinent and clearly linked to the contested judgment (whether in its support of fact or law) and the arguments of the appeal, there are legal grounds. Jurisprudential additions or eventual doctrinal citations will sometimes reinforce the allegations made, but generally do not constitute their essence. As this Chamber has already indicated in interpreting article 139 of reference, \"it is required that the appeal have minimum legal grounds ... the reasons on which he bases his action must be explained, combatting the legal arguments of the appealed judgment and setting forth, at least, some normative reference that gives it support\" (Resolution no. 318-A-2008, of 14:25 on May 8, 2008). The grounds are, therefore, alien to the confused display of norms and allegations; to the mixture of unintelligible arguments or the simple exposition of opinions on the appropriateness or justice of the case, or to the recounting of the mistakes considered committed in the appealed judgment, without support in legal norms or criteria. Hence, if the appeal completely omits that technical-normative relationship to which reference has been made, or the one it makes is irrelevant or manifestly and evidently unconnected to the case, it will have to be understood that it lacks \"total legal grounds\", and therefore, fails to comply with the necessary requirement established in numeral 139.3, which is punishable by outright rejection, pursuant to the provisions of article 140, subsection c) of the same Code of Procedure (Código de rito). of the same referenced Code. Likewise, this Chamber, repeatedly, has pointed out that for an appeal to pass the admissibility review, it is required, in addition to the sufficient statement of reasons, the corresponding mention of and linkage to the contested judgment of the applicable norms that are deemed infringed. In this regard, among other resolutions, nos.\n\n677-A-S1-2021 of 09 hours 40 minutes on March 25, 2021 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1029345); 755-A-S1-2022 of 10 hours 55 minutes on March 29 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1082042); and 1663-A-S1-2022 of 10 hours 05 minutes on July 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1112340), both from the year 2022.\n\nXIV. In this line of thought, after a thorough study of the objection under review, this Chamber determines that the appellant alleged several dissimilar hypotheses, but, due to the way they were structured, they are inseparable from each other. In this regard, on pages 10 and 11 of the appeal, he stated: “It is observed in the aforementioned copied paragraph that the Judge distinguishes that the reproached conduct caused moral damage (daño moral) to the plaintiff, and that was determined in the Constitutional Court, however, it was enough for him to reach that conclusion simply with the text that promotes the execution of the amparo appeal. […] the fact of waiting so long to undergo the medical procedure causes negative feelings or situations for the plaintiff, which deserve compensation, a conclusion he reached only with the text of the execution.” (The underlining is supplied). If what is challenged occurred, it would give rise to the cassation ground for violation of substantive norms provided for in subsection a) of canon 138 of the CPCA, by virtue of the supposed improper assessment of the executory judgment. However, the argument is informal. The appellant omitted to indicate the substantive norms that were violated by the alleged excess, with a clear and precise explanation of how the transgression occurred, as the technique of cassation imposes, according to what was set forth in the previous section, in accordance with the provisions of numeral 139 subsection 3) ibid. On page 10, he added: “Let this Honorable First Chamber note that the first-instance judgment practically leaves open the possibility of unrestrictedly obtaining double compensation, that of a material nature, upon receiving medical attention, and that of a pecuniary nature, without any proof whatsoever regarding it.” (Only the highlighted text is from the original). What is now alleged would give rise to the cassation ground for violation of procedural norms provided for in subsection 1) point d) canon 137 ibidem: lack of reasoning. However, as happened with the previous ground, the argument is informal, since the challenger did not indicate, with the due rigor, the adjective norms that were transgressed, with a clear and precise explanation of how the violation occurred. Then, on pages 11 and 12, he stated: “In addition to the foregoing, the first-instance judge, straying from the principle of reasonableness, determines that the fact that the service was provided is insufficient to speak of full restorative justice, and that therefore there must also be economic compensation […] In that sense, the first-instance judge directly violates the principle of reasonableness, by granting a compensatory award, maintaining that it is not sufficient that the medical service was provided, given that the fact of waiting so long to undergo the medical procedure causes negative feelings or situations for the plaintiff, which deserve compensation, a conclusion he reached only with the text of the execution. / Regarding this, the judge violates the principle of reasonableness, since despite being clear that a form of restorative justice operated, he grants a pecuniary amount, under the premise that it is not enough that the procedure was performed on her, or that she was attended to, but rather that a person who is on a waiting list and/or exceeds a reasonable waiting time for medical procedures to be performed or to be attended to, deserves a double compensation, which generates a privilege and unjust enrichment. Not to mention that, he does not weigh that a privilege is granted to her over the other insured persons, who were surpassed by the protected person on the waiting list. […] This situation, which as can be inferred, was presented to the judge, was directly disregarded, and even, a possible existence, it is reiterated, of an intention (animus) to convict under any scenario is evidenced in some way, which is reiterated, is contrary to the principle of reasonableness, since this, in addition to depleting the resources that the Institution has to provide the health service, grants a position of privilege to the person who received the required attention, at the expense of those who collaborate to provide an adequate health service.” (The highlighted text is from the original). What is now set forth would give rise to the announced cassation ground for violation of substantive norms, due to the supposed violation of the constitutional principle of reasonableness. The ambiguity evidenced contravenes the technique of cassation, which requires that the grounds of the appeal must be indicated in a clear and precise manner, with the factual and legal foundation of the case (precept 139 subsection 3) of the CPCA). Ergo, the dismissal of the objection under study is required.\n\nXV. SECOND. What was argued by the challenger, concerning whether restorative justice operated in this dispute (support for alleging the violation of the principle of reasonableness), the non-existence of urgency in the appointment of the amparo beneficiary, their consent to remain on the waiting list, and the impropriety of granting compensation for subjective moral damage (daño moral subjetivo), was already the subject of analysis in sections VI through XI of this judgment, so, in order to avoid unnecessary reiterations, reference is made to what is expressed therein.\n\nXVI.\n\nIn the **third** objection, page 13 of the appeal, the appellant announced that he was filing it on the cassation ground for breach of substantive norms provided for in subsection c) of canon 138 of the CPCA: \"**c)** When a legal norm has been unduly applied or interpreted or has been left unapplied.\" He invoked as transgressed articles 46 of Decreto Ejecutivo no. 41457-JP of October 17, 2018, \"Fee Schedule for Professional Legal and Notarial Services (Arancel de honorarios por servicios profesionales de abogacía y notariado)\" and 73.1 of the Código Procesal Civil (CPC). Regarding the personal costs (costas personales) of the amparo appeal, he said, the Enforcement Judge (Juez de Ejecución) opted to award them. This, despite having certainty that, to file an amparo appeal, legal representation is not required. He even added, the amparo appeal being executed was filed by a non-profit foundation. He maintained that the right was granted in the very resolution issued by the Sala Constitucional. He transcribed what was stated in Considerando IX of the contested judgment, titled \"*SOBRE LAS COSTAS DEL AMPARO*\". Despite the fact that the amparo appeal, he pointed out, was filed through a non-profit foundation, which promotes, according to its publicity, the filing of amparo appeals free of charge, and that it did not generate any expense for the protected party (amparada) that has been demonstrated, he made the determination to grant that item. It is clear, he indicated, that it was the \"Fundación Derecho sin Fronteras\" who filed the amparo appeal, using, for this purpose, the generalized template with which it has filed more than 4,000 amparo appeals—according to its own statement, publicity on its page—, which it manages free of charge. The same principle of gratuity, he stated, must be applied to the case, since, as a non-profit foundation, it is enough, for its stigma, to favor a user by advancing their appointment, surgery, and other medical procedures provided by the CCSS. He coincided with the judicial authority, he asserted, that a legal professional participated in the accompaniment of the formulation of the template. However, he said, the proceeding was formulated through a non-profit foundation, filing the appeal free of charge. Consequently, given that the principle of gratuity applies to the filing of the amparo appeal, the foundation is a promoter of the same principle, coupled with the fact that, under the premise that there is no proof whatsoever of expense on the part of the protected party, nor an invoice presented by the lawyer to the non-profit foundation, the appropriate course was exoneration from costs (exoneración en costas). The questioned judgment, he alleged, unduly applied article 46 of Decreto Ejecutivo no. 41457-JP. There is no evidence in the case file, he asserted, that proves that the presentation, formulation, and processing of the amparo appeal generated a cost for the executing party (ejecutante). It is certain, he indicated, that the foundation that filed the appeal managed it free of charge, therefore, it is not appropriate to grant that compensation, given that, furthermore, there is no proof of any expense. For this reason, he affirmed, the proceeding is covered by the principle of gratuity. The amparo appeal was filed by a foundation through its legal department. A proceeding that was done free of charge, as they publicize, and there is no proof in the case file that demonstrates any expense or charge whatsoever or a salary for the professional on the foundation's payroll. All the more reason, he said, to affirm that the foundation promotes the well-being of the population without expecting anything in return. It was the Fundación Derecho Sin Fronteras that managed the amparo appeal, therefore it is improper to award attorney's fees (honorarios) under the precept of article 46 of the aforementioned Decreto no 41457-JP. He reproduced, as pertinent, the first precept of that normative body. In accordance with that text, he indicated, the application of that Fee Schedule would be valid, insofar as the professional provides a service for the charging of a fee (canon). In this litigation (lite), he commented, in addition to the appeal being formulated by a foundation, there is no evidence proving the charging of fees for the study, analysis, drafting, and processing of the amparo appeal. He even added the premise that the foundation that promoted the appeal maintains, which is that it is provided free of charge. He considered, as there are no fees that must be paid for the formulation of the appeal, since the proceeding was done by a non-profit foundation, which uses the same template—more than 4,000 cases—, and which provides the service free of charge. For this reason, he noted, awarding costs based on article 46 of the indicated Decreto is improper. He transcribed article 73.1 of the CPC. The very content of the norm establishes that attorney's fees (honorarios de abogado), compensation for time invested, and indispensable expenses of the process shall be considered costs (costas); for which, he noted, there is no proof or reference in the questioned judgment. Given that the executing party did not provide any proof whatsoever that there was an investment of money for attorney's fees, coupled with the fact that the appeal was filed by a foundation that provides the service free of charge, he noted, the Judge was compelled to grant any amount for costs of the amparo appeal, in the form of fees. There is no proof that they have been paid, as there is no evidentiary means demonstrating the participation of a legal professional hired under remuneration for the processing of the amparo appeal. At the time of its execution, he asserted, it does not fall within the requirements of article 46 of the Decreto. To receive full compensation for an expense, he indicated, it must, necessarily, be demonstrated. Which cannot be condoned by this representation. No proof whatsoever was presented that this expense occurred. That is where the error of the judgment is clearly marked: awarding the amount for costs of the amparo appeal as if it were for fees, without there being the slightest proof thereof. The reasons why costs are awarded to a prevailing party in a judicial proceeding must be clear. The magistrate of the Sala Constitucional, Mr. Fernando Castillo Víquez, he said, has on multiple occasions been clear in ordering, both the CCSS, when extra-procedural satisfaction of the condemnations of the Sala Constitucional is carried out; and the contentious-administrative jurisdiction (jurisdicción contencioso-administrativa), to ensure that the awarded amounts effectively reach the hands of the protected parties (amparados). He transcribed, as relevant to his interest, what was stated in the separate note of the vote of that Sala no. 2016-012528.\n\nThe contested judgment, it stated, should have rejected that point, since, having been accredited that the petitioner of the amparo remedy was a non-profit foundation, which manages amparo remedies on behalf of users free of charge; in addition to the fact that there is no evidence provided of the expense the foundation has to have, within its payroll or staff, professionals who formulate amparo remedies, or that for this meritorious service it generates a cost for them, that point cannot be granted, much less, it concluded, based on Article 46 of Executive Decree No. 41457 -JP.\n\n**XVII.** Regarding what was set forth in the preceding section, it is necessary to indicate the following. **FIRST.** The appellant for cassation, on pages 16 and 17 of the appeal, indicated: \"Therefore, the judgment should have rejected that point, since, having accredited that the petitioner of the amparo remedy is a non-profit foundation, which manages amparo remedies on behalf of users free of charge, besides the fact that there is no evidence that has been provided to the process of the expense the foundation has to have within its payroll or staff professionals who formulate amparo remedies, and/or that for this meritorious service it generates a cost for them, that point cannot be granted, and much less based on Article 46 of the Fee Schedule for Professional Legal and Notarial Services\", No. 41457 -JP.\" The foregoing constitutes the crux of what was argued by the challenger in the censure under study. However, contrary to what was affirmed, in the enforceable judgment it was not accredited, nor in the now contested one, that the person who formulated the amparo remedy was a non-profit foundation called \"Fundación Derecho sin Fronteras\". On the contrary, in the heading of the judgment being enforced it was indicated: \"Amparo remedy processed in file No. **23-018591-0007-CO**, filed by **LEONARDO GÓMEZ SALAZAR**, identity card 0108760664, on behalf of **JOHNNY FRANCISCO VALVERDE PORRAS, identity card 0108500565**, against the **CAJA COSTARRICENSE DE SEGURO SOCIAL**.\" (Only the underlining is supplied). For its part, as the appellant for cassation himself indicated, the Enforcement Judge, in section IX of the judgment now objected to, was emphatic in indicating that in \"[…] *the case file remains fully demonstrated that Lic. Gómez Salazar was the legal professional in charge of filing and processing the amparo remedy*, on behalf of Mr. Valverde Porras and that is sufficient to demonstrate the Lawyer's work in the judicial venue.\" (The underlining is supplied). Therefore, as it was not accredited (in the constitutional venue or in the enforcement of the judgment) that the person who managed the amparo remedy was the indicated non-profit Foundation, if what was argued were to occur, it would give rise to the ground for cassation for violation of substantive norms provided for in subsection a) of article 138 of the CPCA. However, what was argued by the challenger is informal. He did not identify the evidence with which his statement is demonstrated; indicating, with clarity and precision, just as the technique of cassation imposes it, as was set forth in Recital XIII of this judgment, under the protection of what is prescribed in article 139 subsection 3) of the CPCA, how it was improperly assessed. The foregoing imposes the outright rejection of the objection under study.\n\n**XVIII.** Without prejudice to the foregoing and, for greater abundance of reasons, it is necessary to indicate the following. **SECOND.** This Chamber, for a long time, has indicated the difference between personal costs and attorney's fees, concluding that personal costs belong to the party, not to the lawyer. In this regard, one may consult, mutatis mutandis, decisions nos. 432-F-S1-2017 of 09 hours 30 minutes of April 20, 2017 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-950854); 515-F-S1-2018 of 11 hours 20 minutes of May 30, 2018 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-892742); 28-F-S1-2024 of 11 hours 05 minutes of January 11 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1208396) and 297-F-S1-2024 of 17 hours 27 minutes of March 21 (https://nexuspj.poder-judicial.go.cr/document/sen-1-0004-1221250); both from the year 2024. **THIRD.** The CPCA, in article 193, expressly regulates the imposition of costs; just as canon 73.1 of the CPC does. Consequently, it is the norm of the CPCA that is applicable to this litigation. However, this provision does not regulate, as that of the CPC does, what are considered costs. Ergo, this procedural principle, like those contained in articles 76.1 and 76.4 ibid., by virtue of the referral made by Article 220 of the CPCA, is applicable to this litigation. In this sense, precept 73.1 of the CPC provides: \"[…] *Attorney's fees shall be considered costs*, the compensation for the time spent by the party in attending the procedural acts where their presence was necessary and the other indispensable expenses of the process.\" (The underlining is supplied). In this same order of ideas, precepts 76.1 and 76.4 ibid. indicate: \"*76.1 Right to fees and setting*. *Attorney's fees belong to the latter*, with the exceptions established by law. When the party is a lawyer and has acted personally, they shall be entitled to them. Unless otherwise agreed, they shall be set in attention to the work, the status and the economic significance of the process, based on the provisions of Law No. 13, Organic Law of the Bar Association, of October 28, 1941, and the decree on lawyers' and notaries' fees.\" […] \"*76.4 Contractual setting of attorney's fees.* Lawyers and their clients may contractually set the amount of the fees and their payment modalities respecting the limits imposed by law and the respective decree. *Said stipulation shall not affect the opposing parties of the process, for purposes of setting personal costs*.\" (Only the underlining is supplied). In light of the provisions of said norms, it is clear that, for purposes of costs, attorney's fees must be calculated based on the legal limits and the rates established in the respective Decree, independently of any private agreement between the lawyer and their client. This implies that, in the settlement of costs (liquidación de costas), it is not necessary for the executing person to demonstrate the agreement they have with their lawyer or the payment they have made to them, since the regulations provide that the calculation of that point must be carried out in accordance with the fee schedule or respective decree, in order to ensure an objective criterion in the settlement of costs. Thus, if a party had legal representation in the processing of a case and obtained payment of costs in their favor, the amount that will be recognized as attorney's fees will necessarily be that which is established in the \"Fee Schedule for Professional Legal Services\", according to the work carried out. Consequently, it is not indispensable that an invoice or payment receipt in favor of the legal professional be provided for the recognition of that point to proceed.\n\nIn this litigation, it is insisted, the objector did not prove that Mr. Johnny Valverde Porras lacked legal representation during the processing of the amparo proceeding; or that it was provided free of charge. On the contrary, as indicated, it is determined from the final judgment that his special judicial attorney-in-fact in this enforcement proceeding was the one who filed the amparo action on his behalf before the Constitutional Chamber. This allows one to infer that said professional defended the interests of the protected party in the constitutional venue. Ergo, the failure to present the invoice or proof of payment claimed by the appellant is not sufficient to demerit or dismiss the item of personal legal costs (costas personales) liquidated by the party and expressly recognized in the final judgment. It is reiterated, because the enforcing party had legal representation during the processing of the amparo and obtained in his favor the payment of legal costs. That is, he has the right to be recognized as legal costs the amount that, for attorney fees, the applicable tariff establishes. Corollary, this Chamber does not observe the alleged legal violations and, consequently, the rejection of the challenge will be imposed.\n\n**XIX.** In the **fourth** and last censure, page 17 of the petition, the objector announced he was filing it on the cassation ground for breach of substantive norms provided for in subsection c) of article 138 of the CPCA. He alleged improper application of canon 193 *ibid*. In the contested judgment, he said, the Enforcement Judge granted the legal costs of the judgment enforcement proceeding. He considered that there is no reason to exonerate his principal, despite his opposition that the enforcing party could not substantiate the subjective moral damages (daño moral subjetivo) and did not provide proof or technical support demonstrating the existence of a causal link between what was ordered in the enforceable judgment and the specific items sought to be enforced. The aforementioned canon, he said, establishes that the losing party will be exonerated from the payment of legal costs when, by the nature of the matters debated, there was sufficient reason to litigate. He reproduced section XI of the contested judgment, called, “*ON THE COSTS OF THE ENFORCEMENT*”. The Judge, he noted, weighed both the order of legal costs of the appeal and the moral damages awarded to justify the non-exoneration under the terms of subsection 2 of the indicated article 193 *ejusdem*. Had the evidence been assessed properly, he said, and the scope of what was mentioned, he would have arrived at the conclusion that the award of moral damages was not appropriate, nor any amount for the concept of legal costs of the amparo appeal. Reason to affirm that the canon granted for enforcement legal costs is improper. The Adjudicator, he commented, improperly applied the aforementioned precept 193 subsection 2) *ibid*, since said norm establishes that the losing party may be exonerated from the payment of legal costs when, by the nature of the issues debated, there was sufficient reason to litigate. Taking into consideration purely arithmetic extremes, and only the amounts granted, he alleged, they represent a total of ₡231,000.00. This implies, he argued, that of the total sought, the enforcing party obtained 48.07% -without counting the legal costs of the enforcement that have not been set-, which entails, *contrario sensu*, that they did not obtain 51.98% of what they sought to obtain. Consequently, he alleged, it is denoted that his represented party had to litigate. He succeeded, he added, in ensuring that the enforcing party did not obtain the totality of its claims. For this reason, he questioned: how was this not even minimally visualized by the Adjudicator, who dismissed the thesis that his principal had sufficient reasons to litigate? Especially being before a judgment enforcement of a right granted in the abstract, where one was faced with a scenario of extreme petitions, which implied that this representation had to exercise the defense of institutional interests. If the Judge had assessed the foregoing, he stated, he would have determined that his represented party had reasons to litigate. Among different elements, he pointed out, there are the following: **1)** barely 48.07% of the total sought was granted; **2)** 51.98% of the total requested was rejected; **3)** one is faced with a claim with an evident search to obtain extremes above what can be considered parallel to reasonableness; and **4)** this Chamber, in judgment no. 1502-S1-2022, indicated that it is irrational to impose on the tripartite contribution fund of social security and, on the other insured beneficiaries of said funds, additional compensation to someone who has consented to the wait and received, through judicial protection, the required medical care. Added to this, he provided guidelines to determine whether compensation should or should not be mediated, such as whether the patient's type of pathology refers or not to an emergency, or the conformity with inclusion on a waiting list and, even, compensation “*in natura*”. That is, his represented party started from positions developed by this Chamber to litigate in the proceeding, which was pointed out to the Judge, without him taking it into consideration. For the foregoing, he argued, it is evident that this representation had to litigate in the proceeding. Not satisfied with that, the Judge decided to order legal costs against his principal, leaving her in a clear position of vulnerability and disadvantage, since defending, including the financial sustainability of the Institution, is clearly a sufficient reason to litigate. Therefore, he pointed out, it can be deduced, directly, clearly, and simply, that his represented party had sufficient reasons to litigate, in view of the fact that the public treasury was being effectively protected, in defense of the few resources it has. She was forced to oppose the lawsuit, considering the amount requested by the enforcing party for subjective moral damages -₡300,000.00- to be unreasonable and disproportionate, a circumstance that led to said amount being rejected in the judgment and reduced to ₡50,000.00. Having set forth the reasons to challenge both the item of moral damages and that of the legal costs of the amparo appeal, and finding support the reasons to cassate those extremes, upon upholding the claim against them, the support by which the judicial authority did not exonerate his represented party would vary. Reason that justifies the motive to challenge that extreme. Being correct in the arguments set forth, and had article 193 subsection b) of the CPCA been properly applied, the Judge would have exempted his principal from the payment of the legal costs of the enforcement proceeding, given that it is evident and manifest, in addition to being simply verifiable, he noted, the fact that there was sufficient reason to litigate the present proceeding. Therefore, he concluded, the present grievance must be upheld and the judgment cassated.\n\n**XX.** Regarding what was set forth in the preceding Consideration, it is necessary to indicate **FIRST.** After a conscientious study of the objection under review, this Chamber reaches the conviction that the appellant invoked several hypotheses dissimilar among themselves, but, due to the way he structured the objection, they are indivisible.\n\nIn this regard, on page 18 of the appeal, it stated: “In that sense, having properly assessed the evidence, and the scope of what was mentioned, it would have reached the free conviction that the award of moral damages (daño moral) is not appropriate, nor any amount for the costs of the amparo appeal, a reason to affirm that the fee granted for the enforcement costs is improper.” The argument, if it were to succeed, would give rise to the cassation ground for violation of substantive norms provided for in section 138 subsection a) of the CPCA, due to improper evidentiary assessment. However, it is informal. The appellant did not individualize any means of conviction, explaining how it was violated by the objected judgment, as the technique of cassation imposes, as has already been pointed out. On the other hand, on that same page 18, it invoked the violation, by erroneous application, of section 193 subsection b) of the CPCA, since, in its view, due to the nature of the debated issues, its principal had sufficient reason to litigate. This is because, as it indicated, the amounts granted to the enforcing party total ₡231,000.00. That is, 48.02% of what was sought. This means, according to its view, that its represented party had to litigate in this lite. In that regard, the stated matter would give rise to the announced cassation ground, provided for in subsection c) of precept 138 of the CPCA. Then, on pages 18 and 19 it pointed out: “[…] it is not understood how the first-instance judge did not even minimally visualize, who rejects the thesis that my represented party did have sufficient reasons to litigate the judgment enforcement process, especially when facing a judgment enforcement of a right granted in abstract, where we were practically facing a scenario of extreme petitions, which imply that this representation had to exercise, without any discussion, the defense of institutional interests. / If the first-instance judge had valued the foregoing, he would have determined that my represented party had more than enough reasons to litigate the judicial process, given that, among different elements, the following exist: […]”. (The underlining is supplied). In what has now been set forth, the appellant alluded to the cassation ground for violation of procedural norms, provided for in article 137 subsection 1) point d) of the CPCA: lack of reasoning (falta de motivación). However, the argument is informal, by omitting to indicate the procedural norm violated, with the clear and precise explanation of how the violation occurred, as the technique of cassation imposes. As was already set forth in section XVI of this judgment, the confusion put in evidence clashes with the technique of cassation, which imposes that the grounds for the appeal must be indicated in a clear and precise manner, with the factual and legal basis of the case (precept 139 subsection 3) of the CPCA). Ergo, the rejection of the objection under study is imposed.\n\n**XXI. SECOND.** Without prejudice to the foregoing and, for greater abundance of reasons, it is necessary to indicate the following. On pages 19 and 20 the appellant indicated: “Added to this, having set forth the reasons to appeal both the canon of moral damages (daño moral) and the costs of the amparo appeal, the reasons to quash these extremes finding basis, by upholding the claim against them, the support by which the judicial authority does not exonerate my represented party varies, an additional reason that justifies the reason to appeal this extreme. / Therefore, being correct in the arguments presented, and had article 193 subsection b) of the Código Procesal Contencioso Administrativo been properly applied, the first-instance judge would have exempted my represented party from paying the enforcement costs, given that it is evident and manifest, besides simple verification, the fact that there was sufficient reason to litigate the present process, for which it is estimated that the present grievance should be upheld, and the judgment quashed.” The foregoing is nothing more than an argumentative allegation devoid of all factual and legal support. It configures an expectation of the cassation appellant that, for the reasons set forth when studying each grievance, was not configured. The criteria by which this Chamber deems the inadmissibility of each of them were provided, a reason why, unlike what was argued, the support for imposing the recognition of the enforcement process costs on the enforced party has not varied.\n\n**XXII. THIRD.** In accordance with the statement of the answer to the complaint, pages 31 to 147 of the electronic judicial file, the general judicial representative of the CCSS argued and requested that his principal should not be condemned to pay subjective moral damages (daño moral subjetivo), since the enforcing party did not provide any element of judgment -in accordance with what is provided in canons 180 subsection 1 of the CPCA and 41.1 of the CPC-, nor did it mention any that credited what was set forth in the complaint, much less, the basis for requesting said extreme in the amount sought. On the contrary, the Enforcement Judge determined the existence of subjective moral damages (daño moral subjetivo) by virtue of the facts that served as the basis for the upholding of the amparo appeal, which was endorsed by this Chamber, as was set forth. Furthermore, it set its amount according to its prudent discretion and under the principles of reasonableness and proportionality, which was also shared by this deciding body. Likewise, the petitioned amount for the personal costs of the amparo appeal was granted. Also, the legal interest on the granted amounts and the costs of the enforcement process were granted, as was requested. Corollary, different from what the appellant stated, and as was correctly resolved, it was imposed to condemn to the payment of the costs of the enforcement process, as provided in canon 193 of the CPCA, as none of the grounds for exoneration provided in that norm concurred. **FOURTH.** As pointed out in section XV of this judgment, what the appellant indicated, concerning the existence of restorative justice and the non-existence of urgency in the appointment of the person protected by the amparo, the having consented to the wait, and the inadmissibility of granting an indemnity for the concept of subjective moral damages (daño moral subjetivo), was already subject to analysis in sections VI to XI of this judgment, so, in order to avoid unnecessary reiterations, it is referred to what was expressed therein.\n\n**XXIII.** In merit of the reasons indicated, the rejection of the appeal filed is imposed.\n\nIn accordance with the provisions of Article 150, subsection 3) of the CPCA, since this Chamber does not consider that the cassation appellant has sufficient grounds to appeal, for the reasons stated when analyzing each grievance, it shall be ordered to pay the costs of the cassation appeal, which must be settled in the sentence execution phase, in order to guarantee the right of defense of the executed party, granting it the respective hearing on the settlement submitted (Articles 41 and 153 of the Political Constitution).\n\n**XXIV. DISSENTING VOTE OF MAGISTRATE ROJAS MORALES.** I depart from the majority opinion insofar as it deems it appropriate to condemn the defendant to pay subjective moral damages (daño moral subjetivo). Regarding the damages arising from a ruling of the Constitutional Chamber when granting a writ of amparo, it is pertinent to bear in mind that, given their nature, these types of judgments contain an abstract condemnation, without any factual consideration, and do not prejudge, as they were not the subject of analysis, their existence, their causal link, or their quantification. Said Court merely determines the constitutional violation. When executing these aspects, the causal relationship between what was declared in the abstract and the specific matter must be established. Thus, the fact that the Constitutional Chamber condemns in the abstract to the payment of damages does not entail an automatic condemnation to be executed, as the Executing Judge seems to wrongly understand it. It falls to the judges responsible for deciding on the settlement to assess, in each specific case, the existence of sufficient merit to grant the requested compensation. In this direction, the following must be analyzed: the particular circumstances of the case, the position of the parties, the nature, object, and purpose of the compensation, as well as the constitutional principles of reasonableness and proportionality. Furthermore, when the matter concerns alleged subjective moral damages suffered by a person facing a lack of medical care, as in the present case, an examination of additional aspects becomes indispensable. In the first place, the factor of **urgency** must be assessed, for it is evident that the situation is not the same for someone requiring urgent care from the CCSS, for example: an administered person suffering from cancer that advances irremediably, compared to someone presenting an ailment for whom a surgical intervention or a medical appointment has been prescribed without urgent character; in both cases, the waiting time to receive the medical service does not yield the same result. Likewise, the moral impact will not be of equal intensity. On the other hand, the **inactivity of the patient** due to the passage of time on the waiting list (canon 30, subsection ch) of the Ley de la Jurisdicción Constitucional -LJC- and 38 of the Código Procesal Contencioso Administrativo) must be analyzed, which ceases when they file a writ of amparo before the Constitutional Chamber or before the courts of justice to claim the medical care or treatment they need (administrative activity). It should be noted that the passage of time without action has clear consequences under Costa Rican law regarding the expiration of the action, an aspect assessable ex officio. A pecuniary advantage cannot be derived from inactivity, as this conflicts with the principle of proportionality in the strict sense. Thirdly, the **satisfaction derived from the order of a court of justice** must be weighed, by which the performance of a medical act or the delivery of medications is ordered (even if it arises from a precautionary measure). Indeed, the most recent jurisprudence of the Constitutional Chamber has assessed **the satisfaction generated from the notification of the course of the amparo**. These are cases in which, on the occasion of the amparo and regardless of the time elapsed between the filing of the appeal and the administrative response received, the appealed authority acknowledges to the administered person the required medical care (granting a certain date for surgery or a medical consultation, providing the needed medication, rescheduling an appointment, etc.). Cases of last binding resolution erga omnes (according to Article 13 of the LJC), in which the Constitutional Judges have considered it inappropriate to impose costs, damages, and losses, resolving even without condemnation in those aspects; these must be assessed by this Chamber when ruling on ongoing proceedings. In that sense, one may consult, among others, judgment numbers: 2024-000017 at 9 hours 15 minutes on January 9, 2024, 2024-000026 at 9 hours 15 minutes on January 9, 2024, and 2024-006673 at 9 hours 15 minutes on March 8, 2024. It is worth highlighting that granting the required medical service constitutes a manifestation of restorative justice, which this Deciding Body must assess. The compensation granted in violation of the stated reasoning becomes unreasonable and disproportionate, especially when in a universal social security system, like Costa Rica's, such compensations are paid by all insured persons, including those displaced by the executing party. Upon examining the described aspects and the particular case of Mr. Johnny Francisco Valverde Porras, it becomes inappropriate to compensate the emotional distress granted in the judgment. It is on record that, on February 24, 2023, the Neurosurgery Service of the Hospital Monseñor Víctor Manuel Sanabria in Puntarenas issued Mr. Johnny a hospitalization request for surgery, without a certain date. On August 4, 2023, he filed a writ of amparo before the Constitutional Chamber; that is, for approximately six months he remained waiting for the intervention to be scheduled. The possibilities of social security in an area such as Neurosurgery must be taken into account, where there are not enough specialists to serve the population, especially since the number of people requiring intervention in that area is increasing. On the other hand, it is important to note that, even though the Hospital Monseñor Víctor Manuel Sanabria issued him a hospitalization order for surgery, it did not do so with urgent character. Added to the above, it is an undisputed fact that, as a consequence of the constitutional ruling, Mr. Valverde Porras received the required medical care, given that the surgical intervention took place on November 16, 2023 (as stated in official communication HMS-DG-0513-2024 of February 14, 2024, issued by Mr. Randall Álvarez Juárez, General Director of the Hospital Monseñor Sanabria). That is, the only waiting time that the executing party endured to receive the needed care was around three months, counted from when he filed the writ of amparo on August 4, 2023, until the surgery was performed on November 16 of the same year. Even this period is shorter if one considers that the final judgment was notified on August 23, 2023. These are reasonable timeframes from the point of view of providing a non-urgent service and given the need to fulfill the preoperative requirements inherent in any surgical intervention. It should be noted that, from the filing of the amparo, the executing party was never subjected to a prolonged or indefinite wait. He received the medical care within a more than reasonable timeframe (even shorter than waiting periods in private medicine). Without overlooking that the assessment appointment was scheduled without urgency. The foregoing indicates the non-existence of the settled damage.\n\nIt is worth noting that in cases such as the one under study, there is no doubt that the user's satisfaction was already achieved; therefore, it would be contrary to law to grant additional compensation beyond that already received (medical evaluation with individual removal from the waiting list). The foregoing, far from causing moral harm (afectación moral) to the plaintiff, granted her a privilege over the other insured individuals, which diminishes the claim for moral damages (daño moral) raised. It is irrational to impose upon the tripartite contribution fund (fondo de contribución tripartito) of the social security system, and upon the other insured beneficiaries of those funds, additional compensation to someone who has already received the required medical care through judicial protection. For the reasons stated, the compensation awarded does not conform to criteria of reasonableness and proportionality (established by the Constitutional Chamber itself). By virtue of the foregoing, the undersigned considers that the appropriate course was to uphold the first and second grounds of appeal of the filed recourse and, consequently, to annul the challenged judgment —only— insofar as it recognized the amount of ¢50,000.00 for subjective moral damages (daño moral subjetivo), in order to, instead, ruling on the merits, reject that claim.\n\nPOR TANTO\n\nBy majority vote, the recourse is declared without merit, with its costs to be borne by the appellant entity, Caja Costarricense de Seguro Social, which shall be liquidated during the judgment enforcement stage (etapa de ejecución de sentencia).\n\nMagistrate Rojas Morales issues a dissenting vote to grant the appeal by virtue of restorative justice having been configured. mja.\n\nRocío Rojas Morales\n\nDamaris Vargas Vásquez\n\nJorge Leiva Poveda\n\nCarlos Guillermo Zamora Campos\n\nIgnacio Jose Monge Dobles\n\nDigitally Signed Document\n-- Verification Code --\nGRVXS1NVCFE61\nTelephones: (506) 2295-3658 or 2295-3659, email sala_primera@poder-judicial.go.cr"
}