Q8. A landslide occurred in the middle of the night on 20th July. 2023 in a remote mountain hamlet, approximately 60 kilometres from Uttarkashi. The landslide was caused by torrential rains and has resulted in large-scale destruction of property and life. You, as District Magistrate of that area, have rushed to the spot with a team of doctors, NGOs, media and police along with numerous support staff to oversee the rescue operations.
A man came running to you with a request for urgent medical help for his pregnant wife who is in labour and is losing blood. You directed your medical team to examine his wife. They return and convey to you that this Woman needs blood transfusion immediately. Upon enquiry, you come to know that a few blood collection bags and blood group test kits are available in the ambulance accompanying your team. Few people of your team have already volunteered to donate blood.
Being a physician who has graduated from AIIMS, you know that blood for transfusion needs to be procured only through a recognized blood bank.
Your team members are divided on this issue; some favour transfusion, while some others oppose it. The doctors in the team are ready to facilitate the delivery provided they are not penalized for transfusion. Now you are in a dilemma. Your professional training emphasizes on prioritising service to humanity and saving lives of individuals.
(a) What are the ethical issues involved in this çase?
(b) Evaluate the options available to you, being District Magistrate of the area.
(Answer in 250 words) Ethics Case Study
This case study is a classic example of conflict of interest of a civil servant’s moral duty of saving an individual’s life at the same time following professional ethics being a physician.
(a)Ethical issues involved in the case
- Professional conduct vs empathy
- Duty vs morality
- Human life vs legal procedures
- Conflict of values: Objectivity vs Compassion
- Conflicting professional duties (as a district magistrate and as a physician)
- Team disagreement
(b)Different options available being a district magistrate
- Allow the transfusion of blood and not penalise the doctors.
- Keeping the value for life at highest priority and showing empathy, compassion and humanity.
- Applying the values taught in training like prioritising service to humanity and saving lives of individuals in true essence
- Applying teleological approach of ethics (those actions are ethical which leads to right ends)
- Optimum utilisation of available resources (blood donors)
- Leaving professional ethics of the physician behind
- Bypassing legal obligations and previously set procedure
- Compromising professional values of self as well as of others
- Start the process of blood transfusion with available resources and in the meantime arrange for blood from nearby blood banks or call any mobile blood bank van to the spot.
- Showing qualities of both professional ethics as well as legal duty.
- Showcase the ability of quick decision making to save human life.
- following the legal procedure of blood transfusion and encouraging the volunteers to donate blood through proper channels.
- Delay in blood transfusion process may be fatal for both the pregnant lady and unborn.
- The process of arranging blood from nearby blood banks may temporarily disturb the rescue efforts (against utilitarian approach of greatest good of greatest number
- Start the procedure with available resources and refer the patient to nearby district hospital in an ambulance
- Proper medical facilities are required for a newborn
- More focus on rescue operation
- Referring the patient in such a critical condition involves substantial risk
Most appropriate course of action in this situation would be option 2 as available resources are utilised in an optimum manner along with following set procedures. Calling the blood bank mobile van to the rescue spot will also help in treating the injured and landslide affected people.
In such situations the key is to balance the ethical principles of doing good for saving individuals life while also adhering to legal and regulatory requirements. For this the civil servants need a mixture of emotional intelligence with quick responsiveness.
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