Q. A landslide occurred in the middle of the night on 20th July, 2023 in a remote mountain hamlet, approximately 60kilometers 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 the 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 labor 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 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 for 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 favor 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 prioritizing service to humanity and saving lives of individuals.
(a)What are the ethical issues involved in this case?
(b) Evaluate the options available to you, being District Magistrate of the area.
Question from UPSC Mains 2023 GS4 Paper
Model Answer:
Ethical Issues Involved:
1. Medical Ethics: As a physician, the district magistrate is trained to prioritize service to humanity and saving lives. However, the medical ethics dictate that blood for transfusion should be procured only from a recognized blood bank. Deviating from this norm could potentially lead to legal implications.
2. Humanitarian Ethics: The pregnant woman is in dire need of a blood transfusion. Denying her the necessary medical attention due to lack of proper resources could result in loss of life, which is against the humanitarian principle of preserving life.
3. Organizational Ethics: As the district magistrate, there is a responsibility to uphold the rules and regulations of the organization. The dilemma arises when these rules conflict with the immediate need to save a life.
4. Professional Ethics: The doctors in the team are willing to facilitate the delivery, but they are concerned about the potential penalization for transfusion. This highlights the conflict between professional responsibility and legal constraints.
Options Available:
1. Prioritize Saving Life: The most immediate concern is to save the life of the pregnant woman and her unborn child. The district magistrate could decide to go ahead with the blood transfusion, prioritizing the value of human life over the procedural norms.
2. Seek Legal Advice: The district magistrate could quickly consult with a legal expert to understand the potential implications of going ahead with the transfusion. This might help in making an informed decision.
3. Mobilize Resources: The district magistrate could try to arrange for blood from a nearby recognized blood bank. This could involve coordinating with local authorities, NGOs, or even the military if they are in the vicinity.
4. Document the Situation: The district magistrate could ensure that the entire situation is well-documented, including the urgency of the situation, the unavailability of resources, and the willingness of the team to donate blood. This could potentially serve as a defense in case of any legal implications.
5. Advocate for Policy Change: In the longer term, the district magistrate could use this situation to advocate for changes in policy that allow for exceptions in emergency situations.
In conclusion, the district magistrate, as a physician and a public servant, is in a challenging position where he/she has to balance medical ethics, humanitarian ethics, organizational ethics, and professional ethics. The decision taken should be in the best interest of the patient, while also considering the potential legal implications. The situation also highlights the need for flexible policies that can adapt to emergency situations.
