Civil Services Prep

Citing the serious adverse effects of long-term medication, a doctor convinces the family of a female patient for surgery. This led the patient to reluctantly consent for the surgery, though her original choice was to opt for medication. Explain the concepts of paternalism and beneficence by analysing the doctor's action.

Model answer

  1. On the request of his Personal Assistant (PA), the District Magistrate (DM) stops the transfer of a schoolteacher who takes private tuition for his daughter diagnosed with learning disability. In this context, discuss the aspects of empathy versus compliance with rules. 10 marks
  2. In what ways can an Indian Administrative Officer apply Gandhi's notion of 'trusteeship' to ensure fairness in governance? 10 marks
  3. An endangered tribe has developed a severe skeletal deformity. A university research has identified a mineral supplement as a possible remedy, though clinical trials are yet to be conducted. Should the District Magistrate (DM) use this research on the tribe? Discuss from the perspective of medical and administrative ethics. 10 marks
  4. Seema is a senior bureaucrat with a reputation for honesty and professional efficiency. She has recently been posted as the District Collector (DC) to Surinder Nagar, where a large industrial area is being established. The new industrial area had caused many farmers to submit applications for change of land use (CLU) to convert their farmlands into residential areas. There is an unusually large backlog of these applications awaiting processing. Seema noticed that some applications had been approved selectively with no visible chronological pattern. The case files showed a few complaints of some approvals being subject to receipt of large bribes from the applicants. On further fact-finding, Seema realized that a small group of touts was controlling this illegal activity through some subordinate officials in the Collectorate. This had created a fear in the other employees who were reluctant to process any application. The resultant backlog has been piling up, thereby hindering local economic progress and causing public dissatisfaction. Seema was faced with a major moral and administrative challenge of dismantling this corruption network without hampering daily administrative operations. An aggressive internal investigation would result in institutional resistance and, possibly, a backlash from labour unions. Conversely, ignoring this situation would encourage the wrongdoers and unnecessarily continue this avoidable harassment to the populace. (a) What are the ethical issues involved in this case? (b) Discuss the options open to Seema. Identify the recommended option and justify it. 20 marks
  5. Lata, a mother of two children, was admitted to a hospital for acute abdominal pain. Her sister-in-law, Sujatha, accompanied her. Dr. Mansi examined Lata and recommended a diagnostic laparoscopy. Lata's consent was taken to conduct the medical procedure under general anesthesia. During the laparoscopy, Dr. Mansi's team discovered a tumor in Lata's uterus. A closer examination suggested that the tumor could be malignant. One option before Dr. Mansi was to extract a sample for biopsy. In that case, if the tumor was malignant, Lata would have to undergo another surgery for removal of the uterus. An alternative was to remove the uterus immediately. Dr. Mansi had to take a quick decision. As Lata was under general anesthesia, Dr. Mansi explained the situation to Sujatha. Sujatha agreed with Dr. Mansi's recommendation for a hysterectomy, wherein Lata's uterus would be removed to avoid the risk and pain of undergoing another surgery. Dr. Mansi removed Lata's uterus after receiving Sujatha's consent in writing. Lata was informed of this the next day. She was very upset and felt betrayed as she had not consented to the removal of her uterus. Lata complained to the police, who tried to convince her that Dr. Mansi had acted with good intention to help a patient. Sujatha was of the same opinion; however, Lata was not convinced and decided to approach the court. (a) Discuss the ethical issues involved in this case. (b) Discuss the moral conduct of the doctor in this situation. 20 marks
  6. Ajit has recently been promoted as the Head of the Department of Weapon Sales (DWS) under the Ministry of Defence Production (MDP). His charter of duties includes international sales of weapons produced domestically by MDP. In two recent wars, MDP weapons have performed admirably, resulting in many countries showing interest in buying them, particularly long-range artillery and missiles. Country A and country B have asked for these weapons. However, production constraints restrict DWS to accept only one purchase order. Country A is a developing nation with a sound technology base. MDP is planning R&D collaboration with it for the next generation of weapons. It is not part of any security alliance and needs weapons for protection from a troublesome neighbour. It seeks a large acquisition on a long-term loan. Country B is also a developing nation. Military strength is its priority, with the military budget often ingressing into allocations for human resources and infrastructure development. It is in security alliance with a superpower who has a large military base there and periodically allots it financial grants. It is a member of an economic bloc with which the government is currently negotiating a free trade agreement. It is not a signatory of NPT but possesses smaller nuclear weapons and delivery systems. It supports some guerrilla forces abroad. It has sought a smaller acquisition and is prepared to make some advance payment. It is currently negotiating arms purchases from another nation too. Ajit discussed this case with his counterparts in the related departments. Therein, the significant economic benefits, employment generation and stronger diplomatic relations arising from this sale were highlighted. It was also emphasized that refusing the deal could result in country B purchasing weapons from some other supplier. Ajit was aware that in arms sales, due diligence at each stage was pivotal to ensure conformity to national policy and international treaties. (a) Discuss the options available to Ajit. Which option should he select and why? (b) How can Ajit balance nation's economic and strategic interests with ethical considerations? 20 marks