Ethics Case Study 2 (2023/20 Marks)

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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.

(a) Ethical Issues Involved:

  1. Professional Ethics vs. Humanitarian Need: Balancing the duty to adhere to medical protocols with the immediate need to save a life.
  2. Legal Responsibility: Potential legal repercussions of performing an unregulated blood transfusion.
  3. Team Disagreement: Managing differing opinions within the team while ensuring the best decision for the patient.
  4. Resource Allocation: Deciding how to best utilize limited resources in a disaster scenario.

(b) Evaluating Options:

  1. Transfusion with Donor Blood: This option can save the woman’s life but risks legal and professional ethics violations.
  2. Waiting for Proper Channels: Adheres to legal and professional standards but poses a significant risk to the patient’s life.
  3. Seeking Immediate External Support: Trying to arrange for blood from a nearby recognized blood bank, balancing legal adherence and immediate medical need.
  4. Documenting the Decision Process: Whatever decision is taken, it should be well-documented, explaining the extraordinary circumstances of the disaster.

This situation requires a delicate balance between ethical medical practices and the urgent need to save lives in a crisis.

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