Model Answer
0 min readIntroduction
Ethical dilemmas are inherent in decision-making, particularly when choices involve conflicting moral principles. These situations often lack clear-cut solutions, forcing individuals to navigate complex considerations of right and wrong. As a civil servant, or even as a citizen, one frequently encounters scenarios demanding difficult choices, where upholding one ethical value may necessitate compromising another. This response will detail a specific instance where I faced such a dilemma – a situation during my internship at a local NGO focused on rural healthcare access – and the resulting ethical challenges. The core of ethical decision-making lies not in avoiding dilemmas, but in acknowledging them and navigating them with integrity and transparency.
The Situation: Resource Allocation in Rural Healthcare
During my internship at ‘Aarogya Seva’, an NGO providing basic healthcare services in a remote district, we faced a critical shortage of essential medicines. A sudden outbreak of seasonal influenza led to a surge in demand, quickly depleting our limited stock of antiviral drugs. We had enough medication to treat either a large number of patients with mild symptoms or a smaller number with severe, life-threatening cases. This presented a stark choice: prioritize maximizing the number of people treated or focus on saving the lives of those most at risk.
Ethical Principles at Play
Several ethical principles were in conflict:
- Utilitarianism: The principle of maximizing overall well-being, suggesting we treat as many people as possible, even if it meant less intensive care for each.
- Justice: The principle of fairness and equitable distribution of resources, implying that those most in need (the severely ill) should receive priority.
- Beneficence: The obligation to act in the best interests of patients, which could be interpreted as providing the most effective treatment to those with the highest chance of survival.
- Non-maleficence: The principle of ‘do no harm’, which raised concerns about potentially denying life-saving treatment to vulnerable individuals.
Options Considered
We considered three primary options:
- Broad Distribution: Distribute the medication widely, providing a lower dosage to a larger number of patients with mild symptoms.
- Prioritized Treatment: Reserve the medication for patients with severe symptoms and a high risk of complications.
- Rationing based on Socioeconomic Status: (This option was quickly dismissed as unethical). Allocate medication based on the ability to pay, which would violate the principle of justice.
The Chosen Option and Justification
After extensive deliberation with the NGO director and medical staff, we opted for Prioritized Treatment. The rationale was based on the severity of the situation and the limited resources. While it meant fewer people would receive treatment, it offered the best chance of preventing fatalities. We reasoned that saving lives, particularly those most vulnerable, outweighed the benefit of providing minimal relief to a larger population. We also implemented a transparent triage system, based purely on medical assessment, to ensure fairness in the selection process.
Ethical Dilemmas Faced
Despite the justification, several ethical dilemmas persisted:
- The Dilemma of Exclusion: We were effectively denying treatment to individuals who, while not critically ill, were still suffering from the flu. This felt unjust and created a sense of moral discomfort.
- The Potential for Bias: Despite our best efforts, there was a risk of unconscious bias influencing the triage process. Ensuring objectivity in a stressful situation was challenging.
- The Long-Term Impact on Trust: The decision could erode public trust in the NGO if it was perceived as unfair or discriminatory.
- Emotional Toll: Witnessing the suffering of those denied treatment and knowing we could have alleviated some of their symptoms was emotionally draining.
Furthermore, the situation highlighted the systemic issues of inadequate healthcare infrastructure and resource allocation in rural areas, raising questions about our responsibility to advocate for broader systemic changes.
Addressing the Dilemmas
To mitigate these dilemmas, we focused on clear communication with the community, explaining the rationale behind our decision and emphasizing the scarcity of resources. We also actively sought additional support from government health authorities and other NGOs. We documented the entire process meticulously, including the triage criteria and the rationale for each decision, to ensure transparency and accountability.
Conclusion
The experience underscored the inherent complexities of ethical decision-making, particularly in resource-constrained environments. While prioritizing life-saving treatment felt ethically justifiable, it was not without its moral costs. The situation highlighted the importance of a robust ethical framework, transparent decision-making processes, and a commitment to advocating for systemic improvements. Ultimately, navigating ethical dilemmas requires acknowledging the trade-offs involved, prioritizing core values, and accepting responsibility for the consequences of our choices. It also reinforced the need for continuous self-reflection and a willingness to learn from challenging experiences.
Answer Length
This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.