लता, जो दो बच्चों की माँ है, उसे अचानक तेज़ पेट-दर्द के कारण अस्पताल में भर्ती कराया गया। उसकी ननद सुजाता उसके साथ थी। डॉ॰ मानसी ने लता की जाँच की और एक डायग्नोस्टिक लैप्रोस्कोपी करवाने की सलाह दी। जेनरल ऐनेस्थीसिया देकर उपर्युक्त चिकित्सकीय प्रक्रिया के लिए लता की सहमति ली गई।
लैप्रोस्कोपी करते हुए डॉ॰ मानसी की टीम को लता के गर्भाशय में ट्यूमर मिला। एक गहन जाँच से निकलकर आया कि यह ट्यूमर घातक हो सकता है।
डॉ॰ मानसी के सामने एक विकल्प यह था कि ट्यूमर का एक नमूना बायोप्सी के लिए निकाला जाय। यदि बायोप्सी करने के बाद ट्यूमर घातक निकलता है, तो लता को एक और ऑपरेशन गर्भाशय निकालने के लिए करवाना होगा। दूसरा विकल्प यह था कि उसी समय गर्भाशय निकाल दिया जाय। डॉ॰ मानसी को यह निर्णय तत्काल लेना था।
चूँकि लता जेनरल ऐनेस्थीसिया के कारण बेहोश थी, इसलिए डॉ॰ मानसी ने सुजाता को इस स्थिति से पूरी तरह अवगत कराया। डॉ॰ मानसी की सलाह से सुजाता सहमत थी कि हिस्टेरेक्टॉमी करके लता का गर्भाशय निकालना होगा, जिससे उसे एक दूसरे ऑपरेशन का खतरा और पीड़ा न हो। डॉ॰ मानसी ने सुजाता की लिखित सहमति लेने के बाद लता का गर्भाशय निकाल दिया। इसके बारे में अगले दिन लता को सूचित किया गया। वह बहुत विचलित हुई और उसे लगा कि उसके साथ धोखा हुआ है, क्योंकि गर्भाशय निकालने के लिए उसकी सहमति नहीं ली गई थी।
लता ने पुलिस में शिकायत की। पुलिस ने उसे समझाने की कोशिश की कि डॉ॰ मानसी ने सही इरादे से एक मरीज की मदद की है। सुजाता का भी यही विचार था, लेकिन लता इससे आश्वस्त नहीं थी और उसने न्यायालय जाने का निर्णय लिया।
(a) इस प्रसंग से जुड़े नैतिक मुद्दों पर विचार कीजिए। (b) इस परिस्थिति में डॉक्टर के नैतिक आचरण पर विचार कीजिए।
Read this question in English
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 recommendations 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.
🧭 How to think about this question · directive: “discuss”
Decode the demand
- Two directives, both 'discuss': (a) the ethical issues in the case, several dimensions with reasons; (b) the moral conduct of Dr. Mansi, both sides and a verdict. Each gets its own heading.
- The act in one line: a uterus removed during a diagnostic procedure on a relative's signature, without the patient's consent. Every point must return to this.
- Three things to answer: which values collided, how far the doctor's intent redeems her act, and what right conduct looks like now.
- The trap: writing only 'autonomy v. beneficence' and calling her a villain or a hero. The examiner wants the Kohli test applied: was there an emergency, and could she have waited?
Think in a structure
- Open with the value conflict and Samira Kohli (2008), which is almost this case; a hub of stakeholders shows who is affected.
- (a) in dimensions: autonomy, consent v. proxy, convenience, paternalism, gender dignity, police accountability; each point carries an ethical keyword, a reason and a thinker or ruling.
- (b) as a table of her two options, then points for her, against her, and a verdict; end with what she and the hospital should do, so the answer closes on repair, with Cardozo's dictum as the anchor.
Facts checked at source (9)· open
- Samira Kohli (2008): consent for a diagnostic procedure is not consent for treatment, and the benefit of an unauthorised additional surgery is no defence.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“Consent given only for a diagnostic procedure, cannot be considered as consent for therapeutic treatment. The fact that the unauthorized additional surgery is beneficial to the patient, or that it would save considerable time and expense to the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence”
- Samira Kohli (2008): the only exception is an unauthorised procedure needed to save life or preserve health where it would be unreasonable to wait for the patient to regain consciousness and decide.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“The only exception to this rule is where the additional procedure though unauthorized, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such unauthorized procedure until patient regains consciousness and takes a decision.”
- Lalita Kumari v. Govt. of U.P. (12 November 2013): registration of an FIR is mandatory when the information discloses a cognizable offence.Lalita Kumari vs Govt. of U.P. & Ors, Supreme Court (Constitution Bench), 12 November 2013 — Indian Kanoon ↗“i) Registration of FIR is mandatory under Section 154 of the Code, if the information discloses commission of a cognizable offence and no preliminary inquiry is permissible in such a situation.”
- Lalita Kumari (2013): medical negligence cases are among the categories where a preliminary inquiry may be made before registering an FIR.Lalita Kumari vs Govt. of U.P. & Ors, Supreme Court (Constitution Bench), 12 November 2013 — Indian Kanoon ↗“The category of cases in which preliminary inquiry may be made are as under: a) Matrimonial disputes/ family disputes b) Commercial offences c) Medical negligence cases d) Corruption cases”
- Kant's Humanity Formula: never treat humanity, in oneself or in others, as a means only but always as an end in itself.Kant's Moral Philosophy — Stanford Encyclopedia of Philosophy ↗“This formulation states that we should never act in such a way that we treat humanity, whether in ourselves or in others, as a means only but always as an end in itself.”
- Samira Kohli (2008), para 45: when the patient is a competent adult, no one else can consent on her behalf; with no emergency and only a diagnostic procedure under way, the doctor should have waited for her to regain consciousness.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“When a patient is a competent adult, there is no question of someone else giving consent on her behalf. There was no medical emergency during surgery. The appellant was only temporarily unconscious, undergoing only a diagnostic procedure by way of laparoscopy. The respondent ought to have waited till the appellant regained consciousness”
- Samira Kohli (2008): sparing the patient the pain and cost of a second operation does not justify removing an organ without consent; what matters is the inviolable nature of the patient's right over her body.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“would save the patient from the pain and cost of a second operation. Howsoever practical or convenient the reasons may be, they are not relevant. What is relevant and of importance is the inviolable nature of the patient's right in regard to his body and his right to decide whether he should undergo the particular treatment or surgery or not.”
- Samira Kohli (2008) traces the consent principle to Justice Cardozo's statement in Schloendorff v. Society of New York Hospital (1914): every adult of sound mind has a right to determine what should be done with his body.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“classic statement by Justice Cardozo in Schoendorff vs. Society of New York Hospital - (1914) 211 NY 125 : 'Every human being of adult years and sound mind has a right to determine what should be done with his body; and a surgeon who performs the operation without his patient's consent, commits an assault for which he is liable in damages."”
- Outcome in Samira Kohli (2008): the doctor was denied her entire fee and ordered to pay Rs 25,000 compensation for the unauthorised surgery, although the patient would probably have needed that treatment in the end.Samira Kohli vs Dr. Prabha Manchanda & Anr, Supreme Court, 16 January 2008 — Indian Kanoon ↗“Even assuming that AH-BSO surgery was not immediately required, there was a reasonable certainty that she would have ultimately required the said treatment for a complete cure. On the facts and circumstances, we consider that interests of justice would be served if the respondent is denied the entire fee charged for the surgery and in addition, directed to pay Rs.25,000 as compensation for the unauthorized AH-BSO surgery to the appellant.”
Question: UPSC's CS (Main) 2026, GS Paper IV — paper ↗. Guidance: Minimalist IAS, checked 8 Nov 2026 (how we verify). ·
Model answer· 600words · Minimalist IAS
Autonomy versus beneficence is the crux: a surgeon's well-meant judgement overrode a woman's right to decide what is done to her body. On almost identical facts, the Supreme Court held in Samira Kohli v. Prabha Manchanda (2008) that consent for diagnosis is not consent for treatment, and this case shows why.
Lata's uterus: Lata and her children; Dr. Mansi's team; Sujatha; hospital; police; courts
(a) Ethical issues involved in the case
- Autonomy v. beneficence: a hysterectomy is irreversible and ends reproductive choice; only Lata could authorise it, whatever its medical merit.
- Kohli (2008): a patient's right over her body is inviolable; the convenience of a single surgery is not relevant.
- Informed consent v. proxy consent: a relative cannot consent for an adult who is only temporarily unconscious; Sujatha's signature carried love, not authority.
- Kohli, para 45: for a competent adult there is no question of someone else consenting; the doctor should have waited for consciousness.
- Convenience v. consent: sparing a second operation is a consequentialist shortcut; the only exception is danger to life or health where waiting is unreasonable.
- Paternalism v. partnership: Mill's harm principle allows power over a competent adult only to prevent harm to others; a self-regarding choice was hers alone.
- Dignity and gender justice: others decided the fate of a woman's reproductive organ; Puttaswamy (2017) reads bodily autonomy into Article 21.
- Accountability of the police: dissuading a complainant is not their role; under Lalita Kumari (2013) they must register or inquire.
- Lalita Kumari lists medical negligence among cases where a preliminary inquiry may precede an FIR, not where complaints may be talked away.
The full answer goes on to cover
- (b) Moral conduct of Dr. Mansi in this situation
- What Dr. Mansi and the hospital should do now
With 1 table, 1 flowchart you can reproduce in the exam.
Prepared by Minimalist IAS to the answer standard of Shivam Singh (mentor, 7 years) · facts checked against official sources (how we verify) · updated 8 Nov 2026. UPSC publishes no model answers: compare your structure and coverage with this, then write your own.







