A landslide occurred in the middle of the night on 20th July, 2023 in a remote mountain hamlet, approximately 60 kilometres 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 that 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 labour 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 to 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 from 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 favour 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 prioritising 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.
Approach · directive: “what / evaluate”
What it asks · (a) Name the ethical issues (saving life versus procedure, safety, liability, a divided team); (b) weigh the DM's options and choose a course.
It asks 2 things — answer each
- (a) Identify the ethical issues in the case
- (b) Evaluate the options available to me as District Magistrate and choose a course
Open with · The value conflict: the right to life versus a safety rule, since obeying the blood-bank rule here may let a mother and her unborn child die; then the stakeholders and their stakes.
Cover
- Stakeholders: the woman and unborn child, her husband, doctors and donors, other victims, the administration, and I as DM and physician.
- (a) Issues: right to life v. procedure (Parmanand Katara, 1989; Article 21), beneficence v. non-maleficence, duty v. fear of penalty, consent, leadership.
- (b) Merits–demerits table: refuse, evacuate first, or transfuse with safeguards; seeking orders first cannot wait for a bleeding patient.
- Course: transfuse with grouping, cross-matching, written consent and a written direction, while arranging evacuation; inform superiors at once.
- Why: IPC section 81 (since then, BNS section 19), the DM's emergency powers, and the values of life, compassion, courage and accountability.
- Long-term fix: pre-positioned blood, a field-transfusion protocol, helicopter tie-ups and e-RaktKosh links.
Close with · When no lawful alternative can arrive in time, life comes first; acting with safeguards, consent and transparency, then reporting, honours both the rule's purpose and Article 21.
Add value (verified)
- Parmanand Katara v Union of India (28 August 1989): under Article 21 the State must preserve life; every doctor has a professional obligation to extend services to protect life.Pt. Parmanand Katara vs Union of India & Ors, Supreme Court, 28 August 1989 — Indian Kanoon ↗“Article 21-- Obligation on the State to preserve life--Every doctor has professional obligation to extend services to protect life--All Govern- ment hospitals/Medical institutions to pro vide immediate medical aid in all cases.”
- IPC section 81 (necessity): no offence merely because an act is done knowing it is likely to cause harm, if done without criminal intention and in good faith to prevent other harm to person or property.Section 81 in The Indian Penal Code, 1860 — Indian Kanoon ↗“Nothing is an offence merely by reason of its being done with the knowledge that it is likely to cause harm, if it be done without any criminal intention to cause harm, and in good faith for the purpose of preventing or avoiding other harm to person or property.”
- e-RaktKosh, inaugurated on 7 April 2016, connects, digitises and streamlines the workflow of blood banks and blood storage centres across India.All for a Better Healthcare — MyGov blog (Team MyGov, Ministry of Health and Family Welfare initiatives), 19 July 2018 ↗“e-RaktKosh, inaugurated on April 7, 2016, is a Government of India initiative which connects, digitises and streamlines the workflow of blood banks and blood storage centres across India in a transparent way”
- Bharatiya Nyaya Sanhita, 2023, section 19: an act likely to cause harm is no offence if done without criminal intention and in good faith to prevent or avoid other harm to person or property; the same wording as IPC section 81.The Bharatiya Nyaya Sanhita, 2023 (Gazette of India text, Ministry of Home Affairs) ↗“19. Nothing is an offence merely by reason of its being done with the knowledge that it is likely to cause harm, if it be done without any criminal intention to cause harm, and in good faith for the purpose of preventing or avoiding other harm to person or property.”
Question: UPSC's CS (Main) 2023, GS Paper IV — paper ↗. Approach: Minimalist IAS, checked 1 Oct 2026 (how we verify) — UPSC publishes no model answers. ·
Model answer· 370words · Minimalist IAS
The right to life versus a safety rule: the blood-bank rule exists to protect patients, yet obeying it here may let a mother and her unborn child die.
Stakeholders: the woman and her unborn child (life); her husband (informed consent); doctors and volunteer donors (safety, liability); other victims (rescue); the administration (credibility); and I, as DM and physician (accountability).
(a) Ethical issues involved
- Right to life v. procedure: in Parmanand Katara (1989) the Supreme Court held that Article 21 obliges the State to preserve life and that every doctor has a professional obligation to extend services to protect life; the rule was written for normal conditions.
- Beneficence v. non-maleficence: untested blood risks infection and mismatch; the kits allow grouping, not full screening.
- Duty v. fear of penalty: the doctors' hesitation reflects a system that punishes deviation more than inaction.
- Autonomy: the husband, and the woman if conscious, must know the risks and consent.
- Leadership: a divided team needs a decision that I must own, not pass to the doctors.
(b) Options available to me as District Magistrate, evaluated
| Option | Merits | Demerits |
|---|---|---|
| Refuse, follow the rule | Legally safe | Two lives likely lost |
| Evacuate first | Within the rules | Night, landslide, fatal delay |
| Transfuse with safeguards | Saves life now | Some infection risk |
- Seek orders first: shares responsibility, but a bleeding patient cannot wait for a reply.
- My course, at once: I would order transfusion with safeguards while calling for evacuation and bank blood: group and cross-match donors, take written consent, and issue a written direction that protects the doctors.
- Then: inform superiors immediately and record every step for review.
- Why: IPC section 81 (since then, BNS section 19) excuses an act done in good faith, without criminal intent, to prevent other harm, and the DM's emergency powers under the Disaster Management Act support extraordinary measures; life, compassion, courage and accountability point the same way.
- Long-term fix: pre-positioned blood units in disaster-prone districts, a protocol for emergency field transfusion, helicopter tie-ups, and links to e-RaktKosh, launched in 2016 to connect and digitise blood banks' workflow across India.
When no lawful alternative can arrive in time, life comes first; acting with safeguards, consent and transparency, then reporting, honours both the rule's purpose and Article 21.
Prepared by Minimalist IAS to the answer standard of Shivam Singh (mentor, 7 years) · facts checked against official sources (how we verify) · updated 1 Oct 2026. UPSC publishes no model answers: compare your structure and coverage with this, then write your own.
