GS Paper IV 2026 · Q7 (Section B)
20 marks · 250 wordsLata, 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.
Approach · directive: “discuss”
What it asks · Identify the ethical issues in removing a patient's uterus on a relative's consent during a diagnostic procedure, and evaluate the doctor's conduct.
The question has 2 parts — answer each
- (a) Discuss the ethical issues involved in the case
- (b) Discuss the moral conduct of Dr. Mansi in this situation
Open with · Consent to a diagnostic laparoscopy is not consent to a hysterectomy; the Supreme Court held so on similar facts in Samira Kohli v. Prabha Manchanda (2008).
Cover
- Stakeholders: Lata, Dr. Mansi and her team, Sujatha, Lata's family and children, the hospital, the police, the medical profession.
- Autonomy and bodily integrity: removing a reproductive organ is irreversible; only the competent adult patient can consent, and a sister-in-law is not a valid proxy.
- Beneficence vs paternalism: sparing a second surgery was well meant, but malignancy was only suspected; there was no life-threatening emergency.
- Informed consent: Samira Kohli allows unauthorised surgery only to save life or health when delay is unreasonable; here, biopsy first, then Lata's decision.
- Justice and dignity: women's reproductive rights; under Lalita Kumari (2013) the police must register or inquire into the complaint, not talk her out.
- Doctor's conduct: well-intentioned but ethically and legally flawed — it overrode Lata's choice, breached professional norms and damaged trust.
- Way forward: honest disclosure and apology, institutional review, compensation if due; hospital protocols for unexpected findings and extended consent.
Close with · Good intentions cannot replace the patient's own voice; medicine keeps its trust by treating the patient as a person, not a problem.
Add value (verified)
- 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.”
Question: UPSC's CS (Main) 2026, GS Paper IV — paper ↗. Approach: Minimalist IAS, checked 1 Oct 2026 (how we verify) — UPSC publishes no model answers. ·
Model answer · 330 words (UPSC limit 250) · Minimalist IAS
Lata consented to a diagnostic laparoscopy and woke without her uterus. In Samira Kohli v. Prabha Manchanda (2008) the Supreme Court held that consent for diagnosis is not consent for treatment, and that the benefit of an unauthorised surgery is no defence.
Stakeholders
- Lata and her children; Dr. Mansi and her team; Sujatha; the hospital; the police; the medical profession and every future patient's trust.
(a) Ethical issues involved in the case
- Autonomy and bodily integrity: a hysterectomy is irreversible and ends reproductive choice; only the competent adult patient can authorise it.
- Invalid proxy: a sister-in-law is neither guardian nor Lata's chosen decision-maker; her signature transfers nothing.
- Beneficence versus paternalism: sparing a second surgery was well meant, but malignancy was only suspected. Kohli allows an unauthorised procedure only to save life or preserve health when delay would be unreasonable; a biopsy first was available.
- Informed consent as a process: foreseeable findings should have been discussed before anaesthesia.
- Gender and justice: others decided about a woman's reproductive organs, and the police tried to talk her out of complaining. Lalita Kumari (2013) makes registering an FIR mandatory for a cognizable offence, though a preliminary inquiry is allowed in medical-negligence cases.
(b) Dr. Mansi's moral conduct
| Assessment | Conduct |
|---|---|
| In her favour | Good intent, clinical reason, written consent, next-day disclosure |
| Against her | Non-emergency treated as emergency; a relative's word for the patient's |
| Core flaw | Paternalism: deciding for Lata, not with her |
- Kantian test: treating Lata as a body to be fixed, not a person who decides, uses her merely as a means.
- Right conduct now: full disclosure, a sincere apology, cooperation with the inquiry and compensation if due.
Systemic fix
- Layered consent: consent for exploratory surgery that covers foreseeable findings; a rule that non-emergency extra procedures wait for the patient's own decision; ethics-committee review of such cases.
Medicine keeps its trust by treating the patient as a person who decides, not a problem to be solved; Lata's grievance is the assertion of that principle.
Written by Minimalist IAS from facts checked at source (how we verify) — a little fuller than exam length, so every part of the question is covered; in the hall, keep the structure and trim the detail. UPSC publishes no model answers: compare your structure and coverage with this, then write your own.