On the fateful night of 20th July 2023, tragedy struck Irshalgad wadi in Khalapur, Raigad district, as a landslide claimed the lives of around 20 individuals and left approximately 100 injured near the Irshalgad fort.
This incident prompts a crucial examination of the ethical dilemmas faced by professionals in emergency situations, particularly the conflicting responsibilities of medical practitioners torn between their professional obligations and the moral imperative to save lives.
(a) Ethical Issues Involved in this Case:
- Compromise of Medical Code or Compassion Towards Human: The situation raises the ethical dilemma of choosing between strict adherence to medical codes and the compassionate duty to save human lives.
- Disagreement in Team and Dilemma for the Leader: Team disagreements intensify the complexity of the situation, placing leaders in a moral quandary.
- Conflict Between Objectivity and Empathy: The clash between objective decision-making and empathetic considerations further complicates the ethical landscape.
- Dilemma for the District Magistrate (DM) vs Physician: The DM faces a dilemma between serving humanity and saving lives, while physicians must adhere to established medical codes.
- Breach of Legal and Regulatory Compliance: In urgent situations, there is a risk of breaching legal and regulatory compliance, adding an additional layer of complexity to the ethical considerations.
(b) Options Available:
Option 1: Allow Transfusion Considering it an Exceptional Situation:
- Saving a human life.
- Upholding values of compassion and empathy.
- Avoiding a crisis of conscience.
- Compromising medical and legal codes.
- Breach of objectivity and compliance procedures.
- Compromising professional values.
Option 2: Refer Patient to Nearby Hospital in an Ambulance:
- Following medical and legal codes.
- Better facilities in a hospital for the patient and newborn.
- Adherence to objectivity and compliance.
- Delay can risk the life of the critical patient.
- Not the best utilization of available resources at the site.
- Poor decision-making capability in an urgent situation.
Option 3: Start the Transfusion Urgently with Consent and Arrange Alternatives:
- Upholding professional ethics and values of compassion and empathy.
- Fulfilling the moral duty of saving human life.
- Quick and balanced decision-making abilities.
- Might cause a delay and increased risk to life.
- Probability of disruption of rescue procedure.
Additional Considerations and Actions:
- Exploring alternatives like consulting legal authorities for exceptions.
- Volunteers revealing health conditions to prevent infections.
- Professional judgments by physicians.
- Post-transfusion action of testing all blood samples for early diagnosis.
- Documenting the situation as an exception rather than a violation.
Civil servants, particularly medical professionals, need to possess emotional intelligence and quick decision-making capabilities to effectively address such emergency situations.
The ability to navigate ethical dilemmas while upholding both professional codes and the moral duty to save lives is crucial in ensuring effective crisis management.