2023 · GS Paper 4 · Q8 · 20 marks
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.
In short
The DM should authorise a cross-matched emergency transfusion with informed consent and a written order, while arranging evacuation in parallel. This reconciles the Right to Life with the Rule of Law, as Parmanand Katara (1989) made preserving life a doctor's paramount duty.
Model answer
Ghissu Editorial · Verified 4 Oct 2026 · 287 words
Right to life
Parmanand Katara (1989) [case] made preserving life a doctor's paramount duty.
Patient safety
Unscreened blood can transmit HIV, hepatitis or malaria.
Rule of law
Bending the Drugs and Cosmetics Act sets a precedent; fearful doctors turn defensive.
Consent and leadership
Informed consent is essential, and a divided team needs the DM to decide rather than let responsibility diffuse.
(i) CAPITULATE [Strict-Legal]
Refusing and waiting is legally safe but may cost the mother's life: Omission Bias.
(ii) CONFRONT [Empathetic-Humanitarian]
An untested transfusion is fast but risks infection.
(iii) EVADE [Procedural-Evasive]
Leaving it to doctors is Conscience Laundering.
(iv) COMPROMISE [Compromised-Hybrid]
Transfusing off record leaves doctors exposed.
(v) RECONCILE ✓ [Balanced]
Cross-matched transfusion with consent, a written order and parallel evacuation (recommended).
This model answer is indicative and the model can make mistakes; please verify key facts independently.
Practise this question
1Get the answer sheet
Sized for this question.
2Write your answer
Timed, by hand.
3Get it marked
Your score and what to fix.
This chapter in the exam
Disaster and Emergency Response6 questions
Asked in 6 of 14 sittings since 2013
- 2026Rajapuram is a border district. Jhara and Biru, its two major communities are in continual conflict with each other. The social fabric is fractured and demands mending. Ethnic tensions between the two communities have erupted into violence resulting in a large number of deaths. The stated causes are conflicting land claims, uneven resource allocation and inadequate political representation in government bodies. Separate relief camps had to be created for the two communities. The situation is volatile and appears to be getting out of control. Rajan has been appointed the District Magistrate (DM) of Rajapuram and tasked to quickly get the situation under control. His immediate tasks include restoring administrative authority, reopening the highway and initiating peace talks. On taking over his appointment, Rajan realized that the inter-community rivalry had even seeped into the local administration and police. With functional neutrality being the immediate casualty, it had made both communities distrustful of the government. The neighbouring country could utilize the opportunity to spur insurgent activity and further aggravate the situation. Rajan favoured a controlled approach starting with opening the highway to restore food and medical supplies. He toyed with the idea of requisitioning CRPF units to help restore administrative control. (a) Discuss the ethical issues that need to be addressed in this case. (b) What are the options open to Rajan? Which option would ensure protection of his non-partisan image without compromising ethics?
- 2025Vijay was Deputy Commissioner of remote district of Hilly Northern State of the country for the last two years. In the month of August heavy rains lashed the complete state followed by cloud burst in the upper reaches of the said district. The damage was very heavy in the complete state especially in the affected district. The complete road network and telecommunication were disrupted and the buildings were damaged extensively. People's houses have been destroyed and they were forced to stay in open. More than 200 people have been killed and about 5000 were badly injured. The Civil Administration under Vijay got activated and started conducting rescue and relief operations. Temporary shelter camps and hospitals were established to provide shelter and medical facilities to the homeless and injured people. Helicopter services were pressed in, for evacuating sick and old people from remote areas. Vijay got a message from his hometown in Kerala that his mother was seriously sick. After two days Vijay received the unfortunate message that his mother has expired. Vijay has no close relative except one elder sister who was US citizen and staying there for last several years. In the meantime, the situation in the affected district deteriorated further due to resumption of heavy rains after a gap of five days. At the same time, continuous messages were coming on his mobile from his hometown to reach at the earliest for performing last rites of his mother. (a) What are the options available with Vijay? (b) What are the ethical dilemma being faced by Vijay? (c) Critically evaluate and examine each of these options identified by Vijay. (d) Which of the options, do you think, would be most appropriate for Vijay to adopt and why?
All 6 questions, sorted by sub-topic, with model answers and practice.
Question from the official UPSC Civil Services (Main) Examination 2023 paper. Answer written by Ghissu's engine and checked against our editorial standards. Found an error? Tell us and we correct it within 48 hours.