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GS Paper: Paper 4

  • Radioactive Chapatis: Concern over a 1969 experiment on South Asian women

    chapati

    Central Idea

    • A Member of Parliament in the UK demanded a statutory inquiry into medical research conducted on Indian-origin and South Asian women in Coventry.
    • Women of Indian origin were fed Chapatis containing a radioactive isotope of iron, Iron-59 to verify if it treats anaemia.

    The 1969 Chapati Study

    • The study took place in 1969 and involved approximately 21 Indian-origin women from Coventry.
    • These women were given chapatis containing a radioactive isotope of iron, Iron-59, as a part of an effort to combat widespread anaemia.
    • The UK’s Medical Research Council (MRC) concluded that the study demonstrated the necessity for increased iron intake among Asian women due to the insolubility of iron in flour.

    Ethical Considerations

    • The release of the documentary “Deadly Experiments” in 1995 drew attention to the administration of radioactive substances in research during the 1950s and 1960s in the UK and the US.
    • Women were unaware of the experiment and its purpose; chapatis were delivered without clear information about their content.
    • An independent Committee of Inquiry was established in response to public criticism following the documentary’s release.
    • Principles violated in the experiment:
    1. Informed consent
    2. Participant-centeredness and
    3. Transparent engagement

    Reflections on Past Practices

    • Researchers made judgments about benefits and costs without prioritizing participants’ well-being.
    • The study’s design aligned with the prevailing “paternalistic nature of science” and societal attitudes of the time.
    • The report suggested providing study materials in participants’ languages and addressing challenges with informed consent.
    • Determining informed consent many years later remains a significant challenge.
    • The MRC no longer possessed the participant list, and public appeals for participants yielded no results.

    Understanding Radioactive Isotopes

    • Radioactive isotopes are unstable forms of elements that emit radiation during their transformation into stable forms.
    • Unstable nuclei contain excess energy, which is released as radiation in the form of waves or particles.
    • The long-term health effects of radiation exposure vary depending on the type and amount of radiation.

    Current Repercussions

    • An MP emphasized the MRC’s unfulfilled recommendation to identify and engage the women participants.
    • Identifying participants would have enabled them to share experiences, receive support, and learn from the experiment.
    • The MRC reaffirmed its commitment to engagement, transparency, and upholding the highest research standards.

    Conclusion

    • The study underscores ethical concerns within historical medical research.
    • Reflecting on past practices informs present and future medical research endeavours.

  • With Great Power Comes Great Responsibility: In context of Civil Services

    Responsibility

    Central Idea

    • In his historic address to the first batch of IAS probationers in 1947, Sardar Vallabhbhai Patel envisioned a new era for India and the civil services. He emphasized the importance of embodying a genuine spirit of service and adapting to the democratic governance of independent India. The ideals set by Patel are enshrined in the All-India Service Conduct Rules, outlining the values that officers must embrace.

    What do the quote suggests “with great power comes great responsibility’?

    • The quote “With great power comes great responsibility” suggests that when an individual possesses significant power or authority, they also bear a corresponding and significant responsibility to use that power wisely and for the benefit of others.
    • It implies that power should be accompanied by a sense of duty and a commitment to act in a responsible and accountable manner.
    • For instance, a prime minister has the power to implement policies that can stimulate economic growth and create jobs, but they also have the responsibility to ensure equitable distribution of resources, address income inequality, and protect vulnerable populations.

    How does this quote specifically apply to the civil servants?

    • Power to Make Decisions: Civil servants have the power to make decisions that can shape public policies, allocate resources, and affect the lives of individuals and communities. With this power comes the responsibility to make well-informed and ethical choices that prioritize the welfare and needs of the people they serve.
    • Case, for example: An IAS serving as Sub-Divisional Magistrate overseeing the process of land acquisition for an upcoming expressway interacted with a farmer who shared demands related to the land acquisition. As the land acquisition collector, he realized that their authority and power were necessary to protect the rights and interests of the affected individuals. This showcases how civil servants have the power to make decisions that directly impact the lives and well-being of citizens
    • Stewardship of Public Resources: Civil servants are entrusted with managing public resources, including financial, natural, and human resources. They have a responsibility to ensure the transparent and accountable use of these resources for the benefit of the public, avoiding any misuse or corruption.
    • Case for example: District administration’s involvement in managing oxygen supplies and hospital beds during the second wave of the Covid-19 pandemic. Civil servants were responsible for judiciously utilizing scarce resources to save lives. This demonstrates their role as stewards of public resources, ensuring they are allocated effectively and efficiently to address critical needs.
    • Service to the Common Good: Civil servants are public servants, and their primary responsibility is to serve the common good and promote the welfare of society. They must act impartially, without favouritism or discrimination, and work towards achieving inclusive and equitable development.
    • Upholding Integrity and Ethical Standards: Civil servants should demonstrate high levels of integrity, honesty, and ethical conduct in their work. They must avoid conflicts of interest, act in accordance with the law, and adhere to the codes of conduct and professional ethics that govern their service.
    • Accountability and Transparency: Civil servants are accountable to the public for their actions and decisions. They have a responsibility to provide transparency in their work, communicate effectively with the public, and be responsive to their needs and concerns.

    Sardar Vallabhbhai Patel’s vision of Civil servants in Independent India

    • Genuine Spirit of Service: Patel emphasized that civil servants should be guided by a genuine spirit of service towards the nation and its people. This reflected his belief in the selfless dedication and commitment that civil servants should embody in their work.
    • Adaptation to Democracy: Patel recognized the shift towards democratic governance in independent India. He urged civil servants to adapt to this new form of governance, where they would view themselves as being one with the common people. This emphasized the importance of aligning their actions and decisions with the needs and aspirations of the citizens they serve.
    • High Ethical Standards: Patel emphasized the need for civil servants to uphold high ethical standards. This included integrity, honesty, and moral uprightness in their personal and professional lives. Patel believed that these ethical values were essential for civil servants to effectively contribute to nation-building.
    • Merit, Fairness, and Impartiality: Patel stressed the promotion of merit-based principles, fairness, and impartiality in the work of civil servants. He believed in providing equal opportunities and treating all citizens fairly, regardless of their backgrounds or affiliations. This principle aimed to ensure that civil servants acted without bias or discrimination, upholding the principles of justice and equity.
    • Accountability and Transparency: Patel emphasized the importance of accountability and transparency in the functioning of civil servants. He believed that civil servants should be accountable for their actions, decisions, and the utilization of public resources. Transparency was seen as a crucial element in building public trust and confidence in the administration.
    • Responsiveness to Weaker Sections of Society: Patel recognized the importance of addressing the needs and concerns of the weaker sections of society. He believed that civil servants should be responsive to the marginalized, disadvantaged, and vulnerable sections of society, ensuring that their voices were heard and their rights protected.

    Challenges that hinder its complete realization in today’s context

    • Political Interference: Civil servants often face challenges due to political interference in their work. This can hinder their ability to function impartially and independently, affecting their capacity to uphold the values of merit, fairness, and accountability.
    • Bureaucratic Red Tape: The bureaucratic processes and procedures can sometimes be slow and cumbersome, leading to delays in decision-making and implementation. This can hamper the responsiveness of civil servants and their ability to address the evolving needs of society effectively.
    • Lack of Adequate Resources: Insufficient allocation of resources and inadequate infrastructure can pose significant challenges for civil servants in delivering quality public services. Limited resources may hinder their ability to address the needs of weaker sections of society and promote inclusive development.
    • Complex Societal Challenges: The evolving and complex challenges faced by modern society, such as rapid urbanization, climate change, technological advancements, and social inequalities, require civil servants to adapt and develop innovative solutions. Balancing the traditional roles and responsibilities with emerging challenges can be demanding.
    • Ethical Dilemmas and Corruption: Civil servants often encounter ethical dilemmas and face the challenge of maintaining high ethical standards in the face of various temptations. Instances of corruption can undermine the vision of ethical conduct and accountability, eroding public trust in the civil service.
    • Capacity Building and Skill Development: The evolving needs of governance and administration demand continuous capacity building and skill development for civil servants. Ensuring that civil servants have the necessary competencies and expertise to tackle complex issues is crucial for effectively realizing Patel’s vision.
    • Technological Advancements: The rapid advancement of technology brings both opportunities and challenges for civil servants. Embracing and effectively utilizing technological tools while ensuring data security, privacy, and digital inclusivity pose challenges that need to be addressed.

    Way forward

    • Strengthen Institutional Frameworks: Enhance the autonomy and independence of civil service institutions to protect civil servants from undue political interference. Establish mechanisms to ensure merit-based recruitment, promotions, and postings, fostering a culture of professionalism and competence.
    • Enhance Transparency and Accountability: Promote transparency in decision-making processes and ensure accountability for actions and resource utilization. Implement robust mechanisms to detect and prevent corruption, providing protection to whistleblowers. Encourage a culture of integrity and ethical conduct among civil servants.
    • Promote Continuous Learning and Skill Development: Invest in capacity building programs and provide opportunities for civil servants to enhance their skills and adapt to emerging challenges. Foster a culture of learning, innovation, and knowledge-sharing within the civil service.
    • Embrace Technology and Digital Transformation: Harness the power of technology to streamline processes, improve service delivery, and promote digital inclusivity. Implement e-governance initiatives, digital platforms, and data-driven decision-making to enhance efficiency, transparency, and citizen-centric services.
    • Strengthen Citizen Engagement and Participation: Foster meaningful engagement with citizens, civil society organizations, and other stakeholders to understand their needs, concerns, and aspirations. Encourage participatory governance, involving citizens in policy formulation, implementation, and monitoring processes.
    • Promote Diversity and Inclusion: Ensure diversity and inclusion in the civil service by encouraging representation from marginalized communities and underrepresented groups. Embrace the perspectives and experiences of diverse civil servants, fostering an inclusive and representative bureaucracy.
    • Encourage Research and Evidence-based Decision Making: Emphasize the importance of research and evidence-based decision-making within the civil service. Promote the use of data and analytics to inform policy formulation, monitor progress, and evaluate outcomes.
    • Strengthen Public Service Values and Ethics: Instill a sense of public service values and ethics through training, mentoring, and professional development programs. Promote a culture of public service, where civil servants internalize the values of integrity, honesty, and a genuine spirit of service

    Conclusion

    • The power of an IAS officer extends far beyond the perceived glamour or privilege associated with the position. It entails immense responsibility and a genuine spirit of service. By upholding high ethical standards, political neutrality, and embodying the values enshrined in the All-India Service Conduct Rules, civil servants can contribute meaningfully to nation-building. Their power lies in their ability to advocate for fellow citizens, effect positive change, and carry forward the legacy of those who shaped modern India.

    Also read:

    Code of Conduct for Civil Servants: A Review

     

  • CJI criticizes Forum Shopping Practice

    Central Idea

    • The CJI, DY Chandrachud expressed his disapproval of forum shopping, a practice in which litigants or lawyers deliberately choose a specific judge or court that they believe will provide a more favorable judgment.

    Understanding Forum Shopping

    • Forum shopping refers to the intentional selection of a court or judge by litigants or lawyers with the expectation of obtaining a favourable outcome.
    • It involves strategically moving a case to a particular jurisdiction based on a perception of better judgment.
    • Lawyers consider the appropriate forum as part of their litigation strategy, sometimes opting for higher courts like the Supreme Court to gain wider attention for their case.
    • However, deliberately avoiding a specific judge or manipulating the process to obtain favourable treatment is generally discouraged.

    Concerns and Criticisms

    The practice of forum shopping raises several concerns, including:

    • Injustice to the Other Party: Forum shopping can result in unfair treatment and injustice to the opposing party, as it undermines the principle of impartiality and equal access to justice.
    • Overburdening Certain Courts: Concentrating cases before specific judges or courts can overload their workload, causing delays and hindering the judicial process.
    • Interference with Judicial Process: Forum shopping interferes with the smooth functioning of the judicial system, as cases may be filed and refiled in multiple jurisdictions, leading to unnecessary duplication of efforts.

    Approaches in Common Law Countries

    • Countries following the common law tradition, including the US and UK, have criticized forum shopping and adopted measures to discourage or prohibit the practice.
    • One such measure is the principle of “forum non-conveniens,” which grants courts discretionary powers to refuse jurisdiction when another court or forum would be more appropriate to hear the case.
    • This allows the court to dismiss a case in the interest of justice and fairness, redirecting it to the appropriate venue.
    • The Supreme Court, in its ruling in ‘Chetak Construction Ltd. vs. Om Prakash (1988),’ emphasized that a litigant should not be allowed to choose the forum and called for stern action against any attempt at forum shopping.

    Supreme Court’s View on Forum Shopping

    • In a 2022 ruling, the Supreme Court reiterated its condemnation of forum shopping, citing its previous 2017 ruling in ‘Union of India & Ors. vs. Cipla Ltd.’
    • The court established a “functional test” to determine whether forum shopping is occurring.
    • The test considers the functional similarity between different courts or whether a litigant is employing subterfuge to manipulate the system.

    Way Forward

    To address the issue of forum shopping, it is essential to:

    • Create Awareness: Raise awareness among litigants, lawyers, and the general public about the negative consequences of forum shopping and the importance of upholding judicial integrity and fairness.
    • Strengthen Ethical Standards: Emphasize the ethical obligations of lawyers to uphold the integrity of the legal profession and discourage forum shopping practices.
    • Streamline Jurisdictional Rules: Develop clear guidelines and rules regarding jurisdictional issues to prevent unnecessary disputes and ensure cases are heard by the appropriate courts.
    • Judicial Training and Monitoring: Provide training and guidance to judges on identifying and addressing instances of forum shopping, while also monitoring court proceedings to detect any potential manipulation.

    Conclusion

    • By implementing these measures, the legal system can discourage forum shopping, uphold the principles of justice and fairness, and maintain the integrity of the judicial process.

     

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  • Importance of Science of Empathy and Inclusivity in IITs

    Empathy

    Central Idea

    • The recent spate of suicides among IIT students and the subsequent media attention, which has brought to the fore the social behavior and anxieties within the IIT student community. It emphasizes that studying at the IITs can be highly stressful, especially for students from socially marginalized backgrounds.

    For instance: JEE Exam and Social Inequality

    • There are disparities among students from different social strata in the JEE Advanced entrance exam, with lower cut-offs for SC/ST students compared to general category students.
    • This disparity in scores can be attributed to cultural and material inequalities faced by SC students, such as lack of basic amenities like water, sanitation, and transportation.

    What is mean by material inequality?

    • Unequal distribution of resources and basic amenities: Material inequality refers to the unequal distribution of resources and basic amenities such as food, water, shelter, healthcare, education, and access to opportunities, among individuals or groups in a society.
    • Factors responsible: It is a result of various factors such as income, social class, gender, race, ethnicity, and geographical location.
    • Negative effects: Material inequality can have negative effects on the well-being and opportunities of individuals and communities, leading to disparities in access to resources and basic needs.

    How IITs can engage with local communities?

    • Conduct Field and Community Studies: Students from all disciplines can conduct field and community studies to understand the causes of material inequality in the surrounding areas. This will provide them with insights into the problems that exist and help them design effective solutions.
    • Interdisciplinary Field Work: IITs can adopt an interdisciplinary fieldwork pedagogy where professors from different disciplines work together to design solutions for societal challenges. This will help students to develop mutual respect, empathy, and a collective understanding of how the state and the market work.
    • Local Problem Areas: IITs can identify and work on concrete problems of all sizes and difficulty levels, such as cooking energy, public transport, small enterprises, and pollution, in the surrounding districts. Faculty members can work with district administrations to address these and involve both IIT and local college students.
    • Collaboration and Teamwork: Engaging with local communities will reduce competitive stress and increase collaboration and teamwork within the student body. Students will appreciate the diversity of backgrounds and understand the adversities many among them have had to face.
    • Democratic Science: Students should demand training in a science of empathy and diversity that probes and explores all nooks and crannies of knowledge and society. Only when Indian science turns more democratic will the university become more empathetic and the society more equal and prosperous.

    Value addition box

    IIT Bombay as an example:

    • IIT Bombay can use the communities in surrounding districts as problem areas for research and academics. From cooking energy to public transport, there are concrete problems of all sizes for students and faculty members to grapple with.
    • Faculty members can work with district administrations to involve both IIT and local college students, thereby creating an ecosystem of higher education that satisfies its institutional and cultural roles.

     What is empathy?

    • Empathy is the ability to understand and share the feelings of another person. It involves being able to put oneself in another person’s shoes and perceive things from their perspective.
    • Empathy allows individuals to connect with others emotionally, recognize their needs and respond with sensitivity and compassion.
    • It is an important aspect of emotional intelligence and plays a crucial role in building strong relationships, effective communication, and social cohesion.

    What do you understand by mean science of empathy?

    • Science of empathy refers to the study and application of empathy as a scientific concept, including understanding its mechanisms, impact, and potential applications in various fields such as healthcare, education, and social justice.
    • It involves using scientific methods to study empathy, including neuroscience, psychology, and social science research.
    • The goal is to deepen our understanding of empathy and how it can be applied to improve social and emotional outcomes for individuals and communities.

    Why Empathy is important in IITs?

    • Addressing social inequalities: IITs are known for their rigorous academic curriculum and high-achieving students, but they also have a responsibility to address social inequalities that exist in society. Empathy can help students and faculty understand the challenges faced by underprivileged communities and develop solutions that address these challenges.
    • Fostering collaboration: Empathy can help IIT students and faculty work together more effectively by understanding each other’s perspectives and experiences. This can lead to better collaboration and teamwork, which is essential for tackling complex problems.
    • Developing socially responsible professionals: IITs aim to produce professionals who can make a positive impact on society. Empathy is an important quality for professionals who want to understand the needs and concerns of their clients or users, and develop solutions that meet those needs.
    • Enhancing research: Empathy can also enhance research by promoting interdisciplinary collaborations that consider a wide range of perspectives and experiences. This can lead to more innovative and effective solutions to complex problems.

    Why Empathy is important along with science in higher education?

    • Social Responsibility: Higher education institutions have a social responsibility to produce graduates who understand the societal impacts of their work and who are capable of creating solutions that benefit all members of society. Empathy helps students to understand the perspectives of those who may be affected by their work and to create solutions that are more inclusive and equitable.
    • Collaborative Work: In higher education, collaborative work is increasingly common across disciplines, cultures, and even national borders. Empathy enables students to understand the needs and motivations of their collaborators and to work effectively as part of a team.
    • Diversity and Inclusion: Diversity and inclusion are key principles of higher education, and empathy plays a crucial role in achieving these goals. Empathy helps students to understand and appreciate the experiences and perspectives of others who come from different backgrounds, leading to a more inclusive and welcoming learning environment.
    • Ethical Considerations: Science and technology can have ethical implications, and empathy is necessary to understand the impact of scientific and technological advancements on different groups of people. Empathy can help students to identify potential ethical dilemmas and to create solutions that align with ethical principles.

    Conclusion

    • The issues of social inequality and stress among students in the Indian Institutes of Technology (IITs) suggests the need for an empathetic and inclusive approach towards higher education. Interdisciplinary fieldwork and community engagement can create a diverse and inclusive ecosystem of higher education, preparing students to become better professionals and citizens.

    Mains Question

    Q. Empathy along with science is an essential ingredient in higher education in India. In light of this statement discuss how IITs can play a critical role in promoting empathy and reducing social inequalities in India.

  • Ethical Animal Research: Prospects and Challenges

    animal

    A proposed measure in Switzerland would have made that country the first to ban medical and scientific experimentation on animals.

    What counts as ‘Ethical’ animal research?

    • There is no single standard definition of ethical animal research.
    • Ethical animal research refers to the use of animals in scientific studies while ensuring that the animals are treated humanely and their welfare is protected.
    • It involves balancing the benefits of the research with the potential harm to the animals and minimizing any harm or suffering that the animals may experience.

    Issues involved in animal research

    • Inhumane treatment: Animals are often not treated humanely and are mishandled throughout the research process, including during transport, housing, and experimental procedures.
    • Animal rights ignored: Animal rights advocates argue that animals have inherent rights and should not be used for human purposes. They argue that animals have the right to life, liberty, and freedom from suffering, and that using animals in research violates these rights.
    • Animal distress: We should consider animals’ distress. If something is known to be painful in humans, it is assumed to be painful in animals as well.

    The 4 R’s of animal research

    The 3 R’s encourage scientists to develop new techniques that allow them to replace animals with appropriate alternatives.  The principles are summarized as:

    1. Reduction
    2. Refinement
    3. Replacement
    4. Rehabilitation

    Guidelines for animal research

    Federal research agencies follow guiding principles in evaluating the use and care of animals in research.

    • Empathy for all: One is that the research must increase knowledge and, either directly or indirectly, have the potential to benefit the health and welfare of humans and other animals.
    • Minimal use: Another is that only the minimum number of animals required to obtain valid results should be included.
    • Minimise pain and distress: Researchers must use procedures that minimize pain and distress and maximise the animals’ welfare.
    • Using IT tools: They are also asked to consider whether they could use non-animal alternatives instead, such as mathematical models or computer simulations.

    Significance of such guidelines

    Ans. Defined protocol

    • They have made sure that scientists create protocols that describe the purpose of their research and why animals are necessary to answer meaningful question.
    • The protocol must outline how animals will be housed and cared for, and who will care for and work with the animals, to ensure that they are trained to treat animals humanely.

    Why is animal research essential?

    • Non-invasive study: Animal research benefits both humans and animals. Numerous medical advances exist because they were initially studied in animals.
    • Benefits entire wildlife: Animal research has allowed for the eradication of certain diseases in cattle, for example, leading not only to reduced farm cattle deaths and human famine, but also to improved health for wild cattle.
    • Veterinarian care: Health care advances for pets – including cancer treatments, effective vaccines, nutritional prescription diets and flea and tick treatments – are also available thanks to animal research.

    Way forward

    • Specific guidelines for ethical animal research are typically established by national governments.
    • Independent organisations also provide research standards.
    • Create Institutional Animal Care and Use Committee.

     

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  • Complex issue of Assisted Suicide

    suicide

    A renowned French filmmaker died earlier this week by assisted suicide at the age of 91.

    What is Assisted Suicide?

    • Assisted suicide and euthanasia are practices under which a person intentionally ends their life with active assistance from others.
    • These have long been contentious topics of debate as they involve a complex set of moral, ethical and in some cases, religious questions.
    • Several European nations, some states in Australia and Colombia in South America allow assisted suicide and euthanasia under certain circumstances.

    Difference between assisted suicide and euthanasia

    • Euthanasia is the act of intentionally ending a life to relieve suffering – for example a lethal injection administered by a doctor.
    • Intentionally helping another person to kill themselves is known as assisted suicide.
    • This can include providing someone with strong sedatives with which to end their life or buying them a ticket to Switzerland (where assisted suicide is legal) to end their life
    • Euthanasia can further be divided into active and passive.
    • The practice of passive euthanasia involves simply stopping lifesaving treatment or medical intervention with the consent of the patient or a family member or a close friend representing the patient.
    • Active euthanasia, which is legal in only a few countries, entails the use of substances to end the life of the patient.

    India and Assisted suicide/ Euthanasia

    • In a landmark judgment, the Supreme Court of India legalised passive euthanasia in 2018, stating that it was a matter of ‘living will’.
    • According to the judgment, an adult in his conscious mind is permitted to refuse medical treatment or voluntarily decide not to take medical treatment to embrace death in a natural way, under certain conditions.

    Consideration for ‘living will’

    • In the 538-page judgment, the court laid down a set of guidelines for ‘living will’ and defined passive euthanasia and euthanasia as well.
    • It also laid down guidelines for ‘living will’ made by terminally ill patients who beforehand know about their chances of slipping into a permanent vegetative state.
    • The court specifically stated that the rights of a patient, in such cases, would not fall out of the purview of Article 21 (right to life and liberty) of the Indian Constitution.
    • The SC’s judgment was in accordance with its verdict in March 2011 on a separate plea.
    • While ruling on a petition on behalf of Aruna Shanbaug Case, the court had allowed passive euthanasia for the nurse who had spent decades in a vegetative state.

    Who was Aruna Shanbaug?

    • Shanbaug had become central to debates on the legality of right to die and euthanasia in India.
    • Shanbaug died of pneumonia in March 2015 at the age of 66, 42 years of which she had spent in a room at KEM Hospital in Mumbai, after a brutal rape left her in a permanent vegetative state.

    Recent cases in India

    • In 2018, an old couple from Mumbai wrote to then President Kovind, seeking permission for active euthanasia or assisted suicide.
    • Neither of them suffered from a life-threatening ailment.
    • The couple stated in their plea that they had lived a happy life and didn’t want to depend on hospitals for old age ailments.

    Justification for Euthanasia/Assisted Suicide

    • It provides a way to relieve extreme pain.
    • Euthanasia can save  life  of  many  other  people  by  donation  of  vital organs.

    Issues with such killings

    • Euthanasia can be misused. Many psychiatrists are of the opinion that a terminally ill person or someone who is old and suffering from an incurable disease is often not in the right frame of mind to take a call.
    • Family members deciding on behalf of the patient can also lead to abuse of the law legalizing euthanasia as it can be due to some personal interest.

     

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  • Medical Ethics of Charaka

    The National Medical Commission (NMC), the regulator for medical education and practices that replaced the Medical Council of India in 2020, has suggested to medical colleges that the traditional Hippocratic Oath should be replaced by a “Charak Shapath”.

    Who was Hippocrates?

    • The Hippocratic Oath is attributed to Hippocrates of the island of Kos, a Greek physician of the classical period (4th-5th centuries BC, until the death of Alexander the Great in 323 BC).
    • It broadly corresponds to the period from the death of the Buddha (486 BC) to the rise of the Mauryas (321 BC) in India.
    • Among the great contemporaries of Hippocrates were the Athenian philosopher Plato and his teacher Socrates, and Plato’s student and Alexander’s tutor, the polymath Aristotle.
    • He is regarded as the “father of modern medicine”.

    What is the Hippocratic Oath?

    • Basically, the Hippocratic Oath is a charter of ethical principles that physicians over the ages have sworn to uphold in the practice of their profession.
    • The earliest available fragments of what is understood to be the original oath date back to the late 3rd century AD, and a millennium-old version is now in the library of the Holy See.

    What are general outlines of a Medical Oath?

    • Always exercise his/her independent professional judgment and maintain the highest standards of professional conduct
    • Respect a competent patient’s right to accept or refuse treatment
    • Not allow his/her judgment to be influenced by personal profit or unfair discrimination
    • Be dedicated to providing competent medical service in full professional and moral independence, with compassion and respect for human dignity
    • Deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception
    • Certify only that which he/she has personally verified
    • Respect the local and national codes of ethics

    About Charaka and Charak Samhita

    • The Charak Samhita is a medical pharmacopeia and collection of commentaries and discussions on medical practices that is dated to the 1st-2nd centuries AD.
    • Along with the compendium of Susruta (c. 4th century AD), which is about surgery, the Charak Samhita is considered the foundational text of ancient Indian medicine,.
    • It is an evolved system of understanding and treating disease that resembled that of Hippocrates and Galen (2nd century AD), and was in some ways ahead of the Greeks.
    • In theory and praxis, ayurvedic medicine today remains broadly unchanged from these ancient Indian principles.

    The medical ethics of Charaka

    • The physician was an important and respected member of ancient Indian society, and medical practice followed rules of professional conduct and ethical principles. It goes on to say that-
    1. You must strive with all your soul for the health of the sick.
    2. You must not betray your patients, even at the cost of your own life.
    3. You must not get drunk, or commit evil, or have evil companions.
    4. You must be pleasant of speech
and thoughtful, always striving to improve your knowledge.
    5. When you go to the home of a patient you should direct your words, mind, intellect, and senses nowhere but to your patient and his treatment.
    6. Nothing that happens in the house of the sick man must be told outside, nor must the patient’s condition be told to anyone who might do harm by that knowledge to the patient or to another.
    • This ethical code is universal, and remains just as relevant and applicable today.

    Arguments in favour of Charaka Oath

    • There is no universally accepted version of the physician’s oath.
    • Many medical schools around the world hold a ceremony in which graduating doctors swear to a broad charter of ethics that are sometimes customised by individual institutions.
    • A version of the ‘physician’s code of ethics’ is commonly displayed in hospitals or clinics in most places, including India.

    Issues with this oath

    • The opposition has criticised the proposal as an attempt to saffronise medical education.
    • Introducing Indian elements into Indian education is necessary, but not at the expense of universal values and standards.
    • Like several other sages mentioned in the literature of ancient India, the historicity of Charaka is still uncertain.

     

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  • What are Immunity Passports?

    There is a growing debate for a rethink on “immunity passport” to be handed out to those who have recovered from COVID-19 for the purpose of travel or work without restrictions of quarantine.

    Try this question form mains:

    Q.Discuss various ethical issues evolved during the outbreaks of pandemics (of the scale of COVID-19).

    Immunity Passports

    • They are the recovery or release certificate or a document attesting that its bearer is immune to a contagious disease.
    • The concept has drawn much attention during the COVID-19 pandemic as a potential way to contain the pandemic and permit faster economic recovery.
    • The can be used as a legal document granted by a testing authority following a serology test demonstrating that the bearer has antibodies making them immune to a disease.

    What is the ongoing debate?

    • Experts argue that if reinfections were a significant problem, by now, there would have been hundreds or at least thousands of cases of reinfections at the global level.
    • Till such time effective vaccines become available people who have recovered from COVID-19 should be permitted to travel without restrictions.

    A case for consideration

    • Immune protection after infection/disease is always much more robust than most vaccines, and definitely than most COVID-19 vaccines in development.
    • Some of the vaccines undergoing clinical trials are mostly directed at a single or a couple of proteins (spike) of the virus.
    • But vaccines under trial that use the inactivated coronaviruses would expose the immune system to a whole range of viral proteins, much like natural infection and can produce immune responses.
    • However, it is not known if people who have experienced asymptomatic infection would show robust immune responses like those who have recovered from moderate or severe disease.

    Ethical issues involved

    • Issuing ‘immunity certificates’ to people who have recovered can be an ethical minefield.
    • Doctors do not generally prefer immunity to be induced by natural infection compared with vaccines. It seems logical, but there are multiple challenges.
    • There might be long-term health complications in those who had COVID-19, whereas the vaccine will have minimal or no adverse health consequences.
    • There is a danger that similar arguments will be made for other vaccine-preventable diseases for which we have a universal immunisation programme.

    There is also a public health risk of issuing immunity certificates:

    • People whose livelihood has have been affected would be encouraged to adopt risky behaviour so as to get infected rather than taking precautions to stay protected from the virus.
    • This would lead to a sharp increase in cases across the country with huge numbers requiring hospitalization.
    • Such a situation would lead to testing capabilities getting overwhelmed, crumbling of the health-care systems and increased deaths.

    Threats over malpractices:

    • Immunity certification will include a system for identification and monitoring, thus compromising privacy.
    • Other contentious issues would be profiteering by private labs performing tests, and the menace of fake certificates which we have already seen in some Indian states.
    • In the end, an immunity passport will further divide the society with different ‘haves’ and ‘have-nots’.

    Way forward

    • We need to look at COVID-19 with a sense of balance and not hysteria.
    • Terms such as immunity passports may not have relevance as we do not know anything about specific kinds of immune responses and the duration of protection in people.
    • There is currently not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate’.
    • The permission to travel or work should be decided on a case by case basis, according to the principles of ethics while dealing with a pandemic.

  • Supreme Court to examine Kerala Act on animal, bird sacrifices

    The Supreme Court has agreed to examine the constitutional validity of the Kerala Animals and Birds Sacrifices Prohibition Act of 1968 that prohibits sacrifice of animals and birds in temples to ‘please’ the deity.

    Try this question for mains:

    Q. The ritual slaughters of animals in India is a greater ethical issue than a legal one. Analyse.

    The dichotomy over ritual slaughter

    • The Supreme Court is set to analyse how the Prevention of Cruelty to Animals Act of 1960 allows the killing of animals but prohibits cruelty to animals.
    • It highlighted the “dichotomy” in animal protection law that allows the killing of animals for food but does not permit “killing of animals for an offer to a deity and then consumption”.

    Why did SC interfere?

    • However, the 1968 Kerala law bans the killing of animals and birds for religious sacrifices but not for personal consumption.
    • This amounted to arbitrary classification.

    Legal protections to Animal sacrifice

    • The Kerala Act criminalizes the intent behind the animal sacrifice and not animal sacrifice per se.
    • If the sacrifice is not for propitiating any deity but for personal consumption even in the precincts of the temple, it is not forbidden.
    • Section 28 of the Prevention of Cruelty to Animals, 1960 does not make the killing of animals for religious purposes and offence.

    Appeal citing the necessity of the practice

    • The oral remarks came in an appeal filed by P.E. Gopalakrishnan and some others, who are Shakthi worshippers, and for whom, animal sacrifice is an integral part of the worship.
    • In their appeal, they said the animal sacrifice was an “essential religious practice” and the High Court had no power to interfere.

    Why animal sacrifice needs a rethink?

    • All religions call for compassion, no religion requires killing or eating animals and hacking animals to death with weapons.
    • The way executioners handle, transport and kill animals for sacrifices typically violates animal transport and slaughter laws, making it a punishable offence.
    • There exist ample ambiguities in religious texts over allowing the ritual slaughter of animals.
    • Moreover, the practice of animal sacrifice normalizes killing and desensitizes humans to violence against animals.

  • How ‘Vaccine Nationalism’ could block vulnerable populations’ access to COVID-19 vaccines

    Hundreds of COVID-19 vaccine candidates are currently being developed. Many countries are securing priority access to doses of COVID-19 vaccine.

    Practice question for Mains:

    Q. What is Vaccine Nationalism? Discuss various ethical issues involved and its impact on vulnerable populations across the globe.

    Vaccine nationalism during COVID-19

    • Vaccine nationalism occurs when a country manages to secure doses of vaccine for its own citizens or residents before they are made available in other countries.
    • This is done through pre-purchase agreements between a government and a vaccine manufacturer.
    • Vaccine nationalism is harmful to equitable access to vaccines.

    US begins to secure

    • In India, the privately held Serum Institute is developing one of the leading COVID-19 vaccine candidates.
    • The Serum Institute signalled that, if the development of the vaccine succeeds, most of the initial batches of the vaccine will be distributed within India.
    • At the same time, India, alongside the US and Russia, chose not to join the Access to COVID-19 Tools Accelerator.
    • This was a WHO moves to promote collaboration among countries in the development and distribution of COVID-19 vaccines and treatments.

    Vaccine nationalism is not new

    • During the early stages of the 2009 H1N1 flu pandemic, some of the wealthiest countries entered into pre-purchase agreements with several pharmaceutical companies working on H1N1 vaccines.
    • At that time, it was estimated that, in the best-case scenario, the maximum number of vaccine doses that could be produced globally was two billion.
    • The US alone negotiated and obtained the right to buy 600,000 doses. All the countries that negotiated pre-purchase orders were developed economies.
    • Only when the 2009 pandemic began to unwind and demand for a vaccine dropped did developed countries offer to donate vaccine doses to poorer economies.

    Issues with such nationalism

    • The most immediate effect of vaccine nationalism is that it further disadvantages countries with fewer resources and bargaining power.
    • It deprives populations in the Global South from timely access to vital public health goods.
    • Taken to its extreme, it allocates vaccines to moderately at-risk populations in wealthy countries over populations at higher risk in developing economies.
    • Vaccine nationalism also runs against the fundamental principles of vaccine development and global public health.

    Why it is unethical?

    • Most vaccine development projects involve several parties from multiple countries.
    • With modern vaccines, there are very few instances in which a single country can claim to be the sole developer of a vaccine.
    • And even if that were possible, global public health is borderless. As COVID-19 is illustrating, viruses can travel the globe.

    Its impacts

    • If COVID-19 vaccines are not made available affordably to those who need them, the consequences will likely be disproportionately severe for poorer or otherwise vulnerable and marginalised populations.
    • Without broad access to a vaccine, these populations will likely continue to suffer more than others, leading to unnecessary disease burden, continued economic problems and potential loss of life.

    Conclusion

    • Nationalism is at odds with global public health principles. Yet, there are no provisions in international laws that prevent pre-purchase agreements like the ones described above.
    • There is nothing inherently wrong with pre-purchase agreements of pharmaceutical products.
    • Vaccines typically do not generate as much in sales as other medical products.
    • If used correctly, pre-purchase agreements can even be an incentive for companies to manufacture vaccines that otherwise would not be commercialized.

    Way forward

    • Equity entails both, affordability of vaccines and access opportunities for populations across the world, irrespective of geography and geopolitics.
    • Contracts should not trump equitable access to global public health goods.
    • Developed countries should pledge to refrain from reserving vaccines for their populations during public health crises.
    • The WHO’s Access to COVID-19 Tools Accelerator is a starting point for countries to test collaborative approaches during the current pandemic.
    • International institutions — including the WHO — should coordinate negotiations ahead of the next pandemic to produce a framework for equitable access to vaccines during public health crises.