The coronavirus disease (COVID-19) pandemic has quickly spread to various countries. As on May 8th, 2020, in India 56342 positive cases of corona had been reported. India with a population of more than 1.35 billion had difficulty in controlling the transmission of coronavirus among its population. Multiple strategies became necessary to handle this outbreak. The Ministry of Health and Family Welfare of India raised awareness about this outbreak and to take all necessary actions to control the spread of COVID-19. Indian Government implemented a 55-day lockdown throughout the country to reduce the transmission of the virus. Schools and colleges had shifted to alternative mode of teaching-learning-evaluation and certification. Online mode became popular during these days. India was not prepared for a sudden onslaught of such a crisis due to limited infrastructure in terms of human resource, money and other facilities needed for taking care of this situation. This disease did not spare anybody irrespective of caste, creed, religion on the one hand and ‘have and have not’ on the other. Deficiencies in hospital beds, oxygen cylinders, ambulances, hospital staff and crematorium were the most crucial aspects. You are a hospital administrator in a public hospital at the time when coronavirus had attacked large number of people and patients were pouring into hospital day in and day out. (a) What are your criteria and justification for putting your clinical and non-clinical staff to attend to the patients knowing fully well that it is highly infectious disease and resources and infrastructure are limited? (b) If yours is a private hospital, whether your justification and decision would remain same as that of a public hospital? (UPSC IAS Mains 2021 General Studies Paper – 4)
As the administrator in a public hospital in the given situation, I have conflicts within my professional roles such as among my responsibility towards patients, my staff, the government and the general public. There are moral demands on my conscience as well.
a)Criteria for putting clinical and non-clinicianstaff to attend the patients:
- The staff should not have age or disease-vulnerability.
- Segregate duties based on complexity of task and competence of the staff. For example, to prevent fire incidents in ventilators.
- Simple but meaningful tasks like helping elderly make video calls to family can be assigned to non-clinical staff.
Justification for having all of my staff attend to infectious disease:
- Consequentialism: Not attending to demands of public health would exacerbate the health crisis and will lead to large number of deaths, dysfunctional medical infrastructure and economy.
- Kant’s duty principle: As public servant, I have duty towards the government, and by extension the public. Dutifulness requires me to allocate resources for handling patients’ needs.
- Utilitarianism: Larger public interest is served if patients are taken care of, such as in control of pandemic, and assistance in economic recovery.
- Common good: I have responsibilities towards my staff for their welfare, but common good lies in controlling pandemic through effective and efficient public health system.
- Compassion: Compassion for the people affected by pandemic, preventing loss of lives like orphaned children, parents losing all their children, sufferings due to the crippled infrastructure, motivate me.
b)As administrator of a private hospital,my commitment to public health would remain the same. I would take following additional measures:
- I would make sure my staff has sufficient protection from infection such as through their vaccination and providing protective gears of good quality.
- I would attend to my staff’s work load as best as possible under given circumstances through additional hiring, rotational shifts, intermittent rest and breaks. The staff can provide care to patients only if they are themselves mentally, emotionally and physically healthy.
- The medical expenses would be graded as per patients’ economic abilities through formal and informal methods of verification like tax filings or assets. Changes in health care costs would attend to needs of poor patients and provide motivational bonus to my staff for their extra efforts.
Ethics as an administrator in public or private hospital during pandemic induce me to render public service in challenging times. As private administrator I have opportunity to attend to the conflict in my conscience through extra care for my staff and needs of equity in healthcare.
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