Sneha is a Senior Manager working for a big reputed hospital chain in a mid-sized city. She has been made in-charge of the new super speciality center that the hospital is building with state-of-the art equipment and world class medical facilities. The building has been reconstructed and she is starting the process of procurement for various equipment and machines. As the head of the committee responsible for procurement, she has invited bids from all the interested reputed vendors dealing in medical equipment. She notices that her brother, who is a well-known supplier in this domain, has also sent his expression of interest. Since the hospital is privately owned, it is not mandatory for her to select only the lower bidder, Also, she is aware that her brother’s company has been facing some financial difficulties and a big supply order will help him recover. At the same time, allocating the contract to her brother might bring charges of favouritism against her and tarnish her image. The hospital management trusts her fully and would support any decision of hers.
(a) What should be Sneha’s course of action?
(b) How would she justify what she chooses to do?
(c) In this case, how is medical ethics compromised with vested personal interest? (Answer in 250 words) [UPSC 2024]

Roadmap for Answer Writing

Introduction

• Context: Introduce Sneha as a Senior Manager at a reputable hospital chain overseeing procurement for a new super specialty center.
• Ethical Dilemma: Highlight the conflict arising from her brother’s bid for a contract amidst his financial difficulties and the potential for accusations of favoritism.
• Objective: Outline the focus of the response: Sneha’s course of action, justification for her decision, and the implications of medical ethics in light of personal interests.

Section A: Course of Action for Sneha

1. Recuse Herself from the Decision-Making Process
   • Rationale: To prevent any bias or appearance of favoritism, aligning with the Doctrine of Conflict of Interest.
   • Fact: Following the CVC guidelines for public procurement emphasizes the need for impartiality (Central Vigilance Commission).
2. Form an Independent Review Panel
   • Rationale: Establish a committee to ensure a fair and transparent evaluation of bids, minimizing implicit bias.
   • Fact: Procedural justice theory supports the creation of independent panels for unbiased decision-making (Thibaut & Walker, 1975).
3. Disclose the Conflict of Interest
   • Rationale: Full transparency about her relationship with the vendor is essential for maintaining trust and accountability.
   • Fact: Ethical leadership principles emphasize the importance of transparency in decision-making (Brown et al., 2005).

Section B: Justification for Her Decision

1. Adherence to Ethical Principles
   • Justification: By recusing herself, Sneha upholds her moral duty to ensure fairness in procurement.
   • Fact: Kantian ethics emphasizes the importance of acting from duty and ensuring impartiality (Kant, 1785).
2. Protecting the Hospital’s Reputation
   • Justification: This choice safeguards both her and the hospital’s reputation against nepotism allegations.
   • Fact: Reputational ethics focus on maintaining public trust, especially in healthcare (Paine, 1994).
3. Prioritizing Patient Care
   • Justification: Ensuring that procurement decisions are based on merit guarantees high-quality medical equipment, ultimately benefiting patient welfare.
   • Fact: The principle of beneficence in medical ethics prioritizes actions that promote the well-being of patients (Beauchamp & Childress, 2013).
4. Long-term Organizational Integrity
   • Justification: Ethical decision-making fosters a culture of integrity and sets a standard for future actions.
   • Fact: Virtue ethics advocates for long-term ethical behavior to sustain institutional credibility (Aristotle).

Section C: Compromise of Medical Ethics with Vested Personal Interest

1. Conflict of Interest
   • Issue: Sneha’s personal connection introduces bias, undermining her professional responsibilities.
   • Fact: Ethical egoism suggests that personal interests can overshadow professional obligations (Rand, 1964).
2. Compromise on Quality
   • Issue: Favoring her brother’s company risks selecting substandard equipment, violating the principle of non-maleficence.
   • Fact: Non-maleficence mandates that medical professionals avoid causing harm to patients (Beauchamp & Childress, 2013).
3. Loss of Stakeholder Trust
   • Issue: Perceived conflict of interest can erode confidence among stakeholders, impacting the hospital’s reputation.
   • Fact: Trust theory highlights the importance of perceived integrity in organizational decision-making (Mayer et al., 1995).
4. Unfair Business Practices
   • Issue: Favoring her brother’s firm creates an imbalance, denying other vendors fair competition.
   • Fact: Distributive justice emphasizes equitable treatment of all vendors in procurement processes (Rawls, 1971).
5. Legal and Ethical Risks
   • Issue: Breaching procurement ethics could expose the hospital to legal challenges from competing vendors.
   • Fact: Contractualism theory underscores the importance of adherence to ethical procurement standards (Scanlon, 1998).

Conclusion

• Summary: Reiterate the importance of ethical decision-making in procurement to uphold the hospital’s reputation and ensure patient safety.
• Final Thought: Emphasize that maintaining integrity and transparency in professional settings is crucial for fostering trust and ethical standards, reflecting a commitment to both personal and organizational values.