Subject: GS 4
Syllabus: Case Study
Questions and Model Structure
- When Sheena reaches one counter of the RTO office for her driving license renewal, the lady in-charge at the counter pass-on one form to fill for the same purpose. She asked Sheena to turn the page and go through it. Back side of the paper there was organ donation consent form which stated:
"Organ Donation: Upon my death I am willing to donate the following - there were then a set of boxes labeled - eyes, liver, kidney, any organ and none, together with a place for her signature."
Sheena asks the lady -"why such things are being pushed at this counter". Lady at the counter explains that this form of camping has been promoted by NGOs for the larger interest of humanity, however it is voluntary and she can escape it if she is not finding it of any worth. Sheena was not sure about giving consent. She was in a dilemma whether to do it or not. After a brief thought she denied and moved from that counter.
On the way back home, her friend Indrani, who was also at the counter, suddenly said, "I did not want to say anything inside, but no way would I ever sign that card. If you get into an accident and they see that you have agreed for organ donation, they will not even try to save you. There is organ shortage, and the doctors want to grab what they can get. My mom says those organ donation cards are like signing your death warrant."
Later that evening Sheena decided to talk to one of her teachers. When she explained about her anxiety, the teacher replied that she should follow her heart in the matter of organ donation.
Answer the following questions based on the above case study:
- What are the options available to her?
- Do you think that people ought to donate their organs? Why or why not? (Make sure that the reasons you provide are ethical reasons, not merely prudent or legal). What advice would you give to Sheena in case you are in place of her teacher?
Model Structure
Options available
(a) From a utilitarian perspective, should Sheena agree to donate her organs? Provide an analysis.
- Utilitarianism, as a form of consequentialism, is concerned with the consequences of actions, the end results, and not necessarily the grounding conditions from which the action has been formed. If we directly consider the significance of organ donation, the greatest utility is that it leads to the satisfaction of the greatest number of patients awaiting transplantation.
- A utilitarian would argue that organ donations save lives because when citizens continue to donate their organs, more lives are spared.
- Organ donations not only save lives but also money and time. For example, if organ donations became prevalent, the organ recipient would no longer need dialysis. Since there is no need for dialysis, the cost to use the machine would lessen; this means that the cost of equipment would decrease, saving money and reducing pain. The process of organ transplantation is life-changing, and time is crucial.
- However, the right action would be in the form of an action that creates the conditions whereby the greatest number of donations can be achieved.
- Thus the managerial efficacy of utilitarianism seems suited to organ donation and to the other ethical questions in modern medical practice with limited resources and increasing demands.
(b) From a Kantian perspective, would refusing to donate one's organs violate a moral duty?
- Kant's principles of ethics are typically invoked in order to put forward strict restrictions on what should be allowed. In the case of organ transplantation, Kant often cites in favour of a prohibition of all organ sales. Kant expressly forbids not only the sale but also the voluntary donation of one's own, even if this donation is obtained without any coercion or even friendly pressure applied upon the seller or the donor.
- Also, Kant considers that one does own one's body, which means that there is a duty of self-conservation. Of course, this duty is not absolute, but needs to be qualified. More precisely, it does not extend to a right to throw other people from a lifeboat in order to save one's own life. Kant limits the duties and rights resulting from the duty of self-conservation to the duty to protect oneself against illegitimate threats and the duty not to harm one's own body.
- But in the given case study, the demand is for organ donation consent upon death. So, according to Kant's principle, she should sign the consent form.
- If we develop an ethical approach following thoughts of Kant, we can establish a three-principle approach in hierarchical order in this case:
- Principle of human dignity
- Difference principle (maximising the life conditions of the worst-off)
- Balancing benefits and harms.
- If we follow this line of thought, there are good reasons for establishing an opt-out regulation together with incentives for all parties involved in the donation. Human dignity is very much linked to the protection of life. The life of everyone whose human dignity is attributed should be protected as far as possible.
(c) Do you think that people ought to donate their organs? Why or why not? (Make sure that the reasons you provide are ethical reasons, not merely prudent or legal). What advice would you give to Sheena in case you are in place of her teacher?
- Transplantation ethics is a philosophy that incorporates systematising, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies for increasing organ supply are bio-ethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, the role of altruism and medical ethical values are significant for the welfare of society.
- Organ donation is founded on the pillars of altruism. When the moral values of an individual's actions are focused mainly on the beneficial impact to other individuals, without regard to the consequences on the individual herself, the individual's actions are regarded as "Altruistic".
- However, there is a flip side also. This is about the commercialisation (organ trade) of organ transplantation. Developments on the ground and in theoretical debate underscore the importance of thinking more about the morality of buying and selling organs. For example, "Transplant tourism" has become a popular means by which patients in need of organs procure them, thus increasing number of bio-ethicists and philosophers are advocating for regulated markets in organs.
- In a typical case of transplant tourism, a patient from a developed nation such as the United States, Saudi Arabia, or Israel pays a fee to have a kidney transplant abroad. A "donor," procured for the patient by a broker, awaits him. The donor or, more accurately, seller is very poor, for example, someone living below the poverty line in some underdeveloped country, and the broker has promised to pay him in cash for his kidney. This is not altruistic in nature; rather, it is unethical as one person is taking advantage of one's situation.
Conclusion
- However, if I were a teacher, I would have suggested signing of the consent form after reading the complete government policy related to it and consulting with an expert so that the practice of organ donation does not get wasted by converting to commercialisation rather than an act of altruism.
- Suppose you are called as the Chief Guest in an educational institution to address a gathering of youth on the issue of ‘cultural transition in India’. You confine your lecture mainly around one of the most apparent pointers of cultural transition taking place in the country, i.e. changing man-woman relationship with the latter being more open, forthcoming and assimilating. But the transition is marred by many sour and ugly events leading to sexual exploitation, honour killings and subjugation and defiance by male dominated office environment. After the lecture there is a question answer session. Answer the following questions that students and teachers posed in front of you:
(a) Are women outrageous in their liberty with regard to dressing up, breaking silence and asking their share in decision making?
(b) What should be the "limits of openness" for women in a culturally transitioning India in an era of globalisation?
(c) Is the institution of family responsible for the aberrant behavior of their male children regarding man-woman relationship?
(d) What will you do as a Civil Servant to change the attitude of society with respect to women?
Model Structure
(a) Are women outrageous in their liberty with regard to dressing up, breaking silence and asking their share in decision making?
- No. It is their natural and human right to choose, question and examine and also to decide.
- Nevertheless, the problem is in the attitude of both. Men do not want to lose their position of primacy in social hierarchy, while sometimes some (feminist) women who are proactive in exercising their liberty lose the sense of proportion and go up to the extent of teasing or provoking the male society.
- Women's liberation is one thing, but the permeation of anti-male sentiment in post-modern popular culture stands testament to the ignorance of society. Things can improve by creating a sync in progressive realisation of women's liberty and social attitude and expectations, which take time to change and adjust. Making haste to expedite social processes is usually counter-productive.
(b) What should be the "limits of openness" for women in a culturally transitioning India in an era of globalisation?
- In the era of globalisation, a cultural transition is taking place in which women not only want to have more control over their bodies, but also over their feminine charm and use them as they wish. Also they want to have a say in a man and woman relationship according to their own understanding and discretion.
- There is nothing wrong with it. But there is always a limit to openness depending upon the "space" in which it is being exercised.
- Here, women shall resort to pragmatism or pragmatic ethics rather than absolute ethics. For example in "private space" women can choose to be more open, proximate and free with their choices and male partners; in the "social space" they need to be conscious about social values and customs because even if women are well within their "right" to be what they like, there is chance of explicit or hidden conflict with the surrounding which is not ready for "new ways."
(c) Is the institution of family responsible for the aberrant behavior of their male children regarding man-woman relationship?
- Yes, the family is responsible to a great extent, because it is a very powerful "first institution" in the lives of the children that creates their world view.
- Seasoning, grooming and nurturing of male children has a lot of bearing on their attitude and outlook towards women when they grow up.
- The way their mothers and sisters are treated, the way women are considered as a living being or objects of pleasure or the way their roles are defined in front of a growing male child- all these bring changes in their outlook and attitude towards women.
(d) What will you do as a Civil Servant to change the attitude of society with respect to women?
- As a civil servant first of all I would try to give dignity to women in day-to-day transactions, irrespective of their socio-economic status. This is so because civil servants, due to their power and authority, are often considered as "role models" which others emulate.
- Secondly, I would have a "collaborative education and awareness programme" with educational institutions, civil societies and grassroots level democratic institutions.
- Thirdly, I would try to be very strict in implementing "law and order" so that women can live freely and fearlessly.
- Fourth, I would create a hotline for women in SOS situations and a dedicated and fast grievance redress system.
- Last, but not least, I would try to incentivise progressive and educated youth who respect and understand women better-both in office and outside.
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