Section B
Lata, a mother of two children, was admitted to a hospital for acute abdominal pain.
Her sister-in-law, Sujatha, accompanied her. Dr. Mansi examined Lata and
recommended a diagnostic laparoscopy. Lata’s consent was taken to conduct the
medical procedure under general anesthesia.
During the laparoscopy, Dr. Mansi’s team discovered
a tumor in Lata’s uterus. A closer examination suggested that the tumor could
be malignant.
One option before Dr. Mansi was to extract a sample
for biopsy. In that case, if the tumor
was malignant, Lata would have to
undergo another surgery for removal of the uterus. An alternative was to remove
the uterus immediately. Dr. Mansi had to take a quick decision.
As Lata was under general anesthesia, Dr. Mansi
explained the situation to Sujatha. Sujatha agreed with Dr. Mansi’s
recommendations for a hysterectomy,
wherein Lata’s uterus would be removed to avoid the risk and pain of undergoing
another surgery. Dr. Mansi removed Lata’s uterus after receiving Sujatha’s
consent in writing. Lata was informed of this the next day. She was very upset
and felt betrayed, as she had not consented to the removal of her uterus.
Lata complained to the police who tried to convince
her that Dr. Mansi had acted with good intention to help a patient. Sujatha was
of the same opinion, however, Lata was not convinced and decided to approach
the court.
(a)
Discuss the ethical
issues involved in this case.
(b)
Discuss the moral
conduct of the doctor in this situation.
Ethical Issues
· Patient - Autonomy
· Doctor – Beneficence
· Doctor – Non-maleficence –To prevent future pain
· Beneficence does not automatically override autonomy
· Paternalism – Only when it is necessary; To be extra careful when we are taking irreversible decisions
· Trust in Healthcare professional
· Informed Consent – Adequate information; what? Benefits? Risks? Alternatives?
· Lata approached court – appropriate; Doctor – Opportunity to explain
Moral Conduct of the Doctor
Merits
· Concern for the patient welfare
· Consultation with a family member
· Communication to Lata after Surgery
Demerits
· Failure to respect Patient Autonomy
· Consent to laparoscopy vs consent to hysterectomy
· Relative’s Consent vs Patent’s consent
· There was no emergency to take decision
Ethical Decision Making
· Intention – Procedures - Consequences
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Ravi is a senior police
officer with vast experience in riot control and cyber-policing. Since one
year, he has been the Superintendent of Police (SP) of a district with a
history of frequent rioting.
Last year, Ravi had sought installation of an AI-enabled software for predictive policing.
This system has been operational for approximately six months. This system
employs advanced algorithms for capturing the biometric data of persons in a
crowd and swiftly relating it to a data library. This has enabled the police to
identify the persons involved in various crimes.
The system has identified an immigrant and
low-income neighbourhood as a centre for gang violence and drug trafficking.
Aided by this AI analysis, the local police has focused its patrolling,
preventive detentions and establishing checkpoints. Consequently, public order
and law enforcement has visibly improved.
Last week, some community leaders, civil rights
lawyers and human rights activists visited Ravi’s office. They submitted a
memorandum that the new system is faulty as it is based on incorrect historical
data caused by social biases and discriminatory policing. The memorandum also
alleges that the increased surveillance has created a climate of tension
amongst residents. This feeling is aggravated by the fact that the residents are
not aware of the data noted against their names.
(a)
What are the ethical
issues including biases involved in the use of AI in data-driven policing?
(b)
Place yourself in
Ravi’s role and discuss the alternatives available. Justify the action that
optimises compliance with ethics.
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