General Studies 2026 GS Paper IV 20 marks 250 words Discuss

GS Paper IV — Q7

Lata, a mother of two children, was admitted to a hospital for acute abdominal pain. Her sister-in-law, Sujatha, accompanied her…

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 recommendation 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. (Answer in 250 words) 20 marks

हिंदी में प्रश्न पढ़ें

दो बच्चों की मां लता को पेट में तेज दर्द के कारण अस्पताल में भर्ती कराया गया। उनकी भाभी सुजाता उनके साथ थीं। डॉक्टर मानसी ने लता की जांच की और डायग्नोस्टिक लैप्रोस्कोपी की सलाह दी। जनरल एनेस्थीसिया (सामान्य निश्चेतना) के तहत चिकित्सा प्रक्रिया करने के लिए लता की सहमति ली गई।

लैप्रोस्कोपी के दौरान, डॉ. मानसी की टीम ने लता के गर्भाशय में एक ट्यूमर का पता लगाया। गहन जांच से पता चला कि ट्यूमर घातक हो सकता है।

डॉ. मानसी के सामने एक विकल्प था बायोप्सी के लिए नमूना निकालना। उस स्थिति में, यदि ट्यूमर घातक होता, तो लता को गर्भाशय निकलवाने के लिए एक और सर्जरी करवानी पड़ती। दूसरा विकल्प था गर्भाशय को तुरंत निकाल देना। डॉ. मानसी को तुरंत निर्णय लेना था।

लता को जनरल एनेस्थीसिया दिया गया था, इसलिए डॉ. मानसी ने सुजाता को स्थिति समझाई। सुजाता ने डॉ. मानसी की हिस्टेरेक्टॉमी (गर्भाशय निकालने की सर्जरी) की सिफारिश से सहमति जताई, जिसमें लता का गर्भाशय निकाल दिया जाएगा ताकि दूसरी सर्जरी के जोखिम और दर्द से बचा जा सके। डॉ. मानसी ने सुजाता की लिखित सहमति प्राप्त करने के बाद लता का गर्भाशय निकाल दिया। लता को अगले दिन इसकी सूचना दी गई। वह बहुत दुखी और ठगा हुआ महसूस कर रही थी क्योंकि उसने गर्भाशय निकलवाने की सहमति नहीं दी थी।

लता ने पुलिस में शिकायत दर्ज कराई, जिसने उसे समझाने की कोशिश की कि डॉ. मानसी ने एक मरीज की मदद करने के नेक इरादे से काम किया था। सुजाता भी यही मानती थी, लेकिन लता संतुष्ट नहीं हुई और उसने अदालत जाने का फैसला किया।

(a)

इस मामले में शामिल नैतिक मुद्दों पर चर्चा कीजिए।

(b)

इस स्थिति में डॉक्टर के नैतिक आचरण पर चर्चा कीजिए। (उत्तर 250 शब्दों में दीजिए)

The question as printed in the 2026 General Studies paper

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Model answer

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Ethical Issues Involved

Patient autonomy: Lata consented only to a diagnostic laparoscopy, not an irreversible hysterectomy; her bodily self-determination was overridden.

Invalid surrogate consent: A sister-in-law cannot consent for a competent adult who is only temporarily under anaesthesia and would soon regain capacity.

Beneficence versus paternalism: Dr. Mansi placed a perceived benefit, sparing a second surgery, above Lata's right to choose her treatment.

Law and institutions: On near-identical facts, the Supreme Court in Samira Kohli v. Dr. Prabha Manchanda (2008) held that consent to a diagnostic procedure does not extend to removing reproductive organs unless needed to save life, and that a relative's consent cannot replace an adult patient's. The police also erred by dissuading Lata instead of registering her complaint.

Moral Conduct of the Doctor

Dr. Mansi's intent was benevolent and she disclosed the removal the next day, but her conduct was flawed. The emergency exception covers only an imminent threat to life; a suspected malignancy was not one. A proportionate option existed: take a biopsy and plan any definitive surgery with Lata's informed consent after recovery. By choosing otherwise, she substituted her own judgment and an unauthorised proxy's assent for the patient's will.

Verdict: Though not malicious, her conduct was a serious ethical lapse. She should have limited the procedure to a biopsy and sought Lata's explicit consent.

How this answer will be evaluated

Framework: GS4 Ethical Dilemma Analysis

What earns full marks: Identifies the autonomy-beneficence conflict and critiques the surrogate consent validity with a balanced judgment.

Evaluation rubric

Each sub-part is marked on its own, against the marks and word limit printed on the paper.

(a) Discuss the ethical issues involved in the case.

discuss— intro → 3-4 dimensions → example → balanced close
Must cover
- Conflict between patient autonomy and beneficence
- Validity of surrogate consent (sister-in-law)
- Scope of consent for diagnostic vs therapeutic surgery
- Duty of disclosure and informed consent
Loses marks
- Listing values without applying them to the case
- Ignoring the specific relationship of the consent provider
Earns more
- Distinction between emergency (threat to life) and non-emergency
- Reproductive autonomy and irreversibility of the harm to Lata
- Legal vs ethical validity of the consent; police role in dissuading the complaint
Extra mark
- Reference to medical ethics codes (e.g., WMA Declaration of Lisbon on patients' rights)
- Note that surrogate/substituted decision-making applies only when the patient cannot regain capacity in time
(b) Discuss the moral conduct of the doctor in this situation. · 250 words

discuss— intro → 3-4 dimensions → example → balanced close
Must cover
- Assessment of the 'quick decision' under pressure
- Justification of the choice (hysterectomy vs biopsy)
- Critique of the consent procedure (Sujatha's role)
- Balanced judgment on 'good intention' vs 'wrong action'
Loses marks
- Preaching instead of reasoning
- Accepting 'good intention' as a complete defence
Earns more
- Identify biopsy with later informed consent as the proportionate, ethically correct option
- Discussion of the doctor's duty to the patient vs. deference to family
- Credit for disclosure the next day, while noting honesty after the act cannot cure absent consent
Extra mark
- Cite Samira Kohli v. Prabha Manchanda (2008), decided on near-identical facts
- Mention the 'doctrine of necessity' and why it does not apply here

What "Discuss" is asking you to do

Lay the issue out from more than one side — how it arose, what is claimed for it, what is held against it, and where it now stands. UPSC attaches discuss to broad topics with several live dimensions, so coverage of the dimensions earns more than the strength of your opinion.

Structure that answers it

Set the issue up → the case as it is made → the case against → the dimension both sides leave out → where the balance now lies

Where marks are lost

Listing facts with no thread between them, or arguing one side throughout and calling it a discussion.

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