Rakesh is a responsible district-level officer, who enjoys the trust of his higher officials. Knowing his honesty, the government entrusted him with the responsibility of identifying the beneficiaries under a healthcare scheme meant for senior citizens.
The criteria to be a beneficiary are the following:
(a) 60 years of age or above.
(b) Belonging to a reserved community.
(c) Family income of less than 1 Lakh rupees per annum.
(d) Post-treatment prognosis is likely to be high to make a positive difference to the quality of life of the beneficiary.
One day, an old couple visited Rakesh’s office with their application. They have been the residents of a village in his district since their birth. The old man is diagnosed with a rare condition that causes obstruction in the large intestine. Therefore, he has severe abdominal pain frequently that prevents him from doing any physical labour. The couple has no children to support them. The expert surgeon whom they contacted is willing to do the surgery without charging any fee. However, the couple will have to bear the cost of incidental charges, such as medicines, hospitalization, etc., to the tune of rupees one lakh. The couple fulfils all the criteria except criterion ‘b’. However, any financial aid would certainly make a significant difference in their quality of life.
How should Rakesh respond to the situation?
The case presents a conflict between two foundational values of civil services, objectivity and empathy & compassion. On this account, Mr Rakesh will face an ethical dilemma. Following are other values and issues involved in the case –
- The trust was reposed by higher officials in Mr Rakesh to implement the scheme with responsibility.
- Maintaining the integrity of the criterion of the scheme.
- Socio-economic justice to the old couple in unreserved category.
If Mr Rakesh accommodates the old couple without fulfilling the criterion, then a significant difference in the quality of their life will happen. It will also amount to the distributive justice of John Rawls. It will fulfil the spirit of equity in our constitution. The state will also seem to oblige the social contract by helping citizens in need.
However, accommodation under the scheme without fulfilment of the criterion will destroy the objectivity of Mr Rakesh. He will also breach the trust reposed in him by his superiors. Taking ado decisions will destroy work culture and objectivity in decision-making. It may also create discontentment in the reserved category for whom the scheme has been formulated. This will impact the image of civil service as being impartial and non-partisan. The decision will also go against the Weberian ideal of a model of bureaucracy.
Mr Rakesh must use emotional intelligence to deal with the situation. He must express the foundational values of empathy and compassion within the contour of legal and rational bureaucracy. Hence, he can adopt the following course of action –
- Recommend to the concerned ministry/authority to amend the criterion of the scheme to fully or partially accommodate unreserved category as well.
- For this, he can prepare a detailed report highlighting the need among unreserved categories as a tool of persuasion.
- On an immediate basis, he can arrange for some financial help to the old couple from himself, family and friends, NGOs working in the health sector, philanthropists etc.
- Also, there are other schemes of the government, where the patient can get treatment such as Ayushman Bharat. He should facilitate the patient to access the same. This will save Mr Rakesh from the possible crisis of conscience and inner dissonance.
Mr Rakesh must show the attitude of a committed bureaucrat. He must work with dedication to fulfil the constitutional promise of justice and support to senior citizens.