Dr. X is a leading medical practitioner in a city. He has set up a charitable trust through which he plans to establish a super-speciality hospital in the city to cater to the medical needs of all sections of the society. Incidentally, that part of the State had been neglected over the years. The proposed hospital would be a boon for the region. You are heading the tax investigation agency of that region. During an inspection of the doctor’s clinic, your officers have found out some major irregularities. A few of them are substantial which had resulted in considerable withholding of tax that should be paid by him now. The doctor is cooperative. He undertakes to pay the tax immediately. However, there are certain other deficiencies in his tax compliance which are purely technical in nature. If these technical defaults are pursued by the agency, considerable time and energy of the doctor will be diverted to issues which are not so serious, urgent or even helpful to the tax collection process. Further, in all probability, it will hamper the prospects of the hospital coming up. There are two options before you : (i) Taking a broader view, ensure substantial tax compliance and ignore defaults that are merely technical in nature. (ii) Pursue the matter strictly and proceed on all fronts, whether substantial or merely technical.

How a topper answered the closest question

Toppers wrote this one in a test series: “You live in a poor urban area bereft of basic amenities. The community faces many problems like lack of health and sanitation facilities. The people are not able to afford education for their children. The pleas of the people have fallen on the deaf ears of the concerned politicians and government officials. You feel cheated that politicians forget about their promises after getting your votes. You have seen officials indulging in corruption. Your pleas to media to cover your issue have been ignored as there is not much matter for increasing the viewership of their channel. You and your best friend have a strong desire to do something for the people of your locality. Your friend lands up in a dream role in one of the biggest movies of the year. He earns a lot of money in the next few years. He decides to work for your locality. He has decided to fund education up to graduation level of 100 students from the locality. He has also decided to provide funds to the local people to get their medical treatments done from private clinics. He also plans to address their other concerns. In an interaction with him you get to know that he indulges in tax evasion. He says that he does not trust the public authorities as they are corrupt and have never used public funds to address the local concerns. He says it is logical for him to directly take the responsibility of the area and help the people out of their misery. You agree with the ends he intends to achieve. However, you are not comfortable about the means used. (a) What are the ethical issues involved in the situation? (b) What shall be your course of action to address the various concerns?”

Toppers’ answers to other close questions

• You are a Sub-Divisional Magistrate of a large city, having the reputation of a very honest and upright officer. A huge hospital in your city is working day and night to ensure Emergency services are carried out because of the COVID-19 pandemic. One night, during monsoons, fire engulfed the Covid ward causing instant death of 20 patients including 10 minors. Many more were seriously injured requiring immediate medical attention. The mishap resulted in a big hue and cry, forcing the government to institute an inquiry. Your preliminary enquiry has revealed a series of anomalies. The material used for the cables was of poor quality. Despite the approved building plans permitting only one basement, an additional basement has been constructed which required more power demand causing stress on the system. This was overlooked during the periodic electrical inspections by the building inspector of the municipal corporation. In your enquiry, you noticed that the hospital has more demand of power than sanctioned by the electricity department. Apart from this you also noticed many irregularities in compliance to the fire safety guidelines. There were no proper exit routes indications and many other technical irregularities with respect to fire safety. The permission to have higher load demand and No Objection Certificate for fire safety was accorded by the previous Sub-Divisional Magistrate who is not only your senior and well known to you professionally, but also a good friend. Prima facie, the case appears to be of a widespread nexus between officials of the district administration and the hospitals. Your colleagues are putting pressure on you to go slow in the enquiry. The previous SDM happens to be a close relative of a powerful minister in the state cabinet. The previous SDM is persuading you to hush up the matter, promising you a fortune to do so. He also hinted that if this matter is not resolved at the earliest in his favour there is somebody in his office who is waiting to file a case against you under the POSH Act. (a) Discuss the ethical issues involved in the case. (b) What are the options available to you in this situation? (c) Explain your selected course of action.1 answer
• You are working as a senior doctor in the oncology department of a super specialty hospital located in Delhi. While accessing the quotations from reputed pharmaceutical companies to hospitals, you unearth a nexus between pharma firms and the hospital administration. You get to know that they are hand-in glove with each other and trying to fleece cancer patients by selling drugs at exorbitant prices, even though low cost alternative drugs are available in the market. Being the head of Alliance of Doctors for Ethical Healthcare, who is working against the arbitrary price regime of life saving drugs, you get a chance to represent your case before the Health Minister of your state. However, certain other doctors of the Alliance have asked you to present a distorted reality in front of the Minister since they are obtaining pecuniary benefits from such a scheme of nexus, which would cease if the nexus gets exposed. 20 (a) Identify the main stakeholders and ethical issues involved. (b) Analyse the possible solutions for addressing the issues. (c) What would be your final course of action and why?6 answers
• You have joined a government district hospital as a junior doctor. After working for few months, you find that substantial misappropriation of public funds is taking place. The fund was meant for procurement of medical devices and essential medicines which are being diverted to private clinics of doctors working in the hospital and to the private pharmacies. You report this to your immediate senior and you find that he too is involved in this, along with the chief medical officer. He asks you to keep quiet and come along or face adverse consequences. Every day you find people spending out of their pockets for medicines to which they are entitled free of cost. What options do you have to ensure probity in the utilization of funds in this case? Which one will you choose and why?1 answer