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Journalism of Courage
The recent cough syrup tragedy, which led to multiple child deaths, underscores the urgent need to revisit medical ethics, particularly the ethics of care. With repeated lapses in healthcare, one must ask: are we truly upholding the basic principles of medical ethics? UPSC has often framed questions and case studies, directly or indirectly, around this issue. Nanditesh Nilay, our ethicist, helps explore this question through a caselet.
Father and son — both were doctors. There was a great camaraderie between them. The father was a well-known figure in the medical fraternity, while the son was more of a seeker. However, whenever the chips were down, the father used to say, “You have made it this far.”
They were Hamdards and were referred to as Senior Hamdard and Junior Hamdard. “I am getting old, and one day you will have to see all your patients. So work on your concentration and fitness,” the father said. He was not in a good mood. The son replied, “Am I not seeing a large number of patients every day? I don’t want you to work at this age. But you don’t listen to me. And patients trust you more than my ability.”
There was a patient who was nervous upon seeing the huge crowd at their clinic. He asked one of the fellow patients, “I am suffering from fever, cough, and cold. Whom should I consult…Senior Hamdard or Junior Hamdard?” The fellow patient replied, “If your cough and cold are chronic, see the father. If not, meet the son.” The patient was perturbed and very confused. Finally, he tried to consult the father but was informed that he would have to visit another day. Therefore, he consulted Junior Hamdard.
After a month, the patient was fully recovered. But he couldn’t meet Junior Hamdard next time, as he was traveling. So, the patient consulted Senior Hamdard for his wife, who had been suffering from migraines and other health issues. He said, “Dr. Sahib, you are a walking God on this earth. Everybody speaks about you. But for me, your son is no lesser God. He has your blessings—a magician in my book. But due to his unavailability, I am consulting you for my wife.” Senior Hamdard quietly listened but said nothing.
That day, Junior Hamdard was not in a good mood, as his father was not paying attention to his health. He said, “You have spent your whole life serving patients. Have you ever thought about who will take care of you?” This time, the quiet father smiled, and words rolled through his eyes. He said, “You, my son. You! I am sure you are doing it and you will continue to do so. But don’t say I shouldn’t see patients. I try to help others and simultaneously get the wonderful feeling of always being there for my son.”
The next day, the son was ready and waiting in his car for his father to come. But his father didn’t join him. Finally, the son went to the clinic alone. As usual, there were a lot of patients waiting, many of whom had come specifically for Senior Hamdard. Due to his absence, all decided to consult Junior Hamdard.
“Sir, we came to meet your father, but he is not here, so we came to meet you,” one patient said. Junior Hamdard was hurt but, like a cultured human being, preferred to remain quiet. Later, he said, “My father is a better doctor than me. I will always be a student and a humbled son. But don’t worry, you will be cured.” Meanwhile, a few other patients came into Junior Hamdard’s chamber.
“Your father is a God, and God’s son cannot be a lesser God,” one of them said. In the meantime, Junior Hamdard was inquiring about his father’s health and was surprised to learn that his father was not home. He became worried.
He came out of the clinic and saw, at a distance, around fifty people surrounding someone. They were urging the old man to meet Junior Hamdard, promising he would be cured. The old man resisted, showing discomfort. Nevertheless, Junior Hamdard approached the gathering and said loudly, “Baba! He is my Baba. What are you all convincing him about? He is the Senior Hamdard.” The father simply hugged his son and whispered, “Any advice for this old man, doctor?” Junior Hamdard smiled and demonstrated the ethics of care.
When we examine this case, we see two doctors and their association with their profession as well as their relationship with each other. Medical ethics revolves around care, relationships, dependency, and the highest form of empathy. Our valuable relationships, particularly those involving dependency, are key to the ethics of care. Carol Gilligan believed that morality is primarily about care and responsibility. Though she discussed it in the context of female moral development, the central idea of the ethics of care is not about following only impartial or universal principles but about responding to the needs of those directly or indirectly dependent on us. It is about virtues like love, kindness, and concern for others, which guide and manifest various layers of moral decision-making.
This case exemplifies the spirit of care between father and son, as well as their care for patients. Recent incidents, such as the cough syrup tragedy, have been inhuman and cruel, demonstrating a failure of the ethics of care. Who could have understood this better than Junior and Senior Hamdard?
The story of the doctors shows how professionals have responsibilities not just to themselves or their careers, but to those they serve and to their relationships. In today’s scenario, where vulnerable groups (children, patients, the poor) are impacted, this sense of responsibility is very relevant. The father‑son doctors build trust through consistent, caring behaviour. It is through this behaviour that people remain confident in institutions and individuals.
When systems fail — e.g., contaminated syrups reaching children — the consequences are catastrophic.
Ethics of care isn’t an optional add‑on; it is central to prevention of harm. In many recent incidents, protocols may have existed but oversight, quality control and a mindset of caring for the vulnerable were lacking. Focus on relational sensitivity and responsiveness (rather than just ticking boxes) shows what real ethics looks like. Remember, ethics in governance means going beyond compliance to proactive care.
The above story, in fact, goes beyond medical professional ethics. While entering the world of public service, readers (here, aspirants) must remember that ethics (not just in the medical profession but also elsewhere) is lived through actions and attention to human needs, not merely through rules.
What are the basic principles of medical ethics? How and why should recent incidents of health mishaps remind us of the ethics of care?
(The writer is the author of ‘Being Good’, ‘Aaiye, Insaan Banaen’, ‘Kyon’ and ‘Ethikos: Stories Searching Happiness’. He teaches courses on and offers training in ethics, values and behaviour. He has been the expert/consultant to UPSC, SAARC countries, Civil services Academy, National Centre for Good Governance, Central Bureau of Investigation (CBI), Competition Commission of India (CCI), etc. He has PhD in two disciplines and has been a Doctoral Fellow in Gandhian Studies from ICSSR. His second PhD is from IIT Delhi on Ethical Decision Making among Indian Bureaucrats. He writes for the UPSC Ethics Simplified (concepts and caselets) fortnightly.)
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