1. What should be Sneha’s course of action? 
2. How would she justify what she chooses to do? 
3. In this case, how is medical ethics compromised with vested personal interest?

As Warren Buffett once said, “It takes 20 years to build a reputation and five minutes to ruin it.“ In Sneha’s case, being entrusted with the responsibility of managing the procurement for a super-specialty center requires her to prioritize transparency, fairness, and ethical standards over personal considerations.

Guiding Principle – “स्वार्थसंपन्नं कर्म न धर्माय कल्पते” (Svārthasaṃpannaṃ Karma Na Dharmāya Kalpate) – “Actions driven by self-interest do not lead to righteousness.”

Course of Action for Sneha:

1. Declare the Conflict of Interest to the hospital management and procurement committee. This will ensure honesty and transparency, upholding professional ethics.
2. Recuse Herself from the Decision-Making Process: She can delegate the responsibility of vendor selection to an impartial subcommittee. This demonstrates a commitment to objectivity and fairness. 
3. Follow Hospital Governance Guidelines on procurement and conflict of interest, seeking advice from the legal or compliance department if needed.
4. Establish Transparent Procurement Criteria: These criteria should focus on aspects like quality of equipment, pricing, warranties, after-sales service, and vendor reliability.
5. Engage a Diverse Committee consisting of members from diverse departments (medical, financial, technical), allowing for multiple perspectives in the decision-making process.
6. Maintain Complete Documentation of the Process including all communications, evaluations, and justifications for the final decision. This creates a transparent paper trail that can be reviewed if any concerns arise later. 
7. Consider External Auditing or third-party evaluation of the procurement process to further ensure fairness and transparency.
8. Communication with Vendors – Equal treatment and Clear communication about timelines, expectations, and selection criteria should be maintained.
9. Handle the Outcome with Integrity: Regardless of whether her brother’s company is selected or not, Sneha should ensure that she communicates the decision in a professional and transparent manner, especially within her family and among the stakeholders.

Justification for Sneha’s Decision:

1. Transparency and Integrity: Declaring the conflict of interest and recusing herself shows professional integrity, demonstrating that Sneha prioritizes the hospital’s interests over personal ones.

1. Fairness in Procurement:mDelegating the decision-making process ensures fair competition among vendors and guarantees that the hospital gets the best value for its investment.
2. Maintaining Reputation: By stepping aside, Sneha avoids any appearance of impropriety, preserving both her own reputation and the hospital’s credibility.
3. Protecting Long-Term Trust that the hospital management and colleagues have placed in her, avoiding any backlash or future doubts about her judgment.
4. Setting Ethical Precedents: By handling the situation ethically, Sneha sets a strong example for others, reinforcing virtue ethics, which emphasizes character and moral integrity.

How Medical Ethics is Compromised with Personal Interest:

1. Compromised Patient Care: Awarding a contract to her brother without merit risks compromising equipment quality, ultimately affecting patient care.
2. Breach of Professional Ethics: Favoring family in procurement violates impartiality, a core principle under the Indian Medical Council Regulations (2002).
3. Conflict of Interest: It leads to decisions that benefit an individual (in this case, Sneha’s brother) over the hospital’s duty to prioritize patient welfare and cost-effectiveness.
4. Erosion of Trust: Favoring a family member could lead to suspicion and distrust among colleagues, other vendors, and hospital stakeholders. 
5. Ethical Duty to Patients: The principle of non-maleficence—“do no harm”—is core to medical ethics. 
6. Negative Impact on Professional Integrity: Sneha’s involvement in awarding a contract to her brother could result in allegations of nepotism, damaging her own professional integrity and future career prospects, especially if suboptimal products are delivered.
7. Violation of Fiduciary Duty: Sneha’s fiduciary responsibility to the hospital is compromised by personal interests. 

“Integrity is doing the right thing, even when no one is watching.” — C.S. Lewis

By choosing to prioritize integrity and transparency, she can ensure that her decisions serve not only her brother’s interests but, more importantly, the well-being of the patients and the reputation of the hospital.