MPO CASE WRITING

UNFAIR PRACTICES
AND ETHICAL
DILEMMAS: A CASE
STUDY AT LOK NAYAK
HOSPITAL

WRITTEN BY :
HIBA (EMBA/03/26)
RAJAT SINGH (EMBA/03/33)
MPO Case Study

Unfair Practices and Ethical Dilemmas: A Case Study at

Lok Nayak Hospital

This case has been developed by Ms. Hiba and Mr. Rajat Singh, EMBA Participants
at IIM Amritsar under the guidance of Professor Narendra M Agrawal, Retired
Professor and currently Adjunct Faculty at Indian Institute of Management Amritsar
and IIM Bangalore. Cases are meant to expose the participants to the corporate
context and challenges in the classroom so that they could develop competencies to
resolve those challenges. The names of the people and the project have been
camouflaged to protect the identities of the individuals in the case.

Abstract:
This case delves into the story of Adhiyajna K, a biomedical engineer at Lok Nayak
Hospital, a central government entity, who resigned due to the lack of vacancies for
General category candidates and the questionable appointment practices within the
organization. The case explores the impact of the Indian Reservation System, the
protagonist's perception of unfair treatment, and the ethical dilemmas faced in the
workplace.

Characters:
Protagonist (Name): Adhiyajna K. - Biomedical Engineer (Ad-hoc) at Lok Nayak
Hospital.
Antagonist 1 (Name): Abhay Pandey - Scientific Officer ‘B’ at Lok Nayak Hospital.
Antagonist 2 (Name): Aarti Gupta - Scientific Assistant ‘B’ (Ad-hoc) at Lok Nayak
Hospital, who received a questionable appointment.

15th May, 2023

During the hot month of May, when Varanasi's old streets looked shiny like gold in
the past, Adhiyajna K experienced a different kind of heat in his life. His dreams were
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like the sunlit steps by the Ganges River, seeming to cook in an intense fire.
Adhiyajna worked at Lok Nayak Hospital and faced complex challenges similar to the
city's confusing alleys. The Indian Reservation System, like the blazing sun, showed
him how tough his professional journey was. Job opportunities that were once
plentiful, like flowers at temples, disappeared due to the heat, leaving few chances.

As the city's religious ceremonies happened by the river, Adhiyajna's own journey
was like the Ganges' tides. The easy progress in his career turned into unhappiness,
much like the soft prayers at the temples. Could he, like the city itself, find a way to
succeed despite difficulties? Maybe he could use Varanasi's strong faith to deal with
problems and rediscover his own strong purpose?

A Glint of Hope Fades

In the busy hallways of Lok Nayak Hospital, Adhiyajna K, a hardworking biomedical
engineer, encountered a discouraging situation. The Indian Reservation System,
which aimed to offer chances to less privileged parts of society, had given him fewer
choices for advancing his career. The many job opportunities that used to be available
had reduced, making it tough for Adhiyajna, a candidate from the General category, to
find good options.

Shadows of Favoritism
One day, Adhiyajna's senior colleague, Abhay Pandey (Scientific Officer ‘B’),
introduced him to Aarti Gupta, a new recruit. As Adhiyajna exchanged pleasantries,
he learned that Aarti's appointment as Scientific Assistant ‘B’ hadn't followed the
usual process. This revelation gnawed at him, intensifying his sense of injustice. He
couldn't fathom how someone could be handed a position without undergoing the
rigorous selection procedures.

Murmurs of Dissent
In the hospital's dining area, Adhiyajna talked privately with his friends, Pritish, Sejuti,
and Nakshatra. The information about Aarti being treated better reached everyone
quickly, causing a strong feeling of unhappiness among the staff. Their irritation
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could be heard in the discussions as they doubted the organization's honesty.
Adhiyajna became even more committed to dealing with the unfairness, especially
because his friends supported his efforts.

A Voice of Concern
Adhiyajna sat in Dr. Neha Kapoor's office at Lok Nayak Hospital. The office looked
important with certificates and medical books on the walls. Dr. Kapoor signaled
Adhiyajna to sit down. Adhiyajna felt thankful for the chance to talk and said, "Thank
you, Dr. Kapoor. I've been part of Lok Nayak Hospital for a long time, and I've seen it
do well. But some recent things worry me, especially how we pick our employees."
Dr. Kapoor wanted to know more about Adhiyajna's worries, so she said, "You can
tell me what's bothering you, Adhiyajna. Your thoughts are important."
Adhiyajna explained, "I'm glad you understand, Dr. Kapoor. Our hospital has always
believed in choosing the best people based on their work. But the way Aarti Gupta
was chosen recently makes me doubt this. I want to know how she was picked."
Dr. Kapoor nodded and said, "Your honesty matters, Adhiyajna. We believe in being
clear, and we'll address your concerns. Normally, we pick employees by looking at
their qualifications, experience, and how suitable they are for the job. I get why you're
questioning how things happened this time."
Adhiyajna continued, "Exactly, Dr. Kapoor. Being clear not only helps our workers
trust us but also makes our hospital better. I want to know more about how we
decided who to pick and what things were important."
Dr. Kapoor explained, "We have a good process. First, we look at everyone's
application, then we interview them, and sometimes we test their skills. The things we
check can change depending on the job. But generally, we look at their experience,
skills, and if they match our hospital's values."
Adhiyajna thought this sounded okay but wanted to be sure, so he asked, "That makes
sense. Did everyone, including Aarti Gupta, know about these rules? And did we treat
everyone the same way?"
Dr. Kapoor said, "We make sure everyone knows how we pick employees. But
because of your worries, I'll double-check to be fair. It's important to be consistent. If
we find any problems with how we did things, we'll fix them."
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Adhiyajna felt better knowing Dr. Kapoor would check. He said, "Thank you, Dr.
Kapoor. I feel better knowing you care about this. Aarti's hiring has made others lose
faith. Fixing this can make our hospital fair again."
Dr. Kapoor appreciated Adhiyajna's concern, "You really care about our hospital's
values, Adhiyajna. We want to solve this the right way. Your ideas matter, and keep
suggesting positive changes."
They talked more about how to make picking employees fairer. Adhiyajna felt
hopeful as he left Dr. Kapoor's office, thinking he could help make things better for
everyone at the hospital.

A Bold Decision
Weeks later, Adhiyajna found himself at a crossroads. The turmoil within him had
reached its peak, and he decided to resign from Lok Nayak Hospital. In a poignant
conversation with Abhay Pandey, Adhiyajna expressed his reasons for leaving. He
refused to let the fire of justice die out, vowing to stand up against the unfair practices
even if it meant leaving the institution he had dedicated himself to.

A Spark Ignites As Adhiyajna walked away from Abhay's office, a quiet

determination filled his heart. The corridors of Lok Nayak Hospital continued to pulse
with life, but within Adhiyajna, a revolution had begun. His decision to stand up
against favoritism and injustice was a testament to the power of a single voice. The
story of Adhiyajna K. would forever be a reminder that change, no matter how
daunting, could be ignited by the spark of courage and principle.

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 Solution: Implementing Fairness and Ethical Reform

1. Acknowledging the Issue - The first step in addressing the situation is for the
hospital administration, including HR and senior management, to acknowledge
the concerns raised by Adhiyajna and other employees. An open and transparent
conversation should be initiated to demonstrate that the hospital values the input
and concerns of its staff.
2. Reviewing Appointment Procedures - The hospital should form a committee to
review the appointment procedures and policies, ensuring that they are
transparent, fair, and inclusive. This committee should include representatives
from various departments and categories, including General, to ensure diverse
perspectives.
3. Introducing Equal Opportunity Training - Implement mandatory training
programs for all employees that emphasize the importance of equal opportunities,
ethical conduct, and non-discrimination in the workplace. These programs should
not only educate staff but also foster a culture of awareness and fairness.
4. Ensuring Transparency - The hospital should adopt a policy of transparency
when it comes to appointments, promotions, and other career advancement
opportunities. Vacancies should be advertised internally and externally, and all
qualified candidates should have a chance to apply and be considered.
5. Strengthening Grievance Mechanisms - Develop a robust grievance redressal
mechanism that allows employees to voice their concerns without fear of
retaliation. This system should ensure confidentiality and a swift resolution
process.
6. Ethical Oversight Committee - Establish an independent ethical oversight
committee composed of representatives from different departments, professional
bodies, and even external experts. This committee can provide recommendations
on ethical matters, investigate complaints, and ensure compliance with fair
practices.
7. Evaluating the Reservation System - While the Indian Reservation System aims
to promote social justice, its implementation may inadvertently lead to perceived

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 inequities. The hospital should engage with policymakers and relevant authorities
to discuss possible refinements to the system, ensuring that it achieves its
intended goals without creating unfairness.
8. Performance Evaluation Criteria - Create clear and objective criteria for
evaluating employee performance. This will help prevent subjective biases and
ensure that promotions and opportunities are based on merit.
9. Employee Engagement Initiatives - Develop initiatives to boost employee morale,
engagement, and satisfaction. This could include regular feedback sessions,
recognition programs, and opportunities for skill enhancement.
10. Long-Term Cultural Change - Cultural change takes time, but with consistent
effort and commitment from the hospital's leadership, it can be achieved.
Encouraging open dialogue, celebrating ethical behavior, and setting an example
from the top will contribute to fostering a fair and ethical organizational culture.

Conclusion
By following these steps, Lok Nayak Hospital can address the unfair practices and
ethical dilemmas presented in the case study. Implementing these measures will not
only rectify the immediate issues but also contribute to the hospital's long-term
growth, employee satisfaction, and reputation as an organization that values fairness,
integrity, and ethical conduct.

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 ANNEXURE
1. Organization Chart
Fig.1 Organizational Chart of Hospital

2. The Ethical Oversight Committee Charter of the Institutional Ethics Committee

(IEC) at Lok Nayak Hospital, Varanasi, establishes the hospital's commitment to
upholding high scientific and ethical standards in patient care, education, and
research. The IEC reviews research proposals to ensure ethical standards are
maintained in various types of clinical research. Established in September 2019,
the IEC has conducted 23 full board meetings and reviewed 116 Investigator
Initiated Projects in biomedical and clinical research. The committee is registered
with the National Ethics Committee Registry. The IEC's mandate involves
maintaining ethical standards in patient care and research, integrating ethics into
various aspects of the institution, and promoting a scientific and ethical approach
to research and education.

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