You are the District Health Officer (Civil Surgeon) during the second wave of a viral pandemic. Oxygen supply to your 22 hospitals has dropped to 60 per cent of need. A local industrialist, who owns a metal-fabrication unit, offers to divert his industrial oxygen — 8 tonnes a day for 14 days — provided his factory is exempted from a state-wide industrial-oxygen-export ban that you would have to recommend. The State Disaster Authority has not yet decided on exemption protocols. ICU patients are dying. The State Health Minister is sympathetic but silent. What course of action would you take? Justify with the values involved.

Dilemma: ICU patients are dying for want of oxygen and an industrialist offers eight tonnes a day for fourteen days — but only if his factory is exempted from the state-wide industrial-oxygen-export ban the Civil Surgeon must recommend. The dilemma is between immediate, identifiable lives saved by a conditional offer and principled refusal of a quid-pro-quo that would distort future allocation and breach PCA 1988 Section 7.

Stakeholders: ICU patients in 22 hospitals (Article 21, Rawlsian worst-off); the industrialist (commercial interest); other industrial users denied the same exemption (level playing field); the SDMA (policy primacy); the IMA; the silent State Health Minister; CAG and State Vigilance; the media; future emergency offers whose precedent this sets across India.

Options analysed: (a) accept the conditional offer — saves lives now, but ties the exemption to a private bargain, sets a precedent that scarcity can be traded for regulatory favour, and falls within PCA 1988 Section 7 'undue advantage' territory; (b) refuse outright on principle — integrity preserved at the cost of avoidable deaths, failing Beauchamp-Childress beneficence; (c) accept the eight tonnes under Disaster Management Act 2005 Section 65 (requisition) and Section 30 at market rate, with a written undertaking that no policy exemption attaches, and parallel-route the exemption question to the SDMA for an open, criteria-based policy applicable to all industrial owners — the hard right.

Decision and reasoning: Option (c). The Civil Surgeon issues a Section 65 requisition for 8 tonnes a day for 14 days, pays the market rate, and signs a written note that the requisition carries no exemption, current or future, from any ban. A parallel memo to SDMA proposes three published criteria for any exemption — life-saving criticality, scale, and substitutability — applicable to every industrial owner. Three named values anchor it: Kant's universalisability test, since any owner offering capacity at market rate must qualify on identical terms (integrity); the Rawlsian max-min, which protects the ICU patient as worst-off (justice); and the Nolan principle of openness through full publication of the transaction.

Safeguard / institutional fix: Section 4 RTI publication of the requisition order, payment terms and the industrialist's letter; CAG audit hook; IMA and Collector co-signing the protocol; written non-quid-pro-quo certificate by the industrialist; SDMA exemption policy released within seven days with public consultation; weekly oxygen-allocation dashboard; transparent allocation across other industrial users so the level playing field is preserved; Tandon (2021 Delhi HC) judicial oversight retained as fallback.