What is the News ?

14 States and Union Territories are yet to sign a crucial Memorandum of Understanding (MoU) with the Union Education Ministry.

Facts About:

Higher education Institutions (HEIs) in India

Statistics

As per the AISHE report 2020-21, there are 1,113 Universities, 43,796 Colleges, and 11,296 Stand Alone Institutions.

• There are 422 State Public Universities that have 41,836 affiliated colleges.
• 446 Universities are privately managed and 475 Universities are located in rural areas, 17 are women-centric universities.

Total enrolment in higher education has been estimated to be 4.13 crores with 2.12 crores boys and 2.01 crores females.

• Females constitute 48.7% of the total enrolment.

There are 2,255 students enrolled in Integrated Ph.D. in addition to 2.11 lakh students enrolled in Ph.D. Level.

Major problems currently faced by the higher education system in India – As identified by National Education Policy 2020:

• A severely fragmented higher educational ecosystem; less emphasis on the development of cognitive skills and learning outcomes;
• A rigid separation of disciplines, early specialization, and streaming of students into narrow areas of study;
• Limited access particularly in socio-economically disadvantaged areas, with few HEIs that teach in local languages;
• Limited teacher and institutional autonomy;
• Inadequate mechanisms for merit-based career management and progression of faculty and institutional leaders;
• Lesser emphasis on research at most universities and colleges, and lack of competitive peer-reviewed research funding across disciplines;
• Suboptimal governance and leadership of HEIs;
• An ineffective regulatory system; and large affiliating universities result in low standards of undergraduate education.
• PM-USHA aims to address the key gaps and issues identified by NEP 2020. 

What is Pradhan Mantri Uchchatar Shiksha Abhiyan (PM-USHA)?

Background

• Rashtriya Uchchatar Shiksha Abhiyan (RUSA) was a Centrally Sponsored Scheme to fund States/UTs institutions.
• It was launched with the vision to attain higher levels of access, equity, and excellence in the State higher education system with greater efficiency, transparency, accountability, and responsiveness.
• The first phase of the scheme was launched in 2013 and the second phase was launched in 2018.
• Now, in the light of the National Education Policy, RUSA scheme has been launched as Pradhan Mantri Uchchatar Shiksha Abhiyan (PM-USHA).

About

• It is a centrally sponsored scheme of the Government of India executed through the Ministry of Education.
• The scheme aims to work with over 300 HEIs including the state universities, its affiliated colleges to raise the quality of education. 

Key Objectives of Pradhan Mantri Uchchatar Shiksha Abhiyan

The key objectives of PM-USHA are to improve access, equity and quality in higher education through planned development of higher education at the state level. 

The objectives also include:

• creating new academic institutions,
• expanding and upgrading the existing ones,
• developing institutions that are self-reliant in terms of quality education, professionally managed, and characterized by greater inclination towards research.

Funding

• The PM-USHA aims at providing strategic funding to eligible state higher educational institutions.
• The central funding is based on norms and is outcome dependent.
• Funds flow from the central ministry through the state governments/union territories before reaching the identified institutions.
• Funding to states is made on the basis of the critical appraisal of State Higher Education Plans, which enlist each state’s strategy to address issues of equity, access and excellence in higher education.

Source: https://www.education.gov.in/sites/upload_files/mhrd/files/upload_document/pm-usha_guidelines.pdf

What is the News ?

According to the National Medical Commission’s Registered Medical Practitioner (Professional Conduct) Regulations or NMC RMP Regulations 2023, doctors can now refuse treatment to the unruly and violent patients.

Facts About:

The National Medical Commission Act, 2019:

• It was introduced to address various issues and challenges in the medical field, including improving the quality of medical education, enhancing access to healthcare services, and ensuring ethical and transparent practices.
• Key Provisions include:
  • Ethical and Professional Conduct: The Act emphasizes maintaining ethical and professional conduct among medical practitioners and includes provisions to address any deviations from these standards.
  • Community Health Providers: The Act introduces the concept of Community Health Providers who are allowed to practice limited medicine in underserved rural areas to address the shortage of doctors.
  • Formation of the National Medical Commission (NMC): NMC is an regulatory body which regulates medical education and medical professionals.
  • Establishment of Medical Advisory Council.
  • Reforms in Medical Education.

Refusing treatment is a complex issue that involves various stakeholders viz. doctors and healthcare professionals, patients and their families, healthcare institutions, medical associations and regulatory bodies, legal authorities, ethics committees, public opinion and media, religious and cultural communities, etc.

Arguments in Favour of the Regulation:

• Unruly Behaviour
  • Justice: If an unruly patient’s behaviour poses a threat to their own safety, the safety of healthcare staff, or the safety of other patients, refusing treatment might be justified as a means to mitigate these risks.
    • For example, a 21-year-old patient attacked a doctor with a knife during consultation at Delhi’s Sir Ganga Ram Hospital.
  • Dignity and Integrity: Unruly behaviour can sometimes cross ethical boundaries, leading to disrespectful or abusive treatment of healthcare staff. Doctors have a right to work in an environment that respects their dignity and professional integrity.
    • For example, a 40-year-old doctor on duty in a  hospital in Faridabad was assaulted by attendants of a patient as the doctor was attending to another patient, he could not immediately attend to the patient.
  • Brings Deterrence: Allowing unruly behaviour to go unchecked might enable a cycle of disruptive or non-compliant behaviour, which could negatively impact the patient’s overall health outcomes. By refusing treatment, the doctor may communicate that certain standards of behaviour are expected for a therapeutic relationship to proceed.
  • Right to Freedom to practise any profession: The regulations give the doctors the right to choose whom they will serve, except in case of a life-threatening emergency.

• Financial Constraints
  • Autonomy and Consent: Doctors are ethically obligated to provide patients with accurate information about their treatment options,including potential costs. 
    • If a patient cannot afford the treatment, the doctor might argue that proceeding with treatment without full financial transparency could undermine the patient’s autonomy and informed consent.
    • In extreme cases, relatives of patients have been known to hold doctors or hospital staff hostage, demanding treatment.
  • Professional Boundaries: Some proponents of this perspective argue that doctors have a professional duty to provide medical care and expertise, but they are not obligated to address broader societal issues such as patients’ financial difficulties.

• Ethical Boundaries: Doctors have ethical responsibilities not only toward their patients but also toward themselves, their families and the healthcare community.
  • For example, potential threats and violence have long-lasting impacts which manifests in the degradation of personal and professional relations.
• Objectivity: Taking decisions which are free from subjectivity caused by emotions, perceptions and individual bias is necessary for long term sustainability.
  • For example, Free medical care for a desperate patient may be ethical, but providing it to many patients may not be feasible for one provider.
• Selfless Duty: Medical practitioners often prioritize the well-being of their patients above their own comfort, personal time and space. However, the job can be thankless at times.
  • For example, During COVID-19 despite their selfless dedication, medical professionals were subjected to regular assaults and verbal abuse throughout the country.

Arguments against the Regulation

• Dedication and the Duty of Care: Dedication is the sense of deep rooted commitment to devote oneself to a cause.. This includes a duty to provide care to those in need, regardless of their financial status.
• • In India, out-of-pocket health expenditure accounts for more than half of total health expenditure pushing many households into poverty. This shows the dire need for empathy and compassion towards those in need.For example, Dr Ramanand Singh has been treating his patients for just Rs 50 for the past 35 years in Bihar. He even waives off his fees in cases where the patients cannot afford medical treatment. 
• Justice and Equity: The principle of justice requires that healthcare be distributed fairly and equitably.Denying treatment to a patient solely based on their inability to pay could be seen as unjust, perpetuating disparities in healthcare access.
• Hippocratic Oath: Physicians pledge to do what is in the best interest of their patients and to avoid causing harm. 
  • Physicians promise to treat all patients fairly, regardless of their background, and to provide care to the best of their abilities without bias.
• Unholy Nexuses: Many doctors form nexuses with drugmakers to prescribe specific drugs from their brand instead of generic drugs leads to considerable rise in treatment costs for patients.
  • For example, freebies given to doctors including travel expenses, gifts etc. by drugmakers is a common practice.Beneficence: It means kindness or generosity and this principle refers to the moral obligation to act in a manner that will benefit others.The principle of beneficence obligates doctors to act in the best interests of their patients and to promote their well-being. 
• Compassion: It is the desire to end someone’s suffering which forms the core principle of a medical practitioner. Refusing treatment to individuals on certain grounds could lead to the possibility of crisis of conscience among several practitioners.
  • Loss of Trust and Credibility: The medical profession relies on public trust, and denying treatment to those in need could erode that trust and damage the reputation of the medical community.
• Responsibility: Some argue that healthcare professionals have a broader social responsibility to address systemic issues in healthcare, including affordability and access. Refusing treatment might be seen as abdicating this responsibility.
• Undermining Right to Life: Providing a legal caveat for the registered physicians to refuse treatment is against the fundamental right guaranteed under Article 21 of the Constitution. 
  • Further, there is no specific definition of “abusive” in law as it is purely a subjective interpretation that may depend on the personal opinion of any individual.
  • Subjective interpretation may further lead to exclusion on the basis of race, religion, caste, sex etc.

What Should be Done?

• Persuasion: Influencing patients to follow prescribed norms for behaviour and ensuring smooth functioning.
  • For example, during COVID-19 pandemic, voice messages were circulated using caller tune to make people aware of the importance of vaccination and prevent attacks on health workers.
• Emotional Intelligence: Equipping and training medical personnel with necessary skills so that they can manage their emotions and try to avoid escalation of situation and providing practical solutions to the given problems.
• Transparent Approaches: Consider alternative approaches before refusing treatment. This might involve social workers, mental health professionals, or conflict resolution experts to address the underlying issues contributing to the unruly behaviour.
  • For example, Doctors in San Diego (USA)refer patients to low-cost family health centersthat provide caring, affordable, high-quality health care and supportive services to everyone.
• Ethical Principles Balancing: Weigh the principles of patient autonomy, duty of care, patient safety, and respect for healthcare personnel’s well-being. Consider how refusing treatment aligns with these principles and what potential consequences might arise from the decision.
  • For example, Doctors Without Borders is a Nobel Peace Prize receiver charity that provides humanitarian medical care in conflict zones to all those in need of medical care, irrespective of the role played by them in the conflict. 
• Tolerance: Accepting actions and practices which may be considered to be incorrect but still tolerable to some extent that they should not be prohibited or penalised heavily.
  • For example, a significant number of the cases of unruly behaviour arises in situations which may not be considered as “common” and even the most well-behaved might behave in a way which is not acceptable in society due to the shock or intensity of the moment which one may not be able to handle.
• Consent: Communicating the decision clearly to the patient, and explaining the reasons behind it thus ensuring that the patient understands the potential consequences of their behaviour on their health and the doctor-patient relationship.
• Offering Continuity of Care: If possible, provide recommendations for alternative sources of care, whether within your healthcare institution or elsewhere. Ensure the patient’s ongoing health needs are addressed.

Conclusion

We must protect those who heal. Ethical decisions in healthcare are rarely black and white. It’s important to approach each situation with sensitivity, professionalism, and a commitment to upholding the well-being of patients, healthcare staff, and the broader community. Consulting with colleagues, supervisors, and ethics committees can provide valuable guidance in making these difficult decisions

Source: https://indianexpress.com/article/explained/explained-health/doctors-new-national-medical-commission-guidelines-8890632/#:~:text=The%20guidelines%20say%20that%20doctors,but%20at%20least%20three%20credits.

What is the News ?

Prime Minister Narendra Modi officially launched Urea Gold fertiliser.

Facts About:

• In a significant development, Prime Minister Narendra Modi unveiled Urea Gold, a novel fertiliser product, created by Rashtriya Chemicals and Fertilizers Ltd (RCF), a state-owned entity. This pioneering formulation involves enhancing urea with sulphur to address crucial agricultural challenges.

What is Urea Gold?

• Traditional urea primarily consists of 46% nitrogen (N). Urea Gold represents a leap forward by combining 37% nitrogen and 17% sulphur.
• This innovative composition serves two primary purposes: bolstering soil quality and boosting nitrogen utilization efficiency.

Soil Deficiencies Nitrogen Utilization Efficiency (NUE)

• Soil Deficiencies in India
• Indian soils suffer from deficiencies, particularly in key nutrients like sulphur (S).
• This deficiency is particularly crucial for certain crops such as oilseeds and pulses, which play a significant role in India’s agricultural output. These crops require adequate sulphur for healthy growth and optimal yield.
• The deficiency in sulphur can hinder their productivity and affect the overall agricultural landscape.
• Nitrogen Utilization Efficiency (NUE) Challenge
• NUE refers to the proportion of applied nitrogen fertilisers that is effectively taken up by crops for growth and yield production.
• Only about 35% of the nitrogen from urea, a commonly used fertiliser, is utilized by crops in India.
• The rest, roughly 65%, is lost through various processes, including ammonia volatilisation into the atmosphere and leaching into the ground as nitrate.

Challenges in Urea Consumption in India

• Import Dependency: India heavily relies on imported urea due to insufficient domestic production. Around 7.6 million tonnes of urea were imported out of the total 35.7 million tonnes sold last fiscal year.
• Feedstock Dependency: The feedstock for domestic urea production, natural gas, is predominantly imported. This adds to the overall import dependence for the fertiliser.
• High Consumption: Urea is India’s most widely used fertiliser, with consumption rising from 26.7 million tonnes to 35.7 million tonnes between 2009-10 and 2022-23.
• Environmental Impact: Excessive urea usage contributes to environmental problems such as air and water pollution. Ammonia emissions and nitrate leaching are associated with these environmental challenges.
• Higher Input Costs: Inefficient fertiliser use due to low NUE leads to higher input costs for farmers. They need to apply more fertiliser to achieve desired yields.

Significance of Urea Gold

• Nutrient Enrichment: Urea Gold is a novel fertiliser fortified with sulphur (S). It contains 37% nitrogen (N) and 17% sulphur, addressing soil deficiencies that are critical for crops like oilseeds and pulses.
• Targeted Improvement: The sulphur content in Urea Gold addresses the specific nutrient requirements of oilseeds and pulses, which are crucial components of Indian agriculture and are significantly import-dependent.
• Packaging and Pricing Shift: Urea Gold’s introduction might entail packaging in 40-kg bags, adapting to the preferences of farmers.While exact pricing remains undisclosed, market trends suggest Urea Gold could be priced between Rs 400 to Rs 500 per 40-kg bag.
• Enhanced NUE: The sulphur-coated urea granules in Urea Gold facilitate a controlled and gradual release of nitrogen. This extended nutrient availability improves NUE, leading to reduced fertiliser application frequency and better crop health.
• Sustainable Agriculture: Urea Gold’s dual focus on addressing soil deficiencies and improving NUE contributes to more sustainable agricultural practices. It reduces excessive fertiliser use and associated environmental impact.
• Economic Benefit: The improved NUE offered by Urea Gold has the potential to reduce input costs for farmers, as they can achieve similar or better yields with lower fertiliser quantities.
• Potential Yield Boost: The sustained nitrogen release mechanism of Urea Gold can potentially lead to increased crop yields due to longer periods of vibrant foliage and enhanced nutrient availability.

Potential Hurdles

• Pricing Uncertainty: Lack of clear pricing details for Urea Gold could impact its adoption among farmers.
• Subsidy Disparity: The current additional rates offered by the government may not sufficiently incentivize companies to promote fortified fertilisers like Urea Gold.
• Limited Farmer Incentives: Farmers might perceive fortified fertilisers as more expensive compared to traditional options, leading to reluctance in adoption.
• Distribution Challenges: Ensuring uniform distribution and application of fortified fertilisers presents logistical complexities.
• Regulatory Influence: Regulatory aspects, such as pricing controls and subsidy structures, can affect the feasibility of fortified fertiliser products.
• Awareness Gap: Limited farmer awareness regarding the benefits and correct usage of fortified fertilisers might hinder their willingness to switch.
• Production Scalability: Scaling up fortified fertiliser production to meet demand and ensure availability poses a significant hurdle.

Way Forward

• Price Rationalization: The government could consider revisiting subsidy rates to make fortified fertilisers economically attractive for both companies and farmers. This would encourage the adoption of innovative products like Urea Gold.
• Subsidy Structure: Tailoring subsidies to reflect the enhanced benefits of fortified fertilisers, such as improved NUE and reduced environmental impact, could encourage their adoption.
• Education Campaigns: Launching awareness campaigns about the advantages of fortified fertilisers, like Urea Gold, can educate farmers and dispel misconceptions about their higher costs.
• Field Demonstrations: Organizing on-field demonstrations of the benefits of fortified fertilisers could provide tangible evidence to farmers, boosting their confidence in making the switch.
• Long-Term Perspective: Encouraging farmers to consider the long-term economic and environmental benefits of fortified fertilisers could shift their focus from initial cost concerns.
• Market Diversification: Exploring partnerships with private sector players and agribusinesses to promote fortified fertilisers could enhance market penetration.
• Gradual Transition: Gradually phasing in fortified fertilisers while continuing to offer traditional options at subsidized rates can ease farmers into adopting the new products.

Source: https://indianexpress.com/article/explained/explained-economics/how-to-make-urea-more-efficient-as-a-fertiliser-and-why-thats-needed-8891183/

What is the News ?

The number of bail appeals filed in India’s High Courts surged post 2020, according to the ‘High Court dashboard’ by DAKSH, a think-tank focussed on law and justice system reforms. 

Facts About:

• Bail appeals went up from around 3.2 lakh to 3.5 lakh each year before 2020, to 4 lakh to 4.3 lakh thereafter.
• Consequently, the number of pending bail appeals in High Courts also surged from around 50,000 to 65,000 to between 1.25 lakh to 1.3 lakh.

Reasons for rise in bail appeals post 2020

• One possible reason could be the sharp increase in cases related to the flouting of COVID-19-related lockdown norms during the pandemic. 
• At the same time, pending bail cases piled up as the functioning of the courts was compromised during this time.
• The DAKSH ‘High Court dashboard’ explains that in 77% of regular bail cases, it was not possible to ascertain the Act under which the person seeking bail was imprisoned. 
• It was not mentioned in the e-courts data of various High Courts. An analysis of 23% of cases in which the Act was mentioned shows that the Epidemic Diseases Act, 1897, was ranked fourth, hinting at the possibility of cases surging under this Act as the reason for more bail appeals.
• The database also reveals that the median number of days taken from the filing date to the decision date for regular bail applications was 23. However, for some High Courts, the median days taken for disposal were much higher.

Conclusion

• Delays in resolution have the same effect as denying bail as the accused remains in prison for the duration of their trial,” the DAKSH database argues.
• Finally, data regarding the outcome of bail appeals in High Courts were also missing in many cases. In close to 80% of the disposed bail cases in all High Courts, the outcome of the bail appeal — whether it was granted or rejected — was either unclear, or the outcome was missing.

Source: https://www.thehindu.com/data/data-indian-judicial-data-hides-more-than-it-reveals-in-bail-cases/article67198313.ece