Ethics, Discrimination, and Dignity: A Shared Institutional Failure in Indian Healthcare

Abstract

Social position shapes healthcare access and experience in India, while Accredited Social Health Activists often work under insecure and weakly protected conditions. This perspective argues that patient-facing mistreatment and worker-facing precarity reflect linked accountability gaps rather than separate ethical problems. Evidence from childbirth care, caste- and class-linked waiting-time inequities, community health worker policy, and public insurance implementation shows that formal access does not necessarily ensure accountable care. Existing reforms have expanded standards, financing, ethics training, and digital systems, but program intent alone cannot ensure remedy when patients or workers experience harm. Dignity should therefore be treated not only as an ethical aspiration, but as a measurable, auditable, and enforceable health-system function.