Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.
| Medical Indications Beneficence and Nonmaleficence | Patient Preferences Autonomy |
| · Based on the clinical diagnosis of acute glomerulonephritis in conjunction of Strep A infection with elevated blood pressure, the physician made the recommendation of requiring immediate dialysis (supportive of nonmaleficence). · After delay of care based on parents wishes, the physician made a clear recommendation that would require the child to have a kidney transplant within year with identified ideal match being twin brother (supportive of beneficence). | · Being that is patient underage at 8 years old and unable to legally make medical decisions on his own the parents made all healthcare decisions for him There was never any mention as to what James’ thoughts are/were. All decisions made for further care lies with his parents (supportive of autonomy). · The medical provider showed respect to James’ parents decision to forego dialysis and place their faith in God (supportive of autonomy). |
| Quality of Life Beneficence, Nonmaleficence, Autonomy | Contextual Features Justice and Fairness |
| · Recommendations of a required kidney transplant to improve quality of life (supportive of nonmaleficence). · Patient’s families decision to move James to a faith healing service. This decision was based on witnessing a close friend heal miraculously by prayer (supportive of autonomy). · The enforcement by medical professions to place James on dialysis based on his worsening condition (supportive of beneficence). | · The testing of faith when the choice between proceeding with kidney transplant in order to save James (supportive of justice). · Was it fair to James to postpone treatments based on his parents views; even though he is very young? It is never noted what James thoughts were (supportive of fairness)?
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Part 2: Evaluation
Answer each of the following questions about how the four principles and four boxes approach would be applied:
- In 200-250 words answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)
| In the Christian worldview, all four principles can be specified and weighted as illustrated in the case study presented. The principle of autonomy is specified by James’ parents to forego initial treatment and place their faith in God. The weight of this decision is sometimes considered one of the most important to some Christians as they put their decisions into the hands of God. Medical practitioners do their part and respect these decisions. The principles of beneficence and nonmaleficence are specified by the recommendations set forth by the medical practitioner. In two separate scenarios, the physician made clear diagnoses and treatment plans. As both were weighted, all treatment recommendations were to benefit James and to do no harm to him. The principle of justice was specified at the end of the case study with the recommendation for James’ twin brother to be a donor for him. This predicament is heavily weighted on the parents. Without a new kidney, James is as risk to die. The parents are clearly aware of the ramifications of his quality of life without the transplant. Now, they are faced with another challenge when having to decide what quality of life their other son will endure now living with only one kidney. |
- In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)
| Balancing each of the four principles to ethical decision-making has become a prevailing framework for the care provided in most health care settings (Hoehner, 2020). Ethics is the foundation of most Christian’s belief systems and balancing them can sometimes be a daunting task. The principle of autonomy plays a clear role in the case study as James’ parents exercise this principle when turning to their faith in God. Although, James’ parents were able to deal with autonomy quite easy it was harder for them to balance the principle of justice when confronted with the option of James’ brother being the donor. One way to balance each of the four principles is to fully understand the role that a person may have in the medical decision-making and to determine the level at which all four principles are applied. This can be illustrated in the case study when referencing beneficence and nonmaleficence. The physician that was handling the case was able to exhibit his duty to show that he could be of a benefit to the patient and family as well as do not harm in making recommendations to proceed with treatment. As a devout Christian it becomes difficult at times to see all aspects because most are very patient-centric but one needs to fully understand and recognize the main features of principlism that assist in making the difficult-medical decisions. Knowing that while the four principles are universal they are not absolute.
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References:
Hoehner, Paul, J., (2020). Practicing Dignity, An Introduction to Christian Values and Decision Making in Health Care, Biomedical Ethics in the Christian Narrative, Chapter 3. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3.