This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.
Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
Part 1: Chart
This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, non maleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principal-ism would be applied according to the Christian worldview.
Remember to support your responses with the topic study materials.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Biomedical Ethics
The main purpose of this assignment is to explain and look into the four ethical principles
| Medical Indications
Beneficence and Non-maleficence |
Patient Preferences
Autonomy |
| Ø Medical indications define the clinical data that is necessary for patient diagnosis. It is also helpful in showing the extent to which the medical problem is severe (Carreon et al., 2012). Therefore, it helps in the determination of the most suitable treatment options.
Ø Beneficence involves the care provider balancing the treatment benefits against the involved costs and risks. It entails the provider working with the best intentions in care provision. Ø The principle of non-maleficence means one should avoid any cause of harm. Ø James needs a kidney transplant from a person with matching tissues. Ø The failure of his kidney is a result of complications related to a throat infection he had suffered. In his state, he needed immediate interventions to prevent his health from deteriorating. Ø Since there was a contradiction between his parents’ belief and hence delayed treatment, his condition moved from bad to worse, and as a result, he needed a kidney transplant. Ø Beneficence; the physician in charge believed and was sure that James needed immediate dialysis so that they could prevent further injury to the kidney. Ø On the other hand, James’ parents believed in God and thought their son should visit a healing service to get better. They had friends who got better after attending these services, and one was healed after experiencing a stroke. Therefore, they thought that if they took their son to the healing center, God would heal him, and there will be no need for dialysis (GCU, 2019). Ø Even though the two parties, James’ parents and the physician, did not agree on what was best for James, they all had the best interest at heart. Ø Non-maleficence; from this principle, the physician in charge must promote the health of his patient, and he is aware that he needs to undergo dialysis for his kidneys to restore their functions (Orr, 2015). Ø The physician is not trying to harm James as he understands that what he needs is dialysis. Ø The parents also believe that their God is a healing God, and if James visits the center, he will get better. Neither the parents nor the physician intends harm to the patient, and they just have different beliefs. Ø The physician wants the best for his patient, but he also respects the decision of the parents. He does so because he probably knows that they are doing what they believe is best for him. |
Ø The preference of a patient refers to the patient’s expressed choice or that of their decision-makers.
Ø The principle of autonomy emphasizes the obligation of a caregiver to respect other people’s decisions concerning their lives. Ø Since James is not an adult but an underage child of eight years old, he cannot practice his autonomy rights. Ø Therefore, in this case, it is the parents that make the necessary medical decisions for him. Ø The doctor did his part and explained everything on the patient’s condition to the parents. Ø I believe the physician played his part and explained to the parents all the essential information, including the effects of delayed treatments. Ø Therefore, he allowed James’ parents to decide independently on their child’s behalf. Ø Therefore, it is fair to conclude that after talking to the physician, the parents were aware that their child needed immediate care. It is for that reason that the physician advised for immediate dialysis. Ø They, however, opted to skip the medical dialysis process and take him to a healing service. Ø The hospital and physician respected the parent’s autonomy as they were allowed to decide what they believed worked best for their child. Therefore, even though they came back later with a patient whose health had deteriorated, it was their choice. |
| Quality of Life
Beneficence, Non-maleficence, Autonomy |
Contextual Features
Justice and Fairness |
| Ø Quality of life is the relevant features of a patient’s medical life before and after receiving treatment.
Ø Before treatment, James’ condition was terrible, but it improved after going through dialysis. Ø However, it is essential to note that he needs a kidney transplant within the year so that he can finally adequately address his condition. Ø His father is contemplating between his brother donating him one kidney or relying on faith once more to find a healing miracle. Ø However, from their previous experience at the healing service, it would be best to consult with James about the available options. Doing so would give James a chance to give his view and thoughts even though he is only 8. Ø When the parents depended on their faith before dialysis, James’ health worsened, and it is for this reason that they should consult and give him a chance to present his opinion. Ø As much as they are the decision-makers on his health, their last decision almost killed him, and that is why before they decide anything on the transplant, they should sit with him and explain to him what is going on, and the available options are. |
Ø Contextual features are the determinants of the social, familial, and legal settings that impact a person’s medical decisions (Sørensen et al., 2012).
Ø Justice refers to equality and fair medical services distribution. Ø The parent’s faith that James could receive healing through prayers had a lot of influence on their decision-making process. Ø From the beginning of the scenario, James’ condition was not bad, and all he needed was dialysis to improve his health. Ø However, after his stay at the healing service, his condition worsened, and he needed to have a kidney transplant. Ø In addition to this, the parents are also contemplating believing in their faith to heal James instead of giving him a chance to have his brother’s one kidney. Ø His parents and other church members had offered to donate their kidneys, but unfortunately, they were not his match. Ø From this scenario, James is receiving the fairest benefits distribution. He does so because he probably knows that they are doing what they believe is best for him. |
Part 2 Evaluation
According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why
In the case study, the most pressing issue is James’ parents are trying their best to prove the faith they have in God. According to them, if they do not follow the doctor’s instructions and take James to a healing service, he will be healed. It is okay to have faith in their God, and the bible says in the book of Psalms 2:12, “Blessed are all they that put their trust in him.” In the case scenario, beneficence would be the most weighted. It is so because, in the world of Christianity, parents are obligated to protect and act in the best interest of their children. In the case, James’ parents have faith and believe that God would heal their son. It is for that matter that they opt not to take James to a healing service. They believed that through intensive prayers, their son would be healed as a result; they preferred prayers to treatment (Choudry, Latif & Warburton, 2018). They cannot be blamed for their son’s worsened situation as they acted in good faith. In addition to this, when they noticed the change in James and he had worsened, they brought him back to the hospital. The principle of autonomy respects the patient’s right to make medical decisions. Respecting James’ parent’s decision on trusting in their God showed and demonstrated autonomy. They made their choice on what they felt was right for their son, and they followed. James’ parents were responsible for his medical decisions. The non-maleficence principle would weigh next. The principle focuses on causing no harm to the patient. James going through a kidney transplant, is still okay from the Christian perspective. Christians believe in organ donation as, according to them, it is a God-given gift.
According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why
In the Christianity world, I believe they would balance the principles so that the beneficence principle will come first, followed by non-maleficence. Justice, fairness and autonomy would be last. It is so because, in the world of Christianity, it is the responsibility of the parent to love their children always and ensure that they act in the children’s best interest. From this perspective, it is related to the autonomy principle. In the case study, the parents were responsible for the decision making process on James’ medical matters. Since James was a child, it is the parents who decide on what is best for the children by making the right decisions. It is the responsibility of James’ parents to show him love and protect him. Secondly, all parents should ensure that no matter what they do or believe in, they should never harm their children. This is related to the non-maleficence principle. Even though James’ parents took him to a healing service and his health worsened, they believed in God’s miraculous healing. Their intentions were clear, and they meant no harm to James. In all the encounters of Christians, they should always practice fairness and justice no matter what occurs (Molina et al., 2015). Lastly, a Christian must give other people chances to give their opinions on individual decisions. This is another aspect related to the autonomy principle. In the case scenario, James’ parents were his primary medical decision-makers. However, their first decision almost killed James. Therefore, before they decide regarding the transplant, it would be fair and just to allow James to give his opinion and what he thought on the transplant matter or believe in a miracle-working God.
References
Carreon, L. Y., Djurasovic, M., Canan, C. E., Burke, L. O., & Glassman, S. D. (2012). SF-6D values stratified by specific diagnostic indication. Spine, 37(13), E804-E808.
Choudry, M., Latif, A., & Warburton, K. G. (2018). An overview of the spiritual importance of end-of-life care among the five major faiths of the United Kingdom. Clinical Medicine, 18(1), 23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330909/
Grand Canyon University (GCU), (2019). Case Study: Healing and Autonomy. PHI-413V
Grand Canyon University (GCU) (n.d.) Lecture notes. PHI-413V Lecture 3. Phoenix Az.
Molina, A., Moliner, C., Martínez-Tur, V., Cropanzano, R., & Peiró, J. M. (2015). Unit-level fairness and quality within the health care industry: A justice–quality model. European Journal of Work and Organizational Psychology, 24(4), 627-644.
Orr, R. D. (2015). Incorporating spirituality into patient care. AMA Journal of Ethics, 17(5), 409-415. https://journalofethics.ama-assn.org/article/incorporating-spirituality-patient-care/2015-05
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC public health, 12(1), 80.
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