Applying the Four Principles: Case Study
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Part 1: Chart (60 points)
Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information using bullet points or a well-structured paragraph in the box. Gather as much data as possible.
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Ø Kidney malfunction
Ø Acute glomerulonephritis
Ø Fluid retention
Ø Dialysis
Ø High blood pressure
Ø James is a minor under his parents’ custody
Ø The parents decide to forego dialysis since their faith in God is more elevated
Ø They take James to a healing service
Ø The child needs hospital care because of his deteriorating condition. James also needs a transplant
Ø After going back for dialysis, he stabilizes even though he still needs a donor in a year
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
Ø The doctor contends that the minor needs dialysis to avert further damage
Ø The parents, on the other hand, want to attend a healing service
Ø After the situation worsens, the minor might need permanent dialysis
Ø A transplant within a year is needed
Ø The doctor asserts that James’s brother might be a perfect donor since he is a match
Ø The father, as a stalwart Christian, asks why God is ignoring him
Ø The parents must decide whether to use Jame’s sibling as a donor
Ø Even though it looks great for James, what does the sibling think?
Ø Samuel is still a minor (8 years), meaning he has a whole life ahead of him.
Ø The father’s reasoning evolves around life and death, needing more conviction
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)
There may be conflicts between the four postulations in establishing the one to be prioritized. Nonetheless, founded on the evaluation, the four philosophies are vital for health and welfare of James. However, in the outlook of Christians, autonomy has more weight than other principles. Autonomy provides everyone self-determination, freedom, and independence to choose the best without influence from an outside party except God (Varkey, 2021).). Thus, healthcare professionals must allow their patients to make decisions without coercing or influencing them. In this case, since James is a minor, Mike and Joanne have the autonomy to select the best mode of therapy for their son. Even though the physician disagrees with the parent’s decision, little choice is left. The doctor does strive to influence their miracle beliefs. If a Christian has a specific view that may limit health provision, the physician must provide autonomy to the decision.
Further, the beneficence principle can also be weighted in the Christian worldview. According to the parent’s beliefs, they are acting in the best interest of their child. Initially, they thought that dialysis would be painful and believed attending a healing service was more effective since a church member was healed in one of the services. However, after the condition worsened, they were forced to return their son to the hospital. The situation is out of hand; the only solution is a kidney transplant, and the perfect match is James’s twin, Samuel. The parents are in a dilemma since they have to think about the future of both children.
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)
A Christian can arrange these principles in a specific order. Nonmaleficence that promotes less injurious processes may be ranked at the apex. This postulation guarantees no intentional harm toward an individual. As parents, Mike and Joanne should have weighed the best option for their child before rushing to make a decision that harmed their child. The second principle is justice and fairness. People are entitled to advancements in their fields of interest. In this case, the doctors were willing to use their best upgrades to treat James. However, the parents ignored this principle. The parents and child would have gained from dialysis, and the transplant may have been avoided. In Proverbs 16:11, “The Lord demands fairness in every business deal. He established this principle.” (The Living Bible). This means that both the physicians and parents must act in a fair manner that will benefit James.
Further, beneficence ranks third, and it promotes intent toward patients (Strickland & Stoops, 2018). Thus Christians must choose the best for themselves and their friends and relatives. The principle is against anybody, including Christians who fail to seek medical attention because of their faith. This may lead to severe illness, like in James’s situation or death. Even though vital, autonomy can be ranked last by Christians. Influence from the outside world is a principle that Christians shun and may lead to detrimental health outcomes.
References:
Strickland, J. C., & Stoops, W. W. (2018). Evaluating autonomy, beneficence, and justice with substance-using populations: Implications for clinical research participation. Psychology of Addictive Behaviors , 32 (5), 552.
The Living Bible. (n.d.). Living Bible (TLB) – version information – biblegateway.com. Retrieved February 25, 2023, from https://www.biblegateway.com/versions/The-Living-Bible-TLB/
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice , 30 (1), 17-28.
Applying the Four Principles: Healing and Autonomy Case Study Sample 2
Applying the Four Principles: Case Study
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Healthcare professionals adhere to the ethical principles of beneficence and nonmaleficence while providing healthcare services to their patients. Beneficence holds that medical professionals should aim at doing good to their patients (Varkey, (2021). The principle of beneficence is applied in the scenario when the nephrologist advises Mike and Joanne to consider dialysis during the first visit since it would result in the best health outcomes for James. On the other hand, nonmaleficence requires healthcare professionals to avoid exposing their patients to potential harm (Varkey, 2021). In the scenario, the nephrologist protected James from potential harm that would be caused by kidneys from donors who were not compatible.
The principle of patient autonomy gives patients the right to make all significant decisions during diagnosis and treatment without being interrupted (Zhang et al., 2021). In this case, the client is a minor with no consenting capacity. Thus, the parents have a right to make all significant decisions concerning their son’s treatment. Patient autonomy is demonstrated by the nephrologist respecting parents’ treatment decision even if it would not give the best results.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
In improving the patient’s quality of life, the nephrologist adhered to the three ethical principles, including beneficence, nonmaleficence, and autonomy. The nephrologist demonstrated beneficence by proposing dialysis as the best treatment intervention for James. Nonmaleficence was demonstrated by informing the parents about the adverse effects associated with receiving a kidney from a non-compatible donor. Lastly, the nephrologist demonstrated autonomy by respecting the patient’s treatment decision. Bombard et al (2018), reported that patient autonomy emphasizes respecting a patient’s choices and preferences during treatment.
Justice and fairness emphasize the equal treatment of all patients irrespective of their socio-economic status. The nephrologist adhered to these ethical principles by giving James an equal opportunity to access quality treatment services.
Part 2: Evaluation
In 245-250 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)
The four ethical principles are applicable in this scenario according to the Christian worldview. The first principle is justice and fairness which emphasize the equal treatment of all patients without any form of discrimination. Just like God treats all individuals equally and fairly, healthcare providers should treat all individuals equally and allow them access to quality healthcare services irrespective of their socio-economic status or ethnicity. Therefore, the nephrologist should give James equal opportunities to utilize a dialysis machine and access quality healthcare services, which would improve his health outcomes and quality of life. The second principle is beneficence. The Bible instructs individuals to love their neighbors as they love themselves. In this case, the nephrologist should love James as he loves himself. Thus, he should advocate for dialysis since it is an effective treatment intervention for individuals diagnosed with kidney disorders (Romagnani et al., 2019). This treatment intervention would prevent the deterioration of James’ health condition, improving his overall health status. The third principle is nonmaleficence, which warns healthcare providers from causing harm to others. Just like mankind was given the responsibility to take care of the rest of God’s creation, healthcare providers should take care of the patients by preventing potential harm. Consequently, the nephrologist should avoid causing harm to James by giving him kidneys from non-compatible donors. The last principle is patient autonomy, which gives Mike and Joanne the right to make decisions concerning their son’s treatment. In this scenario, patient autonomy allows the parents to demonstrate their strong faith.
In 245-250 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
The four ethical principles utilized in this scenario, including beneficence, nonmaleficence, patient autonomy, and justice and fairness can be balanced based on the Christian worldview. First, a Christian should adhere to the ethics of patient autonomy, which gives patients the right to make all major decisions regarding their treatment without being influenced by healthcare providers. This principle is important for Christians since it allows them to demonstrate their faith and trust God for healing. Therefore, Christians who have faith in God can wait for a healing miracle without being forced to undergo medical procedures or treatment therapies such as dialysis. Furthermore, a Christian can adhere to the ethical principle of beneficence. As a healthcare provider, a Christian should focus on benefiting the patients by providing them with high-quality patient care and improving health outcomes (Varkey, 2021). Thus, beneficence is important since is life-saving, protecting the God-given gift of life. Thirdly, a Christian can adhere to the ethical principle of nonmaleficence, which requires healthcare providers from exposing patients to any form of harm (Varkey, 2021). Hence, as a Christian, a healthcare provider should prevent patients from potential harm that might result in adverse health outcomes. This ethical principle is important since it aligns with biblical teachings that warn people from causing suffering to others. Lastly, Christians need to adhere to the ethical principle of justice and fairness. By treating others equally and fairly, Christians can give equal opportunities to all individuals to access medical care, resulting in positive health outcomes.
References
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science , 13 (1), 1-22.
Emanuel, E, J., Persad, G, Upshur, R., Thome, B., Parker, M., & Glickman, A, et al. (2020). Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med ; 382(21):2049–55.
Romagnani, P., Remuzzi, G., Glassock, R., Levin, A., Jager, K. J., Tonelli, M., … & Anders, H. J. (2019). Chronic kidney disease. Nature reviews Disease primers , 3 (1), 1-24.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice , 30 (1), 17-28.
Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: a comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics , 22 (1), 1-8.
Applying the Four Principles: Healing and Autonomy Case Study Sample 3
Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Patient’s Spiritual Needs: Case Analysis” case study, fill out the relevant boxes below. Provide the information utilizing bullet points or a well-structured paragraph in the box. Gather as much data as possible.
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Beneficence and nonmaleficence are fundamental ethical principles considered during healthcare delivery and treatment. The ethical principle of beneficence states that healthcare providers should aim at benefiting their patients by providing quality and safe health care (Varkey, (2021). The nephrologist adhered to this ethical principle by advising Mike and Joanne to consider dialysis during the first visit since it was the best intervention for James at this time. Additionally, the nephrologist advised James’ parents to consider a kidney transplant during the second visit since James’ health had deteriorated. The two proposed interventions, including dialysis and kidney transplant, would improve James’ health condition. Nonmaleficence states that medical professionals should focus on reducing potential harm during care delivery (Varkey, 2021). The nephrologist rejected kidneys offered by various willing donors, including James’ parents and friends. Kidneys from these donors would not match James’ tissues, resulting in adverse reactions.
Patient autonomy states that patients have the right to decide on their diagnosis and treatment processes (Zhang et al., 2021). Medical professionals should not influence patients while making decisions concerning their treatment. However, patient autonomy is replaced with parent autonomy if the patient is a minor and unable to make significant decisions regarding his or her treatment (Kuruvilla, 2017). The nephrologist respected the parent’s autonomy, respecting Mike and Joanne’s decisions regarding their son’s treatment even if it was not the best decision. The nephrologist did not oppose James’ parents’ decision to take their son to the healing service and trust God for a miracle.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
The major ethical principles, including beneficence, nonmaleficence, and autonomy, were considered while providing health care services to James to improve his quality of life. First, the nephrologist adhered to the ethical principle of beneficence by proposing dialysis as the best treatment intervention during the first visit and transplant as the best treatment therapy during the second visit. Secondly, the nephrologist adhered to the ethical principle of nonmaleficence by pointing out dangers that would arise upon receiving a kidney from proposed donors due to a mismatch. The nephrologist also considered patient autonomy by respecting Mike and Joanne’s decision to take their son to a healing service and trust in God for healing. Respecting patients’ preferences, values, and interest facilitates their compliance with the treatment intervention, improving health outcomes and quality of life (Bombard et al., 2018).
Finally, ethical principles of justice and fairness were considered during James’ treatment. Healthcare professionals should embrace equity and fairness while treating their patients. The limited medical resources should be distributed equally to all patients irrespective of their social-economic status (Emanuel et al., 2020). The nephrologist treated James fairly and equally to other patients by giving him a chance to use scarce dialysis machines during the first visit.
Part 2: Evaluation
In 245-250 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)
Ethical decisions are part of medical practice where healthcare practitioners require evaluating different factors concerning medical treatment procedures before the process starts. The case study shows that the autonomy principle has been part of the treatment dilemma where all involved parties in a treatment procedure need to critically evaluate the situation to engage in an informed decision-making process (Varkey, 2021). The physician believes that James needs to engage in dialysis to prevent the adverse effect of his kidney condition through the parents finds the option a temptation towards their Christianity beliefs. However, one thing that they forget is that James failing to undergo dialysis and a Kidney transplant will deteriorate his current conditions. Hence, using the Christianity lens, there is a need to ensure that faith and actions work together for better medical outcomes. That shows that Mike and Joanne have been misinterpreting what the Bible teaches for the longest time since; they have been inclined more toward faith and forgetting that action towards the healing process also matters. For James’s case study, the most conflicting principles are the non-maleficence and beneficence principles. While Mike tries to weigh out the issue of kidney transplants for James’s overall positive health outcomes, the brother might also face risk as a donor, a situation that Mike and Joanne may live to blame themselves forever. The Bible teaches Christians about the need to ensure that they do not harm other people. In such a case, the principle of beneficence comes in with the support of Christian beliefs where the physician will need to ensure that the kidney donor and the patient will not experience any harm during the treatment process. Additionally, the healthcare provider should adhere to the ethical principle of justice by allow James to use dialysis machines to improve his health outcomes.
In 245-250 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
Christians should focus on balancing the four ethical principles, including autonomy, Nonmaleficence, justice and fairness, and beneficence since they are beneficial to human beings. The ethical principle of patient autonomy is important since it allows Christians to make treatment decisions, including trusting God for healing. Through strong faith in Jesus, Christians can receive healing and good health. Secondly, the ethical principle of nonmaleficence is important since it prevents healthcare providers from exposing Christians to any form of harm. This ethical consideration is important since the Bible warns the Christians against causing harm to others. Furthermore, the ethical principle of beneficence is important since it emphasizes on doing good to others. Similarly, the Bible states that Christians should love their neighbors as they love themselves and strive to do good to them. Finally, the ethical principle of fairness is significant. It insists on treating all patients fairly and distributing limited medical facilities to all patients without discriminations. Similarly, the Bible advocates for fairness. It states that all human beings are equal in the eyes of God. Therefore, all the four principles should be applied in this case to ensure James receives quality care, improving his health outcomes and quality of life.
References
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science , 13 (1), 1-22.
Emanuel, E, J., Persad, G, Upshur, R., Thome, B., Parker, M., & Glickman, A, et al. (2020). Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med ; 382(21):2049–55.
Kuruvilla, H. G. (2017). Autonomy and Patient Care: To What Extent Should Children Make Their Own Decisions? Bioethics in Faith and Practice , 3 (1), 2.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice , 30 (1), 17-28. Applying the Four Principles: Healing and Autonomy Case Study
Wiles, K., Chappell, L., Clark, K., Elman, L., Hall, M., Lightstone, L., … & Bramham, K. (2019). Clinical practice guidelines on pregnancy and renal disease. BMC nephrology , 20 (1), 1-43.
Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: a comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics , 22 (1), 1-8. Applying the Four Principles: Healing and Autonomy Case Study
