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 of principlism.
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 principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principalism 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.
Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
Expert Answer and Explanation
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.
Beneficence and Nonmaleficence
|Beneficence focuses on how the patient can positively benefit by interacting with the medical practitioner. The benefits include treatment, care delivery, and medication prescription to alleviate the pain and other issues affecting the patient. Nonmaleficence on the other hand entails the measures that can be taken by the doctor to prevent harm either by intentional or unintentional. These principles are evident in the case where the doctor informs the parents who have the power of attorney for the child of the best modes of medication to mitigate the severity of the symptoms on the child. The doctor also takes measure to prevent harm by telling the parent that they should consider visiting the facility in the event that their decision to focus on prayer alone does not lead to the outcome they want.||The principle of autonomy is controversial as it binds the doctors, despite having professional knowledge, to abide by the needs and requirements set forth by the patients. The doctor has to conform to the needs of the patients and offer medical care that is aligned with how the patient wants. The most important attribute of care is the preference of the patient even when the doctor is against the decision. Autonomy is evident in the care where the parents decide to take the hold for prays as opposed to following the doctor’s advice of offering dialysis treatment. The parents are now faced with the decision on whether to use the twin brother as the donor.|
|Quality of Life
Beneficence, Nonmaleficence, Autonomy
Justice and Fairness
|Patient car can have two outcomes depending on the mode of medication, patient decision and availability of resources. In order to ensure the quality if life and the overall sustenance of the patient from harm, there is need for collaboration. The patient is responsible for the provision of consent through autonomy which will facilitate the delivery of care. The doctor on the other hand is responsible for beneficence through administering quality care and other medical benefits. The final attribute for quality of care is the combined care and prevent harm through the use of nonmaleficence. These processes are identifiable in the case and the utilization of each process leads to the quality of life. Failure to implement one strategy led to the child needing a kidney transplant.||Justice and fairness are critical towards care delivery and equality of care. The doctor demonstrated justice and fairness by ensuring all the information required to treat the child was said on time and there was no discrimination of age or spirituality.|
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)
|The Christian worldview focuses on the need to safeguard one’s life and as human beings were made in the image and likeness of God. All human beings are subject of the laws and rules provided in the bible and should make decisions based on the teaching. The four principles hold different weights on the Christian worldview in reference to the case of the twins and the Christian parents (Saad, 2018). The suffering that the patient would be subjected to would be immense leading to additional suffering of the mother who don’t have the financial capacity to meet the overall obligations. The moral obligation lies with both the patient and the doctor where the patient is to offer advice while the patient to choose the desired medication for their condition. In this light, the principles weights from nonmaleficence, beneficence, autonomy and then justice and fairness. Nonmaleficence holds much weight as it addresses the aspect that human beings should be protected at all times. The doctor and the parents should focus on coming up with a means to ensure less suffering among the patient (Walker et al., 2017). Beneficence should also be in line with the creation of a proper measures to ensure the safety of the patient and prevent further harm.|
2. 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)
|There is need to strike a balance between the four principles and ensure that the Christians in need of healthcare have a basis for making the decisions. One of the key teachings about Christianity is that people should act both with a moral perspective and also to the interest of those around them (McCormick, 2013). To create an effective balance, an informed order should be put in place and ensure all the key processes and achievements are attained. To begin with, the first principle would be beneficence as it focuses on ensuring that no harm befalls the patient by offering suggestion and recommendations, the second would be autonomy where the patient can decide whether to follow the instructions of the doctor or make their own (Veatch & Guidry-Grimes, 2019). The third principle is that of nonmaleficence which requires the doctors to refrain from causing harm to the patients. The final principle is justice and fairness where the provision of medical care should be in line with the equality and fairness for all the patients regardless of age, gender, or racial affiliation (Visagie et al., 2019). These processes re important as they can be used to determine the best decision regarding a dilemma or challenging medical decision. Doctors and patients should be aware of these roles to ensure the adherence to the Christian balance and proper medical care.|
McCormick, T. R. (2013). Principles of bioethics. Ethics in medicine. Retrieved 4 March 2020, from https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/articles/principles-bioethics
Saad, T. C. (2018). The history of autonomy in medicine from antiquity to principlism. Medicine, health care and philosophy, 21(1), 125-137.
Veatch, R. M., & Guidry-Grimes, L. K. (2019). The basics of bioethics. Routledge.
Visagie, R., Beyers, S., & Wessels, J. S. (2019). Informed Consent in Africa–Integrating Individual and Collective Autonomy. In Social Science Research Ethics in Africa (pp. 165-179). Springer, Cham.
Walker, J., Lovett, R., Kukutai, T., Jones, C., & Henry, D. (2017). Indigenous health data and the path to healing. Lancet, 390(10107), 2022-2023.
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