PHI 413 Biomedical Ethics in the Christian Narrative: Case Analysis
Topic 3: Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Bioethics is the study of ethical issues that occur in medicine. The four main ethical principles are beneficence, nonmaleficence, autonomy, and justice. In the provided case study, James is diagnosed with acute glomerulonephritis kidney failure. He presents with high blood pressure and fluid buildup, necessitating temporary dialysis. The attending physician recommends immediate dialysis, but James’ parents, Mike and Joanne, opt first to attend faith healing services. James is later brought in a deteriorated state and will now require a kidney transplant. The purpose of this assignment is to discuss ethical principles as they relate to the case and the Christian worldview.
| Medical Indications
Beneficence and Nonmaleficence |
Patient Preferences
Autonomy |
| · Medical indications include interventions that seek to meet a patient’s needs.
· Beneficence is the moral duty to do good. · Providers have an ethical duty to do good and act in the patient’s best interest (Fowler & Schoonover-Shoffner, 2023). · Nonmaleficence is the moral obligation to cause no harm to the patient. · It requires the healthcare provider not deliberately to harm or injure a patient. · The two principles are applied in healthcare decision-making (Fowler & Schoonover-Shoffner, 2023). · They require healthcare providers to bear in mind the potential risks and benefits of any medical indication in patient care. · In the case scenario, dialysis is a medical indication for fluid buildup. · The physician acted in the best interest of James by recommending dialysis to alleviate the fluid buildup, which could worsen his condition, which upholds beneficence and nonmaleficence. · James’ father demonstrates nonmaleficence when he expresses concerns about Samuel donating a kidney since it can have health consequences. |
· Autonomy refers to a patient having the final decision-making responsibility for their treatment.
· Patient preferences are often based on an individual’s past experiences, cultural beliefs, and values (Fowler & Schoonover-Shoffner, 2023). · Respect for autonomy involves obtaining consent from competent patients to proceed with a medical intervention. · The physician upheld respect for autonomy when he engaged James’ parents and explained the available treatment options to them. · The physician also seeks consent from James’ parents to initiate treatment since James is a child.
· The nephrologist also upholds autonomy by engaging James’ father in discussing having Samuel donate a kidney. |
| Quality of Life
Beneficence, Nonmaleficence, Autonomy |
Contextual Features
Justice and Fairness |
| · Quality of life (QoL) is the level of satisfaction that individuals experience and value about their lives.
· Beneficence and nonmaleficence influence a patient’s QoL. · The provider cannot satisfy the criterion of avoiding harm to the patient and acting in the patient’s best interest without respecting their autonomy (Fowler & Schoonover-Shoffner, 2023). · The physician is concerned about James’ health and QoL and thus recommends immediate dialysis to improve symptoms. · Similarly, the nephrologist proposes a kidney transplant, which would improve James’ condition and overall quality of life, considering that he cannot be on dialysis his entire life. · Mike conveys concerns about the QoL of Samuel if he donates a kidney to James. He is worried that the kidney donation might affect Samuel’s QoL due to potential complications. · |
· Contextual features refer to patient-specific factors like family dynamics, finances, religion, or culture influencing decision-making.
· Religious factors influenced Mike to delay James from having immediate dialysis, and they initially preferred attending faith-healing services. · Justice is an ethical principle that entails maximizing benefits to patients and society while putting emphasis on fairness, equality, and impartiality (Fowler & Schoonover-Shoffner, 2023). · The physician upholds justice and fairness by initiating treatment for James when he returns in a critical state. · James’ was in dire need of dialysis at this point, and the available resources were channeled to his treatment, which upholds justice.
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Part 2: Evaluation
Answer each of the following questions about how the four principles approach 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 in this case? Explain why. (45 points)
| The Christian worldview would define autonomy as an individual with a sound mind having a right to decide what will be done to their body. Christians believe it is not the physician’s responsibility to decide what will be done to an individual (White, 2020). For example, the physician may recommend surgery, but the individual eventually must make the final decision. Autonomy is, to some degree, protective of the Christian. In an ideal world, if a person is treated by a physician who respects the patient’s autonomy, a Christian can make decisions that honor God.
Beneficence and nonmaleficence would be viewed by Christians as the physician acting in the patient’s best interest and avoiding doing harm. Christians believe physicians should uphold the two principles by showing compassion when caring for patients (White, 2020). This follows in the footsteps of Jesus Christ, who was compassionate to the sick in society. Lastly, the Christian worldview would describe Justice as the appropriate allocation of scarce resources. Most of the debates in the media and the government when facing limited healthcare resources are related to the principle of justice. Christians are encouraged to advocate for the enactment of just policies by policymakers (White, 2020). Besides, Christian healthcare professionals are encouraged to act justly when dealing with patients from all walks of life. Christians are further encouraged to act just or fair way, which should characterize their lives. |
- In 200-250 words, answer the following: According to the Christian worldview, how might a Christian weigh and balance each of the four principles in this case? Explain why. (45 points)
| A Christian can weigh and balance the four ethical principles that apply to this case by determining the one that will preserve the patient’s life and help James live a comfortable life with minimal symptoms. Although Christians believe that a person should be granted autonomy with the right to make medical decisions, they also believe that one should not make decisions that will endanger one’s life. Christians believe the decision promoting the best outcome possible should be implemented even though it is not the patient’s final decision (White, 2020). Even though Christians may consider James’ parents as having the responsibility to make the final decisions regarding his treatment, they would expect the parents to make the decision that will help improve James’ health. Therefore, beneficence and nonmaleficence would have a heavier weight. Christians would also expect the parents and the physicians to act in the best interest of James’ health. A Christian may recommend that Mike and Joanne be provided with detailed information on the pros and cons of each medical option (White, 2020). Educating individuals about medical options is a way of respecting their autonomy. This empowers them to make the best treatment option while considering their beliefs and values. Furthermore, a Christian would advocate for healthcare resources to be availed and made accessible to those who need them most to improve their health outcomes.
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Conclusion
Beneficence and nonmaleficence take into account the balance of risks versus benefits and benefits over burdens. Autonomy is upheld when the healthcare provider involves the patient in decision-making and respects the patient’s preferences. The physician and nephrologist upheld beneficence and nonmaleficence by recommending treatment options to improve James’ condition. They also upheld autonomy by engaging Mike and Joanne in discussions about treatment options for James and respecting their decisions. The Christian worldview would recommend allowing James’ parents to make decisions about his treatment but expect them to make the decision that will not endanger his life.
References
Fowler, M. D., & Schoonover-Shoffner, K. (2023). Rising to “The Highest Morals”—The Rich History of Nursing Ethics. Journal of Christian Nursing, 40(2), 86–95.
White, N. (2020). Practicing dignity: An introduction to Christian values and decision making in health care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/home
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Assessment Description
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data by means of the four boxes approach to analyze the case will help you apply the four principles (beneficence, nonmaleficence, respect for autonomy, and justice).
Based on the reading of the “Case Study: Healing and Autonomy” and topic Resources, you will complete the “Applying the Four Principles: Case Study” document by including the following:
Part 1: Chart
This chart will formalize the application of 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 maximum of 500 words, that evaluate how the four principles approach would be applied according to the Christian worldview.
Support your response using only Chapter 3 from the textbook Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care and the Topic 3 Resource “Rising to ‘The Highest Morals’ -The Rich History of Nursing Ethics.”
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.