Healing and autonomy

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

Medical indications are the clinical data that is required to diagnose a patient and the extent of severity relating the medical problem thus determining the treatment options. Beneficence indicates acting with the best intentions in mind while non-beneficence emphasizes on do not harm. The parents of James were acting in his best interests despite the medical indications that James’s conditions would get worse if not treated. They had no intention of harming him and came back when his condition did not improve.

Patient preferences refer to the expressed choice of the patient or the substitute decision maker. Autonomy emphasizes on the right of a person to make his/her own decision (Beever, 2016). James is an underage kid that is 8 years old thus cannot exercise autonomy rights. However, the parents should have consulted James before making their decision despite his age to know whether he was comfortable with their decision. The physician could hardly impact this decision but could have at least talked to the parents.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Quality of life refers to the relevant medical features of the life of a patient before and after the treatment. James condition before treatment was worse but after constantly undergoing dialysis his condition improved. However, he needs a kidney transplant to effectively address his condition and his father is thinking his brother should give him the kidney or they should rely on faith. Based on the previous encounter, the parents should first consult James and listen to his views regarding the issue. The last time they depended on their faith, the condition of James got worse, thus they should act with his best interests in mind and allow him to get a kidney transplant from his brother.

Contextual features determine the legal, social and familial setting that influences one’s medical decisions (Gillon, 2018). The faith of James’s parents that he can be healed through prayers influenced their medical decisions. They are also considering on depending on their faith instead of allowing James to have a kidney transplant from his brother. Justice and fairness emphasizes on equality. The conflict of interest came up when the ideal tissue match was identified as that of his brother. The parents therefore were willing to allow other people including themselves to donate a kidney for James but are not willing for his brother to do so.

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Part 2: Evaluation

Answer each of the following questions about how principlism would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)

According to the Christian worldview, beneficence is the principle that is most pressing. This is because the parents are acting with the best of intentions in mind about their son. They have faith that their son will be healed through intensive prayers. They therefore prefer prayers more compared to treatment because of the faith. We cannot put a blame on them because of the deteriorating health of their son because they acted in good faith and as soon as they noticed his condition was getting worse they brought him back to the hospital.

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)

A Christian can rank the priority of the four principles in such a manner that beneficence comes first then non-maleficence followed by justice and fairness and lastly autonomy. This is because according to Christians, parents should show love to their children by acting in their best interests which is associated to the principle of autonomy. Parents should also ensure that no matter what, they should not harm their children which relates to the principle of non-maleficence (Carr, 2017). Christians are supposed to practice justice and fairness in all their encounters and experiences. Lastly, Christians should also give one another a chance to indicate they thought regarding a certain decision which is associated with the principle of autonomy.

References:

Beever, J., & Brightman, A. O. (2016). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and engineering ethics, 22(1), 275-291.

Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and Professionalism (pp. 45-59). Routledge.

Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for Healthcare Professionals (pp. 31-45). Routledge.