This article discusses the application of the four principles of bioethics in a case study. It explores the importance of beneficence, autonomy, nonmaleficence, and justice in healthcare decisions. The case study involves a patient in need of a kidney transplant and the ethical considerations surrounding the decision-making process.
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RunningHead:PRINCIPSLISMOFBIOETHICS 1 Applying the four principles: Case Study Student’s Name: University Affiliation:
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RunningHead:PRINCIPSLISMOFBIOETHICS 2 INTRODUCTION Principalism encompasses the four bioethical approaches which aim at ensuring the wellbeing of patients while causing no harm and considering theneed.Intheancientdaysuponcompetitionofmedicalschool,a practitionerwastotakeanoathofHippocratesknownasthefatherof medicine to protect life and never to administer a drug that could cause harm to a patient. However, with the advancement in the medical field, it was only ideal for the development of the four-principle approach to ensure patients are protected. Data on the four principles based on the case study Medical indications Beneficenceand Nonmaleficence Patient Preference Autonomy 1.Beneficence ï‚·Due to James condition of acute glomerulonephritis accompanied with elevated blood pressure together with fluid buildup, an immediate dialysis was required to help stabilize his condition. ï‚·Upon return from the healing service, James parents were forced to allow a dialysis be done since his condition had seriously deteriorated ï‚·James condition stabilized as a result of the dialysis however a kidney transplant was required within the year. 2.Nonmaleficence ï‚·In the case study Mike struggles to decide whether to have Samuel donate a kidney 1.Autonomy ï‚·Mike and Joanne decide to forego the dialysis and place their faith in God. This decision was made after they witnessed a close friend who had suffered from stroke gain mobility after she was prayed for in a healing service. ï‚·They also agree to return to the hospital within the week in the hopes James would have been healed from the healing service.
RunningHead:PRINCIPSLISMOFBIOETHICS 3 to the brother or wait upon the Lord to perform a miracle. Here it is a matter of life or death. Quality of life Beneficence, Nonmaleficence and Autonomy Contextual Feature Justice and Fairness 1.Beneficence Owing to the state of James condition, the physician suggested an immediate dialysis to the parents so as to help improve his health. In order to completely stabilize James health, his twin brother who is his perfect match is to donate him one of his kidneys. 2.Nonmaleficence Mike has fears on the consequences of Samuel having to donate one of his kidneys to his brother and hence he is struggling to decide whether to allow kidney donation from Samuel or wait upon the Lord. He also fears what if his faith fails? what would be the effect on James? He concludes by saying it is now a matter of life or death. 3.Autonomy After a meeting with James neurologists who informed them of James’ perfect match for kidney donation, the parents are now left to decide whether to go on with the donation or to put their faith in God one more time. James had the right to receive dialysis services during his first visit in order to improve his health. James parents had the right to forego dialysis during their first visit at the expense of their son’s health The physician had no right to force James’ parents to allow him undergo the dialysis however much it was of importance. He had to obtain their consent. By James parents agreeing to subject Samuel to donate one of his kidneys, will they be violating his rights? Evaluation
RunningHead:PRINCIPSLISMOFBIOETHICS 4 AccordingtotheChristianworldview,whichofthefour principles is most pressing in this case? Explain why. (45 points) Inthiscasestudy,accordingtotheChristianworldview,themost pressing principle is beneficence. This principle is concerned with improving the wellbeing of an individual's health. In the case study, James' neurologist isconcernedwithimprovinghishealthandrecommendsforakidney transplant in the year. The only perfect match for James is his twin brother which leaves his parents at a confusing state whether to subject their other son to kidney donation or not. According to Genesis one and two, God is the creator and has authority over all he created. In allowing Samuelwho falls under the vulnerable group and has no autonomy(Cunha and Garrafa 2016) to donate a kidney the parents most probably fear the harm that could follow the other twin. According to Veatch (2016) kidney transplants from paira today has been considered safe and succesful . Based on Beauchamp and Childress bookonprinciplesofbioethics, utilitybeneficence requiresthe practitioner to weigh between benefits and harm to produce the best result. In the case study, the practitioner recommends Samuel as a donor after weighing the benefits and harm that is likely to occur and decides on saving James life. However, the parents do not come to terms with subjecting the other twin to kidney donation. Although it may seem unpleasant to James' parents to allow Samuel to donate a kidney due to their faith in miraculous healing, it is however of the best interest for their ailing son.
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RunningHead:PRINCIPSLISMOFBIOETHICS 5 According to theChristianworldview,how might a Christian rank the priority of the four principles? Explain why. (45 points) In a Christian worldview, the four principles of bioethics can be ranked differently depending on one's faith. The most favored ranking could follow thefollowingorder.Firstisautonomy,justice,beneficenceandfinally nonmaleficence. According to a journal bySacristánillness in itself is a state ofdiminishedautonomyandhenceagoodpatient-doctorrelationshipis needed and should encompass a degree of medical paternalism (Sacristán, 2013). The physician is entitled to disclose all risks and benefits involved in whatever process is to be carried out.According to scholar Beauchamp describes an autonomous person as one with the ability to act on a particular deliberated plan (Beauchamp & Childress, 2013) As a Christian one has the privilege to decide on the actions they take. Second in rank is justice, every individual has the right to receive the scarce medical resources according to the need. According to Beauchamp andChildressjusticealsoinvolvesrespectforpeople'srightsaswellas morally acceptable laws. In taking into consideration others rights, morally acceptable laws should be considered. According to Mc Cormick TR (2008) in a case where a child's parents who are members of Jehovah witness refuse blood donation, the physicians have the responsibility to use federal laws to save the child's life
RunningHead:PRINCIPSLISMOFBIOETHICS 6 Thethirdisbeneficence,thisisthekeyprincipleforhealthcare providers. According toVeatch (2016),the principles should provide the best services to enhance the well-being of their patients. As a Christian one will expect to receive the best services that will enhance their wellbeing (Ten Have, 2016). Finally, just like everybody else who seek medical services, a Christian expectsnoharmfromthemedicalpractitioner.Thisprinciplesitsona balancebetweenwhatismorallyacceptableandwhatthedutyofa practitioner is. According to the article the place of principles in bioethics by ThomasCormick(2013),therearefourconditionsthatapplytothis principle ; action to be taken should not be wrong, only good effects should be intended and not bad although they are unforeseen,bad effects should not be used to achieve a good effect and finally the good effects of the action should outweigh the bad effects. CONCLUSION Principalism of bioethics has been a topic for debate for over thirty yearswithseveralcritiquesontheprinciplesofbioethics.However, Beauchamp and Childress did not have the intention of proving principalism as a moral theory but instead, they try to show the importance of these principles in obtaining ethical resolutions. The principles are still considered of importance in the medical field with the advances and research being carried out so as to protect patients as well as participants in research.
RunningHead:PRINCIPSLISMOFBIOETHICS 7
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RunningHead:PRINCIPSLISMOFBIOETHICS 8 REFERENCES Beauchamp T, Childress J. (2013).Priciples of biomedical ethics.New York: Oxford University Press. Cunha, T., & Garrafa, V. (2016). Vulnerability: a key principle for global bioethics?.Cambridge Quarterly of Healthcare Ethics,25(2), 197-208. Sacristán, J. A. (2013). Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients.BMC medical informatics and decision making,13(1), 6. Ten Have, H. (2016).Vulnerability: challenging bioethics. Routledge. Veatch, R. M. (2016).The basics of bioethics. Routledge. McCormick,T.R.(2008).EthicalissuesinherenttoJehovah's Witnesses.Perioperative Nursing Clinics,3(3), 253-258.