Case Study Analysis: Applying the Four Principles in Healthcare Ethics

This assignment presents a case study focused on biomedical ethics, specifically examining the application of the four principles: autonomy, beneficence, nonmaleficence, and justice. The case involves a child, James, facing kidney failure and the ethical dilemmas surrounding his treatment options, including dialysis, faith-based healing, and a potential kidney transplant from his twin brother, Samuel. The assignment is divided into two parts. Part 1 requires filling out a chart based on the case study, gathering data related to medical indications, patient preferences, quality of life, and contextual features. Part 2 involves answering questions about how principlism is applied within the context of a Christian worldview, including which principle is most pressing and how a Christian might prioritize the four principles. The student's analysis considers the parents' conflicting views, James's autonomy, and the ethical implications of Samuel's potential kidney donation, referencing relevant literature on biomedical ethics and principlism.

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
The lack of early dialysis treatment in favor of spiritual healing
led to irreversible damage to James’ kidneys. However, after
several rounds of dialysis James is in a stumble condition that
can last up to one year. However, a kidney transplant is
necessary for the child to continue living a wholesome life.
The patient James, on a personal level is more inclined to do
according to what is recommended by the parents Mike and
Joanne. As such, he is willing to take on faith-based healing or
physician-based treatment as long as the parents recommend that
action.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
James will have to continuously undergo dialysis for the next
one year and take medication combat further infection allowing
for “optimal” kidney performance, before a kidney transplant is
made possible. James will have to take medication for the rest of
his life to prevent organ rejection; but the alternative would
likely result in death.
Since Samuel is an a good donor match for his twin brother
James because of tissue compatibility, then based on the
willingness of Samuel to aid his ailing brother the most just and
fair option would be to have Samuel donate one of his kidneys to
James.
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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)
The most pressing principle in this case is that of autonomy, the parents are looking for the
“most beneficial” treatment available that will ensure their son James is able to recover
completely and result is little or no harm/cost to others. However, the parents are not
taking into consideration what James would on a personal level prefer in terms of
treatment (Lindridge, 2017). The parents are struggling with their own notions of treatment
that stem from belief, but they fail to ask for James’ input on what he would like done to
ensure that harm and undue suffering are mitigated. The parents consider James to be a
minor and as such they ignore any autonomous decisions that the child may have on the
matter of dialysis, faith-healing, and kidney transplant.
In addition, another major autonomy issue here is on the fairness of putting Samuel in such
a situation because his decision to proceed with the kidney transplant may be influenced
substantially by the parents’ desire (Lindridge, 2017). On the other hand, they are unlikely
to find a suitable donor within one year that will be an exact match for their son.
Nevertheless, the decision by Samuel on whether or not to donate his kidney to his ailing
brother should be devoid of coercion, duress, or other forms of unfair persuasion.
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)
1. Justice: The Christian worldview would emphasis the pursuit of an action that
optimizes on benefit and mitigates on harm (Orr, 2015). Therefore, in most
situation Christian families find it easier to seek faith-based healing as opposed to
temporary remedial solution (e.g. dialysis). However, when a faith-based healing
approach fails, the patient may experience more harm than was possible under a
medical treatment program.
2. Non-maleficence: The Christian worldview strongly condemns against the
performance or lack thereof of any acts that will result in harm to any person. As
such, parents are expected to always perform actions that will not harm their
children but are expected to better them (Orr, 2015). Mike and Joanne saw it fit to
seek spiritual healing as opposed to dialysis as they thought their solution was more
permanent and would not harm James.
3. Beneficence: A Christian is expected to act in a manner that will benefit others.
Therefore, he/she is expected to prevent or eliminate harm. The actions of such a
person are supposed to promote good health. As such, a parent will act in a manner
that he/she deems to be in the best interests of the child as seen in the case of
James.
4. Autonomy: The Christian worldview demands that one put the needs of other
before his own (Orr, 2015). As such, a person like Samuel will feel obligated to
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donate his kidney to his twin brother James because it is what is just and fair from a
Christian perspective.
References:
Beauchamp, T. L., & DeGrazia, D. (2004). Principles and Principlism. G. Khushf (ed),
Handbook of Bioethics, 55-74.
Brosco, J. P., Miller, P. S., Goodman, K. W., & Fuchs, S. R. (2008). Ethical Issues in
Developmental-Behavioral Pediatrics: A Historical Approach. Developmental-
Behavioral Pediatrics , 905-923.
Jonsen, A., Siegler, M., & Winslade, W. J. (2010). Clinical Ethics: A Practical Approach to
Ethnical Decisions in Clinical Medicine (7th ed.). New York: McGraw Hill
Education/Medical.
Lawrence, D. J. (2007). The Four Principles of Biomedical Ethics: A Foundation for Current
Bioethical Debate. Journal of Chiropractic Humanities, 14, 34-40.
Lindridge, J. (2017). Principlism: When Values Conflict. Journal of Paramedic Practice, 9, 158-
163.
Meilaender, G. (2013). Bioethics: A Primer for Christians (3rd ed.). Grand Rapids: Wm. B.
Eerdmans Publishing Company.
Orr, R. D. (2015). Incorporating Spirituality into Patient Care. American Medical Association
Journal of Ethics, 17, 409-415.
Rae, S. B. (2009). Moral Choices: An introduction to Ethics (3rd ed.). Grand Rapids, MI:
Zondervan.
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