Applying Four Principles: Case Study Analysis - Healthcare Ethics

This case study delves into a complex healthcare scenario involving a child with kidney failure, his parents' religious beliefs, and the ethical principles guiding medical decisions. The assignment requires filling out a chart analyzing medical indications, patient preferences, and the principles of beneficence, nonmaleficence, autonomy, quality of life, contextual features, and justice. The case study explores the conflict between medical interventions and patient autonomy, particularly in the context of a Christian worldview. The student is tasked with evaluating which of the four principles (beneficence, non-maleficence, autonomy, and justice) is most pressing from a Christian perspective, explaining the rationale behind this prioritization. Furthermore, the assignment necessitates ranking the four principles according to a Christian worldview and justifying the order. The provided solution addresses these questions, citing relevant literature and providing a comprehensive analysis of the ethical considerations in this challenging medical situation.

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
According to the principle of beneficence, healthcare
professionals are ought to do everything they can in every case
to benefit the individual. All prescribed treatments and
interventions must be designed to achieve the patient's health. To
maximize efficiency, medical practitioners will develop and
maintain a high level of know-how, insure that they have been
trained in the latest and best practice, and recognize the
individual situation of the patients (Garner, 2014). In the light of
Christianity, principle of beneficence applies to actions carried
out for the good of others. This requires acts of compassion,
goodness and the responsibility to do good and to stop evil. In
this case, the principle of beneficence is in conflict with the
principle of autonomy (Garner, 2014). The doctors must
immediately take action by carrying out dialysis followed by
other medical procedures, however the parents were restraining
them from doing so.
The most commonly known of the four principles is probably
non-maleficence. The theory is proposed to serve as the ultimate
goal for all actions of a physician. This ensures that healthcare
professionals have to evaluate whether an action can be
detrimental to others or to a community, although this is done
for the good of a particular patient. In this case, the physicians
should have taken decision adhering to this principle.
Autonomy in medicine is the patient's right to preserve his
body control. A healthcare provider can recommend advice or
otherwise violate this principle by trying to convince or force
the patient to make a choice (Cush, 2014). Ultimately, the
patient has to make his or her decision independently and in
accordance with his own personal values and beliefs–whether
or not the physician believes that these choices are in the
patient's best interest. In this case, the principle of autonomy is
in conflict with the principle of beneficence. According to the
principle of autonomy, the doctors must take decision
respecting autonomy of the patients and their family, thus, in
this case, the parents believed in God and had decided to not
continue the treatment following dialysis, instead pray and
believe God. The doctors have respected patient’s autonomy
that resulted in the deterioration of the patient and risked his
life.
Quality of Life Contextual Features
rand Can on ni ersit ll ig ts eser ed©2019. G y U v y. A R h R v .

Beneficence, Nonmaleficence, Autonomy Justice and Fairness
Quality of life relates to the physiological aspects of a patient's
life both before and after diagnosis. Until diagnosis, James '
health was worse, but his situation changed following
continuous dialysis. However, he requires a kidney transplant to
deal with his condition effectively and his father believes that his
brother ought to provide him the kidney or trust him. The
parents should first communicate with and seek James ' opinions
on the issue on the grounds of the previous meeting. The last
time they relied on their religion, James ' health became worse.
So they should be aware of his best interests to encourage his
brother to undergo a kidney transplant.
The legal, social and family background which affects the
medical decisions is defined by contextual features. James's
parents ' confidence that his health can be restored by prayer
affected their medical choices. They both focus on their belief
rather than on James needing his brother for a kidney
transplant. Justice and equality emphasize fairness. When the
perfect tissue match was found to be from his brother there
emerged a conflict of interest. The parents were therefore
prepared to authorize other people to donate a kidney to
James, but they were not prepared to do this to their child.
rand Can on ni ersit ll ig ts eser ed©2019. G y U v y. A R h R v .

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 Christian view of the world states that beneficence is the most pressing principle. The
beneficence theory applies to actions that are performed for the good of others. This requires
actions of compassion and goodness, and the obligation to do well, and to resist harm (Al-
Bar & Chamsi-Pasha, 2015). A prominent example of beneficence is contained within
Christian tradition in the Good Samaritan parable. A key element of the parable is the notion
of a positive beneficence that is, a positive obligation to benefit others. In this case, the
parents have acted with their son's best interests in mind. They were assured that through
intense prayers their son will be cured. Therefore, they chose prayer and religion over
medical treatment. They can no longer be blamed for the deteriorating health of their son as
they did act in good faith and they took him back to the hospital until they realized his
condition worsened. The doctor gave the family the best possible decision that would save
the child's life but it would also add to the twin brother's risk of life. Also, the autonomy
concept is seen as the second option. In any medical decision the patient is granted the right
to exercise their will. Everyone in Christianity has the right to choose the best option for
them. Nevertheless, in the case study mentioned, James parents felt they misused their right
to autonomy because they chose to avoid the dialysis process originally because of their
conviction that the child would be cured by prayer.
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)
The priorities of the four principles can be placed so that beneficence will be followed first
by non-maleficence, followed by justice and finally autonomy. The explanation is that in
Christians ' view, parents should give their child affection by behaving in their best interests,
which are related to the autonomy concept. Parents must also insure that they do not hurt
their children regardless of what, which includes the concept of non-maleficence Also, the
concept of non-maleficence grants the care taker a moral obligation to do no damage to
others, and to behave to the good of others. In all their encounters and experiences Christians
must practice justice and fairness (Jung, 2014). According to Reilly, a Christian physician
through his medical practice seeks peace in a society that is unequal in only a part of the
challenge of leading a Christian existence. Finally, Christians will allow each other an
opportunity to show that they are aware of a particular decision that is related to the concept
of autonomy (Foster, 2010). In Christian perspective, autonomy is freedom, and the
interrelations between God and humans are an important issue in the Christian scripture. In
Genesis, when man is newly created, Gods gives him the freedom to make choices, such as
following his order and not eating from the tree of knowledge, for to do so "you will surely
die." God created free will that must be valued (Jung, 2014).
rand Can on ni ersit ll ig ts eser ed©2019. G y U v y. A R h R v .

References:
Al-Bar, M. A., & Chamsi-Pasha, H. (2015). Beneficence. In Contemporary Bioethics (pp. 129-139).
Springer, Cham.
Cush, D. (2014). Autonomy, identity, community and society: Balancing the aims and purposes of
religious education.
Foster, C. (2010). Autonomy should chair, not rule. The Lancet, 375(9712), 368-369.
Garner, S. (2014). Christian Theology and Transhumanism: The “Created Co-creator” and Bioethical
Principles. Religion and Transhumanism: The Unknown Future of Human Enhancement: The
Unknown Future of Human Enhancement, 229.
Jung, K. (2014). Christian Ethics and Commonsense Morality: An Intuitionist Account. Routledge.
rand Can on ni ersit ll ig ts eser ed©2019. G y U v y. A R h R v .