This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case
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.
Expert Answer and Explanation
Topic 3: Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Ethical Issues Based on the Principles of Beneficence Nonmaleficence, autonomy and Justice and Fairness
| Medical Indications
Beneficence and Nonmaleficence |
Patient Preferences
Autonomy |
|
|
| Quality of Life
Beneficence, Nonmaleficence, Autonomy |
Contextual Features
Justice and Fairness |
|
|
Part 2: Evaluation
How the Christian Worldview Specifies Each Principle in the Case
| According to the Christian worldview, there are several ways in which the principles could be specified. The principle of beneficence which explains the duty to good could have been accomplished by the doctors (Varkey, 2020).
After observing James’ critical state and listening to Mike’s needs, they allowed him to take the patient home regardless of the condition he was in. This caused more harm to the patient, leading to a more dire health issue which has proven to be hard to solve. The principle of nonmaleficence was unintentionally violated. By granting the principle of autonomy, the health practitioners unintentionally violated the principle of nonmaleficence as they ended up causing more harm to the patient. While they knew the dire state of the patient, they allowed Mike to enjoy some autonomy and respected his decision to remove James from the care, and this led to kidney failure (Fowler & Schoonover-Shoffner, 2023). The principle of justice was evident because regardless of their religious standing, Mike and his family were not treated differently even though some of the staff could have expressed disapproval of how they handled the issue. |
How A Christian Can Balance the Four Principles in the Case
| It is evident that the case was a hard one for the practitioners. As a Christian, the four principles balance the requirements one must consider when offering care to the patient. Nonetheless, there would be better ways of going about the issues presented, ensuring the safety of the twins and the autonomy of their parents.
On the principle of beneficence, it was evident that James was in a critical health condition and needed intervention immediately. However, to protect the patient, while maintaining autonomy, the hospital could have suggested inviting the healers over. This way James could have been under full-time supervision and the negative changes he went through could have been noticed sooner and measures taken to save his liver (Cheraghi et al., 2023). The principle of non-maleficence explains that medical practitioners have a duty not to do harm. Given they were quite aware of the critical condition that James was experiencing, they had a duty to deny Mike autonomy and do what was best for the patient as explained by Bogue et al. (2022). However, they could have denied the principle of autonomy in kind, explaining clearly to Mike the consequences that awaited him if he chose to remove James under their care. The principle of justice and fairness is also complicated in the case especially because it now involves the other twin. The rush to save James’s life has been hard with no perfect donor available. However, his identical twin brother can save him and even though Mike has to make the call, they should consult the young twin first. After making him understand what his brother was experiencing, they could ask him to consider donating his kidney and if he refused, they should not compel him to the task (Olejarczyk & Young, 2022). It is impressive that other church members wanted to donate a kidney, and it is important to keep praying for James so he can get a match should Samuel feel uncomfortable about donating his kidney. Under the principle of justice, it is important to ensure that Mike is not treated differently because of his beliefs. Additionally, he should have spiritual support whenever he needs it even in the hospital. |
References
Bogue, D., Hogan, M., White, N., Hoehner, P., Self, C., & Evans, K. (2022). Practicing dignity: An introduction to Christian values and Decision Making in Healthcare. In Nursing Bay. Grand Canyon University.
Cheraghi, R., Valizadeh, L., Zamanzadeh, V., Hassankhani, H., & Jafarzadeh, A. (2023). Clarification of ethical principle of the beneficence in nursing care: An integrative review. BMC Nursing, 22(1), 1–9. https://doi.org/10.1186/s12912-023-01246-4
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. https://doi.org/10.1097/cnj.0000000000001039
Olejarczyk, J. P., & Young, M. (2022, November 28). Patient rights and ethics. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/
Varkey, B. (2020). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119
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Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke.
They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant.
Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
