Case Study: Healing and Autonomy”
Part 1: Chart
This chart will formalize the four principles and four boxes approach and 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 that describe how principalism would be applied according to the Christian worldview.
No sources < 5 years old and must be obtainable via web.
Record information on Doc attached – Guideline for writing – Use case study attached
ANSWER
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 |
| James needs immediate dialyses that would ultimately relieve the high blood pressure and the buildup fluid.
His condition has now deteriorated, and he receives mandatory dialyses. It is evaluated that a kidney transplant is now necessary and should be conducted within a year. Samuel, the twin brother, is the only ideal donor with a tissue match. The major surgery might pose a threat to Samuel but save James’s life, leading to both of them each surviving with one kidney.
|
The physician is respectful of Mike’s decision to have faith in their God and does not perform the dialyses. Mike believes his faith and belief will heal James.
As things get worse, Mike struggles with the acceptance of letting Samuel donate to his brother, whose condition has worsened. However, he questions himself whether that decision would be the most viable, or this stage called for his true test in faith. There is little information on Joanne, and this is a sign of silence on her part. It seems the family setup does not allow her to voice her concerns. James and Samuel are also silent throughout this crucial decision-making. |
| Quality of Life
Beneficence, Nonmaleficence, Autonomy |
Contextual Features
Justice and Fairness |
| The initial dialyses would be the preferred method of rendering treatment to restore the kidney function of James. This should allow his renal function to return to normal, although he might experience some discomfort as a result of the dialyses. The autonomy aspect allows the will of the father, Mike, to prevail, and he relies on his faith for healing upon James, which makes the situation worse. James is now forced to undergo dialyses, and upon further diagnosis, it is ascertained that a kidney transplant is necessary within a year. This situation is bound to be physically draining and reduce the health quality of James.
If Samuel donates his kidney, he will suffer a temporary decline in body functioning and will have to live with one kidney. On the other hand, James’s condition will be better and retrieved almost back to normal with the new kidney and also live with one kidney. Should Samuel develop kidney problems, too, he might also need a kidney transplant in the future. Mike faces nonmalficense on struggling to decide whether it would be appropriate to expose his other son to Surgery and force him to live with one kidney, considering that might be a threat to his life. However, if Samuel donates his kidney, it will be a lifesaving decision and restore the health of his twin brother. This will benefit both of them in terms of the health of James and the mental health of Samuel.
|
The tough decision of whether Samuel should donate a kidney to his brother lies on Mike and Joanne. But is this really their decision to make considering that the twins are the ones to undergo the surgery? Should this not be their decision?
Mike seems very involved in the decision-making and is sloppy regarding his faith as an option. This leaves the question of whether he should be left the one in charge of every decision he is making and is yet to. Why is Joanne’s opinion not mentioned or regarded in this whole situation? Does she not see the harm Mike has done so far to chip in and make a sane decision? Mike questions whether it would be appropriate to let Samuel donate his kidney, which may potentially put him through the same situation as his brother. |
Part 2: Evaluation
Answer each of the following questions about how the four principles and four boxes approach would be applied:
- In 200-250 words, answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)
| According to the Christian worldview, beneficence involves balancing the benefits of treatment against the potential risks and costs associated with it (Torry, 2017). In this, the Christian perspective would allow Samuel to donate to his twin brother. Christianity embraces love and life, and Samuel donating a kidney would be saving his brother’s life and also be an expression of love towards his brother. In this case, the risks are minimal compared to the greater gift of saving a life.
The Christian worldview of non-maleficence means that the causation of harm would be avoided (Torry, 2017). In this case, Samuel would not be allowed to donate. This is because this action might lead to him getting harmed along the way in the event he also suffers a kidney problem as he would have only one. Thus, the principle of non-maleficence would not allow Samuel to be put at risk. This principle will also create a dilemma as James would be at harm at the expense of him not finding a donor as Samuel is the only viable option at the moment. The Christian worldview of autonomy is under the belief that there is true freedom in Christ (Orr, 2015). Autonomy permits patients to make their own decisions on the basis of their values and beliefs. Mike should therefore make a decision freely on whether Samuel should donate to his brother in order to save his life. Justice and fairness under the Christian worldview should be universal for all (Erickson, 2018). Therefore, it is not fair for Samuel to be put through this ordeal and suffer as his brother. |
- In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)
| On beneficence which involves balancing the decision of treatment against risks and costs, a Christian should regard both James and Samuel’s health situations. The decision should be made on the doctor’s say-so on whether Samuel is fit to donate his kidney and the side effects that might be experienced. If the transplant goes smoothly, then this will be the best option to save the life of James and preserve Samuel’s.
As non-malificence dictates that the causation of harm should be avoided, it is also prudent for the Christian to look for alternatives to ease harm. Samuel should therefore donate to his brother to ease his harm, and a good operation will also ensure he also suffers no harm. Autonomy gives patients the freedom to make decisions during treatment. a Christian will therefore regard what decision is suitable for all parties. Samuel should also be allowed this freedom and discuss whether he is comfortable donating his kidney. Justice and fairness should apply to all. It would not be fair to force Samuel to undergo a kidney transplant without his approval. It is also not fair to allow Joanne to express her concerns as this has been silent through all the decision-making.
|
References:
Orr, R. (2015). American Medical Association Journal of Ethics Volume 17, number 5: 409-415. Retrieved from https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/spec1-1505.pdf
Erickson, C.(2018). Biblical justice and Social Justice. Retrieved from https://sharedhope.org/2018/06/04/biblical-justice-and-social-justice/
Torry, M.( 2017). Ethical religion in primary care. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537594/
