Nursing
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.
Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
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 in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.
Remember to support your responses with the topic study materials.
ANSWER
Applying the Four Principles: Case Study
Part 1
| Medical Indications
Beneficence and Non-maleficence |
Patient Preferences
Autonomy |
| Beneficence entails balancing the treatment benefits against the costs and risks involved (Hain, 2020). The physicians acted in good faith to prevent pain since they offered the most appropriate medication to James by recommending that James undergoes temporary dialysis. Non-Maleficence entails avoiding the causation of harm. The parents had no reason for hurting James since the condition was worsening and the primary care givers were acting in the best interest to improve James’ wellness. | Autonomy of the patient states that the physicians’ judgments about how to benefit should not override or ignore the preferences of the patient (Hubbard and Greenblum, 2019). Since James is a minor, the doctors have to follow the medical decision of his parents. The parents believe that their faith in God will heal their son rather than the recommended temporary dialysis. |
| Quality of Life
Beneficence, Non-maleficence, Autonomy |
Contextual Features
Justice and Fairness |
| Beneficence, Autonomy and Non-maleficence demands that every action of the physicians should follow the greatest interest of the longsuffering. However, applying the four principles deteriorated the medical condition thus affecting his quality of life. James condition would have improved if the doctor insisted on the need for dialysis rather than following the parent’s decisions. | Justice and fairness entails making impartial medical decisions that demonstrate ethics in healthcare. The physicians acted in fairness and justice to James after returning to the hospital for help. The conducted a temporary dialysis despite the wrong decision by the parents. The parents would act in fairness and justice by accepting the temporary dialysis to save the life of James. |
Part 2: Evaluation
- According to the Christian worldview, how would each of the principles be specified and weighted in this case?
| The Christian worldview values life and considers life as sacred. According to Christians’ worldview, beneficence has demonstrated value to human life since it minimizes harm and risks of the patient. The autonomy of the patient has conflicted with the value of life since the patents denied treatment that would potentially be beneficial to the life of James. Non-maleficence demands that nurses should avoid harm to the patients to support life. Thus, the principle has respected that life is sacred and needs to be respected. However, the physicians have to follow the decision of the parents. Justice entails treating people fairly and impartially to show how much they are valued (Koepsell, 2017). Despite the conflicting interests the physicians still shown the value of life through offering assistance in a timely manner. The doctor reviewed the medical condition for James and gave recommendations for temporary dialysis to save the life of James. The physician has taken a step to advocate for the life of the patient in order to save life. Non-maleficence and beneficence are a top priority in the Christians’ worldview to protect the patient and to save life which is sacred. Physicians have an obligation of taking positive actions that will prevent harm to patients. |
- According to the Christian worldview, how might a Christian balance each of the four principles in this case?
| With regard to the Christian world view, a Christian can balance the four principles whereby beneficence comes foremost then non-maleficence, then justice and then autonomy. The physician should work to offer benefits and reduce risk of the patient losing their life. Beneficence is highly emphasized in the bible where individuals are requested their neighbor as they love themselves. This law greatly relates to Christian view of value and human dignity while treating others. Caregivers need to focus on the greatest benefit for others to illustrate their respect for human value. Non-maleficence requires the parents and physicians to reduce harm to James. This principle needs to be upheld to reduce the risk of losing James. Throughout the scriptures, Christians are to love others and that love does not harm its neighbors. Justice requires that all people should be treated equally. Christians believe in fairness regardless of age, gender and religion. However, seeking justice has been challenging in the Christian world. There each patient needs to be treated fairly. Autonomy entails the respect that individuals have on the decisions of others. God gave human beings the freedom of choice which should be respected. Therefore, it is important for the physician to consider the decision of the patient and respect freedom of health intervention.
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References
Hain, R. (2020). Principles and ethics in medicine. Medicine.
Hubbard, R., & Greenblum, J. (2019, September). Parental decision making: The best interest principle, child autonomy, and reasonableness. In HEC Forum (Vol. 31, No. 3, pp. 233-240). Springer Netherlands.
Koepsell, D. (2017). Autonomy, dignity, beneficence, and justice. In Scientific Integrity and Research Ethics (pp. 61-71). Springer, Cham.
