PHI 413 Topic 3: Biomedical Ethics in the Christian Narrative Tasks
Applying the Four Principles: Case Study
The provision of care requires physicians, nurses, and other health care practitioners to follow the four biomedical principles that include beneficence, autonomy, justice, and non-maleficence. In the case, “Healing and Autonomy,” it is evident that the providers tackle different aspects that include medical indications, patient preferences, quality of life and contextual issues that impact healthcare delivery. Using the chart, the assignment evaluates the application of the four principles in the case in its first part. The second part addresses the application of the principles.
Part 1: Chart (60 points).
Beneficence and Nonmaleficence
|Medical indications denote to diagnosis, prognosis, suggested measures for evaluation and treatment and expected results from treatment interventions Medical indications concern the need for providers to make professional judgment and entails application of principles of beneficence and non-maleficence (Teven & Gottlieb, 2018). Through beneficence, providers should offer care that bring good to patients while reducing potential harm as indicated by non-maleficence principle.
The case study shows that James needs immediate treatment interventions that include a dialysis and later on a kidney transplant as a long-term solution to his condition that deteriorated due to delays in treatment interventions.
In this case, Mike and Joanne act in the best interest of the child, James who requires immediate treatment to recover from glomerulonephritis. The actions by the parents have no malice or intention to harm James even though they knew that the condition could get worse if treatment is not provided immediately. As Christians, they were faithful since an individual had been healed from stroke. However, when the healing service could not offer recovery to James, they brought him back for medical attention. The decision by the parents may have affected immediate treatment by the healthcare team which could have prevented the current medical indications that are not pleasing. However, physicians and other providers have a duty to exercise the principles of beneficence and non-maleficence and ensure that James’ condition gets better and should involve the parents in decision making since the patient is a minor.
|Patient preferences refer to the choices that individuals make when they encounter decisions about health and medical treatment. These choices reflect the individual patient’s experiences, values, and beliefs based on the provider’s recommendations (Teven & Gottlieb, 2018). When a patient has decision-making abilities, physicians and other providers should respect their preferences and use them to guide care and medical plans. The implication is that patient preferences arise from the principle of autonomy which implores providers to respect any decisions or care interventions informed by a patient’s beliefs, values, and experiences. A core aspect of the principle of autonomy is getting informed consent from patients based on their decision-making capacities. Minor patients like James may not have the decision-making capacity to exercise their autonomy as demonstrated in the case. In such situations, parents assume the role of making critical decisions.
In this case, the physician (nephrologist) gave the family full information when James was brought to the facility for treatment. However, the parents exercised his autonomy since he is a minor and decided to take him to church for a healing service. The physician respected the autonomy and could not offer treatment without their consent but allowed them to go to church due to their faith preference.
The pursuit for miracle healing was not effective and when the parents made the decision to return James for medical intervention, it was based on their preferences, informed consent, and autonomy.
|Quality of Life
Beneficence, Nonmaleficence, Autonomy
Justice and Fairness
|Illness or medical and health condition can have negative effects on quality of life. Since a principle goal in medicine is the preservation, restoration, and improvement in quality of life, both patients and healthcare providers must discuss how treatment will impact the quality of life, in this case for James. The discussion should focus on the three principles of beneficence, non-maleficence, and respect for autonomy. Quality of life assess the level of satisfaction that patients experience and value about their lives as a whole based on the three principles (Teven & Gottlieb, 2018). Physicians, nurses, and other healthcare providers should use evidence-based practice interventions to enhance a patient’s quality of life but by ensuring that it is based on their autonomy and need to prevent harm while offering benefits.
In this case study, James’ quality of life deteriorated due to delays in treatment interventions after a diagnosis. The healthcare team exercises the principle of autonomy by allowing Mike and Joanne to make the decision to take James to their church for healing. However, this did not lead to recovery and the patient was brought back. James is now on dialysis to help him function well but the long-term solution is a kidney transplant where parents need to make a critical decision. The matching kidney for James comes from his twin brother, Samuel after all other donors’ kidneys failed to match. The parents want the best for James but are worried about having Samuel donate a kidney to him. The implication is that both parents and the physician should act in the best interest of the pediatric patient and agree to the recommendations by the physicians to save the boy’s life and prevent further health risks.
The parents should also engage both James and Samuel so that they understand what is happening despite their young ages. Beneficence is not just acting in ways that help other individuals in need through treating or curing illness, but entails acting in ways that bring satisfaction to others. The implication is that the parents should involve their sons to ensure that they are satisfied about the actions that they intend to take in the proposed procedure for James’s better prognosis.
|According to Gillon (2018)), clinical cases do not occur in isolation as they are part of broader circumstance that are critical to ethical analysis of care cases. contextual features affect the decision-making process and include patient specific factors like family dynamics, financial resources, and cultural and religious identity (Teven & Gottlieb, 2018). These features may also comprise of possible legal ramifications in care provision, and personal bias of those involved in patient care.
In this case, James is a minor and the parents and physician have a responsibility to offer influence the treatment options. For instance, the decision to opt for spiritual intervention through miracle prayer demonstrates the religious factors that impact care plan in the case. Further, the parents come back and the physician shows that a transplant is the long-term intervention. However, the parents are skeptical after James’s twin brother’s kidney becomes the matching kidney. The implication is that the physician can only opt for the intervention if the parents’ consent to having Samuel donate his kidney to save James’s life.
Imperatively, the parents must involve Samuel while the physician should implement recommendations based on the best interests of James and implore the parents to consider long-term effects of any actions that they take now.
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)
|The Christian view advances that God gives life and sustains it. From the perspective, the specification and weighing of the principles should encompass Christian beliefs and teachings as advanced in the Bible. The principles would be specified and weighted based on the need to protect the inherent human dignity and value that man has and given by God. The first principle would be autonomy followed by beneficence and non-maleficence and lastly justice. Autonomy should be specified first since respect of freedom is an imperative because man was created to be free and exercise their freedom to choose based on the Christian values and teachings (Carr & Winslow, 2017). Autonomy advances that after a physician diagnoses a patient, they should inform them or the family and then respect the free choice that they make. In this case, the physician informed Mike and Joanne about the treatment interventions and allowed them to make their decisions on behalf of James since he is a minor.
Non-maleficence is the second principle as it provides a caregiver a moral obligation to ensure that no harm occurs a patient by making the best decision and acting in the best interests of a patient. Beneficence is specified and weighted third as it is God’s command to love others as one loves themselves. The principle dictates how physicians and healthcare providers should treat and interact with their patients. caregivers should also seek to benefit patients with reduce risk of harm. The fourth principle is justice as it implores on healthcare providers and systems to treat patients equally and share available resources equitably. They should treat patients with compassion and dignity despite their diversity as all people are equal before God and made in his image.
- 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)
|The Christian worldview advances that one must demonstrate love and ensure that they benefit others without causing harm or undue suffering. According to the Christian worldview, man is created in God’s image and love should drive all actions, including care given to patients by healthcare providers (Carr & Winslow, 2017). In this case, a Christian will balance each of the principles by basing their actions or decisions on teaching, values and beliefs. Consequently, the first aspect is to consider beneficence which one should balance with non-maleficence and the need to do good. Beneficence is the most pressing principle as all involved should focus on James’ interest and ensuring that he gets quality life. While James’ parents opted for miracle service, one cannot blame them since they had faith in prayers than treatment. They acted with best intentions and interests to benefit James even when they realized that the healing service could not solve the issue.
The second aspect is ensuring that no harm happens to an individual as demonstrated in the case where the decision to have a transplant for the patient would bring benefits to him. The parents have opted for dialysis to prevent any harm to James. They believe that their choices are based on their faith in God. Autonomy becomes a third aspect in balancing the principles as it shows that while patients have the freedom to choose, they must consider different spiritual aspects that affect their perspectives on issues (Gillon, 2018). For instance, the parents have a choice to make on whether James will receive a kidney from his twin brother, Samuel or not, and the impact of the decision. The final principle to balance is justice as it is not a much of a concern to the parents but critical in ensuring that James gets treatment to prevent deterioration of his condition.
The need to balance different biomedical principles requires healthcare providers to use the four box approach and understand other aspects that may impact or influence the delivery of care. The case study shows that factors like contextual features, patient preferences, medical indications and quality of life impact care decisions and interactions with patients. As such, making decisions requires the stakeholders to consider all these issues.
Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for
Healthcare Professionals (pp. 31-45). Routledge.
Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and
Professionalism (pp. 45-59). Routledge.
Teven, C. M. & Gottlieb, L. J. (2018). The Four-Quadrant Approach to Ethical Issues in Burn
Care. AMA Journal of Ethics, 20(6):595-601. DOI: 10.1001/journalofethics.2018.20.6.vwpt1-1806.
In order to help doctors begin an ethical analysis of a case, this assignment will contain a commonly used practical tool. The four principlism principles will be easier to apply if the data is organized in this manner.
Case Study: Healing and Autonomy, as well as other topic study materials, will be used to complete the “Applying Four Principles: Case Study” paper, which covers the following.
For Christians, provides a framework for interpreting the world and many aspects of daily life. According to Christians, the Bible is the foundation for all of their religious convictions since it tells the account of human creation, fall, and redemption.
The concept of “creation” for Christians is that God is the originator of all. According to Hoehner’s (2020), Because God made us in his image alone, we have more value and worth than anything else he has made. It is our duty to treat each other as God treats us, by loving and aiding one another. Person life begins at conception, and no human should ever injure another human in any way. The mandate to “love thy neighbor as thyself” in Lev 19:18 (King James Version, 1769/2017) is one of the many ways in which we might show our reverence for God.
Adam and Eve, the first humans, disobeyed God and produced a separation between God and humanity known as sin. “The fall” refers to this. All humanity suffered and died as a result of Adam and Eve’s initial transgression. It’s important to note that these concepts are both physical and spiritual, as sin weaken and eventually kills a person’s spirit. According to Hoehner’s (2020),
Redemption refers to God’s plan to save us from our sins by sending His son, Jesus, into the world. We all suffer temptations, but
Jesus stayed pure and blameless because he was a human being. Because he had done nothing wrong in his life, he was crucified and resurrected after three days in a tomb as a permanent sacrifice to atone for the sins of all mankind. If you accept Jesus as your savior and repent of your sins, you’ll be promised eternal life in heaven, according to Christian doctrine. As a result of Jesus’ death, the rift between God and humanity was repaired, and the harm caused by sin was reversed. God offered his son to save us because he loves us and wants to spend eternity with us.
A “restoration” of heaven, earth, and rebirth from sin, pain, and death. God will establish a new heaven and a new earth, and all people who have been saved will be called to spend eternity with Him in the new heavens and new earth.
As a Christian healthcare provider, you should try to alleviate pain and suffering while treating every patient as a precious, loved human being who deserves the finest care possible. Even if we may not know exactly what our patients are going through, we can listen to, advocate for, and care for them. We can also sympathize with our patients. The love of God gives Christians the strength to persevere in the face of adversity.
Hoehner, P. J. (2020). Biomedical ethics in the Christian narrative. In Grand Canyon University [GCU]. Practicing Dignity: An introduction to Christian values and decision making in healthcare. (ch.3).
King James Bible. (2017). King James Bible Online. https://www.kingjamesbibleonline.org/ (Original work published 1769)
Part 1: Chart
This chart will formalize principlism 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.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. Refer to the for assistance.
Applying the Four Principles: Case Study
Principlism has been heavily criticized, particularly in the context of bioethics in the United States, for elevating the principle of autonomy to such a high level that it trumps all other principles or values. How important do you think each of the four principles is? How do you think they should be arranged in the context of the Christian biblical story? In your response, refer to the topic overview and other topic study materials.
DQ 1 for Topic 3
every human being is created in the image and likeness of God. The ability to be conscious, self-aware, and productive is commonly associated with the quality of a person’s life in society. (2013) (Meilaender) Those who lack cognitive abilities, such as the severely disabled, demented, or comatose, and do not have advance directives, may face bioethical dilemmas. Bioethics are medical ethical concerns about contentious issues such as abortion, stem cell research, and euthanasia, to name a few. Principlism is an approach to ethical, reasonable decision making that involves gathering data and then applying what is known as the four-boxes approach. During ethical medical decision making, ethics committees apply the four principles of this model. (2019, Grand Canyon University) Respect for autonomy or the patient’s preference, nonmaleficence or causing no harm to the patient’s quality of life, beneficence or balancing risks and benefits of medical indications, and justice requiring fairness of the context of the risks, benefits, and cost are the four principles. (2019, Grand Canyon University) In terms of importance, I would rank autonomy first, followed by respect for the patient’s wishes. As previously discussed, the patient may lack cognitive abilities, which makes ethical decision making difficult, and the four-boxes approach comes into play. Patient safety and ethical care should come first, so nonmaleficence comes next. The next consideration should be beneficence, or balancing the risks and benefits to the patient’s health outcome. Finally, justice, as well as the equitable distribution of risks, benefits, and costs, should be determined at this time. The Christian biblical narrative summarizes humanity’s creation, fall, redemption, and restoration. God is the ultimate creator of life, and His creation has order, which is known as Shalom. (2019, Grand Canyon University) According to the Christian biblical narrative, I believe the four principles should be ordered as follows. According to Christian biblical narrative, beneficence and the quality of life are understanding and appreciating that a person is more than just a spirit and a body, but a being where freedom and finitude coexist. (2013) (Meilaender) When Adam and Eve sinned and disrupted Shalom, the order of creation that God intended, they lost their autonomy. This brought death, disease, and suffering to humanity. The sacrificial death of Jesus Christ brought about God’s plan of redemption, forgiveness, and justice. Restoration, Shalom, quality of life, and nonmaleficence will return with Jesus Christ’s resurrection. (2019, Grand Canyon University) References University of the Grand Canyon (2019). The Christian Narrative and Biomedical Ethics Grand Canyon University is located in the Grand Canyon. https://lms-ugrad.gcu.edu../user/users.lc?operation=loggedIn&token=AhND0fyWQKJ0OayMKYMQt1O5W5cmelta5KA3C percent 2buDc6g8tcwkSU2LtXHxlz
G. Meilaender (2013). Bioethics for Christians: A primer (3rd edition). Eerdmans Publishing Company, William B. http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics a primer for christians ebook 3e.php
DQ 2 for Topic 3
What do the four parts of the Christian biblical narrative (creation, fall, redemption, and restoration) say about God’s and reality’s nature in relation to the reality of sickness and disease? According to this story, where would one find comfort and hope in the face of illness? Explain in detail each part of the preceding narrative and discuss the implications.
DQ 2 for Topic 3
The Christian God, according to Christianity, is the creator of everything that exists (Gen.1-2 NIV). There is nothing that exists that was not created by God. There is a clear distinction in Christianity between God and the creation. God created everything, and He described everything He created as very good. If everything created was perfect, there would be no sickness or disease. It means that disease and sickness appeared after creation as a result of human sin. God’s act of creation was deliberate. Everything exists on purpose, not accidentally or purely randomly, in this first act of creation, and it is good. So to speak, there is an order to creation, and everything is as it should be. (PHI-413V Subject 3)
Sometime after the creation, an event in human history occurred in which the created order was broken. In Genesis 3, humanity disobeyed God by refusing to obey his command to refrain from eating the forbidden fruit. The fall is referred to as Adam and Eve’s disobedience because, among other things, it was their rejection of God’s rule over them, which resulted in a break in Shalom. According to the Bible, the fall had far-reaching consequences. The fall brought sin into the world, along with spiritual and physical death. Death, disease, suffering, and, most fundamentally, estrangement from God have all been features of human existence since the break in Shalom. Topic 3 of PHI-413V. Topic 3 of PHI 413: Biomedical Ethics in Christian Narrative Tasks
The rest of the Bible’s story after Genesis 3 is a record of humanity’s ongoing struggle and corruption following the fall, as well as God’s plan for its redemption. This plan of redemption is found in the Bible’s Old and New Testaments and culminates in the life, death, and resurrection of Jesus Christ. The climax of the Christian biblical narrative is Jesus Christ’s atoning sacrificial death, through which God makes forgiveness and salvation available by grace alone, through faith alone. Christ’s death is the means by which the estrangement caused by sin and corruption is repaired. For the Christian, salvation entails the restoration of a right and proper relationship with God, which has consequences not only in the afterlife, but also here on earth. We are promised disease healing and restoration from sickness (PHI-413V Topic 3)
The final chapter of this narrative is yet to fully be realized. While God has madeavailable a way to salvation, ultimately the end goal is the restoration of all creation to astate of peace. The return of Jesus, the final judgment of all people, and the restoration of all creation will inaugurate final restoration (PHI-413V Topic 3)
New Testament Overview
View the online video, “New Testament Overview,” from the Bible Project, located on the YouTube website (2018
Understanding Health and Healing
View the “Understanding Health and Healing” media piece.
Optional – Topic 3: Optional Resources
For additional information, see the “Topic 3: Optional Resources” that are recommended.
Incorporating Spirituality into Patient Care
Read “Incorporating Spirituality into Patient Care,” by Orr, from American Medical Association Journal of Ethics (2015).
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 3 from Practicing Dignity.
Explore “The Messiah” webpage and watch the video on the Bible Project website (2018).
Word Study: Khata/Sin
View the online video, “Word Study: Khata/Sin,” from the Bible Project, located on the YouTube website (2018).
Read Scripture: TaNaK/Old Testament
View the online video, “Read Scripture: TaNaK/Old Testament,” from the Bible Project, located on the YouTube website (2
Sacrifice and Atonement
Explore “Sacrifice and Atonement” webpage and watch the video, on the Bible Project website (2018).
Word Study: Shalom/Peace
View the online video, “Word Study: Shalom/Peace,” from the Bible Project, located on the YouTube website (2017).