coursework-banner

PHI-413V Case Study on Biomedical Ethics in the Christian Narrative

PHI-413V Case Study on Biomedical Ethics in the Christian Narrative

PHI-413V Case Study on Biomedical Ethics in the Christian Narrative

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.

Good post. Bioethics is a subfield of ethics that concerns the ethics of medicine and ethical issues in the life sciences raised by the advance of technology. The issues dealt with tend to be complex and controversial (i.e., abortion, stem cell research, euthanasia, etc.). In addition, bieothics usually also involves questions of public policy and social justice. As such, the complexities of bioethical discussion in a pluralistic society are compounded. There have been several different approaches to bioethical questions put forth that have to do with the theory behind ethical decision making (Fathallah et al., 2020). Three positions have been prominent in the discussion principalism (also known as the four principle approach), virtue ethics, and casuistry. For this lecture, it will be useful to outline principalism and to describe the general contours of a Christian approach to bioethical issues

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

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

Contextual Features

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.

 

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: PHI-413V Case Study on Biomedical Ethics in the Christian Narrative

Part 2: Evaluation

Answer each of the following questions about how the four principles and four boxes approach would be applied:

PHI-413V Case Study on Biomedical Ethics in the Christian Narrative
PHI-413V Case Study on Biomedical Ethics in the Christian Narrative
  1. 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.

 

 

  1. 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.

 

 

Conclusion

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.

References:

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.

The case study, “Healing and Autonomy” demonstrates the importance of providers understanding different components of care provision to help their patients attain quality care by incorporating the ethical principles of beneficence, non-maleficence, autonomy and justice. The four-box method is a critical model that can help healthcare providers to offer care by making ethical decisions (Teven & Gottlieb, 2018). The method is practical as it allows one to sort out salient issues and focus on what really matters (Beauchamp & Childress, 2019). The purpose of this paper is to deploy the four-box method and the relevant principles of biomedical ethics to the case study about James and the decisions that his parents make concerning his treatment.

Part 1: Chart (60 points)

 

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

Medical indications denote diagnosis and proposed measures to evaluate and treat a condition, the prognosis and expected outcomes. Gathering information on the medical conditions allows providers to offer beneficial care and do no harm to patients in their facilities and who require their interventions based on the principles of beneficence and non-maleficence (Teven & Gottlieb, 2018). In this case, James suffers from kidney failure and reversible acute glomerulonephritis. The physician and his team have recommended dialysis as a short-term measure to help address the issue of kidney failure as the parents had taken him for healing services at their church that worsened his acute glomerulonephritis. The medical indications show that James can only have a good prognosis through a kidney transplant with his brother having a matching kidney. The implication is that medical indications implore physician to make decisions in the best interests of a patient for better outcomes. Patient’s preferences are important from both a medical and an ethical perspective, especially when they have decision-making abilities (Teven & Gottlieb, 2018). Upholding patient preferences aligns with the ethical principle of autonomy which advances that physicians and other healthcare providers should respect the decisions that patients make concerning the type of treatment to have or to decline any treatment. Imperatively, healthcare providers should not influence such decisions due to undue influence.

In this case, James is a minor and his parents assume the responsibility of exercising autonomy and make decisions on his behalf. The physician does not interfere, even in situations where such decisions seem irrational like taking James to the healing service that worsened his condition. The physician provided sufficient information for Mike to make the right decisions but could not stop them from taking him to church. The physician was doing this based on the concepts of autonomy and patient preferences.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Disease conditions have negative effects on quality of life. The quality of life is essential as it shows the prospects of one leading a better life after interventions or not. The principles of beneficence, non-maleficence, and autonomy are essential here as the decisions of the providers will either demonstrate effective measures to correct the present condition or not (Teven & Gottlieb, 2018). Factors that contribute to positive influence about this aspect include early interventions and familial support.

In the case of James, his quality of life continues to deteriorate because of the kidney failure problem. James had acute glomerulonephritis that could have been treated by effective antibiotics and allowed him to resume his normal functioning. However, the decision by his parents, based on the principle of autonomy, to take him for a healing session exacerbated his quality of life and made it worse. This implies that James should now get a transplant as opposed to the current dialysis that has negative effects on his quality of life. Medical and healthcare ethics advance that interventions which seem unlikely to offer benefits to patients should not be provided. In this case, the healing service never offered positive outcomes for patients.

Clinical and medical situations are linked to larger contexts which are essential when conducting ethical analysis. The contextual aspects like family dynamics, financial resources, possible legal ramifications of care provision and religious or cultural issues also impact care provision (Gillon, 2018). These components impact patient care and should be considered by providers.

Contextual factors align with the principle of justice where providers and other stakeholder must ensure access to available resources without any bias or discrimination.

In this case, one of the contextual factors is the religious perspective of James’ family, especially his father. He believes that a healing service can offer healing to the son. His faith makes him take James for the service at the expense of conventional interventions. The effect of this action is a worsened state of James who now must be on dialysis before a kidney transplant occurs. The physician recommends Samuel, James’ twin brother to donate his kidney because it is the only matching. However, the parents are hesitant because of their religious faith and other concerns, especially the possibility and fear of losing both sons in case the procedure goes bad.

 

 

Part 2: Evaluation

Answer each of the following questions about how the four principles and four boxes approach would be applied:

  1. 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 worldview advances the need for respect for decisions that people make concerning their health and other aspects of their life since they are inherently free and created in God’s image. They are also independent to make decisions and choices that are pleasing to their lives and circumstances (Torry, 2018). In this case, the principles of autonomy, beneficence, non-maleficence, and autonomy are specified weighted differently. Christian worldview advances that man is a free being because he was created with the inherent freedom from God. Imperatively, he can exercise his rights based on his preferences and existing cultural beliefs, including faith. James’s parents exercise autonomy by making preferences concerning his treatment. They forego early recommendations by the physician and opt for healing service. However, the decision is weighted when their action leads to poorer outcomes for James. Mike fails to make an effective decision and takes advantage of the principle to negatively affect the treatment process of his son.

The principles of beneficence and non-maleficence are specified when the physician and his team make suggestions about the treatment interventions for James with the best interests to improve his condition (Gillon, 2018). However, the parents, especially Mike, declines the plan of treatment and takes him to a healing service at their church. The decision leads to deterioration of his health and escalation of his condition that now requires a kidney transplant due to failure of his kidneys. The last principle to be specified and weighted is justice. The physician recommends that Samuel, James’s twin brother, is the only person who can donate the required kidney as it matches. However, the parents weigh on this recommendation and find it difficult to allow Samuel have his kidney donated to James.

 

  1. 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 proposes modeling of sacrificial love which entails one foregoing their interests and issues for the sake of others, like Jesus Christ’s death for human salvation and restoration. The Christian belief system is based on ethics and attaining a balance of these principles needs one to focus on the ethical approaches as taught in the bible. Christian balances by focusing on the principle of autonomy. God has given everyone free choice and freedom. James parents choose to take him for a healing service as a first option implying that Christians will consider the decisions that they make at a personal level (Torry, 2018). The parents deal with autonomy but find it difficult to balance justice when the physician recommends that Samuel is the only person whose kidney matches with James.

A Christian can balance these principles when they understand their circumstances and their overall roles in such matters, especially the ability to make decisions (Superdock et al., 2018). The case shows this approach as relevant since the physician recommends interventions based on beneficence and non-maleficence. The physician and his team are keen on giving the best care based on patient interest and benefits as well as reducing the harm caused by the condition. His recommendations show no harm directed to the patient. The implication is that Christians should model their responses based on Christ’s teachings. They should balance all the principles equally as they carry similar importance and demonstrate the expectations of the individuals in attaining better care.

 

Conclusion

The four quadrant box method is a core component of understanding how providers can make effective and ethical decisions in healthcare that impact overall care delivery of patients. The paper shows that biomedical principles are essential and providers must use appropriate approaches like the four-box method to make salient care decisions. The Christian worldview considers these principles as critical based on its teachings.

References

Beauchamp, T., & Childress, J. (2019). Principles of biomedical ethics: marking its fortieth

anniversary. The American Journal of Bioethics, 19(11), 9-12.

DOI: 10.1080/15265161.2019.1665402.

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. https://journalofethics.ama-assn.org/article/four-quadrant-approach-ethical-issues-burn-care/2018-06

Torry, M. (2018). Ethical religion in primary care. London Journal of Primary Care, 9(4), 49-53.

DOI: 10.1080/17571472.2017.1317407

Superdock, A. K., Barfield, R. C., Brandon, D. H., & Docherty, S. L. (2018). Exploring the

vagueness of Religion & Spirituality in complex pediatric decision-making: a qualitative study. BMC palliative care, 17(1), 1-14. DOI: 10.1186/s12904-018-0360-y.