Case Study: Healing and Autonomy

Case Study on Biomedical Ethics in the Christian Narrative Assignment

Applying the Four Principles: Case Study

Managing challenges in care provision implores care providers to apply appropriate models like the four-quadrant model that poses questions for a given case concerning medical indications, patient preferences, quality of life and contextual features. Through this model, one can apply the four moral principles to understand a situation that poses an ethical dilemma (Gillon, 2018). Based on the case study of healing and autonomy, this paper addresses the issues raised in two parts. The first part is the chart using the four quadrant approach while the second part evaluates the application of the four principles based on the Christian worldview.

Part 1: Chart (60 points)

 

Medical Indications Beneficence and Nonmaleficence	Patient Preferences Autonomy
Medical indications denote facts, diagnoses, prognoses, suggested or recommended measures for evaluation and treatment and the expected results from the treatment efforts. Clinical situations implore one to describe what is known about the medical facts of a caseChad and Gottlieb (2018. In this case, James suffers from acute glomerulonephritis and requires immediate interventions. The physician suggests immediate dialysis to improve the condition but the parents opt for prayers believing that their son will be healed miraculously (Gillon, 2018). The implication is that after a while they return back and James condition worsens leading to dialysis. Further, the physician tells the parents, Mike and Joanne, that a kidney transplant will offer a long-term remedy. Therefore, the physician is keen on ensuring that James gets benefits from medical interventions suggested. He has no intent to harm the boy. However, because James is a minor, all decisions are made by his parents. The implication is that the physician and his team observe the principles of beneficence and non-maleficence by making fast and effective recommendations based on diagnoses to treat James. Non-maleficence implores the medical team offer quality care without any harm to patient. The decision by James’ parents to opt for prayers because of their faith creates an ethical dilemma for the physicians as they contemplate the need for better medical interventions based on medical conditions to save James’ life. Therefore, any decision concerning therapeutic interventions must weigh clinical and ethical benefits and risks.	Patient preferences denote choices and aspects that a patient values and wishes incorporated in their care plans. The increased diversity in population implores providers to integrate cultural competent care by customizing patient care plans. The approach allows patients to exercise autonomy or independent based on sufficient information offered by physicians and other providers concerning their illnesses (Chad& Gottlieb, 2018). Making informed decisions is a core aspect of autonomy and patient preferences. In this case, James has not autonomy since he is a minor and his parents make all decisions concerning the medical interventions that he should get. For instance, the physician allows James’ parents to take him for prayer session instead of a dialysis since it is their preference. The parents exercise autonomy to the detrimental effect on James who require immediate interventions. Patient exercise their autonomy and preferences when they have sufficient information. In this case, James’ parents have enough information based on all options provided by the physician and his team. However, they make decisions that appear not to benefit James as his condition gets worse to a point of requiring a kidney transplant. Making shared decision is a core aspect of the modern era in medical and healthcare situations. Shared decision making allows physician and patients to work in tandem to arrive at the most appropriate treatment interventions based on patient preferences and autonomy. Decisions are best made by patients and their families with support, sufficient information, and recommendations from medical team. Therefore, Mike and Joanne should exercise autonomy but also consider recommendations by the medical team about James’ condition.
Quality of Life Beneficence, Nonmaleficence, Autonomy	Contextual Features Justice and Fairness
According to Chad and Gottlieb (2018), sickness impacts quality of life negatively. Since the main goal of health intervention is preservation, restoration, and enhancement of quality of life, it is essential to understand the effects of treatment in any presented case. The principles of beneficence, non-maleficence, and respect for autonomy are important. Quality of life denote the relevant medical characteristics of life of a patient before and after the treatment. Beneficence and non-maleficence ensures that providers offer the best care to enhance quality of life for patients with different conditions. James quality of life had deteriorated before he came to the facility. The physician recommended treatment regimens, including dialysis and antibiotic therapy as a way of alleviating his worsening situation. However, based on the right to autonomy, the parents opted for a prayer session to heal him. The decision did not help James and they brought him back in worse condition(Owoc et al., 2018). The quality of his life has deteriorated and immediate dialysis was recommended with a kidney transplant as the long-term intervention. The implication is that James’ quality of life depends on a kidney transplant where his brother, Samuel, is the matching donor but the parents are hesitant to guarantee the decision. James quality of life can only improve if he gets the right treatment interventions for his condition.	Clinical situations do not happen in isolation but as a component of broader situation that may be essential for ethical analysis. Contextual feature that impact decision making denote ethical, situational, and legal factors including patient-specific matters like family dynamics, financial ability, religious and cultural aspects and possible legal consequences of care. personal bias of any stakeholder can also impact care delivery(Varkey, 2021). These issues affect the principle of justice and the need for fairness. In this case, James’ parents’ faith is an issue that affects the ability of the physician to offer treatment as they make the decision to have him go for a prayer session instead of medical intervention as suggested by the physician. They physician cannot act against these preferences since patients have the right to decline treatment. Justice and fairness emphasize equality. In this case, James’ brother, Samuel, is a matching donor but the parents are not willing to let him donate the kidney. They are not fair and fail to give Samuel a chance to save his brother as they contemplate the ramifications of such procedures on the twin brothers(Owoc et al., 2018). The parents are willing to allow others, including themselves, to be matching donors but not their son, Samuel. Therefore, religious practice, family dynamics and perspectives impact equal treatment for James as he cannot get a fair donor kidney to match his tissues.

Mike and Joanne are the parents of , 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?”

Case Study on Biomedical Ethics in the Christian Narrative Assignment

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 of principlism.

Based on the “” 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 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
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

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

©2019. Grand Canyon University. All Rights Reserved.

Part 2: Evaluation

Answer each of the following questions about how principlism would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)

References:

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

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

©2019. Grand Canyon University. All Rights Reserved.

Part 2: Evaluation

Answer each of the following questions about how principlism would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)

References:

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?”

Case Study on Death and Dying – Rubric