Analyze principalism and explain the meaning of the four principle approach autonomy

Analyze principalism and explain the meaning of the four principle approach autonomy

Analyze principalism and explain the meaning of the four principle approach autonomy 150 150 Nyagu

Case Study on Biomedical Ethics in the Christian Narrative Essay examples
Case Study on Biomedical Ethics in the Christian Narrative Essay examples

The purpose of this paper is to analyze principalism and explain the meaning of the four principle approach autonomy, nonmaleficenece, beneficence and justice according to this author’s understanding then, each principle will be apply to the case study “Healing and Autonomy” provided by Grand Canyon University.

According to Grand Canyon University (n.d, p.1) lecture notes for week 3 respect for autonomy is “A principle that requires respect for the decision making capacities of autonomous persons” as a nurse I understand that allowing patients to make their own decisions when capable is crucial for their recovery, it provides them with confidence and the dignity they deserve. According to the same notes nonmaleficence is “a principle requiring that people not cause harm to others” (n.d, p.1) as nurses we have the great responsibility to care for our patient’s lives and to not cause harm, this means physical and emotional harm, patients have the right to know what they are at risk for. Beneficence; as health care providers we are required to provide equal benefits to all people not matter the cost, we are require to weigh the benefits gains risk and make decisions on what benefits patients the most Case Study on Biomedical Ethics in the Christian Narrative Essay examples. The last principal is justice, this principle requires health providers to provide with fair distribution of benefits regardless of people’s race, skin color, or socioeconomically status.

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Autonomy: In this case, Mike and Joanne found out that their son James had kidney failure secondary to glomerulonephritis. They were aware that his condition was acute enough to require immediate care and even though the attending physician suggested immediate dialysis they decided to skip the dialysis, and take James to a faith healing service. Mike and Joana promised to go back to the hospital later the week which they did and by that time James’ condition had deteriorated. The autonomy of the parents was respected, they were allowed to choose what they thought was better for their son James and even though this put James’ life in jeopardy they had the right to choose.

Beneficence: The attending physician believed that James required immediate dialysis to prevent further kidney injury. Mike and Joanne thought that they needed to be faithful and take their son to the healing service to be cure. They had seen friends get better after attending one of this services, they thought that by taking James they would show faith in God and God would heal their son so that he would not need dialysis at all. Both parties, the attending physician and the parents disagreed on what benefits James the most, but is clear that both parties think they know what is best for James. Who is right? both could have been right but, at the end of the case study we find that the Dr. was right and James needed dialysis at that moment. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

Nonmaleficence: The attending physician has a moral duty to promote James health and he knows that is imperative for him to get dialysis to help his kidney restore function, the physician does not want to inflict harm or suffering on James but he understands that this is what James needs at this point. The parents believe their son will be cure if they attending the faith healing service, after all they have witness miracles. The physician has a duty to do what is best for his patients and he knows that by waiting more time might make James’ kidney worse than what it is at this time but, he also understand that he has to respect the parents decision. The physician probably knows that Mike and Joanne want what is best for their son, he is respecting the parent’s autonomy. The parents believe that if their son is cured he won’t even need dialysis at all and they will avoid any suffering cause by dialysis.

Justice: this refers to equal and fair distribution of medical services. At first glance this does not seem to play a major role, but James now needed a kidney transplant for his condition was a lot worse after his parents took him back to the hospital after taking him to the healing service. Mike and Joanne were willing to donate one of their kidneys but they were not match, and none of the people willing to be kidney donors were a match either. The nephrologists suggested that James’ brother Samuel could be the donor since they had not found another match and James needed a new kidney within a year. It seems that is right for James but what about Jacob? after all he is only eight years old. In terms of this class James is receiving fair distribution of benefits for what it read in the case study.

Some of the most pressing issues in this case study have to do with the parents trying to prove their faith to God, they believe that by not following the Doctors advice an attending the healing service God will be please with them and cure their son. They are right to put their faith in God, for we read “Blessed are all they that put their trust in him” (Psalm 2:12, King James Version) but is this what God wants them to do? this author believe that this answer is different and personal for every individual. Is our job a human being to stay in tune with the Holy Spirit to be able to make the right decisions. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

Is the physician’s responsibility to give the parents all the options they have but also to inform them and make them aware of what could happen if they don’t agree to follow with the plan of care for James. Case Study on Biomedical Ethics in the Christian Narrative Essay examples. Were the parents aware that if James didn’t get dialysis right at the time the physician suggested, James could end up losing his kidneys and needing a kidney transplant? perhaps Mike and Joanne did not think James’ conditions was as bad as it was. This author believes that the physician has a duty to respect the parent’s decision but he needs to make sure he is making the parents aware of everything that can happen to James if they do not follow the Doctors advice.

According to Meilaender organs “gifts of the body help some to survive longer than they otherwise could” (Meilander, G. 2013, p.89-90). God has given man the intelligence to figure out ways to help our bodies stay alive. Christians believe that organ donation is a miracle from God. In fact Meilander believes people should be more educated on the benefits and blessing this brings. Treatment refusal by patients is something health care provider see very often, is it our job to force them into getting treated. Meilander explains that sometime people are not intending to die but they are just being faithful to God as they understand such faithfulness (Meilander, 2013). People have the right to denied treatment as long as they are alert and oriented they have the freedom to choose and health care providers have the duty to educate patients about the adverse outcomes they are at risk for if they refuse care, this is when we as health providers respect patients autonomy and is not our job to judge them for most of the time they are just trying to prove their faith to God and not trying cause harm or put their lives in jeopardy as we see in the case of Mike and Joanne, they were not trying to cause James any harm they were just trying to help their son. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

Every case is different and we cannot automatically choose and answer for every dilemma we come across. We do know that every person and every life is valuable and as health care providers we have a duty to help, care and treat every individual with justice, respect their autonomy and do our very best to help them holistically.

References

Grand Canyon University (GCU), (2015). Case Study: Healing and Autonomy. PHI-413V

Grand Canyon University (GCU) (n.d.) Lecture notes. PHI-413V Lecture 3. Phoenix Az.

Meilaender, G. (2013). Bioethics, a primer for Christians (3rd ed.). Retrieved from http://gcumedica.com/digital-resources/wm-b-eerdmans-publisheing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php Case Study on Biomedical Ethics in the Christian Narrative Essay examples

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. Case Study on Biomedical Ethics in the Christian Narrative Essay examples. 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. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

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. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

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? Case Study on Biomedical Ethics in the Christian Narrative Essay examples. Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”

The value of having faith in God is repeatedly spoken in the Bible. For instance, Proverbs 3: 5-6 (New Living Translation) instructs – “Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight.” In Psalm 34: 17-18 (New Living Translation), “The righteous cry out, and the Lord hears them; he delivers them from all their troubles. The Lord is close the brokenhearted and saves those who are crushed in spirit.” Consequently, Christians maintain a staunch faith in God in the midst of trials and tribulations as guided by the Bible Case Study on Biomedical Ethics in the Christian Narrative Essay examples. This case study shows the principle where Christians turn to their faith in God when confronted with dilemmas – whether having to do with morality, principled, or spirituality that require difficult decision making. Analogous, God also instructs Christians to use wisdom – Proverbs 4:6-7 (New Living Translation), “Do not forsake wisdom, and she will protect you; love her, and she will watch over you. The beginning of wisdom is this: Get wisdom. Though it cost all you have, get understanding.” In the case study of Mike and Joanne’s conundrum with their child’s health, applying both faith and wisdom is their ethical and moral responsibility. Christian principles are not one side and are not one-size fits all. Mike and Joanne must find a balance with their spiritual and moral values to decide the most appropriate decision for their son’s health. The case study of Mike and Joanne provides a decisive view on Christian faith versus moral principles when choosing medical treatments for their child James.

Christian Narrative and Vision

It is a misconception that having faith in God is blind. Faith in God, in fact, is based on free-will choice based on the existing information at hand. The Bible supplies Christians with adequate proof of followers choosing to have faith in God. According to Psalms 16:9 (English Standard Version), “ The heart of man plans his way, but the Lord establishes his steps.” The doctor informed Mike and Joanne that James needed immediate dialysis due to “acute kidney failure” and “elevated blood pressure.” James, with no doubt, opted to deny his son dialysis treatments and to apply his faith in God as encouraged by their pastor’s sermon a week earlier on faith and healing. On the other hand, Mike and Joanne promised to return a week later after another “faith healing service.” Mike exercised his autonomy to choose faith although he was aware that James’ condition would worsen so agreed to return. Their doctor had to respect the family’s decision even though it was based on faith versus science.

The secular defines autonomous as a requirement an individual “to have the capacity to deliberate a course of action and to put that plan into action” (Lawrence, 2007, pg. 35). As a devote Christian, I admire Mike’s drive to place their child’s health in Gods hand. On the other hand, as a Christian nurse, I also believe that God has provided us with talent and advancements in the medical field. It is evident that under the Christian narrative and Christian vision, autonomy and faith creates vital concerns in James’ case. For my part, I believe that Mike discounted wisdom by disregarding – or at least not considering – the doctor’s recommendation for dialysis. This is a classic example where autonomy in faith and God-given wisdom could have encouraged Mike and Joanne to have faith in God’s healing power by considering the advantages of modern medicine. Nonetheless, as a nurse, I would have to disavow my own opinion over that of my patients. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

Bioethicists

In the case of adolescent James, no indication substantiated that the physician grappled with the decision made by Mike and Joanne. He acknowledged their decision as all too common scenarios where “significant challenges arise for clinical care teams when patient or surrogate decision-maker hopes a miracle will occur” (Bibler et. al., 2018, pg. 40). Nonetheless, the physician exercised his advocacy for James as his patient by suggesting the best course of medical treatment of dialysis. However, it has been said that “for Christianity, medicine is called to serve God’s call and purposes, and everything is done in remembrance of, and in light of, Jesus’ ultimate authority and kingship” (Grand Canyon University, 2015, para.16). For James’ doctor, bioethics, also referred to as pluralism, delegates the application of four general conventional principles of “health care ethics, which include the Principle of respect for autonomy, Principle of nonmaleficence, Principle of beneficence, and. Principle of justice” (McCormick & Min, n.d., para. 5).

The doctor in James’ case respected the parents’ decision; however, realizing that their resolution based on faith in God may worsen their child’s condition, he strategically applied the principle of autonomy – “requires respect for the decision making capacities of autonomous persons” (Grand Canyon University, 2015, para.2). While Mike demonstrated to be an automonous individual discarding the recommended medical care for James, the doctor provided the principle of nonmaleficence – “requiring that people not cause harm to others” – with

intervention treatments to certify that Mike was well-informed on the reprocussions to James’ health without the dialysis (Grand Canyon University, 2015, para.2). Consequently, Mike accepted returning after “the faith healing services later in the week, and in hopes that James would be healed by then.” Thus, the doctor’s recommendations also served the premise of principle of beneficence – “requiring that people prevent harm, provide benefits, and balance benefits against risks and costs.” Whether the doctor deemed Mike and Joanne’s decision as a hindeorus to improving James’ quality of life via medical treatment, he provided the princple of justice – “fair distribution of benefits, risks and costs” by explaining the treatment opportunities available for James. This was demonstrated by Mike and Joanne’s willingness to return a week later.

At the end of the day, the doctor could not prevent Mike and Joanne from walking out the hospital even though they rejected dialysis for James. Case Study on Biomedical Ethics in the Christian Narrative Essay examples. It is the patient or the guardians of the patient, in this case, who must make the decision to accept or decline their doctor’s recommendation for treatment.Whether the doctor believed the decision ade by James’ parents was unfounded, his personal bias is incapacitated at this point.

Case Analysis

Although Mike and Joanne faithfully returned a week later, it was to the demise of James’ health who now needed a kidney donation to survive. In the Christian narrative, the Bible does not explicitly speak to the rejection of medical advice or, in this case, a donation of a kidney organ to save James’ life. Intrepretation of scriptures, however, often intangle an individual’s moral and ethical beliefs. In fact, this case study illuminates the struggle of a Christian with faith and wisdom. In order to save James’ life, Mike and Joanne offered their own kidneys although not a match. Moreover, James’ parents accepted friends’ and congregation’s offering of their own kidney although, again, none were compatible. Even though Mike and Joanne, in the Christian narrative, initially believed in the healing power of Jesus, they eventually grasped for hope in a kidney transplant Case Study on Biomedical Ethics in the Christian Narrative Essay examples. However, Mike tussled with the donation of the only kidney match for James – his twin brother Samuel. At this point, Mike, once again, believes, yet struggles, that the now dire situatuion was a testament to his faith in God for complete healing for James.

This case brings to questions the complete reliance of faith in God and prayer over the successful use of modern medicine to successfully treat James. In fact, based on Mike and Joanne’s faith, “human autonomy may seem good at first, but it [may be] a deception from the enemy, and eventually everything goes wrong” (Shelly & Miller, 2006, pg. 158). Case Study on Biomedical Ethics in the Christian Narrative Essay examples. Solely relying on prayer to heal life-threatening illnesses while discounting the miracle of modern medicine may not be the wisest move for Mike and Joanne. According to Shelly and Miller (2006), Ephesians 6: 10-18 states, “We are given spiritual weapons for this battle: truth, righteousness, peace, faith, salvation, Scripture and prayer” (pg. 163). The truth of the matter is that sometimes it takes more than faith and prayer to avoid the suffering of a child, such as James’ case, from a grave disease or death. God’s scriptures provide Mike and Joanne the autonomy to use wisdom when considering doctor’s recommendations for treatment as an answered prayer. The Bible explicitly explains that God has a calling for every one of us to be used to serve His people. Doctors and nurses, for instance, have been called to serve humanity – God’s creations.

Moreover, Mike and Joanne’s faith could accept James’ situation where having twins may have been ordained by God for saving James’ life. One can argue that Mike and Joanne refusing to use the only kidney compatible to save James’ life may be imprudent and ignorant. Hence, it would be wise for Mike and Joanne as believers to exercise their faith in God by accepting the doctor’s medical treatment and the compatibility of Simon’s kidney as a gift from God. In other words, God has answered Mike and Joanne’s prayers by leading them to a medical professional and a well-matched kidney to save James. In turn, Mike and Joanne can exercise their faith autonomously by praying that God provide wisdom and discernment for the surgeons who will remove Simon’s kidney and transplant it to James. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

Christianity’s View on Sickness and Health

The distinction, in this case, involving life and death exceedingly relies on appreciating the various spiritual weaponry and facets entangled in James’ situation – power of prayer, faith in God, the donated kidney as a gift of modern medicine, and God-given wisdom through doctor’s expertise. Nevertheless, patients have the autonomy to retreat to their own beliefs when considering a medical treatment. Likewise, a doctor can opt to advocate for their patients if they regard, as in this case, James and Joanne’s decision as detrimental to their child’s life. In good conscious, doctors are not permitted to practice bad medicine even at their patient’s request (Devettere, 2010, pg. 234). For instance, James’ physician could respect Mike and Joanne’s decision to practice the power of healing through prayer and laying on of hands; however, as an approach that will not impede essential surgery for James.

It is easy to glorify God in good times; however, as Christians we are also to give God the glory through bad times. Roman 5: 3-4 (English Standard Version) encourages Christians “to rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope.” Thus, dire health, disease, and illness are part of life’s sufferings that Christians’ faith will require rejoicing. Case Study on Biomedical Ethics in the Christian Narrative Essay examples. In this case, Mike and Joanne reluctantly reject the donor kidney, but they still accept James’ life-threatening disease as an opportunity to glorify God for the total healing of their son. On the other hand, “understanding another aspect of the unseen, the moral dimension, is critical” (Shelly & Miller, 2006, pg. 161). Subsequently, Mike and Joanne could accept the doctor’s treatment as God’s divine intervention to save their son. The unseen can be the acceptance as the medical treatment to cure their son’s illness and as the doctor serving as God’s tool or agent. Thus, by accepting James’ doctor’s medical expertise, Mike and Joanne allow God to perform a healing miracle.

Conclusion

Since the ultimate decision on James’ health relies solely on his parents, the doctor could have opted to take a more aggressive approach in advocating and convincing Mike and Joanne on accepting treatment for James. In fact, in the Christian narrative, “medicine is called to serve God’s call and purposes, and everything is done in remembrance of, and in light of, Jesus’ ultimate authority and kingship” (Grand Canyon University, 2015, para.16). Understanding and accepting the doctor’s expertise as God’s purpose for James’ healing would not only prevent the unnecessary suffering of the sick child but bring this matter at the throne of God. In a perfect world, allowing people to exercise their faith in God while disregarding medical treatment would have positive results in every case. However, medical decisions should not bring suffering and harm to patients – regardless of age – despite the reason for which it is made. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

References

Bibler, T. M., Shinall, M. J., & Stahl, D. (2018). Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists. The American Journal Of Bioethics: AJOB, 18(5), 40- 51. doi:10.1080/15265161.2018.1431702

Devettere, R. J. (2010). Practical Decision Making in Health Care Ethics : Cases and Concepts, Third Edition, 1-495. Washington, D.C.: Georgetown University Press.

Grand Canyon University, (2015). God, Humanity, and Human Dignity[Lecture]. Retrieved September 9, 2018 from https://lc- ugrad3.gcu.edu/learningPlatform/loudBooks/loudbooks.html?operation=innerPage&topic MaterialId=a788df13-3e3d-4f98-83d7-029c35f3f96c&contentId=7c6bddaa-839a-46a4- b02048f1f8451ce9&viewPage=current&currentTopicname=Biomedical%20Ethics%20in %20the%20Christian%20Narrative

Lawrence, D. (2007). The four principles of biomedical ethics: a foundation for current bioethical debate. Journal Of Chiropractic Humanities, (14), 34-40. Case Study on Biomedical Ethics in the Christian Narrative Essay examples.

McCormick, Thomas R. & Min, D. Principles of Bioethics. (n.d.). Retrieved from https://depts.washington.edu/bioethx/tools/princpl.html

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). Downers Grove, IL.: IVP Academic. Retrieved from http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php Case Study on Biomedical Ethics in the Christian Narrative Essay examples