Case Study on Biomedical Ethics in Christian Narrative
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.
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| Medical Indications
Beneficence and Nonmaleficence |
Patient Preferences
Autonomy |
| · The diagnosis conducted on James reveals that he suffers from kidney failure and is at the end stage whereby the absence of a health kidney transplant would have fatal consequences for him. He must have a healthy kidney transplant in order to continue living a healthy life.
· James was first diagnosed with a strep throat infection and later an acute kidney failure. He only required dialysis to stabilize his condition with the possibility of improvement. However, the condition has turned from acute to critical as James was denied the recommended medical treatment even as he was taken to a faith healer. · The delay in treatment that caused the kidney failure to turn from acute to chronic means that dialysis in now only a temporary treatment measure since James has a grim prognosis unless he can get a new kidney. · Currently, James care plan can only involve continuing to receive dialysis on a daily basis even as his kidney deteriorates until he receives a new kidney. · James has an identical twin brother, Samuel, who has been determined through medical tests to be a transplant match and viable kidney donor. There is an expectation that the parents of James and Samuel will consent to Samuel donating his kidney to help in saving the life of James. |
· The physician who is attending to James case makes it clear to the parents that James must be placed on dialysis treatment as a matter of urgency in order to stabilize his condition from further deteriorating and possibly save his life. It is unclear if the physician clarified that James needed urgent treatment, and that delaying treatment even for a few days could result in fatal consequences.
· The principle of autonomy is applied when the parents are allowed to make decisions on whether or not James can receive the recommended treatment. The parents applied the principle of autonomy when they withdrew James from the hospital and sent him to a faith healer. Although the physician understood that delaying treatment would worsen the condition with grimmer consequences, the parents were allowed to withdraw James from the lifesaving medical treatment. · James and Samuel must rely on their parents to make their medical decisions. The two boys are minors. The parents are assumed to have the best interests of the two boys at heart and would make the best health care decisions. It is expected that the parents will make the decisions that allow James to receive the best possible medical care while ensuring the best outcomes.Case Study on Biomedical Ethics in Christian Narrative |
| Quality of Life
Beneficence, Nonmaleficence, Autonomy |
Contextual Features
Justice and Fairness |
| · James has a reduced quality of life. The delay in receiving medical treatment as James was taken to a faith health causes his condition to deteriorate. His medical condition shifts from acute to critical kidney failure so that he now needs a new kidney. James can only continue to survive through dialysis treatments that would barely stabilize his condition.
· A viable transplant match for James has been identified as his twin brother, Samuel. Getting Samuel to donate a kidney would improve the quality of life for James by enabling his to have at least one healthy kidney so that he would no longer need to receive regular dialysis. However, donating a kidney would cause Samuel to have a single kidney instead of two thereby restricting the activities he could engage in and reducing his quality of life. · Both James and Samuel are minors. Their parents are expected to make their medical decision, and they will decide what treatment James can receive and if Samuel would donate a kidney to James. · There is a possibility of the whole family suffering if James does not receive a kidney. That is because his health situation would worsen with the possibility of death. The family is left with the difficult options of either letting James continue to suffer or having Samuel donate a kidney. |
· James and Samuel are minors and are not given the opportunity to make decisions about their health care. Their parents retain the right to make their health care decisions. This state of affairs presents concerns about the principle of fairness since the parents appear to be making decisions that are best for them and their faith rather than making decisions that are best for James. They take James to a faith healer and this ends up harming his health as the kidney failure worsens.
· Also, there are concerns about fairness and justice with regards to Samuel’s situation. He is not allowed to make the decision about whether or not he will be donating a kidney to save the life of his brother. This is unfair to Samuel and an injustice. · The parents retain the authority to make health care decisions for James and Samuel. For this they require complete information from the medical personnel. This presents concerns about justice as they would require all the relevant information in order to make the right decisions. They can only make the right decisions if they have the right information. · The physician must content with the principles of justice and fairness when making suggestions and recommendations about care decisions. In allowing the parents to continue making decisions that appear harmful to James, the physician is faced with concerns about justice in terms of the right of James. In addition, there are concerns about fairness in terms of seeing James being denied the necessary treatment thereby causing his medical condition to deteriorate. |
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, which of the four principles is most pressing in this case? Explain why. (45 points)Case Study on Biomedical Ethics in Christian Narrative
| According to the Christian worldview, the most pressing principle of the four under consideration is the principle of beneficence that is focused on preventing harm to others, providing benefits and balancing benefits against costs/harms. The parents appear to have harmed James. They went against medical advice and withdrew James from the recommended medical treatment. Instead they took him to a faith healer thereby delaying his medical treatment and causing the kidney failure to worsen, turning from acute to critical. The parents had the selfish desire to uphold their faith. The result was that dialysis was no longer an effective treatment strategy, and can only be used as a temporary measure. In fact, James now needs a healthy kidney transplant as his diseased kidneys have no hope of recovery (Black, 2020). In addition, the parents appear to be more concerned with exercising their rights to make health care decisions for their sons. It is evident that the parents love their sons as they are using much effort to look for a solution. Visiting a faith healer and taking James to receive medical treatment when his situation worsens are indications of a caring attitude. However, their initial decision to delay medical treatment was wrong and this caused the health condition of James to worsen. The parents are now faced with the choice of continuing to see the health condition of James worsening even as he continues to receive dialysis care, or having Samuel donate a kidney so that his quality of life reduces even as that of James increases. Making a decision that does not cause any harm is difficult in this situation (Black, 2020). |
- 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)
| According to the Christian worldview, the order of priority for the four principles from highest to lowest would be beneficence, nonmaleficence, justice and fairness. The principle of beneficence is ranked first because it focuses on not causing harm. The current situation shows that whatever decision is made is likely to cause harm. James can continue to receive dialysis as his quality of life reduces or can receive a healthy kidney from his brother Samuel thereby improving his quality of life. However, donating a kidney would have potential negative effects on Samuel to include reduced quality of life. Deciding between who should be harmed and who should benefit is difficult. The principle of nonmaleficence is ranked second because it focuses on ensuring that the decisions made do not result in any harm. Case Study on Biomedical Ethics in Christian Narrative According to this principle, every decision that the parents make should not cause harm, and should instead present benefits. The principle of nonmaleficence applied the same arguments as the principle of beneficence (Black, 2020). The principles of justice and fairness are ranked third because they are concerned with ensuring that the costs and benefits of every decision are distributed fairly. These principles help in ensuring that Samuel would only donate a kidney if the associated risk is acceptable and James is offered an opportunity at survival. The principle of autonomy is ranked fourth because it is concerned with respecting actions undertaken and decisions made by autonomous persons. The parents are autonomous persons and they can make decisions for their sons who are minors (Stelle & Monroe, 2020). |
References:
Black, B. (2020). Professional Nursing: Concepts & Challenges (9th ed.). Elsevier Inc.
Stelle, R. B., & Monroe, H. A. (2020). Christian Ethics and Nursing Practice. Cascade Books.Case Study on Biomedical Ethics in Christian Narrative