Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation
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.
Beneficence and Nonmaleficence
Medical indications comprise diagnosis, prognosis, proposed interventions for evaluation and treatment, and the expected treatment outcome (Torry, 2017).
Beneficence refers to the duty of doing and promoting good and preventing or removing harm (Torry, 2017).
Nonmaleficence refers to doing no harm and avoiding harming (Torry, 2017).
In the case study, temporary dialysis is indicated by the attending due to elevated blood pressure and enough fluid buildup.
The attending physician upholds the principle of Nonmaleficence and Beneficence when he recommends that James have immediate dialysis to avoid further deterioration.
The act of Mike foregoing the decision to have James have the dialysis would be considered as failing to uphold nonmaleficence since the decision caused more harm to James.
Mike, however, demonstrates Beneficence when he brings James back for treatment when his condition deteriorated.
• Nonmaleficence is demonstrated when Mike shows concern about allowing Samuel to donate a kidney and whether it would negatively affect him.
Patient preferences result from the patient’s deliberation of certain health elements such as cost of treatment and potential health outcomes (Torry, 2017).
Autonomy refers to respect for the individual patient and his or her capacity to make decisions that involve the patient’s health and future (Torry, 2017).
Autonomy is also the right to self-determination (Torry, 2017).
The attending physician upholds Autonomy when he informs Mike of the available treatment options to ensure he makes an informed decision.
Autonomy is also demonstrated when the attending respects James’ parents’ decision to forego dialysis and seek spiritual healing.
The nephrologist also upholds Autonomy when he presents the available treatment options to James and allows him to decide whether to consent for Samuel to donate a kidney.
|Quality of Life
Beneficence, Nonmaleficence, Autonomy
Justice and Fairness
| Quality of Life (QoL) is the level to which a person is healthy, comfortable, and able to engage in or enjoy life events.
QoL is multidimensional, comprising of physical, emotional, financial, and social well-being (Torry, 2017).
The attending has a motive for improving James QoL when he recommends immediate dialysis to avoid further deterioration.
James’ condition deteriorated; however, his condition stabilized after regular dialysis.
The nephrologist recommends a kidney transplant to improve James’ QoL, which also demonstrates Beneficence.
Beneficence is also demonstrated when the nephrologist proposes to Mike of an ideal kidney donor.
|Contextual features are defined as the context in which a specific case occurs.
This includes familial, professional, religious, legal, financial, and institutional factors that influence clinical decisions (Torry, 2017).
Justice refers to maximizing benefits to patients and society while emphasizing equality, fairness, and impartiality (Torry, 2017).
The attending physician demonstrates Justice and fairness when he provides treatment to James even though his parents had previously declined.
Justice and fairness are also upheld when James is provided the best treatment available.
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 , how would each of the principles be specified and weighted in this case? Explain why. (45 points)
The principles of Beneficence and Nonmaleficence bring about the special duty of care that health providers owe their patients. According to the Christian worldview, no medical procedure or decision should cause unnecessary pain or injury and must be for the patient’s good (Orr, 2015). The principles of Beneficence and nonmaleficence would carry the heaviest weight in the Christian worldview since one is required to love the new neighbor as you love yourself (Brugger, 2016). This is considered the second greatest command and recaps the law on how we treat fellow humans. Consequently, Christians would require health providers to act for the benefit of others.
According to the Christian worldview, the respect to Autonomy gives rise to consent processes and has facilitated bringing the focus of medicine back to the patient rather than the pathology (Brugger, 2016). Respect for Autonomy is an important theme in the Christian scriptures, demonstrated by how God interacts with man in the creation story. In the Christian worldview, humans are free to make decisions that are very unwise and then to live with the consequences (Orr, 2015). Besides, if God created and respects free will, then health providers should do the same. Autonomy would have the second heaviest weight in the case study.
The Christin worldview on Justice is that each person whose circumstances are the same merits the same level and quality of care. In an unjust world, the quest for justice is a great challenge of living the Christian life (Orr, 2015). The Christian worldview would require the health provider to act justly and advocate for patients when they are not treated fairly.
- 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)
|A Christian can balance each ethical principle by determining which principle carries more weight in a given situation. A moral individual’s actual duty is established by weighing and balancing all competing ethical duties in any particular case (Brugger, 2016). Christians can achieve this by understanding the unique features and facts that build the context for that situation. Obtaining relevant and accurate facts is a crucial component in decision making in order to balance each principle (Brugger, 2016). A Christian can approach an ethical dilemma using common morality by appealing to rational reflection, being open to transparency and publicity.
In the case study, the principles can be balanced by understanding the rationale for each of the subjects’ decisions. A Christian can examine the reasons for each decision and the potential consequences of each. A balance of the principles can then be achieved by assessing which principle will influence a decision that will have the greatest impact (Brugger, 2016). For instance, one can examine the principle that influences the attending physician to recommend dialysis and the reasons for Mike to forego the decision to have James undergo dialysis and instead seek spiritual healing. A Christian can then assess the consequences of the decisions and balance the principles based on the impact of each decision.
Brugger, E. C. (2016). The first principles of the natural law and bioethics. Christian bioethics: Non-Ecumenical Studies in Medical Morality, 22(2), 88-103. https://doi.org/10.1093/cb/cbw002
Orr R. D. (2015). Incorporating spirituality into patient care. AMA journal of ethics, 17(5), 409–415.
Torry, M. (2017). Ethical religion in primary care. London journal of primary care, 9(4), 49–53. https://doi.org/10.1080/17571472.2017.1317407