Applying the Four Principles Case Study Assignment

Applying the Four Principles Case Study Assignment

Applying the Four Principles Case Study Assignment

Part 1: Chart (60 points)

Providers encounter a host of ethical challenges in their efforts to offer care to patients in different situations. According to Chad and Gottlieb (2018) providers in any setting nee decision-making capacities based on informed consent from patients or their surrogates. Providers must also uphold the required biomedical ethical principles like autonomy, justice, beneficence and non-maleficence as well as justice when addressing ethical dilemmas. The use of “four boxes approach” is critical in ensuring that these providers can make effective decisions based on their situations. The purpose of this paper is to assess the case of “Healing and Autonomy” using the four box approach and the four principles of biomedical ethics. The paper also evaluates the requisite application of these principles based on Christian worldview.

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Medical Indications

Beneficence and Non-maleficence

Patient Preferences

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Autonomy

Medical indications include diagnoses, prognoses and information as well as interventions by physician and medical team about the treatment of a patient in a health situation (Chad & Gottlieb, 2018). These indications implore providers to use the ethical aspects of beneficence and non-maleficence to offer quality care. In this case, James has acute glomerulonephritis and requires immediate care. The decisions by the physician on the need for dialysis and later on a kidney transplant are based on the medical indications as exhibited by the minor. The team is keen on ensuring that they meet patient’s best interests and do not harm him based on the principle of non-maleficence.

The physician explains the benefits of these procedures to James to his parents, Mike and Joanne so that they can make better decisions, medically. By doing this, the physician demonstrates the need to ensure that James has better outcomes and quality of life.

Patient preferences mean that a patience has the freedom to choose the kind of medical interventions that they feel better based on the principle of autonomy (Gillon, 2018). Based on autonomy patients make decisions on the kind of care that they want. Different issues impact preferences that patients in care provision. These include cultural and personal influences on treatment decisions and information from the providers.

James is a minor and his parents express his preferences as surrogates to make decisions because he lacks competence to be autonomous. Providers must consider the decisions that patients make and adhere to their preferences as illustrated in this case where the physician allowed James parents to make different decisions, including those that appeared detrimental to his health. However, the team cannot stop such preferences because patients have autonomy.

Quality of Life

Beneficence, Non-maleficence, Autonomy

Contextual Features

Justice and Fairness

Quality of life entails the appropriate medical and health characteristics of an individual before and after getting health and treatment interventions. The quadrant focuses on beneficence, non-maleficence, and autonomy. Disease conditions negatively impact the quality of one’s life. The primary aim of any health intervention is the preservation, restoration, and improvement of the quality of life (Gillon, 2018). The parents need to appreciate the effects of treatment in James’ case as it will improve his quality of life.

The principles of beneficence and non-maleficence implore providers to offer the best to improve a patient’s condition. The current diagnosis has negatively affected James and requires all stakeholders, right from his parents, to make better decisions aimed at enhancing his quality of life despite his condition.

 Clinical situations do not happen in isolation but are influenced by contextual issues or those aspects in one’s physical environment and their capacity to make decisions (Chad & Gottlieb, 2018). These aspects may include familial matters, cultural practice and religious beliefs and norms as well as ethical barriers. Therefore, providers need to consider these aspects as part of being fair and just to patients. The contextual issues may also include legal requirements and mandates that all should fulfill to avoid possible suits.

James parents need to be fair and just by allowing their son to access care, even if it is against their religious beliefs and practices as these interventions will save his life. The parents should focus on better ways to help James and accept resources like the kidney transplant from his brother.

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 focuses on sacrificial love as demonstrated through Jesus’ suffering and death with the aim of redeeming human beings and restoration of the lost relationship with God. Christianity implores believers to offer good to others as a means pf getting eternal life and living God’s command of love; the Golden Rule (Carr & Winslow, 2018). The implication is that the four principles should be specified and weighted based on the rule of love as advanced by the Christian Worldview. The principle that should be specified and weighted first is beneficence as illustrated in this case through efforts by different people, especially from the church to donate their kidney to James. Secondly, autonomy is the next principle as illustrated by the physician who allowed James’ parents to make whatever decision they deemed necessary. Thirdly, non-maleficence implores providers and even James’ parents to make sound decisions that do not harm the boy and his health (Singsuriya, 2018). The parents are skeptical of Samuel donating his kidney to his brother because they do not support bad to occur to both as it will mean losing all of them. Fourthly, justice should be specified and weighted as it requires the providers to ensure that they can save James’ life. The implication is that all the stakeholders must seek ways to enhance the quality of life for James through a long-term solution like having the transplant.

 

  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)
According to the Christian worldview, life is a sacred gift from God and no one has power to terminate it except the giver. God gifts physicians with medical knowledge to help human beings for preservation and sustenance of life (Carr & Winslow, 2018). Based on this worldview, a Christian must balance each of the four principles by ranking them based on their importance. For instance, beneficence is the first principle followed by autonomy and thirdly, non-maleficence. Beneficence is first since all efforts based on the Christian narrative should focus on loving one another and doing the best for their interest. Autonomy entails the respect for human freedom and freewill as created by God. Human being have inherent dignity and should be allowed to exercise their free will. Non-maleficence is the third as it requires providers to cause no level of harm to patients when making decisions and choices so that they act in their best interests (Varkey, 2021). The principle of justice requires all people to be treated equally and with dignity and compassion that they deserve. Every patient needs same level of compassion and respect as well as access to health resources and experts. Therefore, a Christian in this case must consider the overall benefits of any intervention for James to improve his health status.

Conclusion

Healthcare providers must develop effective strategies to deal with a host of issues, especially ethical matters to offer quality care. The four quadrant approach and the four principles of health ethics allow providers to assess situations and make better decisions aimed at prevention of ethical and legal implications of their actions. Therefore, they must deploy effective models and strategies to address the arising problems in their facilities.

References

Chad, M. T. & Gottlieb, L. J. (2018). The Four-Quadrant Approach to Ethical Issues in Burn

            Care. AMA Journal of Ethics.

Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and

            Professionalism (pp. 45-59). Routledge.

Carr, M. F., & Winslow, G. R. (2018). From conceptual to concrete. In World Religions for

            Healthcare Professionals (pp. 31-45). Routledge.

Singsuriya, P. (2018). Ethics of Caring Conversation and Dialectic of Love and Justice. Nursing

Ethics, 25(4), 436-443.

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical

            Principles &Practices, 30:17–28. https://doi.org/10.1159/000509119  

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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 and four boxes approach.

Based on the “Case Study: Healing and Autonomy” and other required topic Resources, you will complete the “Applying the Four Principles: Case Study” document that includes the following:

Part 1: Chart

This chart will formalize the four principles and four boxes approach 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

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