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Healing and Autonomy Case Study

PART 1: Chart

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 Non-maleficence

Patient Preferences

Autonomy

The American Psychological Association (APA) has outlined five principles of ethics which include beneficence and non-maleficence. In the principle of beneficence, it is advised that medical professionals should only take those decisions that are beneficial for others (Al-Bar & Chamsi-Pasha, 2015). The principle of non-maleficence advises the physicians that they should ensure that their decision is not going to hurt anyone involved (Andersson et al., 2010). Best outcomes should be achieved for the patients with minimum harm. The case study provides the following examples of beneficence and non-maleficence:

  • On his first visit, James was advised to receive immediate dialysis by his physician. This suggestion was made due to fluid buildup and high blood pressure.
  • During his second visit, regular dialysis was suggested for James as his health was deteriorating and dialysis would help in stabilizing his condition.
  • Although James’ condition had stabilized, he was advised to receive a kidney transplant within a year.
  • His parents, Joanne and Mike were informed that Church members could not be considered for a kidney transplant as their tissues would not match.
  • They were informed that James’ twin Samuel was the ideal donor as his tissues were a match for James.
Autonomy means that everyone has the right to make their own decisions, determine right or wrong based on their beliefs, and independence (Entwistle et al., 2010). All healthcare providers must adhere to the principle of autonomy as they can only provide guidance. If their suggested treatment goes against the beliefs of the patients then it is the right of the patients to reject the treatment and not be influenced or forced to get the treatment. Their decisions should be respected by the healthcare providers even if it is not ideal for the health of the patient to reject the treatment. Following are the examples of autonomy taken from this case study.

  • When Mike and Joanne were making their decision regarding James’ medication, the physician did not interrupt them or try to influence the decision.
  • During the decision when Mike and Joanne decided to put their faith in God and decline the dialysis, the physician respected their decision.
  • The physician did not influence Mike and Joanne’s decision regarding kidney transplants that if they should let Samuel donate the kidney or wait for a miracle from God.
Quality of Life

Beneficence, Non-maleficence, Autonomy

Contextual Features

Justice and Fairness

The physicians should ensure that their decisions will allow the patient to experience a quality of life. Some examples of the quality of life taken from this case are as follows:

  • Mike and Joanne were informed by the physician that they were not the ideal donor for James as their tissues did not match.
  • The physician advised that James receives a transplant within a year despite his condition being stable.
  • Samuel was the ideal donor for James as they were twins and the physician advised that Samuel be the donor for James.
  • In the end, the physician allowed Mike and Joanne to make the final decision of whether or not Samuel should donate his kidney to James or wait for a better outcome.
This principle states that people are entitled to the latest advancements made in the field of medicine and should not be deprived of it. If the healthcare facility has access to advanced medical equipment then they must inform their patients about it along with its benefits and let them decide whether or not they would like to incorporate it into their treatment (Menzel, 2012). The example of justice and fairness took from this case is as follows:

  • James was allowed access to a dialysis machine on daily basis by the physician, which helped in stabilizing his condition.

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, how would each of the principles be specified and weighted in this case? Explain why.

The principle of autonomy would take precedence in this case as it is more relevant to the Christian worldview. Autonomy means that everyone has the right to make their own decisions without being influenced even if that decision is not ideal. Freedom of will is a very important right and healthcare providers must always respect the decisions made by their patients. The patients have the right to make their decisions regarding their health and accept or reject the diagnosis of the doctor. So even though the healthcare providers may not agree with the decision made by their patients, they should respect it and allow them their autonomy. Mike and Joanne’s decisions, in this case, may not have been ideal in the eyes of the physician but he did not try to influence them. They were entitled to the freedom of making their decision regarding their son as he was a minor at that time. If James was not a minor then he may have taken different decisions regarding his health but he was a minor and had to rely on his parents to make the right decision. The physician does not argue with Mike and Joanne when they decide to decline the medication for James and respects their decision. He only advises or guides them throughout the whole procedure and gives them time to make their decisions. He does not try to influence them when they decide to pray to God for a miracle rather than allow Samuel to donate his kidney to James, although; these decisions were putting James’ life in danger and could potentially make him lose his life. He allowed them to make their decision as autonomy took precedence in this case.

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.

The principle of non-maleficence will hold priority according to a Christian as this principle advises to make decisions that ensure that the patient is brought to as minimum harm as possible. This means that the decisions that a physician takes are always in the patients’ best interests. Justice and fairness will come in second as this principle states that every individual is entitled to the advanced technology in the field of medicine and it should not be withheld from them in any case. This principle ensures that everyone can get the best treatment without discrimination. Beneficence is the principle that will take third place in this order and it states that healthcare providers make decisions that are in the best interest of the patients. So the Christians that decline the treatment fail to get timely treatment just like James whose parents decided to put faith in God instead of understanding that the treatment was in the best interest of James. The principle of autonomy comes last as it asks the healthcare providers to respect the decisions of the patients even if those decisions are wrong. This principle, although; protects the freedom to make one’s own decision, does not stop them from making wrong decisions which can lead to dire consequences (Hoehner, 2020).

References

Al-Bar, M. A., & Chamsi-Pasha, H. (2015). Beneficence. In M. A. Al-Bar & H. Chamsi-Pasha (Eds.), Contemporary Bioethics: Islamic Perspective (pp. 129–139). Springer International Publishing. https://doi.org/10.1007/978-3-319-18428-9_8

Andersson, G. B. J., Chapman, J. R., Dekutoski, M. B., Dettori, J., Fehlings, M. G., Fourney, D. R., Norvell, D., & Weinstein, J. N. (2010). Do No Harm: The Balance of “Beneficence” and “Non-Maleficence.” Spine, 35(9S), S2. https://doi.org/10.1097/BRS.0b013e3181d9c5c5

Entwistle, V. A., Carter, S. M., Cribb, A., & McCaffery, K. (2010). Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. Journal of General Internal Medicine, 25(7), 741–745. https://doi.org/10.1007/s11606-010-1292-2

Hoehner, P. J. (2020). Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3

Menzel, P. T. (2012). Justice and Fairness: A Critical Element in U.S. Health System Reform. Journal of Law, Medicine & Ethics, 40(3), 582–597. https://doi.org/10.1111/j.1748-720X.2012.00691.x

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