Ethics is an inherent part of medicine. As such, it is fundamental for healthcare workers to apply medical ethics while carrying out their duties. An in-depth understanding of the four principles of beneficence, nonmaleficence, autonomy, and justice provides a foundation for efficient and respectful care of patients in different settings. Regarding the Healing and Autonomy case, however, a dilemma exists as the parents choose to believe in a miracle for their son, James’ healing, instead of heeding their doctor’s advice. In the case study, we analyze this conundrum and how the physician applied the four principles. Further, the paper explores the weight and specifications of each principle from a Christian worldview and how Mike and Joanne could infuse their spiritual beliefs and science for their son, James.
| Medical Indications
Beneficence and Nonmaleficence The beneficence principle states that physicians should only engage in activities that benefit patients, while nonmaleficence asserts that health practitioners should not hurt anyone in their practice (APA, 2020). In James’ case, the physician suggested immediate dialysis due to his elevated blood pressure, which would stabilize his deteriorating condition. Further, the physician proposed a kidney transplant for James, suggesting an ideal match for him and his twin brother Samuel since the volunteer church members were mismatched. |
Patient Preferences
Autonomy The autonomy principle avers that patients have the right and freedom to make their own choices regarding their care (APA, 2020). In the Healing and Autonomy case, with James being a minor, his parents decided on treatment. In this case, the physician did not interrupt when the parents decided to forego treatment and seek divine healing. Similarly, when James deteriorated, was taken back to the hospital, and the physician suggested that his brother Samuel would be an ideal match, he did not persuade them either while they debated whether to heed the doctor’s advice or wait for God to perform a miracle. |
| Quality of Life
Beneficence, Nonmaleficence, Autonomy To improve the quality of James’ life, the doctor proposed e undergoes a kidney transplant within the year even though he is currently stable. Despite Mike and Joanne and the church members not being a match, the physician advised them to consider a transplant from his brother Samuel who was his ideal match. However, at no point did the doctor pressure them to make any decision, and neither condescended to the parent’s approach to believing in God for healing, despite his belief that science was the best option for James’ wellbeing. |
Contextual Features
Justice and Fairness In the case study, this principle applies because the sick boy was provided the option of using advanced technology to improve his quality of life (APA, 2020). The physician proposed that James undergo daily dialysis rounds to stabilize his condition. |
The principle of nonmaleficence has the most weight as it advocates that no harm should be caused. In the case study, the physician is obligated to provide James’ parents with treatment options that would cause him less harm which was proposing a transplant that would improve his deteriorating health. The principle of beneficence comes in a close second as it advocates for good intentions, in this case, the improvement of James’ health (Veatch, 2020, p. 546). Thus, Mike and Joanne are supposed to embrace a treatment option that provides their son with the most benefit, and by failing to adhere to the treatment protocol, their behaviour denies their son a chance to get better. His health deteriorates, and he is faced with choosing his twin brother Samuel as his kidney donor, which could significantly affect Samuel’s well-being. This decision highlights the weight of the third principle of justice and fairness that advocates that patients should benefit from technological advancements. In this case, undergoing a transplant would significantly improve James’ well-being.
Finally, the principle of autonomy carries less weight. Patients have the freedom to choose the course of treatment. However, it poses a big challenge, particularly for patients who make decisions based on faith instead of facts. In Healing and Autonomy case, James’ parents choosing to believe in miracles for their son’s healing has unfortunately led to the deterioration of his health (Veatch, 2020, p. 551). As such, their religious beliefs have come in the way of their son’s unfair treatment, breaking the most fundamental principle of do not cause harm.
Unquestionable Faith in God is one of the most spoken of values in the Bible. In most instances, Christians are encouraged to maintain staunch faith in God during their trials and tribulations. In the Healing and Autonomy case, the situation was no different. Despite Mike and Joanne receiving factual information about their son’s condition and appropriate course of treatment, they placed their faith in God and trust in his for healing on the foundation of a sermon they had heard at a healing service. However, the Bible also reminds Christians that Faith without actions is dead (Cherry, 2019, p. 7). In this case, Mike and Joanne had a moral responsibility to choose the best treatment option for their son, James, by balancing the four principles. The principle of beneficence and nonmaleficence are the most fundamental. From a Christian worldview, the Bible instructs Christians to love their neighbors as they love themselves, including prioritizing the well-being of others. In this case, the physician means well by recommending a transplant for James, which is the best course of treatment for him giving him a chance to lead a normal life. This course of treatment ensures that James comes into no harm again by dealing with the acute glomerulonephritis once and for all.
On the principle of autonomy, the Bible reminds Christians of the free will bestowed upon them. Decisiveness is also an important principle of the Bible; the parents must decide what is best for James (Cherry, 2019, p. 11). Choosing a way of faith and not science further complicated James’ situation; therefore, it is necessary to make a decision that will guarantee James’ future. Therefore, while the parents are restricted by their religious beliefs on the course of treatment, it is critical to first place their child’s welfare, finding a balance between the four principles and their faith. Therefore, the actionable thing for the parents to do, in complete Faith, is to let James undergo the transplant, which will improve his quality of life.
In conclusion, the Healing and Autonomy case provides insight into the importance of exercising wisdom despite religious beliefs. It shines a light on the narrative that spiritual beliefs are not a one-size-fits-all; in this case, principles could not replace science. While the paper does not negate the importance of faith in a healing journey, it emphasizes the importance of Mike and Joanne exercising their moral principles and assessing facts to choose their son’s treatment course, significantly improving his quality of life.
References
APA. (2020). Ethical principles of psychologists and code of conduct. American Psychological Association. https://www.apa.org/ethics/code/
Cherry, M. J. (2019). Bioethics without god: The transformation of medicine within a fully secular culture. Christian Bioethics: Non-Ecumenical Studies in Medical Morality, 25(1), 1–16. https://doi.org/10.1093/cb/cby015
Veatch, R. M. (2020). Reconciling lists of principles in bioethics. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 45(4–5), pp. 540–559. https://doi.org/10.1093/jmp/jhaa017
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