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Applying the Four Principles: Case Study

Applying the Four Principles: Case Study

Applying the Four Principles: Case Study

Applying the Four Principles Case Study

Part 1:

Medical Indications: Beneficence
and Non-maleficence
Patient Preferences: Autonomy
is a collection of ideologies that require people to prevent harm, avail the necessary
benefits, and creates a balance between benefits and risks (Michelle,
It involves extreme acts of kindness in benefiting others
from all adverse incidents. The physicians are expected to use their
knowledge in ensuring that they extend welfare to their patients. Beneficence
is shown through the kindness of Mike and Joanne, who were willing to offer
their kidneys for the transplant, but their tissues were not a match of their
advises physicians not to harm their patients. Physicians are expected to
abstain from acting with malevolence to patients. Non-maleficence provides
slight concrete guidance in patient’s upkeep. In the case study, the
physician suggests James be given kidney dialysis immediately and not any
other type of treatment that would have caused harm to him.
Autonomy is based off of patients’
preferences which encompass the decisions one makes when they are faced with
health problems, especially on the patient’s medication. Autonomy then
involves respecting the patient’s opinions regarding medication.
Patients have different
preferences based on their culture and beliefs on what they consider to be
right which have to be met by physicians. In Mike and Joanne’s case, autonomy
is shown when decisions making is done by them for their child, James. When
the nephrologist mentioned kidney transplant, Mike was upset and decided to
take James for a healing sermon in the church. Mike is making decisions for
James because he is a minor, hence unable to make the appropriate decision by
himself. The nephrologist does not make the final decision about what should
be done to James, but only provides suggestions. These actions respect the
patient’s autonomy.
Quality of Life: Beneficence,
Non-maleficence, Autonomy
Contextual Features: Justice
and Fairness
Beneficence works towards improving
the quality of patient’s life by removing harm. In beneficence, the patients
are relieved from suffering, and hence, they lead healthy lives, and thus,
they can enjoy their normal life activities (Jonsen, Siegler, &Winslade,
2010). For example, in James’s case, the physician decided to perform a kidney
dialysis to ease James’s suffering. James’s health condition improved for some
time as his parents were searching for a compatible kidney donor while antibiotics
were still being given to James to relieve pain. This gave his parents a peace
of mind.
Non-maleficence also improves the
quality of patients’ lives, but it has a smaller impact compared to that of beneficence.
This happens by stopping the harmful medication to the patients and hence
prevents the effect of intensifying their infection. In the case study, the
nephrologist advised kidney dialysis for James, as they search for a
compatible kidney donor. The nephrologist did not admit unnecessary
medication to James apart from regular dialysis hence making James healthy. Autonomy
may either improve or lower the living standards of human beings, depending
on the patient’s decision. If a patient decides to abandon medication, he may
end up experiencing difficulties that lead to misery and suffering. In the
case study, Mike was almost deciding to abandon medication and have James’s
illness healed under the power of God. In some cases, the issues of faith can
lead to a patient’s recovery, but in most cases, it brings suffering to them as
in the case of James.
features affect the decision making among patients since they touch on
specific factors such as family dynamics, financial statuses, and religious
aspects of the patients. The contextual features also touch on justice and
fairness to the patient by the medical practitioners. In healthcare, justice
and fairness are often interchanged (Daniels, & Sabin, 2018). Justice
refers to acting according to the required laws; some patients attach justice
to Gods will, while others hold the belief that truth is inherent.
is only eight years old therefore, Justice is done to him when both his
parents and the nephrologist when he is provided the appropriate care. Both
parties are familiar with good health as a fundamental human right, and so
they do everything in their power to ensure that the kidney problem does not
affect James any longer than it already has. Justice is shown by when frequent
dialysis is performed on James’s kidneys, as they plan on acquiring a kidney
donor. The principle of justice requires the nurses to work according to the
laws of the state as well as respect the religious beliefs of a patient. The
principle of fairness helps the medical practitioner to treat the patients
with dignity. The policy of fair play promotes the virtues of equity,
equality, and neutrality in terms of healthcare service delivery as in the
case study.

Part 2:

The most pressing principle of medical ethics in Christianity is the patient’s autonomy. According to this principle, the Christian patient has a right to make his own choice on how healthcare intervention should be administered. The principle also asks physicians to respect the opinions of their patients. Some Christians have strong faith that God has a purpose for their sickness (Meilaender, 2013). The belief in that through faith all is possible and so medical administration is not compulsory. For example, Reichman's case study (Biomedical Ethics in the Christian Narrative, 2019) performed in 2005 about Mrs. Jonas, the principle of autonomy, is shown when Mrs. Jones is given time to recover from her unconsciousness to communicate her medication desires to the physician. In my understanding, Mrs. Jones may have been holding onto her faith for healing, and that is an excellent example of how Christianity affects a patient’s autonomy.

The principle of patient’s autonomy also affects Christians
in that most of them take sickness as a test of their faith or a temptation to
be overcome. Due to this reason, a person can be admitted in a hospital but
refuse any medication from the physicians as a result of a strong belief in
God’s healing power. Believing in miracles also affects whether a Christian
will accept medication or not. Let us consider a case in the Bible when Jesus
resurrected Lazarus. Some firm believers hold onto this that it can happen to
them while others do not fear to lose their lives because it is the transition
to eternal life. Nonetheless, all these believes and opinions must be
respected. The physicians should not criticize their patients due to holding a
strong belief in the sanctity of life.

All four principles of medical ethics are significant to Christians. However, they do not take the same position in the Christian religion. The first one is the patient’s autonomy in which the physicians are mandated to respect the opinions of their patients. In this principle, patients have the right to refuse treatment or otherwise allow nature to take its course (Meilaender, 2013). Patients’ autonomy is directly linked with the patient’s faith. In the case study, Mike and Joanne, are willing to forgo treatment for their child, James, and place their faith in God for his healing. The physician will have to respect what they agree to do. Secondly, the principle of medical ethics in beneficence states that physicians should express kindness to their patients and mercy. It implies that medical practitioners and society should act as good Samaritans by coming to the aid of the sick, injured, and dying (Meilaender, 2013). This principle also extends a hand of concern to the elderly patients and requires the community to be comforting to them. In the case study, Mike and Joanne are willing to donate their kidneys to their child, but this did not work since their kidneys were incompatible to that of their child. The principle of beneficence inspires Christians to be merciful and come into the aid of others.

The third-ranked principle of medical
ethics, according to Christians, is non-maleficence. Non- maleficence sends a
warning to all the people that they should not harm patients. Therefore, the
physicians must evaluate this rule and discover the consequences of
administering a particular medication to patients. For example, the physicians
required to avoid using a respirator to elderly patients as this would lead to
more chronic conditions in patients like lung cancer (Meilaender, 2013). In the
case study, the physician did not perform a kidney transplant to James since
all the potential transplants were from incompatible donors. Lastly, the principle
of medical justice is applicable, and it means respecting the rights and
dignity of every human being. In Christians, justice encompasses leading
peaceful and godly life by respecting others. Physicians must be fair and just
to their patients by giving proper medical attention (Michelle, 2017). This
principle is evident in the case study since the physician suggested immediate
kidney dialysis on James. The physician understands that James is mandated to
good medication, and so he is willing to respect this right. In conclusion, all
religions are bound to certain values regarding medication, and hence, their
opinions must be respected.


Biomedical Ethics in the Christian Narrative. (2019). PHI-413V Topic 3 Overview, Grand Canyon University. Retrieved from

Daniels, N.,
& Sabin, J. (2018). Contextual feature in medical ethics. McGraw Hill. Retrieved from:

A. R., Siegler, M., &Winslade, W. J. (2010). Clinical ethics: A practical
approach to ethical decisions in clinical medicine (7th ed.). New York: McGraw Hill Education/Medical.

G.. (2013). Bioethics: A Primer for Christians (3rd ed.). Grand Rapids, MI: Wm.
B. Eerdmans Publishing Company.

Michelle, M.. (2017). The principles of justice and fairness. Beyond Intractability. Retrieved from:



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