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-box 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.
Remember to support your responses with the topic Resources.
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
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Justice and Fairness
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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)
2. 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)
Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
“Principlism,” by Childress, in the Encyclopedia of Ethics (2001).
“Ethics,” by Hobden, from Key Concepts in Nursing (2008).
American Journal of Bioethics
American Journal of Bioethics website.
Presidential Commission for the Study of Bioethical Issues
Presidential Commission for the Study of Bioethical Issues website.
“Bioethics” from the Internet Encyclopedia of Philosophy website.
“Bioethics,” by Waters, from Cambridge Dictionary of Christian Theology (2011).
The Five-Box Method: The “Four-Box Method” for the Catholic Physician
“The Five-Box Method: The ‘Four-Box Method’ for the Catholic Physician,” by Marugg, Atkinson, and Fernandes, from The Linacre Quarterly (2014).
The Four Quadrant Approach to Ethical Issues in Burn Care
“The Four Quadrant Approach to Ethical Issues in Burn Care,” by Teven and Gottlieb, from AMA Journal of Ethics (2018).
Navigating Ethics in a Health-Care Setting
“Navigating Ethics in a Health-Care Setting,” by Sego, from Clinical Advisor (2011).
The Four Principles of Biomedical Ethics: A Foundation for Current Bioethical Debate
“The Four Principles of Biomedical Ethics: A Foundation for Current Bioethical Debate,” by Lawrence, from Journal of Chiropractic Humanities (2007).
The “Four Quadrants” Approach to Clinical Ethics Case Analysis; An Application and Review
“The ‘Four Quadrants’ Approach to Clinical Ethics Case Analysis; An Application and Review,” by Sokol, from Journal of Medical Ethics (2008).
Teaching Clinical Ethics Using the Four Topic Method
“Teaching Clinical Ethics Using the Four Topic Method,” by Ediger, from International Journal of Athletic Therapy & Training (2015).
Autonomy in Applied Medical Ethics
“Autonomy in Applied Medical Ethics,” by Freer, from Ethics & Medicine (2017).
This project will use a common practical tool to assist clinicians in starting to ethically analyze a case. This method of data organization will assist you in applying the four principles and four boxes approach.
You will complete the “Applying the Four Principles: Case Study” document based on the “Case Study: Healing and Autonomy” and other required topic Resources, which includes the following:
Part 1: Graph
The four principles and four boxes approach will be formalized in this chart, which organizes the data from the case study according to the relevant biomedical ethics principles of autonomy, beneficence, nonmaleficence, and justice.
Part 2: Assessment
This section contains questions that must be answered in a total of 500 words and describe how principalism would be applied in the given situation.