Applying The Four Principles: Case Study Part 1 Chart ✓ Solved

Applying the Four Principles: 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:

  • James suffering from acute glomerulonephritis and kidney failure.
  • Initial treatment required due to complications from strep throat infection.
  • Elevated blood pressure and significant fluid buildup necessitating temporary dialysis.
  • Condition acute enough to justify immediate medical attention.

Beneficence and Nonmaleficence:

  • Beneficence: Acting in the best interest of the patient to alleviate suffering.
  • Nonmaleficence: Avoiding harm that could arise from delaying treatment.
  • Emergency dialysis was suggested by the attending physician as a beneficial option.
  • Risk of not proceeding with dialysis led to worsening health for James.

Patient Preferences (Autonomy):

  • Mike and Joanne's decision to forego dialysis based on religious faith.
  • Perspective that faith healing would yield better outcomes than medical interventions.
  • Initial refusal of treatment demonstrates patient (and parental) preference in care.
  • Return to hospital indicates a reconsideration of their autonomy in light of outcomes.

Quality of Life:

  • Assessment of quality of life hindered by severe illness and reliance on dialysis.
  • Potential kidney transplant could improve long-term quality of life.
  • Continual dialysis affects family dynamics and emotional wellbeing.
  • Choices being made impact James's future and familial relationships.

Contextual Features:

  • Religious beliefs influencing medical decisions and values.
  • The family's connection to their faith community plays a role in care decisions.
  • Broader societal perspectives on faith healing versus conventional medicine.
  • Emotional strain on parents impacted by the decision-making process.

Justice and Fairness:

  • Consideration of resource allocation regarding organ donation.
  • Equitable treatment and access to necessary medical care for James.
  • Family's struggle within the healthcare system reflects on fairness in organ transplant criteria.
  • Need for a fair assessment of potential donors, including family members.

Paper For Above Instructions

The case study of Mike and Joanne’s situation regarding their twin sons, James and Samuel, illuminates the complex interplay of medical ethics, parental decision-making, and the role of faith in healthcare. Each of the four principles provides a framework for evaluating the decisions made throughout this scenario.

Medical Indications

James is suffering from acute glomerulonephritis, which emerged as a complication from a strep throat infection. This condition has necessitated his admission to the hospital due to kidney failure. Medical professionals recognize that while some cases of acute glomerulonephritis may resolve with conservative treatment, James’s elevated blood pressure and fluid retention have prompted the recommendation for immediate dialysis as a critical intervention to stabilize his health (Mayo Clinic, 2023).

Beneficence and Nonmaleficence

The principles of beneficence and nonmaleficence play a crucial role in the physician's responsibility to act in James’s best interest while avoiding unnecessary harm. The attending physician’s suggestion of immediate dialysis illustrates an effort to provide beneficial treatment. Delaying this intervention, as per the parents' wishes to rely on faith healing, led to a deterioration in James’s condition, demonstrating the potential harm of such a decision (Beauchamp & Childress, 2019). In retrospect, decision-making is further complicated by Mike's feelings of guilt and fear surrounding their choice to forgo medical intervention.

Patient Preferences (Autonomy)

Mike and Joanne’s decision to opt for faith healing over dialysis encapsulates the conflict between patient autonomy and medical advice. Their decision reflects a deeply held belief system that prioritizes religious faith over traditional medical intervention, suggesting that they believed in the possibility of a miracle due to their recent experiences. The autonomy exercised by Mike and Joanne, however, results in a greater need to evaluate their decision when faced with subsequent medical needs for James. Their eventual decision to return to the hospital marks a potential shift in their understanding of control over health outcomes (Gillon, 2003).

Quality of Life

Quality of life considerations are paramount in this case. Initially forgoing dialysis resulted in significant health deterioration for James, emphasizing the direct impact of medical decisions on his quality of life. The option to consider a kidney transplant emerges in response to the stark realities of his health situation, and it could significantly improve his prognosis. The ongoing medical treatments, including regular dialysis, create a strain not only on James’s physical health but also on the emotional and relational dynamics within the family (Holland et al., 2019).

Contextual Features

The influence of context in this case cannot be understated. Mike and Joanne’s religious beliefs shape their perspectives on medical care and serve as a core component of their identity. The involvement of their community through prayer and support further complicates their situation as they navigate the healthcare system. The case highlights broader societal issues regarding the intersection of faith and medicine, including how such beliefs can significantly guide health decisions, sometimes at the expense of conventional medical recommendations (Coulter, 2020).

Justice and Fairness

Justice and fairness come into play when assessing donor compatibility within the context of organ donation. The family's desires to donate a kidney to James highlight the personal sacrifices parents are willing to make. However, the ethical considerations regarding organ allocation based on compatibility and fairness, as well as the waiting time for potential donors, remains a primary concern. The overarching healthcare system must ensure equitable treatment for all patients, thereby respecting the complexities of familial obligations versus medical realities (Miller et al., 2019).

In conclusion, the dilemma faced by Mike and Joanne emphasizes the need for a delicate balance between the principles of medical ethics—beneficence, nonmaleficence, autonomy, and justice. Each figure into the complex decisions that shape the healthcare journey of their son, James. Though faith plays a critical role in their lives, navigating the harsh realities of medical necessity may ultimately lead them to reevaluate the intersection of these principles in their decision-making process.

References

  • Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
  • Coulter, A. (2020). Engaging Patients in Healthcare. The Health Foundation.
  • Gillon, R. (2003). Medical Ethics: Four Principles Rather Than Four Topics. Journal of Medical Ethics, 29(5), 307-312.
  • Holland, M. et al. (2019). The Impact of Illness on Family Quality of Life. Family Process, 58(4), 1234-1243.
  • Mayo Clinic. (2023). Glomerulonephritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/glomerulonephritis/symptoms-causes/syc-20361682
  • Miller, S. C. et al. (2019). Justice and Fairness in Health Care. Health Affairs, 38(6), 923-931.
  • Veatch, R. M. (2016). Medical Ethics: A Very Short Introduction. Oxford University Press.
  • World Health Organization. (2022). Organ Donation and Transplantation: WHO Guidelines. Retrieved from https://www.who.int/news-room/fact-sheets/detail/organ-donation-and-transplantation
  • Fitzgerald, S. (2020). Religion and Health: A Review of the Evidence. Journal of Health Psychology, 25(1), 3-17.
  • Klein, D. J. (2018). Faith and Medicine: Competing Paradigms. Journal of Religion and Health, 57(1), 34-43.

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