Applying the Four Principles

Applying the Four Principles: Case Study

Part 1: Chart (60 points)

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences


In medical science, treatment options are based on clinical data to make related diagnosis. James had acute glomerulonephritis as a result of strep throat infection that was complicated by elevated blood pressure and fluid overload requiring dialysis and subsequently kidney transplant. Beneficence stipulate acting with the best intensions in mind, while non-beneficence indicates do no harm. Although James parents were acting in his best interest their religious faith obscure their judgment even knowing that James condition would get worse if not treated. They had no intention to harm him, but came to reality when only kidney transplant can save his life. Patient preference is the choice expressed by the patient or a substitute decision maker. James is a minor that did not participate in the decision regarding his health. “Autonomy emphasizes on the right of a person to make his/her own decision” (Beever, 2016). James is 8 years old and underage who cannot exercise his autonomy rights. His parents made the decisions for him without his input. The physician at least spoke with the parents but did not persuade them into agreeing with medical science.
Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Quality of life is the relevant medical features of the patient life before and after treatment. James medical condition was deteriorating while he was undergoing dialysis treatment. It is to a point where he needs kidney transplant and his father is thinking for his brother to be the donor or rely on faith again. Based on previous encounters, faith did not resolve the issue. The question is James valued? They should at least get James opinion, and work on the best interest of James and allow him to get the Kidney from his brother. According to Gillon, (2018), “Contextual features determine the legal, social and familial setting that influences one’s medical decisions. James parents had faith that he could be healed through prayers which influenced their medical decisions”. They are thinking again on faith whether for him to receive his brother kidney. Gillon stated that, “Justice and fairness placed emphasize on equality. The conflict of interest arises when an ideal match for the kidney was identified and that happened to be his brother. The parents were willing for others and including themselves to donate a kidney but not his brother”.

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Part 2: Evaluation

1. Beneficence is the most pressing principle according to Christian worldview. The parent’s intentions in mind are the best interest of mind. They believe their faith will heal their son through prayers. By so doing their preference was to believe in prayers initially than medical intervention. According to the bible, life is a precious gift from God; as such Christian believers must do their best to preserve a life (Orr, 2015). Besides saving James life, the goal is to bolster his quality of life which is attainable only through beneficence. If the parents allows his brother to be the donor, then that is morally acceptable since the ultimate goal is to protect a life. Healthcare providers and the parents must act in good faith to “promote good” on behalf of James. From a Christian perspective, we must love one another as we love ourselves. This is in compliance with the ten commandment of God. No man should take another man’s life is the basic teaching in biblical principles. In other words we must protect life, humans did not make or give life, only God, and thus he is the only one to take life. God has demonstrated his love for us, his people in multiple ways. With this in mind the principle of beneficence stands out in James case. Any decision made must have the basic principle of “doing good”.


2. People from different background will rank the four principles differently based on their belief, their worldview, and origin. Ranking might be different from say a Hindu. From a Christian perspective beneficence should be most priority. The goal of the commandment is for Christian to love one another, and do good actions no matter the circumstances. Due to the close proximity to beneficence, nonmaleficence takes the second spot. This principles advocate for people not to harm other people. According to Carr, (2017) “parents should also ensure that no matter what, they should not harm their children, which is in relation to the principle of nonmaleficence. Based on Christian worldview it is sinful to cause harm to others”. As Christians, they must be “healers” not “destroyers”. The third principle of priority is justice. “Typically, justice addresses issues such as equality, fairness in the distribution of resources, and compliance to morally acceptable laws” (Lozano, 2004). As Christian, they are supposed to practice justice and fairness in all their encounters and life experiences. The Christianity scriptures teach followers to be fair and just in everything they do. Their action represents justice and fairness. The last principle is autonomy. It is prudent for Christians to allow others to give their opinion on certain decisions. In essence they should respect other people opinions even when there is disagreement. By doing this will uphold the principle of autonomy.


Beever, J., & Brightman, A. O. (2016). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and engineering ethics22(1), 275-291.

Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for Healthcare Professionals (pp. 31-45). Routledge

Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and Professionalism (pp. 45-59). Routledge.

Lozano, A.J (2004). Principles of Bioethics for Christian Physicians: Autonomy and Respect. The Linacre Quarterly, 71(2), 104-113

Orr, R.D. (2015). Incorporating spirituality into patient care. AMA journal of ethics, 17(5), 409-415.

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