PHI-413V Week 3 Case Study On Biomedical Ethics In The Christian Narrative Paper

PHI-413V Week 3 Case Study On Biomedical Ethics In The Christian Narrative Paper

PHI-413V Week 3 Case Study On Biomedical Ethics In The Christian Narrative Paper

Applying the Four Principles: Case Study

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The case study on healing and patient autonomy demonstrates the delicate balance that providers experience when faced with situations that involve the use of the four biomedical principles. In this case, the patient, a minor, cannot make decisions and the parents, Mike and Joanne, have the competence but seem to make choices that are not beneficial to the boy. While the four principles are essential in making decisions on the type of care to offer patients, other factors also emerge that based on the four-box quadrant method. These include medical indications which align with beneficence and non-maleficence, patient preferences that impacts autonomy, quality of life that is affected by the first three principles and the contextual features which align with the last principle of justice and fairness (Gillon, 2018). The purpose of this paper is demonstrate the application of the four principles in the case and discuss the Christian perspective in evaluating the principles based on the four-boxes approach.


Part 1: Chart (60 points)

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences


Medical indications are the diagnoses, prognosis, and proposed measures for patient assessment and treatment as well as the expected outcomes. In clinical practice like the current scenario, medical indications describe the strep throat infection that has escalated and led to acute glomerulonephritis and kidney failure in James. The physician asserts that James has good prognosis if treatment begins early since such infections are treated with antibiotics if they fail to improve on their own. The proposed measures in this case include a dialysis. However, the parents decide to take James for the faith healing services only to return few days later with the condition having worsened. The physician proposes a dialysis but is definite that a transplant would be required.

The physician carries out the assessment, diagnosis and explains the prognosis as well as suggested measures based on the principle of beneficence and non-maleficence. These two principles focus on ensuring that patients get better outcome from their condition (Gillon, 2018). The medical indications are emphatic that James requires a transplant since his condition cannot be treated by a one-off dialysis. The suggestions by the physician aim at ensuring that James’ quality of life improves through the interventions. Again, the principles of beneficence and non-maleficence implore the physician to make better decisions in the best interest of the patient and not to cause any harm.

Patient preferences are essential from both a medical and ethical perspective as they demonstrate their independent decision-making capacity. Competent patients with decision-making capacity have preferences based on the principle of autonomy. In this case, patients exercise autonomy based on the level of information offered to them by physicians and other healthcare providers. Autonomy allows them to either accept or decline the proposed treatment interventions. The role of the care providers is to offer sufficient information and options as demonstrated by the physician so that individual patients can make choices and select one that they prefer.

James has not decision-making capacity since he is a minor and his parents, Mike and Joanne, make the decision on his behalf using the principle of autonomy. The physician cannot interfere with the choices that they make and that’s why they decide to take him for healing services. However, when the service failed, they bring him back for dialysis after his condition worsens and requires now a kidney transplant. The scenario illustrates that the patient and his family have a good interaction and relationship with the physician. It is based on these relationships that they bring James back and follow all suggested interventions, including looking for a matching kidney for the transplant. Therefore, physicians and other healthcare providers like nurses should respect patient autonomy when making decisions based on their preferences.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Diseases can negative affect the quality of life. The main goal of medicine is preservation and improvement of the quality of life. In evaluating the quality of life (QOL) the principles of beneficence, non-maleficence, and autonomy are essential. According to Teven et al. (2018) QOL is subjective but essential in determining effective interventions for patients. In this scenario, the physician and his team implore Mike and Joanne to accept the medical interventions based on the diagnosis to improve James’ quality of life. The parents make decisions with the aim of improving his quality of life but they end up being detrimental to his health. As such, the physician allows them to exercise autonomy and make choices that they deem beneficial to their son. The implication is that effective and quality decisions can improve the quality of life for patients like James with acute glomerulonephritis condition. Withdrawal of care does not arise in this scenario as all stakeholders’ focus on reducing and preventing any harmful effects of the condition on James. Clinical situations do not occur in isolation but are a component of the larger situation that may require ethical analysis. Contextual matters that impact the decision-making abilities in healthcare and clinical settings include patient-centered aspects like family dynamics, financial resources and religious practices and beliefs (Gillon, 2018). Again, they may also comprise of legal effects of care and personal bias based on patient’s preferences and need to exercise autonomy in making decisions.

In this case, contextual issues are about fairness and justice for James and his parents’ insistence on using faith healing service instead of medical interventions. Mike questions his faith in Christ when the healing service fails to cure James. The decisions that they make are mainly based on their religious beliefs and practices yet they seem contradictory to contemporary medical practice interventions. However, the physician cannot ignore these beliefs and practices and allows them to take the boy for the service based on the principles of autonomy, beneficence, and non-maleficence. Again, the need for a matching kidney exposes the level of contextual issues that impact care provision as the parents are reluctant to allow Samuel to donate a kidney for his brother, James as they fear that they may lose all of them due to the surgical process.   

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)
The case provides a delicate analysis from a Christian perspective on the principles of biomedical ethics. Christians believe that preservation of one’s life and dignity is core to demonstrating sacrificial love for others (Hoehner, 2020). As such, they advance that any actions should aim at offering benefits, especially to those suffering under the burden of diseases and other afflictions (Carr et al., 2019). Imperatively, the principle of beneficence is specified and considered the most critical to improve the quality of care offered to patients. For instance, James’ parents make choices because of having James’ interest at heart. They act in good faith and demonstrates their resolve when they bring him back for treatment.

They acted independently and bring back James based on the principle of autonomy. These decisions reduce more harm to James as he is placed on dialysis to improve his condition. As such, the principle of autonomy is specified and weighted as the second most important. The decisions by both parents and physician focus on attainment of quality outcomes and reducing possible harm based on the principle of non-maleficence (Gillon, 2018). The parents focus on reducing harm and attaining beneficial outcomes when the decide to allow the physician carry out a kidney transplant. However, they are dismayed that they may lose both sons. The last principle is justice and fairness. While it is a delicate situation of having Samuel donate a kidney to James, the parents have no option since it is the matching one and will show justice for both children. As such, without this intervention, James’s quality of life will decline and may succumb earlier than expected. Therefore, these principles are weighted and specified based on their overall role in patient care provision. 


  1. 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)
The Christian perspective is emphatic that providers, healthcare facilities and patient’s family should place the patient’s interest at first. Such interest should override all aspects of care provision for patients, especially those with delicate situations like James. As such, Christianity ranks the four principles in a manner that guarantees benefits to patients and their families. Beneficence is the first principle that Christians consider since they want the patient’s best interest (Hoehner, 2020). Christians rank non-maleficence as the second important ethical principle since all actions by an individual should confer benefits to people and not harm them. Christians are commanded to love their enemies and pray for those who persecute them. The implication is that harm should not feature in any decisions that a Christian makes concerning the welfare of others. Christians rank justice and fairness as the third most essential principle as it is important to ensure that all people are treated equally without and favoritism and biases. The implication is that James requires a kidney and his parents should be fair by allowing Samuel to donate the matching one to save his life as a sign of sacrificial love. Decisions on the interventions should not be a preserve of the affected individual but the family. Therefore, autonomy, while important is the last principle for Christians in their ranking of these ethical principles. As such, all the principles are essential and applicable simultaneously to improve a patient’s overall condition.  



The application of ethical principles and the use of fox boxes approach are essential to improving overall understanding of different aspects that impact decision making in healthcare. The case study on “healing and autonomy” shows the need for providers to comprehend the different factors that lead to certain decisions that providers make and influence patient care. Patients have a right to sufficient information so that they can make better decisions. The Christian perspective on biomedical principles allows Christians to rank and weigh each of them differently to attain quality patient care.


Carr, M. F. & Winslow, G. R. (2019). From Conceptual to concrete. In World Religions for

            Healthcare Professional (pp.31-45). Routledge.

Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Health Ethics, Law and

            Professionalism (pp.45-59). Routledge.

Hoehner, J. (2020). Practicing dignity: An introduction to Christian values and decision making

in health care.


Teven, C. M., & Gottlieb, L. J. (2018). The four-quadrant approach to ethical issues in burn care. AMA journal of ethics, 20(6), 595-601.

DOI: 10.1001/journalofethics.2018.20.6.vwpt1-1806.


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-boxes 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.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

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