PHI-413V Wk 3 Assignment- Case Study

PHI-413V Wk 3 Assignment- Case Study

Applying the Four Principles: Case Study

Part 1: Chart (60 points)

Based on the “Healing and Autonomy” case study, fill out all the 4 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.

1st box Medical Indications

Beneficence and Nonmaleficence

2nd Box Patient Preferences


3rd box Quality of Life

Beneficence, Non maleficence, Autonomy

4th box Contextual Features

Justice and Fairness

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)PHI-413V Wk 3 Assignment- Case Study



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.PHI-413V Wk 3 Assignment- Case Study

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?”

The “Health and Autonomy” Case Study of James and Samuel: Applying the Four Bioethical Principles in an Environment Ruled by the Christian Worldview

Part 1: Chart
Medical Indications

Beneficence and Nonmaleficence

Patient Preferences


·         Of the four bioethical principles, beneficence has the meaning of giving interventions to the patient that will only bring benefit or good to the patient. It is reinforced by nonmaleficence (primum non nocere), which means avoiding causing intentional harm to the patient by either omission or commission (Chonko, 2012; Page, 2012).

·         In the case of James who needed immediate dialysis, it is the physician who demonstrated beneficence by ordering that James be given what they needed and would benefit them immensely – dialysis.

·         The parents of James and Samuel (Mike and Joanne) as well as their friends and church members also demonstrated beneficence by agreeing to donate one of their kidneys to James.

·         Beneficence was also apparent in the nephrologist’s actions. He came up with the idea that if nobody matched with James, his twin brother could be the next most possible donor.

·         The parents of the twin brothers exercise non maleficence when they voice their reservations about Samuel losing one of his kidneys for his brother. What if the remaining kidney for Samuel fails too? It has to be acknowledged, however, that donating a kidney would actually be beneficence on the part of James.

·         Autonomy a bioethical principle that is all about letting the patient remain in control of their treatment decisions. In the case of a minor, this authority is with the parents. Autonomy also includes informed consent. Allowing the patient (or parent) to exercise their autonomy means that they can either accept or refuse treatment. This is exactly what Mike did when he refused dialysis for James, even though the physician had ordered that it be done (Chonko, 2012; Page, 2012).

·         The physician does not object to the decision by Joanne and Mike to forego dialysis and take James to a faith healing service. This is a good example of autonomy in action. It is instructive that they are not prevented by anyone to do what they want, even though the best logical option would be to do hemodialysis for James.

Quality of Life

Beneficence, Non maleficence, Autonomy

Contextual Features

Justice and Fairness

·         Beneficence is shown by the physician ordering hemodialysis for James, the parents accepting to donate a kidney to James, the nephrologist suggesting that Samuel is the best donor to James, and church members and friends agreeing to donate a kidney to James.

·         Non maleficence or primum non nocere was shown when Mike and Joanne felt that by donating a kidney; Samuel would be placing himself at a risk of kidney failure himself with his one remaining kidney.

·         Autonomy was demonstrated by the parents of the twin boys when they chose to go to a faith healing service instead of having their son do hemodialysis a ordered by the physician.PHI-413V Wk 3 Assignment- Case Study

·         Justice is the fourth ethical principle and involves fair treatment of all patients without discrimination or bigotry based on appearance, beliefs, ethnicity, creed, or color. The family of Mike and Joanne were treated very fairly in this case study. The physician and nephrologist were not judgmental and did not force the parents to follow their orders.

·         Fair treatment or justice was also evident when the nephrologist proposed that Samuel donate a kidney to James. He did not get tired with James just because James’ parents were flip flopping on the appropriate care that they wanted for their son.

·         The act of the parents of bringing James back for dialysis after the faith healing service also demonstrated justice for James.

Part 2: Evaluation
  1. The Christian worldview is a set of beliefs that basically state that there is a superior being known as God the Almighty who has power over all living and non-living things in the whole universe. Christianity subscribes to the teachings of Jesus Christ (the Gospels) that can be found in the New Testament of the Christian Bible (Summit Ministries, 2019). One of the most important teachings that Jesus Christ gave was that every person should love their neighbor just the way they love themselves. But who is my neighbor? You may ask. To answer this question, Jesus told the story of the Good Samaritan. A traveler was traveling to a distant part of the country when they happened to come across bad men who beat them and robbed them of their valuables. As he lay beside the road, everybody who came by just passed by and went about their business. This was until a Samaritan came along. He immediately took care of the injured stranger whom he did not even know and sought help to treat his injuries. PHI-413V Wk 3 Assignment- Case Study

According to the above anecdote the most pressing bioethical principle in this case study is beneficence. Even though all the four bio ethical principles work together to balance each other out, in this case what James needs is relief from the effects of his kidney failure. Donating a kidney to him would solve his problems and bring him good. Whoever will do this will be his true neighbor that loves him the way they love themselves, as explained by the Christian worldview.

  1. The Christian worldview does not advocate for doing evil to anyone, even if they wronged you. It is a worldview that preaches love and forgiveness. What it requires is that only good should come out of the actions of anyone of us. It frowns upon retribution and malice. This is why Jesus himself answered when asked that the greatest commandment of all is that you should love your neighbor as you love yourself. For a Christian, therefore, they would rank beneficence on top of all the four bio ethical principles of principle. He or she might then place the rest in the following order: non maleficence, autonomy, and justice.


The reason why the principle of beneficence would come on top when a Christian ranks the principles is because it addresses directly the concept of doing good to others. The presupposition in this instance is that the person to whom you are doing good is person you love. As stated above, Jesus in his teachings stated very clearly that the greatest commandment of all is that of love – loving your “neighbor” as you love yourself. I would be unimaginable to think that one would do good to a person that they do not love. It would therefore appear that love is a prerequisite of beneficence, at least according to the Christian narrative and worldview. PHI-413V Wk 3 Assignment- Case Study Beneficence is followed by non maleficence because non maleficence or primum non nocere is just another way of saying beneficence. It means the avoidance of harm to others who are in our care. Causing intentional harm to a person in our care such as a patient would violate the bioethical principle of non maleficence. Autonomy means letting the patient or a parent in a minor’s case to decide on the trajectory that their care will take. In the case study, for instance, the physician clearly states that James needs immediate hemodialysis. However, the parents are of a contrary opinion and decide that they would rather take him to a faith healing crusade. Nobody prevents them or forces them against this decision. The reason is that they have been allowed (as it should be) to exercise their autonomy on behalf of James. It can be argued that allowing a patient or their attorneys to exercise autonomy brings good to that person in a psychological sense. Lastly but not least is the bioethical principle of justice in the order arranged by a hypothetical Christian. Justice means treating people fairly without discrimination. In this case, after doing good to someone, avoiding causing them intentional harm, and giving them the voice to decide what happens to them; it would only make sense that they are also treated fairly to cap it all.


Chonko, L. (2012). Ethical theories. The University of Texas at Arlington.

Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making? BMC Medical Ethics, 13(10).

Summit Ministries (2019). Christian worldview.

PHI-413V Wk 3 Assignment- Case Study