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Applying the Four Principles

Applying the Four Principles

Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information using bullet points or a well-structured paragraph in the box. Gather as much data as possible.

Medical Indications

Beneficence and Nonmaleficence


Patient Preferences



The Principle of Nonmaleficence, founded on derivations from the Hippocratic oath, refers to an obligation of healthcare providers not to cause harm to the patient. The beneficence principle states that healthcare providers should only undertake medical interventions beneficial to the patient (Bogue et al., 2022). While most interventions in medicine could be considered harmful, a risk-benefit analysis should be undertaken to achieve the desired outcome against a rational and justified intervention (Grand Canyon University, 2022a). James’ case and how it was handled shows incidences where the principles of beneficence and nonmaleficence were upheld. The physician determined that the fluid buildup and increased blood pressure were an immediate concern and suggested that dialysis should be done immediately. After the second visit, a decision to do regular dialysis was made to stabilize the worsened condition, with the parents informed that a transplant should be done within the year. The nephrologist also told Mike and Joanne that Samuel was an ideal tissue match and, thus, a possible donor. This was after both the parents and other donor volunteers from the church were found to be mismatched and, therefore, not suitable donors. Autonomy refers to the ethical principle of allowing persons to use their innate and unconditional worthiness to make rational choices (Bogue et al., 2022). In this case, the healthcare providers respected the autonomy of the parents who make the decisions concerning James, a minor.

The physician did not impact the decisions surrounding James’ pharmacotherapy and allowed Mike and Joanne to discuss and agree without interruption. Further, the family was allowed time and space to seek faith healing over dialysis and decide whether to pick Samuel as an organ donor or depend on God’s miracles. All these scenarios show that James’ parents were accorded respect and freedom to make an informed choice.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Medical problems and their interventions affect patients in many ways (Bogue et al., 2022). It is essential to assess the patient’s overall well-being by exploring their perception of the illness and its effects on their values and goals. Before starting clinical interventions, healthcare providers must consider all these aspects of the patient and their family (Grand Canyon University, 2022). In this case, this was considered in the following ways:

·         The nephrologist identified that Mike, Joanne, and other church members were not ideal kidney donors to James due to tissue mismatch.

·         The physician informed Mike and Joanne of the urgency with which James was to undertake the kidney transplant, putting a one-year time frame to it.

·         The physician helped identify an ideal kidney donor by proposing Samuel and allowed Mike and Joanne to decide without interrupting and influencing their decision.

Like many other encounters in life, clinical encounters happen in a bigger context involving socioeconomic, institutional, and personal factors (Bogue et al., 2022). All these have the effect of possibly complicating the clinical picture. Justice and fairness featured prominently in this clinical picture and were observed. The physician upheld James’ right to healthcare and equal and just treatment by availing the dialysis machine to ensure that his condition was stabilized.

Part 2: Evaluation

Answer each of the following questions about how principlism would be applied:

In 200-250 words, answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)

The case highlights the impact of the overall worldview on ethical theories and their downward effect on healthcare practice (Bogue et al., 2022). Accordingly, autonomy is the most pressing principle in this case. Autonomy involves respecting an individual’s right to self-determination and control over their course. In healthcare practice, the focus of autonomy provides that all persons are entitled to freedom, self-sufficiency, and self-determination in decision-making. All healthcare providers should uphold this principle regardless of whether the final decision is agreeable. In this scenario, Mike and Joanne are entitled to this principle regarding the independence of thought in the decision-making process. The healthcare providers, in this case, upheld their right to self-determination. They provided proper and accurate information about the clinical status of James in a manner that was not increasingly detailed or complex and allowed them space and time to make their decision.

Additionally, the physicians respected the decisions made on multiple occasions, irrespective of whether they did or did not agree. The healthcare personnel was willing to allow the patients to go home and wait upon God’s miracle instead of approving the decision to make Samuel donate a kidney. As any healthcare personnel would advise, this decision is not wise and increases the risk of James dying. While many accounts exploring the four-principle approach assume autonomy trumps the other principles, this case scenario provides systematic evidence justifying the assertion.

In 200-250 words, answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)

Christian worldview affects how these principles are specified, weighed, defined, and applied in managing a Christian patient (Bogue et al., 2022). Research evidence shows that a Christian will rank the principle of nonmaleficence as the first principle. The principal advocates for using the least harmful procedure in the drive to restore health. It ensures that healthcare providers minimize harm and achieve best-case clinical results. Justice and fairness are following on this ranking. The principle provides that Christian patients seeking care are entitled to the best available care, which is technologically advanced and effective. The principle of beneficence is third and assures patient safety while in contact with the healthcare system. Therefore, Christian patients should synthesize the evidence-based information provided to them by healthcare personnel and make the most beneficial decision to minimize disease deterioration and achieve desired clinical outcomes. The principle of autonomy is the fourth in this rank. Christian worldview supports respecting patient autonomy within the confines of moral ethics and the sanctity of human life. Patients draw their decisions from provided information and their faith to inform their choice of intervention (The Bible Project, 2022). In this clinical case, the parents were accorded independence of thought and decision-making when choosing an intervention for their child’s medical condition. However, the undoing of this principle is it endangers patients who tend to put greater emphasis on faith over facts.


Grand Bogue, D., Hogan, M., White, N., Hoehner, P., Self, C., and Evans, K., 2022. Biomedical Ethics in the Christian Narrative. [ebook] Grandon Canyon University. Available at: <> [Accessed 24 March 2022].

Grand Canyon University, 2022. The neighborhood Christian clinic.Available at: <> [Accessed 24 March 2022].

Grand Canyon University, 2022. The neighborhood Christian clinic. Available at: <> [Accessed 24 March 2022]

The Bible Project, 2022. The Messiah. Available at: <> [Accessed 23 March 2022].


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This assignment will incorporate a standard practical tool in helping clinicians begin to analyze a case ethically. Organizing the data this way will help you apply the four principles and four boxes approach.

Applying the Four Principles

Applying the Four Principles

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.

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