PHI 413V Week 3 Case Study on Biomedical Ethics in the Christian Narrative

PHI 413V Week 3 Case Study on Biomedical Ethics in the Christian Narrative

Applying the Four Principles: Case Study

Part 1: Chart (60 points)

Providers face ethical challenges when managing different care cases and patient interventions that require them to apply the biomedical principles. Providers must evaluate different aspects of care provision based on models like the “four-quadrant” approach alongside ethical principles of beneficence, autonomy, non-maleficence, and justice (Chad & Gottlieb, 2018). Providers must possess decision-making capacity, get informed consent from patients, and evaluate all components of care (Gillon, 2018). The four-quadrant approach allows provides to make ethical decisions when faced with dilemma situations, balance, and weigh the four principles. The purpose of this paper is to analyze the “Healing and Autonomy” case study by using the four-quadrant approach in its first part. In its second part, the paper evaluates the use of the four principles based on a Christian perspective.


Medical Indications

Beneficence and Non-maleficence

Patient Preferences


Medical indications are diagnoses, prognoses and recommended treatment interventions by physicians and their teams based on a patient’s condition(Chad & Gottlieb, 2018). The indications imply that providers must offer beneficial and non-harmful care to patients with the aim of improving their quality of life.

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Beneficence and non-maleficence are ethical principles focused on enhancing quality of life through provision of effective care to patients after medical evaluation and diagnosis(Gillon, 2018). Clinical situations presented by patients inform physicians of the requisite care interventions. The present case “Healing and autonomy” highlights a minor, James, suffering from an acute glomerulonephritis and need immediate care intervention. The healthcare team recommends immediate dialysis. However, Mike and Joanne, James’ parents choose a prayer session to help heal their son and not medical intervention based on their faith and the principle of autonomy.

The physician in this case can only offer care based on informed consent and autonomy exercised by James’ parents. The only obligation for the physician is to offer sufficient information for the parents to make informed decision and choice.

Patient preferences entail choices, decisions and actions that patients and their families make regarding recommended treatment interventions based on their sociocultural positions and teachings (Chad & Gottlieb, 2018). Patient preferences show that individuals can make independent decisions on the type of care interventions they want from providers and healthcare facilities. Patient preferences are based on the level of information and engagement between providers and patients and their families.

The case study on “Healing and Autonomy” details James’ acute kidney condition that requires immediate attention and the decisions that his parents make concerning the issue. The parents exercise autonomy and preferences in this as demonstrated by their decision to take their son for a spiritual healing session instead of medical interventions.

Providers are duty-bound to consider choices and preferences that patients make regarding their treatment. Providers must respect them regardless of their negative or positive outcomes(Singsuriya, 2018). The physician allowed Mike and Joanne to take their son to church for a prayer session instead of a dialysis based on the principle of autonomy as their preference. The parents preferred a prayer session and not a medical intervention for James despite having sufficient information about the condition. However, they are exercising their autonomy and preferences which the physician cannot interfere with.

Quality of Life

Beneficence, Non-maleficence, Autonomy

Contextual Features

Justice and Fairness

Quality of life comprises relevant medical and health characteristics of an individual’s life prior to and after getting treatment interventions. The quadrant has beneficence, non-maleficence, and autonomy as essential ethical principles that providers should consider (Chad & Gottlieb, 2018). James’ present condition does not provide him with quality life and any intervention should focus on preserving, restoring, and improving it. Treatment interventions for the acute glomerulonephritis will allow James to attain benefits, reduce potential harm but only based on the parents’ informed consent as exercised by the concept of autonomy.

The two principles of beneficence and non-maleficence implores providers to offer the best care to improve a patient’s quality of life (Gillon, 2018). James’ current diagnosis affects the quality of life leading to recommending a dialysis as the immediate solution with a kidney transplant to offer a lasting remedy. The parents took James for the prayer session before bringing him when it failed because they exercise autonomy and preferences for their son. A prompt dialysis intervention will restore his life but matching kidney from his twin brother will offer much relief. However, it complicates the parents’ preferences and choices.

Clinical or medical situations are influenced by different aspects within society. Therefore, contextual features denote situations surrounding patients and their capability to make effective and sound decisions and choices. The contextual aspects include familial dynamics, religious and cultural practices and beliefs and ethical dilemmas against professional obligations among physicians and their teams (Chad & Gottlieb, 2018). Legal ramifications and provisions are also part of the contextual features that providers deal with when attending to patients.

Justice and fairness are a part of the contextual factors that implore providers to ensure fair distribution of resources and equality in treatment of all patients regardless of their backgrounds.

In this case, James’ parents’ religious practices affect treatment interventions as prescribed by the physician. The parents choose a prayer session to heal their son and not medical intervention in the first place. The physician cannot object their preferences and allows them to make informed choices and decisions. When James’ condition gets worse, they return to the facility and the physicians begins a dialysis as a short term intervention. A kidney transplant is the only long-term intervention. However, the parents are not willing to allow Samuel, James’ twin brother, to donate his matching kidney because of family dynamics and religious dimensions.

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 Christian worldview implores on people to practice sacrificial love as demonstrated by Jesus Christ through his passion and death as redemption for human beings and restoration of the lost relationship with God. Christianity mandates believers to do good to others as a way of attaining eternal life promised by God. These four principles should be weighted and specified based on the Christian worldview that is founded on unconditional love. The first principle is beneficence where people should demonstrate their sacrificial love of significant ones to them and even others. Through beneficence, they attain benefits from the others. James’ parents and the church members show love by their willingness to donate a matching kidney for him. The second principle is autonomy as illustrated by James’ parents who choose to take him for prayers upon having sufficient information from the physician and his team (Gillon, 2018). The third principle is non-maleficence as illustrated by the decision to have a transplant and the ongoing dialysis to save James’ life and not to continue having adverse effects of acute glomerulonephritis. The physician prescribes the intervention that will save James. However, the parents fear that their second son, Samuel, may be harmed by donating his kidney to the brother and are hesitant for them to undergo the procedure. The last principle is justice as illustrated by the parents who are keen on saving both sons and not ready to have them undertake the complex transplant as recommended by the physician.



  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 worldview is categorical that life is a sacred gift from God and cannot be taken away arbitrary by any person, including the individual themselves. In this case a Christian should balance each of the principles in the case based on the need to preserve life and its sanctity. The balancing of these principles should entail ranking them based on their importance to the value of life (Chad & Gottlieb, 2018). Autonomy should be the first principle followed by non-maleficence, beneficence, and lastly justice. Autonomy implores one to respect the inherent freedom and dignity bestowed on human beings during their creation (Gillon, 2018). Man is created with freewill and can make decisions and choices the way he wants. This freewill is given by God. Non-maleficence implores providers to ensure that they do not cause harm but give benefits to patients. They should act with the best interest of the patients to ensure that they attain beneficence as a principle. God’s command is loving others as one loves themselves. The implication is that providers should treat and relate to patients the best aspects of care(Owoc et al., 2018). They should seek to confer benefits to their patients with the minimal harm at all. Every patient an individual requires similar levels of compassion and dignity regardless of their diversity. Therefore, justice and fairness show that all people are equal as created by the same God. The implication is that providers should treat their patients equally and give them same resources. Mike and Joanne need to be fair to James and provide him with all the support and love required, including considering having the brother donate his kidney.



The analysis shows the need for healthcare providers to develop and use effective and evidence-based models to solve ethical challenges in their settings. The four quadrant model and the four principles of biomedical ethics allow nurses and other providers to analyze clinical scenarios, make effective decisions and tackle ethical dilemmas in practice. Through their effective deployments, healthcare providers can prevent potential litigations that may have adverse effects on their career progression and reputation.


Chad, M. T. & Gottlieb, L. J. (2018). The Four-Quadrant Approach to Ethical Issues in Burn

Care. AMA Journal of Ethics.

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

            Professionalism (pp. 45-59). Routledge.

Owoc, M. S., Kozin, E. D., Riemenschneider, A., Duarte, M. J., Hight, A. E., Clay, M., … &

Briggs, S. (2018). Medical and bioethical considerations in elective cochlear implant

array removal. Journal of medical ethics, 44(3), 174-179

Singsuriya, P. (2018). Ethics of Caring Conversation and Dialectic of Love and Justice. Nursing

Ethics, 25(4), 436-443.


Assessment Description
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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