1.
Applying the Four Principles: Case StudyPart 1: Chart (60
points)
Based on the “Healing and Autonomy” case study, fill out all
the 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.
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Faster dialysis will end up relieving or reducing high blood
pressure as well as fluid buildup of James. James is placed on
dialysis due to deteriorating condition. Also he needs the kidney
transplant in a year. Samuel, James’s twin brother is the only
one regarded as an ideal tissue donor. While conducting the
kidney transplant would save the life of James, it will threaten
the life of Samuel due to major surgery and losing one kidney
(Ghaderi et al. 2018).
The care provider has abided by the parent’s autonomy
through permitting them to exercise their spiritual beliefs. The
care provider has also agreed to the patient’s faith the spiritual
beliefs will restore the health of the patient. Mike the father of
the twin thinks that miracle will heal his son as he struggle with
the probability of going ahead with surgery. More so, little
opinion is aired by Joanne the mother of the twins and this
raises eyebrows as why
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
Medical treatment will help in restoring the kidney
functionality of James as well as save his life, however he will
experience some discomfort due to the temporary dialysis.
Medical treatment should bring James’s renal function to

2.
normalcy however; he has not received such treatment as results
of autonomy and parent’s decision on depend on faith. This led
to continues deterioration of the health condition of the patient.
The deteriorating condition will only demand kidney transplant.
James is now going to depend on dialysis is which lower the
quality of life, because the procedure has to be conducted three
times in a week and it is physically draining (Ghaderi et al.
2018). With time he will lose life or undergo kidney transplant.
Having a kidney from Samuel will improve James’s quality
of life. Samuel on the other hand will temporary decline in
functionality and if he lose the one kidney, he will also require
a transplant (Shaha et al. 2018).
If Samuel gives his brother a kidney he will save life of his
brother ad not lose hm. He will in turn improve his life
.Nomalificience principle is highlighted Mike struggle with the
decision of losing one son and putting the other can on a major
surgery leading to increased risk of surviving on one kidney
(Gracindo et al. 2018).
Mike, the father of the twins wonders and is in dilemma
whether it is just or fair to put Samuel through the great ordeal
of surgery and go through the risk of having only one kidney.
However, given the close relationship between James and
Samuel, it would be proper if Samuel would have provides the
kidney to his brother instead of losing him. Further, the opinion
and thoughts of their father is taking center stage. Joanne’s
feelings are not also acknowledged on the matter. Another
thing that raises eyebrows is whether, Mike has right to place
Samuel’s life primarily in his faith (Tilburt, Pacyna, &
Rusthoven, 2020).
©2019. Grand Canyon University. All Rights Reserved.
Part 2: Evaluation
Answer each of the following questions about how principlism
would be applied:
1. In 200-250 words answer the following: According to the

3.
Christian worldview, which of the four principles is most
pressing in this case? Explain why. (45 points)
Based on the Christian perspective autonomy is the
pressing principle in this particular scenario. Autonomy has to
do with letting the patient decide or make choices related to
their treatment in regard to their experiences, values as well as
beliefs. Autonomy is demonstrated by mike when they decide
not to go ahead with the surgery due to the moving sermon they
had experienced in church thus, taking their son to healing
services. The parent has therefore decided to let faith take its
course (Shaha et al. 2018). Later the condition worsened.
Autonomy plays a key role as the father struggle with the
possibility of going ahead with surgery and putting Samuel at
risk. The principle of justice is also crucial at this point when
mike figures out if it would be fair to put the o through Samuel
through ordeal of surgery. He is undecided and only hope that
the son to be healed through faith.
In healthcare sector, the principle of autonomy is always
considered and care providers are supposed to abide by or
respect the decision made by the patient. If the patient is not
fully autonomous in making choices in regard to medical
treatment the care provider has duty to let the patient participate
in medical decisions in relation to consequences of the choices
or decision made (Shaha et al. 2018).
Religious objection has a very strong foundation in the
legal precedent in constitution. It can be challenging for any
curt to justify where when the patient or parents refuse
medication for intention a that are not founded on the
recognized religion. However, where the spiritual treatment the
quality of life of the patient the patient autonomy may be
excluded (Tilburt, Pacyna, & Rusthoven, 2020).
2. 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)
In regard to Christian perspective, the Christian would run

4.
the importance or priority of the four principles in relation to
faith. Western medicine was commenced by Judeo-Christian
and the Greco-Roman heritage (Gracindo et al. 2018). Further in
relation to principles of medical ethics there are different
principles of the medical ethics comprising of moral code,
doctor, patient relationship, nomalificience, moral justification,
autonomy, justice and beneficence. There are only four
principles named in the biomedical ethics including non-
maleficence, justice, beneficence and autonomy. In regard to the
Christian world view, the four principles would rank in the
following manner. Autonomy will be the most prioritized
principle to Christians. The respect for free is one of the most
crucial topic in the biblical doctrine together with the
interaction among human beings and GOD (Tilburt, Pacyna, &
Rusthoven, 2020). In the book of genesis, a man is newly
created and then given freedom to make choices. The man is
given choices to follow commandment and not eat from the tree
of knowledge because he would die in the process. Therefore
God created and also respected the free will. Therefore, the
work of care provider is to inform ad and then respect the
choices made by the parents or patients. Non maleficence
principle comes second where the care provide has the moral
obligation not to cause harm to patient. Beneficence comes
second and it is clearly stated in the bible that “love your
neighbor as you love yourself” (Tilburt, Pacyna, & Rusthoven,
2020). The care providers should focus on benefiting others.
Justice has to do with treating people with fairness and
distributing resources equally. Therefore, the biblical law
outlines how people should treat one another in spite of having
diverse race and religion. All patients should be treated with
compassion and dignity.
References:
Ghaderi, A., Malek, F., Mohammadi, M., Maskopaii, S. R.,
Hamta, A., & Madani, S. A. (2018). Adherence to principles of
medical ethics among physicians in
Gracindo, G. C. L., da Silva Gallo, J. H., & Nunes, R. (2018).

5.
Threats to bioethical principles in medical practice in Brazil:
new medical ethics code period. Brazilian Journal of Medical
and Biological Research, 51(5).
Shaha, K. K., Patra, A. P., Chaudhari, V. A., Das, S., & Das, S.
K. (2018). A review on Applications of Principles of Medical
Ethics in the Practice of Surgery. South-East Asian Journal of
Medical Education, 12(1).
Tilburt, J., Pacyna, J., & Rusthoven, J. (2020). Christian
Integrity Regained: Reformational Worldview Engagement for
Everyday Medical Practice. Christian bioethics: Non-
Ecumenical Studies in Medical Morality. mazandaran province,
iran. Archives of Iranian medicine, 21(1), 19.
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

6.
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.
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?”
© 2019. Grand Canyon University. All Rights Reserved.