The document presents a case study involving a boy named James, whose deteriorating health requires a kidney transplant, with his twin brother Samuel as a potential donor. The parents prioritize their faith in divine healing over medical intervention, leading to complications and a delay in necessary treatment. The analysis discusses the ethical principles of autonomy, beneficence, and nonmaleficence in the context of their decision-making and the implications of respecting patient choices.

1. Applying the Four Principles: Case Study
Part 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
From the case study, it can be noted that James’ health
continues to deteriorate, and it worries since he missed his
dialysis. As a result, his blood pressure has increased. The
condition to the extent that he needs a kidney transplant. He has
a potential donor in his twin brother. Kidney transplant can save
the life of James, but it may also pose significant harm to
Samuel, who is going to donate the kidney. However, it is the
responsibility of medical practitioners to ensure that James
regains his health.
James' parents were given the autonomy to have control over his
health. The health care provider allowed them to believe in
God’s miracle to restore their son’s health. James’ parents
deliberately skipped his dialysis schedule for a church healing
service. The parents also had the autonomy to decide whether
Samuel can donate his kidney to James, his twin brother.
Seemingly, James’ father (Mike) preferred believing in is faith
for his son’s healing. This case is a perfect example of respect
for autonomy. The health care practitioner respected the
parents’ belief in God and gave them the opportunity of

2. deciding the intervention that would help James restore his
health.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
According to the doctor, James’ health can only be restored
through a kidney transplant; otherwise, he would die. However,
this move may put Samuel’s health into risk because of losing
one kidney through surgery. But Mike should understand that
this is the only chance to have James alive. James' health lies in
his hands. Failure to let Samuel donate a kidney may lead to
James’ death. It is clear that Mike is struggling to decide
between the kidney transplant and his faith in the healing
service. He is taking long to decide, and this continues to
worsen James’ health.
Mike has the autonomy of making decisions on James’ medical
intervention. The case gives him the sole responsibility of
deciding whether James should get a kidney transplant.
However, Joanne (James’ mother) is seemingly not part of the
decision making process. Emphasis has been put on the belief
and faith of Mike. It would be fair to include Joanne in decision
making. At the same, Samuel may be young, but he should be
consulted on whether he can donate his kidney to his brother to
save his life. 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
Christian worldview, which of the four principles is most
pressing in this case? Explain why. (45 points)
Respect for autonomy is the principle that takes center stage in
this case. According to this principle, patients should have the

3. authority to make their own decision regarding the medical
intervention they need (Beauchamp & Childress, 2014). In this
case, Mike is given the autonomy to decide James’ next medical
intervention. He opted to forgo James’ dialysis schedule to seek
God’s miracle healing. The physician did not interfere with
their choices. Mike argued that subjecting their son to multiple
dialyses is not a lasting solution to the problem and believed
that only God could heal. The physician sat down with James'
mother to explain to her about the importance of the dialysis,
treatment options, risks involved, and dangers the child may
experience if he does not get the right medical attention. He
then left the final decision to them to make. Since James is still
a minor, the parents assume autonomy responsibility. As a
result, they acted by putting their belief in God’s healing first.
However, this failed to bear fruits, and James' health continued
to worsen. He needed a kidney transplant; otherwise, he would
die. The principle of autonomy plays a key role in medical
decision making, and physicians must respect the decision of
their patients (Beauchamp & Childress, 2014).
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)
Based on the Christian worldview, the four principles would be
ranked based on their significance: Autonomy; b). Non-
maleficence; c). Beneficence, and d). Justice.
Respect for autonomy is a major principle. Christians treat
respect as a key component of relationship building with God
and fellow humans. During creation, God provided man with the
power to rule over the world and make their own choices.
Christians expect physicians to respect patient autonomy. And
according to the law of bioethics, patients have the authority of
accepting or declining certain medical treatments, medications,
or surgery (Lawrence, 2007). Some decisions may not serve the
best medical interest of the patient, but physicians are expected
to respect them.

4. As a Christian, I believe that the four principles should appear
just as they are. Autonomy would form my first and major
principle. Patients should have the chance to take part in their
care and make decisions about their treatment interventions. I
also value the principle of non-maleficence, and it would come
second because I believe that humans should not be harmed.
Physicians should make decisions that improve the health of
patients (Ediger, 2015). The principle of maleficence, which
promotes all that is good, would be ranked third. The principle
of justice would be last. Among the four, it is the least
applicable principle even though its significance in medical care
cannot be ignored. References:
Beauchamp, T. L., & Childress, J. F. (2014). Principles of
biomedical ethics (7th ed.). New York: Oxford University Press.
Ediger, M. J. (2015). Teaching Clinical Ethics Using the Four
Topic Method. International Journal of Athletic Therapy and
Training, 20(6), 10-13.
Lawrence, D. J. (2007). The four principles of biomedical
ethics: a foundation for current bioethical debate. Journal of
Chiropractic Humanities, 14, 34-40.
©2019. Grand Canyon University. All Rights Reserved.
Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical

5. 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

6. 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.