Mike and Joanne are the parents of identical twins James and Samuel. James has developed kidney failure from a strep infection and requires dialysis or a kidney transplant. Mike and Joanne initially refused dialysis, hoping faith healing would cure James. When his condition worsened, they agreed to dialysis but now James needs a transplant. Samuel is identified as an ideal tissue match donor but Mike struggles with whether to have Samuel donate or wait for another miracle. This case study applies the four principles of biomedical ethics - autonomy, beneficence, nonmaleficence, and justice - to help analyze the ethical issues.