Case Analysis

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

· James was earlier diagnosed with strep throat infection.

· The infection deteriorated to Acute glomerulonephritis which led to kidney failure.

· Acute glomerulonephritis eventually led to acute kidney failure.

· The patient had elevated blood pressure and fluid build-up that required temporary dialysis to relieve.

· Proposed measures of evaluation included immediate dialysis to relieve the fluid up.

· The patient condition further deteriorated, and a kidney transplant was required.

· Daily dialysis is used as a temporary intervention.

· The patient will require a kidney transplant

· The patient who is 8 year lacks the capacity for decision-making

· The parents are the surrogate, and are required to make decision in the best informed decisions for the patient.

· The physician decision has to abide by the surrogates' decision.

· The physician provided adequate decision to the parents to make an informed question.

· The physician was not consulted in the decision to delay the dialysis and pursue healing.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

· Immediate dialysis would have prevented further worsening of the patient’s acute glomerulonephritis condition

· The healing intervention negatively affected the quality of life of the patient.

· After worsening of the condition, regular dialysis was required to stabilize the condition of the patient.

· The patient required a kidney transplant within a year. It was the parent’s choice to decide whether the patient would undergo the kidney transplant.

· The patient's parents are strong Christian believers and believe in the power of religion.

· The patient’s parents have an alternative to therapeutic intervention which affects their commitment to the prescribed treatment procedures.

· Decisions like the immediate dialysis after detection of fluid buildup.

The principle of nonmaleficence is an obligation not to harm, cause suffering or pain. In this case, the physician should brief the parents on the possible negative implications if James fails to undergo dialysis. This would make the parents think about their decisions carefully before deciding whether they should take James to faith healing.

In this case, the principle of justice would be encouraged by ensuring that the patient received healthcare resources fairly and equitably. The fairness to the patient should take precedence. For example, the physician should advocate for immediate dialysis and inform the parents of the likely consequences when it is not carried out soonest. This would communicate to the parents the gravity of the situation and the possible outcomes when it is not immediately carried out.

The principle of beneficence offers the physician an obligation to act for the benefit of the patient. It is placed upon them to defend the rights of others, remove conditions that will cause harm, and help people with disabilities. In this case, the physician should explain to the parents how the delay in treatment was associated with the deterioration of James' kidneys. Additionally, the physician should also explain to James' parents why a kidney is essential for his survival and everyday living.

The principle of autonomy accords the patient or their surrogates the power to make their rational decisions and moral choices. Additionally, they should be allowed to exercise their capacity for self-determination. However, this should not be extended to a person who lack the capacity to act autonomously either due to developmental, mental, or physical inequities. In this case, James lacks the autonomy to make decisions and therefore his parents decide what is best for him.

A Christian can balance the principle of autonomy by confidently sharing what they advocate for but at the same time. Autonomy allows the patient to advocate their values and preferences. However, autonomy should be weighed against the patient's decision-making capacity and knowledge of the clinical condition. The physician should disclose all medical information and treatment options which are necessary for the patient to exercise self-determination.

A Christian can also consider the possibility of the action taken not to cause harm in the principle of nonmaleficence. The Christian should weigh benefits against burdens of all interventions the best course of action for the patient. It is important to acknowledge that this may not be aligned with the prioritized Christian beliefs at times.

The principle of beneficence requires that each action is for the benefit of the patient. The principle involves promoting the patient’s welfare. The Christian should pursue what is best for the patient even when it entails pursuing medical care in place of healing practices. This ensures that the patient gets the best care.

A Christian should also ensure that there is fair, equitable, and appropriate distribution of healthcare resources. This ensures that there is an equal share of the existing resources according to the need, effort, merit, and contribution. Fairness is also encouraged in Christianity.