Weekly discussion

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

James has kidney failure. Initially, a dialysis was the best option to alleviate his problem according to the doctor. However, the parents felt the best option was to take James for prayers in a healing service. Currently, the best option is for James to have a kidney transplant.

James is a minor. Therefore, h has no autonomy over his healthcare. This responsibility is held by his parents. The parents initially forewent a dialysis in favor of prayer. They have now agreed for a kidney transplant. However, they have to make a decision if they are ready to let Samuel donate his kidney to his brother. Samuel also lacks autonomy in the scenario.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Currently, only Samuel seems to be the viable kidney donor. If he donates his kidney to his brother, there is a likelihood that his quality of life will drop. Since he has no choice on the matter, a kidney transplant my harm his health and not be in his best interest. On the other hand, if James receives the kidney, the quality of his life will improve. However, there is no guarantee of this happening. The parents have to make a decision on whether to risk the lives of both their children or commit to ensuring Samuel lives the best life possible without asking him to sacrifice his kidney.

Taking Samuel’s kidney without his consent would be unfair to him. It would be putting his life in danger for his brother. Although this would be a noble action, there is no guarantee that the transplant will be successful. Therefore, it will be unfair and unjust to risk Samuel’s life for the sake of James.

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First, there is the principle of non-maleficence. This refers to act of doing no harm. The doctor is required to appraise the scenario before making decisions. He is supposed to be aware of how his decisions will harm the patient or not. In the scenario, the doctor is always suggesting the best option for the patient. He asked for a dialysis, which was initially the best option. Eventually, he asked for a transplant, which is currently the most viable option. Non-maleficence would rank first when it comes to weighing the principles.

Second, there is the principle of justice. This refers to treating and offering care fairly to all patients regardless of their situation (Torry, 2018). The doctor has not shown any unfair treatment to the patient and his family. He has always been professional and done his best to offer the right care. He has done so while incorporating the parents into the decision-making process. Justice would rank second when it comes to weighing the principles.

Third, there is the principle of beneficence. This refers to ensuring that the choices made for a patient should be done with the intention of doing good (Andersson et al., 2020). It points to the act of showing mercy or kindness. In the scenario, the parents thought they were showing kindness to their son by foregoing dialysis and taking him for prayers. However, they later realized this was a mistake and took him for dialysis. It was already too late leading the doctor to call for a kidney transplant. After exhausting all avenues for a kidney donor, the doctor suggested that Samuel would likely be the best kidney donor. Although this is not a desirable solution, it may be a choice made with the intent to good for the patient. Beneficence would rank third when it comes to weighing the principles.

Finally, there is the principle of autonomy. This refers to the freedom or right of a patient to have control of their body. The doctor is required to respect the patient’s freedom to choose what is appropriate or right for them. In the scenario, the patient is a minor. Therefore, the patient has no autonomy and decision making is left for the parent. The autonomy of the patient would rank last when it comes to weighing the principles.

In the context of the Christian biblical narrative, I believe the four principles would be ordered as follows non-maleficence, justice, beneficence, and autonomy. Christianity values the principle of doing no harm (Fosarelli, 2019). The Book of Romans 13:10 states, "love does no harm to a neighbor; therefore, love is the fulfillment of the law." The principle of non-maleficence is promoted in Christianity in the context of people's relationships with others in daily life. By doing no harm to others, a person will be treating others the same way he/she would like to be treated. Nevertheless, although each of these principles has a distinct objective, they all combine to empower healthcare practitioners while promoting ethical, safe, and high-quality healthcare for patients.

To balance each of the four principles in the case, the parents and the doctors should discuss the impact of Samuel donating his kidney to his brother. Currently, only Samuel seems to be the viable kidney donor. If he donates his kidney to his brother, there is a likelihood that his quality of life will drop. Since he has no choice on the matter, a kidney transplant my harm his health and not be in his best interest. On the other hand, if James receives the kidney, the quality of his life will improve. However, there is no guarantee of this happening. The parents have to make a decision on whether to risk the lives of both their children or commit to ensuring Samuel lives the best life possible without asking him to sacrifice his kidney.