Sample Nursing Case Study on Medical Ethics

PART 1

Medical Indications

Beneficence and Non-maleficence

Patient Preferences

Autonomy

A medical diagnosis is crucial towards determining the best mode of treatment, outcome, and quality of care for the patient. Beneficence refers to taking actions that have the best intention in mind (Beauchamp, 2016). On the other hand, non-maleficence is the act of not harming the patient. In this case study, James has acute post-streptococcal glomerulonephritis complicated with hypertension and fluid overload later causing acute renal failure. The attending physician practices beneficence by prescribing antibiotics and regular dialysis for James to manage his condition. James’ nephrologist recommends a renal transplant owing to the deterioration of his condition. The nephrologist also identifies the best compatible donor of a kidney for James’ kidney to reduce the chances of graft rejection. Additionally, the parents opt for healing at a faith-healing service since they had witnessed the healing of a close friend who had a stroke. However, this alternative led to the deterioration of James’ condition hence the concept of non-maleficence. Autonomy encompasses the inherent right of individuals to make their own decisions (Beauchamp, 2016). However, it has limitations. For instance, James has no right to autonomy since he is a minor and the decisions regarding the management of his condition solely rely on his parents. Nonetheless, the physician and his parents should have tried to explain to him about his condition and the indications for treatment to relay anxiety and to determine his preference. Moreover, the physician should have convinced Mike and Joanne about the need of attending regular dialysis sessions concurrent with the faith healing mission instead of doing away with treatment.  The physician practices autonomy by giving Mike and Joanne the best treatment options and allowing them to choose what they prefer. James’ parents then go on to seek healing at a faith-healing service rather than undertaking dialysis hoping their son would be healed.

 

Quality of Life

Beneficence, Non-maleficence, Autonomy

Contextual Features

Justice and Fairness

The patient is presented with the best possible solution, which is the best care for him. Taking him to the faith healing service does more harm than good. The practitioners provide them with the best treatment options but leave them to decide on their own. Transplanting the kidney from Samuel would not be fair as he would be exposed to risk even though it would suit James. Hence the sharing of risks and benefits is not uniform. Additionally, it is not just to rely on healing by faith in God alone since it puts James’ health at risk.

 

 

PART B

Question 1

The Christian world incorporates the four principles of medical ethics in matters of life and health. Christians believe that life is sacred and that God is the life-giver (Saunders, 2015). Additionally, the love commandment obliges every Christian to act in the best interest of the other regardless of the circumstance. The principles of beneficence and non-maleficence stem from these core beliefs. Therefore, in the case study, the options that give James the best chance at life. the first step would be to evaluate James’ condition to determine the best possible treatment modality to prevent the natural progression of the disease. beneficence and non-maleficence would be applied by offering dialysis schedules and renal transplant therapy to improve James’ condition. Moreover, the best donor match would be sought to save James’ life. However, the health of the donor will be considered too, to ensure that the procedure does not harm him.

In Christianity, the scriptures teach fairness and justice in all undertakings and offer the power of choice. In this case, the physician and the nephrologist must offer justice to James and his parents and provide the best treatment possible. They uphold this value by prescribing the best suitable treatment and recommending kidney transplantation from his brother Samuel, who is in good health and can function optimally with one kidney. Finally, according to the Christian perspective, each individual has the right to make his own decisions that should be upheld and respected by others (Saunders, 2015). As such the right to deny or agree on a certain treatment lies with the patient. In this case, the physician respects the choice of seeking healing from a faith-healing service. However, the parents misuse their right to autonomy when they opt to ignore the dialysis process only to bring James to the hospital when his condition deteriorated.

Question 2

The scripture clearly outlines the moral obligations that Christians should strive to conform to. A careful analysis reveals that biomedical ethics arise not from mere laws and regulations but the bible teachings of love, respect for humans, social justice and right to life (Butts& Rich, 2019). From a Christian perspective, there is a need to strike a balance between biblical teachings and the principles of medical ethics because their application varies depending on the presenting scenario.

From this case, a Christian should employ the value of love in guiding the actions taken by James’ parents in ensuring they act in the best interest and not to inflict more harm to James. For example, the parents should be advised that they should attend to dialysis schedules and plan for the kidney procedure for James alongside seeking healing at the faith service. On the other hand, a Christian would make certain that the health practitioners act in good faith in getting the right diagnosis and the best treatment for James’ condition, thereby respecting the right to life and ensuring justice is served. Despite the intuitive straightforwardness of the obligation to respect autonomy, applying the principle becomes complicated in several instances. In this case, for example, a Christian would consider foregoing the right to autonomy with the desire to do good since James’s life is at risk (Torry, 2017). Therefore, the Christian duty of ensuring justice and the right to life would prevail over  James’ parents’ decision to rely on miracles and the faith-healing service options alone.

 

References

Beauchamp, T. L. (2016). Principlism in bioethics. In Bioethical decision making and argumentation (pp. 1-16). Springer, Cham. Retrieved from https://link.springer.com/chapter/10.1007/978-3-319-43419-3_1

Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning. Retrieved from https://books.google.co.ke/books?hl=en&lr=&id=dx6DDwAAQBAJ&oi=fnd&pg=PP1&dq=principles+of+healthcare+ethics&ots=RojQMcRJ54&sig=Y_qdFW1XHb69pXaapwJGTLsSydc&redir_esc=y#v=onepage&q=principles%20of%20healthcare%20ethics&f=false

Saunders, J. (2015). Doing good medical ethics: a Christian perspective. Journal of Medical Ethics, 41, 1, 117-120. Retrieved from https://jme.bmj.com/content/41/1/117

Torry, M. (2017). Ethical religion in primary care. London Journal of Primary Care, 9, 4, 49-53. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537594/