Case Study on Moral Status : Case Study: Fetal Abnormality

PHI 413 Case Study on Moral Status : Case Study: Fetal Abnormality
Case Study on Moral Status : Case Study: Fetal Abnormality
Applying the Four Principles: Case Study
The provision of care requires physicians, nurses, and other health care practitioners to follow the four biomedical principles that include beneficence, autonomy, justice, and non-maleficence. In the case, “Healing and Autonomy,” it is evident that the providers tackle different aspects that include medical indications, patient preferences, quality of life and contextual issues that impact healthcare delivery. Using the chart, the assignment evaluates the application of the four principles in the case in its first part. The second part addresses the application of the principles.
Part 1: Chart (60 points).
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Medical indications denote to diagnosis, prognosis, suggested measures for evaluation and treatment and expected results from treatment interventions Medical indications concern the need for providers to make professional judgment and entails application of principles of beneficence and non-maleficence (Teven & Gottlieb, 2018). Through beneficence, providers should offer care that bring good to patients while reducing potential harm as indicated by non-maleficence principle.
The case study shows that James needs immediate treatment interventions that include a dialysis and later on a kidney transplant as a long-term solution to his condition that deteriorated due to delays in treatment interventions.
In this case, Mike and Joanne act in the best interest of the child, James who requires immediate treatment to recover from glomerulonephritis. The actions by the parents have no malice or intention to harm James even though they knew that the condition could get worse if treatment is not provided immediately. As Christians, they were faithful since an individual had been healed from stroke. However, when the healing service could not offer recovery to James, they brought him back for medical attention. The decision by the parents may have affected immediate treatment by the healthcare team which could have prevented the current medical indications that are not pleasing. However, physicians and other providers have a duty to exercise the principles of beneficence and non-maleficence and ensure that James’ condition gets better and should involve the parents in decision making since the patient is a minor.
Patient preferences refer to the choices that individuals make when they encounter decisions about health and medical treatment. These choices reflect the individual patient’s experiences, values, and beliefs based on the provider’s recommendations (Teven & Gottlieb, 2018). When a patient has decision-making abilities, physicians and other providers should respect their preferences and use them to guide care and medical plans. The implication is that patient preferences arise from the principle of autonomy which implores providers to respect any decisions or care interventions informed by a patient’s beliefs, values, and experiences. A core aspect of the principle of autonomy is getting informed consent from patients based on their decision-making capacities. Minor patients like James may not have the decision-making capacity to exercise their autonomy as demonstrated in the case. In such situations, parents assume the role of making critical decisions.
In this case, the physician (nephrologist) gave the family full information when James was brought to the facility for treatment. However, the parents exercised his autonomy since he is a minor and decided to take him to church for a healing service. The physician respected the autonomy and could not offer treatment without their consent but allowed them to go to church due to their faith preference.
The pursuit for miracle healing was not effective and when the parents made the decision to return James for medical intervention, it was based on their preferences, informed consent, and autonomy.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
Contextual Features
Justice and Fairness
Illness or medical and health condition can have negative effects on quality of life. Since a principle goal in medicine is the preservation, restoration, and improvement in quality of life, both patients and healthcare providers must discuss how treatment will impact the quality of life, in this case for James. The discussion should focus on the three principles of beneficence, non-maleficence, and respect for autonomy. Quality of life assess the level of satisfaction that patients experience and value about their lives as a whole based on the three principles (Teven & Gottlieb, 2018). Physicians, nurses, and other healthcare providers should use evidence-based practice interventions to enhance a patient’s quality of life but by ensuring that it is based on their autonomy and need to prevent harm while offering benefits.
In this case study, James’ quality of life deteriorated due to delays in treatment interventions after a diagnosis. The healthcare team exercises the principle of autonomy by allowing Mike and Joanne to make the decision to take James to their church for healing. However, this did not lead to recovery and the patient was brought back. James is now on dialysis to help him function well but the long-term solution is a kidney transplant where parents need to make a critical decision. The matching kidney for James comes from his twin brother, Samuel after all other donors’ kidneys failed to match. The parents want the best for James but are worried about having Samuel donate a kidney to him. The implication is that both parents and the physician should act in the best interest of the pediatric patient and agree to the recommendations by the physicians to save the boy’s life and prevent further health risks.
The parents should also engage both James and Samuel so that they understand what is happening despite their young ages. Beneficence is not just acting in ways that help other individuals in need through treating or curing illness, but entails acting in ways that bring satisfaction to others. The implication is that the parents should involve their sons to ensure that they are satisfied about the actions that they intend to take in the proposed procedure for James’s better prognosis.
According to Gillon (2018)), clinical cases do not occur in isolation as they are part of broader circumstance that are critical to ethical analysis of care cases. contextual features affect the decision-making process and include patient specific factors like family dynamics, financial resources, and cultural and religious identity (Teven & Gottlieb, 2018). These features may also comprise of possible legal ramifications in care provision, and personal bias of those involved in patient care.
In this case, James is a minor and the parents and physician have a responsibility to offer influence the treatment options. For instance, the decision to opt for spiritual intervention through miracle prayer demonstrates the religious factors that impact care plan in the case. Further, the parents come back and the physician shows that a transplant is the long-term intervention. However, the parents are skeptical after James’s twin brother’s kidney becomes the matching kidney. The implication is that the physician can only opt for the intervention if the parents’ consent to having Samuel donate his kidney to save James’s life.
Imperatively, the parents must involve Samuel while the physician should implement recommendations based on the best interests of James and implore the parents to consider long-term effects of any actions that they take now.
Part 2: Evaluation
Answer each of the following questions about how the four principles and four boxes approach would be applied:
In 200-250 words answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)
The Christian view advances that God gives life and sustains it. From the perspective, the specification and weighing of the principles should encompass Christian beliefs and teachings as advanced in the Bible. The principles would be specified and weighted based on the need to protect the inherent human dignity and value that man has and given by God. The first principle would be autonomy followed by beneficence and non-maleficence and lastly justice. Autonomy should be specified first since respect of freedom is an imperative because man was created to be free and exercise their freedom to choose based on the Christian values and teachings (Carr & Winslow, 2017). Autonomy advances that after a physician diagnoses a patient, they should inform them or the family and then respect the free choice that they make. In this case, the physician informed Mike and Joanne about the treatment interventions and allowed them to make their decisions on behalf of James since he is a minor.
Non-maleficence is the second principle as it provides a caregiver a moral obligation to ensure that no harm occurs a patient by making the best decision and acting in the best interests of a patient. Beneficence is specified and weighted third as it is God’s command to love others as one loves themselves. The principle dictates how physicians and healthcare providers should treat and interact with their patients. caregivers should also seek to benefit patients with reduce risk of harm. The fourth principle is justice as it implores on healthcare providers and systems to treat patients equally and share available resources equitably. They should treat patients with compassion and dignity despite their diversity as all people are equal before God and made in his image.
In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)
The Christian worldview advances that one must demonstrate love and ensure that they benefit others without causing harm or undue suffering. According to the Christian worldview, man is created in God’s image and love should drive all actions, including care given to patients by healthcare providers (Carr & Winslow, 2017). In this case, a Christian will balance each of the principles by basing their actions or decisions on teaching, values and beliefs. Consequently, the first aspect is to consider beneficence which one should balance with non-maleficence and the need to do good. Beneficence is the most pressing principle as all involved should focus on James’ interest and ensuring that he gets quality life. While James’ parents opted for miracle service, one cannot blame them since they had faith in prayers than treatment. They acted with best intentions and interests to benefit James even when they realized that the healing service could not solve the issue.
The second aspect is ensuring that no harm happens to an individual as demonstrated in the case where the decision to have a transplant for the patient would bring benefits to him. The parents have opted for dialysis to prevent any harm to James. They believe that their choices are based on their faith in God. Autonomy becomes a third aspect in balancing the principles as it shows that while patients have the freedom to choose, they must consider different spiritual aspects that affect their perspectives on issues (Gillon, 2018). For instance, the parents have a choice to make on whether James will receive a kidney from his twin brother, Samuel or not, and the impact of the decision. The final principle to balance is justice as it is not a much of a concern to the parents but critical in ensuring that James gets treatment to prevent deterioration of his condition.
Conclusion
The need to balance different biomedical principles requires healthcare providers to use the four box approach and understand other aspects that may impact or influence the delivery of care. The case study shows that factors like contextual features, patient preferences, medical indications and quality of life impact care decisions and interactions with patients. As such, making decisions requires the stakeholders to consider all these issues.
References:
Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for
Healthcare Professionals (pp. 31-45). Routledge.
Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and
Professionalism (pp. 45-59). Routledge.
Teven, C. M. & Gottlieb, L. J. (2018). The Four-Quadrant Approach to Ethical Issues in Burn
Care. AMA Journal of Ethics, 20(6):595-601. DOI: 10.1001/journalofethics.2018.20.6.vwpt1-1806.
Write a 750-1,000-word reflection on “” and the required topic Resources, answering the following questions:
What is the Christian view of the nature of human persons, and with which moral status theory is it compatible?
How does this relate to the inherent worth and dignity of human beings?
Jessica, Marco, Maria, and Dr. Wilson are using which theory or theories to determine the moral status of the fetus?
What specifically in the case study leads you to believe that they subscribe to the theory you’ve chosen?
How does the theory r determine each of their action recommendations?
Which theory do you believe in?
Why?
How would that theory influence or determine the recommendation for action?
Remember to use the topic Resources to back up your responses.
While APA style is not required for the body of this assignment, solid academic writing is expected, and source documentation should be presented using APA formatting guidelines, which can be found in the Student Success Center’s APA Style Guide.
This assignment makes use of a rubric. Please review the rubric before beginning the assignment to become acquainted with the requirements for successful completion.
You must turn in this assignment to LopesWrite. If you require assistance, a link to the LopesWrite technical support articles can be found in Class Resources.
Attachments
HLT 302 Grand Canyon Week 3 Case Study on Moral Status
Case Study on Moral Status
Write a 500-750 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:
1- Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? Explain.
2- How does the theory determine or influence each of their recommendation for action?
3- What theory do you agree with? How would the theory determine or influence the recommendation for action?
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Case Study on Moral Status
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. Case Study on Moral Status
HLT 302 Grand Canyon Week 3 Personhood Chart
Complete the “Personhood Chart.”
HLT 302 Grand Canyon Week 4 Assignment
Healing Hospital: A Daring Paradigm
Consider how the paradigm of a healing hospital might influence your philosophy of caregiving and write an essay of 750-1,000 words that addresses the following:
1- Describe the components of a healing hospital and their relationship to spirituality.
2- What are the challenges of creating a healing environment in light of the barriers and complexities of the hospital environment?
3- Include biblical aspects that support the concept of a healing hospital.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
HLT 302 Grand Canyon Week 9 Assignment
Collaborative Learning Community Meeting The Spiritual Needs Of The Acutely And Or Chronically Ill
Details:
This is a CLC assignment.
Select one of the following special populations of patients who suffer with:
Cancer
HIV
Renal failure
Mental illness
Cognitive impairment
Another acute or chronic condition
Research the patient group and select at least three research articles to be used in the presentation.
As a group, prepare an overview describing how to employ the health care provider process in analyzing the spiritual dimensions of the provider-patient relationship.
Pay attention to patient needs in your chosen population (adults or children). What interventions can be used to meet the spiritual needs of a patient in your chosen population in the following areas
Hope
Trust
Courage
Faith
Peace
Love
Each group will determine the most effective manner in which to present the information that engages the entire class.
APA format is not required, but solid academic writing is expected.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
HLT 302 Grand Canyon Week 10 Assignment
Health Care Provider and Faith Diversity Final Draft
Your instructor will send you your peer-reviewed assignment from Module 4.
Use the comments from the peer review to revise your document and turn it into a final draft. Not all comments need to be followed. Use your best judgment in revising your first draft to an assignment that better meets the requirements of the original assignment, found in Module 3.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
Case Study on Moral Status – Rubric
Criteria Description
Christian View of the Nature of Human Persons and Compatible Theory of Moral Status
5. Excellent
60 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and explained with a deep understanding of the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
4. Good
51 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and and explains the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
3. Satisfactory
45 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear and explains the basic relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
2. Less Than Satisfactory
39 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is unclear. Explanation is not clearly supported by topic study materials.
1. Unsatisfactory
0 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is insufficient. Explanation is not supported by topic study materials.
Criteria Description
Determination of Moral Status
5. Excellent
40 points
The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws insightful relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.
4. Good
34 points
The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.
3. Satisfactory
30 points
The theory or theories that are used by each person to determine the moral status of the fetus is explained and draws relevant conclusions. Rationale for choices made is supported by topic study materials and case study examples.
2. Less Than Satisfactory
26 points
The theory or theories that are used by each person to determine the moral status of the fetus is not clearly explained. Rationale for choices made is unclearly supported by topic study materials or case study examples.
1. Unsatisfactory
0 points
The theory or theories that are used by each person to determine the moral status of the fetus is not adequately explained. Rationale for choices made is not supported by topic study materials or case study examples.
Criteria Description
Recommendation for Action
5. Excellent
40 points
Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials.
4. Good
34 points
Explanation of how the theory determines or influences each of their recommendations for action is clear and demonstrates an understanding of the theory. Explanation is supported by topic study materials.
3. Satisfactory
30 points
Explanation of how the theory determines or influences each of their recommendations for action is clear. Explanation is supported by topic study materials.
2. Less Than Satisfactory
26 points
Explanation of how the theory determines or influences each of their recommendations for action is unclear. Explanation unclearly supported by topic study materials.
1. Unsatisfactory
0 points
Explanation of how the theory determines or influences each of their recommendations for action is insufficient. Explanation is not supported by topic study materials.
Criteria Description
Personal Response to Case Study
5. Excellent
40 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful.
4. Good
34 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear and relevant.
3. Satisfactory
30 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear.
2. Less Than Satisfactory
26 points
Evaluation of which theory is preferable along with how that theory would influence personal recommendations for action is lacking a personal connection.
1. Unsatisfactory
0 points
Evaluation of which theory is personally preferable along with how that theory would influence personal recommendations for action is inadequate.
Criteria Description
Organization, Effectiveness, and Format
5. Excellent
10 points
Writer is clearly in command of standard, written, academic English.
4. Good
8.5 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
3. Satisfactory
7.5 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
2. Less Than Satisfactory
6.5 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
10 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. Good
8.5 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
7.5 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. Less Than Satisfactory
6.5 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.
Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.
Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.
Rubric Criteria
Total 200 points
Criterion
1. Unsatisfactory
2. Less Than Satisfactory
3. Satisfactory
4. Good
5. Excellent
Personal Response to Case Study
Personal Response to Case Study
0 points
Evaluation of which theory is personally preferable along with how that theory would influence personal recommendations for action is inadequate.
26 points
Evaluation of which theory is preferable along with how that theory would influence personal recommendations for action is lacking a personal connection.
30 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear.
34 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear and relevant.
40 points
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful.
Organization, Effectiveness, and Format
Organization, Effectiveness, and Format
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
6.5 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
7.5 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
8.5 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
10 points
Writer is clearly in command of standard, written, academic English.
Recommendation for Action
Recommendation for Action
0 points
Explanation of how the theory determines or influences each of their recommendations for action is insufficient. Explanation is not supported by topic study materials.
26 points
Explanation of how the theory determines or influences each of their recommendations for action is unclear. Explanation unclearly supported by topic study materials.
30 points
Explanation of how the theory determines or influences each of their recommendations for action is clear. Explanation is supported by topic study materials.
34 points
Explanation of how the theory determines or influences each of their recommendations for action is clear and demonstrates an understanding of the theory. Explanation is supported by topic study materials.
40 points
Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials.
Christian View of the Nature of Human Persons and Compatible Theory of Moral Status
Christian View of the Nature of Human Persons and Compatible Theory of Moral Status
0 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is insufficient. Explanation is not supported by topic study materials.
39 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is unclear. Explanation is not clearly supported by topic study materials.
45 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear and explains the basic relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
51 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and and explains the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
60 points
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and explained with a deep understanding of the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
Determination of Moral Status
Determination of Moral Status
0 points
The theory or theories that are used by each person to determine the moral status of the fetus is not adequately explained. Rationale for choices made is not supported by topic study materials or case study examples.
26 points
The theory or theories that are used