Re: Topic 3 DQ 1
Principleism or also referred to as the “four principle approach,” is part of the framework of bioethics. The four ethical principles include autonomy, beneficence, nonmaleficence, and justice(Grand Canyon University,2019). The four principles were initially developed by Dr. Thomas Beauchamp and Dr. James Childress, and are defines as follows.Autonomy is the ability to decide for oneself without control from others, and with an appropriate level of understanding to make informed decisions. Beneficence is described as two principles, one being positive beneficence and the other principle of utility. Positive beneficence meaning moral agents must provide benefit and principle of utility, stating moral agents must weigh the benefits and risks to provide the best result (Lawrence,2007). Nonmaleficence simply means, do no harm and justice being the fair distribution of benefits, risks, and costs ( Grand Canyon University,2019).

In my opinion, autonomy would be most important. A patient must be fully informed in detail the risks and benefits of electing to proceed as well as if they decline. A patient must agree to whatever it is before any of the other three principles would come into play. Next, in order of importance, is nonmaleficence or “do no harm.” Once the patient agrees, as moral agents, we must ensure there will be no harm to the patient; this leads to beneficence. As moral agents, we must be sure to weigh the risks and benefits, ensuring what is going to be done is beneficial and will provide the best outcome for our patients.

According to, Bioethics: a primer for Christians sin distorts every human relationship; it leads the powerful to abuse and diminishing of the weak and voiceless; therefore, every individual’s dignity must be protected, with that said I believe autonomy would be most important through the Christian biblical narrative. Next in importance would be beneficence coupled with nonmaleficence, as I feel these principles work hand in hand. An ethic shaped by the Christian vision states, “Such an ethic does not evaluate actions only in terms of progress, only in terms of beneficial goals that might be achieved (Lawrence DJ, 2007) To achieve said goals, no harm shall be done. Last, justice or the fair distribution of benefits, risks, and costs to human beings. Principlism, especially in the context of bioethics in the United States

Resources

Grand Canyon University. (2019) PHI-413V Topic Overview: Biomedical Ethics in the Christian Narrative

Lawrence DJ. (2007). The four principles of biomedical ethics: a foundation for current bioethical debate. Journal of Chiropractic Humanities, 14, 34–40.

Meilaender, G. (2013). Bioethics: a primer for Christians (3rd ed.). Grand Rapids, MI: W.B. Eerdmans Pub. Co

Re: Topic 3 DQ 1

Principlism, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values.

• How would you rank the importance of each of the four principles?

In practice, my own ranking of the four moral principles would be 1) Nonmaleficence, 2) Respect for Autonomy, 3) Beneficence, and 4) Justice. (Grand Canyon University, 2019)   Nonmaleficence for a healthcare provider is paramount, as it is our duty to apply clinical knowledge to the plan of care for each patient in a way that does not bring harm. We are responsible for applying clinical skills and decision making skills that our licenses and scopes of practice prepare us for, in the safest way for our patients. Above all, we are responsible to do no harm.

Respect for autonomy is ranked second only due to the responsibility of first doing no harm. A patient’s right to make their own decisions must be respected. If a patient is unable to understand and make decisions, then their loves ones’ wishes are considered. As a nurse, the education provided to the patient and/or loved one is of the utmost importance, as this knowledge will very likely guide their decision making process. It cannot be stressed enough that the role of educator is a weighty one; nursing influences patient outcomes in all aspects, but especially in helping patients understand what their choices are, and the implications of those choices.

Beneficence would come next as a healthcare provider. This should always be a focus; to improve outcomes and overall patient wellness. Weighing benefits with risks, and finding the best plan of treatment in respect to the whole person is not to be discounted. If I can do this considering body, mind and soul, then I have done well. Principlism, especially in the context of bioethics in the United States

The moral principle of Justice is by no means to be taken lightly, but in reference to the secular way that justice is applied, it should be considered, but not at the top of the list for a healthcare provider in clinical care decisions. “Questions of justice usually come to the forefront in terms of the equal and fair distribution/allocation of medical goods and services (i.e., organ donation, health insurance.” (Grand Canyon University, 2019) All things considered, this is likely applied to the first tier of decisions in many modern health settings, due to financial pressures. Principlism, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values

• How do you believe they would be ordered in the context of the Christian biblical narrative?

I believe that from a Christian biblical narrative, many of the moral principles would be applied simultaneously, or overlap. As we are given free will, it would stand to reason that Respect for Autonomy would be placed first, although after further examination I’ve instead placed them as follows: 1) Beneficence, 2) Nonmaleficence, 3) Respect for Autonomy, and 4) Justice.

In light of being created in his image and all that we have be given, Beneficence should likely be placed as the first of the moral principles to be applied to ethical decision making from a Christian perspective. This would naturally come along with not harming others, expressed as the moral principle of Nonmaleficence. We have been given free will to choose to follow Christ, or not, so then the moral principle of Respect for Autonomy follows next. The fourth moral principle from a Christian perspective is Justice. When considering this, I reflected on how God is a true and just God. So, in this way perhaps justice could be place first. Christ did pay that ultimate cost for our sins, so cost and justice is applicable. I did not place it as such because of the worldlier, cost weighing part of decision making that Justice represents in this context.   When facing difficult dilemmas, prayer and striving to be Christ like should be applied to a Christian’s application of ethical decision making.  “Kilner identifies four ethical guides as especially pertinent for health care: (1) promoting life, (2) acting justly, (3) respecting freedom and (4) telling the truth. There are times when we are not sure what should be done in specific situations. Then we need to discern how to apply these guides. Our Guide, the Holy Spirit, helps us.” (Miller, A.B., Shelly, J., 2006)

References

Grand Canyon University. (2019) PHI-413V Topic 3 Overview: Biomedical Ethics in the Christian Narrative

Lawrence DJ. (2007). The four principles of biomedical ethics: a foundation for current bioethical debate. Journal of Chiropractic Humanities

Meilaender, G. (1996). Bioethics: A Primer for Christians. Retrieved from http://gcumedia.com/digital-resources 

          /wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php

Miller, A.B. and Shelly, J.A. (2006). Called to Care: A Christian Worldview for Nursing.

Retrieved from: http://gcumedia.com/digital- resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for- 

           nursing_ebook_2e.php

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