Principlism and Christian Worldview

PART ONE
Medical indications (beneficence and non-maleficence).
Medical indications include all facts about a patient’s condition which form the basis of
interventions suggested by the physicians, patient themselves, and their family members (Gillon,
2018). James is suffering from kidney failure. To make James better, the doctor recommends
dialysis. James’ parents, on the other hand, believe that prayers will help their son’s condition to
improve. Since both suggestions are meant to benefit, not harm, James, the principles of
beneficence and non-maleficence apply to them. The principle of beneficence requires that ones
makes decisions that provide benefits and prevent harm while simultaneously achieving a
balance between the benefits attained and the costs and risks involved (Gillon, 2018). The
principle of non-maleficence, on the other hand, requires one to act in a manner that does not
harm other people (Gillon, 2018).
Patient preferences (autonomy).
Patient preferences are wishes of patients about their treatment and health. The principle
of autonomy recognizes that patients have a right to make decisions affecting their health and the
kind of treatment employed to make them healthy again (Gillon, 2018). Even though James is
just 8 years old, it was not right for his parents to decide to forego dialysis suggested by the
doctor and take him to be prayed for without asking for his input. The decision, therefore,
violated the principle of autonomy.
Quality of life (beneficence, autonomy, and non-maleficence)

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Quality of life relates to one’s satisfaction with their life, including physical health
(Gillon, 2018). After being taken for prayers instead of being put on dialysis, James’ health has
deteriorated and now he not only needs dialysis but also a kidney transplant. Clearly he is not
satisfied with the quality of his health. If the parents decide to take James for prayers again
instead of having a kidney transplant using his brother’s donated kidney, they would be violating
the principles of beneficence and non-maleficence. The former requires one to balance between
risks and benefits of a particular course of action. Since James’ condition deteriorated despite
prayers, taking him again for prayers without having a kidney transplant is likely to make his
condition even worse. The decision will, therefore, not be a proper balance between risks and
benefits because it has more risks than benefits. It also violates the principle of non-maleficence
because it is likely to cause harm to James. Lastly, it violates the principle of autonomy because,
like in the first instance, James’ father is considering making the decision without considering
the wishes of James.
Contextual features (justice and fairness)
Contextual features are factors that influence medical decisions of a person. They include
familial setting, social, and legal factors (Johnstone & Facn, 2019). When James’ father realizes
that it is only his son Samuel who can offer James his kidney for transplant he is reluctant to take
that option. The principle of justice and fairness applies to James because having his son Samuel
donate his kidney is not fair to him.

PART TWO SECTION ONE

Of the four principles considered in this case study, the most pressing for Christians is
non-maleficence. Christians believe God to be the creator of everything in the world. They also

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believe in respecting God’s will (Carr & Winslow, 2017). These beliefs explain why Christians
may be reluctant to accept medical procedures that may cause suffering to the patient because it
is difficult for them to believe that causing harm and suffering, even if it is just temporarily, may
be God’s will.
This belief is in line with the principle of non-maleficence. The principle requires one not
to cause harm to another person. With regards to medical procedures such as dialysis which may
cause suffering to the patient, Christian believe that prayer is the better option because it causes
no harm to the patient while, if it works, conferring to the patient great benefits. Thus, according
to Christian worldview, the decision Mike, James’s father to take him to prayers instead of
having him undergo dialysis was the right now. Apart from causing zero harm to the patient they
also affirm a Christian’s belief in the power of God.
Prayers are also attractive to Christians because they follow the example of Jesus Christ
(Carr & Winslow, 2017). When on earth, Jesus healed multiple people by simply praying for
them. Thus, for a Christian, taking a sick person for prayers is not strange, it just follows a
tradition set by Jesus Christ.

PART TWO SECTION TWO

In order of priority, a Christian would rank non-maleficence as the most important of the
four principles. Then beneficence, justice and fairness, and lastly, autonomy. For a Christian,
causing no harm to another person, whether it helps them or not, is frowned upon because it is
believed that such harm cannot be serving God’s purpose and will.
Beneficence ranks second because it requires one to act in the best interests of the other
person. Christians find this principle attractive because it follows Jesus’ example who sacrificed

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himself so that mankind could be saved. Jesus, therefore, acted in the interests of humanity, not
himself. Likewise, Christians are supposed to act in the interest of others, not themselves. That
means that, in the context of medical interventions, choosing an intervention that serves the
patient’s best interests.
A Christian would rank justice and fairness third because that will be following the
example of God who is a God of justice. Ranking below justice and fairness is autonomy.
Christians believe that God’s will is superior to our own will and desire (Carr & Winslow, 2017).
Thus, instead of acting based on our wishes, it is important that we act based on the wishes of
God. It is this desire to fulfill God’s desires rather than our own that makes Christians to rank
autonomy low because the principle of autonomy requires one to make decisions based on their
own personal wishes.

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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.
Johnstone, M. J., & Facn, P. B. R. (2019). Bioethics: a nursing perspective. Elsevier.