The four principles, 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? How do you believe they would be ordered in the context of the Christian biblical narrative? Refer to the topic Resources in your response.
Example 1 (yessenia)
The four principles of medical ethics hold an integral part for exceptional patient care, respectively. These principles are specified and balanced based on different scenarios, and they are interpreted differently according to worldviews, traditions, and philosophies (Hoehner, 2018). I would rank the order of importance for these four principles as follows: Respect for autonomy, Beneficence, Nonmaleficence, and Justice. I believe that humans should respect the decision-making capacities of autonomous persons if they are able to make choices. This includes respecting an individual’s religious beliefs and values ranging from diet choices to receiving or rejecting blood transfusions. When an individual is unable to make choices based on their current mental and physical state, we should follow the principle of Beneficence, which embodies the medicine’s goal, rationale, and justification for our actions towards our care for the patient (Hoehner, 2018). Allowing this principle to guide the healthcare professional’s actions will give intent to the patient care and interventions provided. Next, nonmaleficence should guide healthcare professionals to refrain from doing what is morally wrong. Healthcare professionals shall do no harm in the context of not doing additional and/or unnecessary procedures to the patient. This principle guides healthcare professionals to act with intent. Justice in medical ethics refers to fair distribution of medical benefits, risks, and costs (Hoehner, 2018). Because this is a more generalized concept and it does not affect the immediate care of a patient, it is a principle that can guide agency regulations.
I believe that in the context of the Christian biblical narrative, the principles would be ordered as follows: Respect for autonomy, Nonmaleficence, Beneficence, and Justice. I believe that in the Christian worldview, nonmaleficence will be upheld before beneficence because the human value is placed above all, and it is the human obligation to not cause harm to another being. In Christianity all humans are of equal value and justice is to treat everyone with the same respect, but in terms of direct patient care, I believe that it does not triumph all other principles.
Reference:
Hoehner, P. (2020). Biomedical Ethics in the Christian Narrative. In Grand Canyon University (Ed.), Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3
example 2 (Taylor)
The four core principles of medical ethics include respect for autonomy, beneficence, nonmaleficence, and justice (Hoehner, 2020). They are most commonly used in bioethics and are principles to be followed unless they conflict with an equal or stronger obligation or principle. Aspects pertaining to these principles can be enhanced by worldviews, traditions, and philosophies. They provide guidance rather than absolute moral rules or decision-making. Respect for autonomy involves the respect for an autonomous person’s decision-making capacities. Values and beliefs guide their views, actions, and choices that they have a right to endure. There are three requirements in order to deem an individual autonomous which include intention, understanding, and freedom. Health care professionals must be respectful when caring for patients and disclosing information, taking into consideration that the patient has the ability to understand the information provided. Beneficence is described as acts of kindness, friendship, mercy, and altruism. In health care, this includes committing actions that are intended to benefit the patients we care for. There are two aspects pertaining to beneficence: positive beneficence and utility. Positive beneficence involves providing benefits to others while utility requires one to weigh benefits, risks, and costs to achieve the best possible outcome.
Nonmaleficence is described as the requirement in which an individual refrains from harming others (Hoehner, 2020). Health care professionals have the obligation of nonmaleficence as well as beneficence when caring for patients. The broad definition of nonmaleficence in health care simply means that one should avoid unnecessary or unjustifiable harm to a patient. This also includes avoiding actions that would cause unwarranted risks of harm. The last principle, justice, as it applies to health care is defined as providing fair distribution of benefits, risks, and costs. Justice attempts to answer questions related to health care access and delivery, including what services should be available to society and who receives them. On a more personal level, justice involves respecting everyone’s rights and dignity with enhanced interest in protecting vulnerable individuals. I believe that all the principles hold tremendous value and should be considered equal in importance when caring for patients. Regarding the Christian narrative, I believe the principles would be ranked as 1- respect for autonomy because of the importance of respecting all life, 2- beneficence because of the works of charity that is implored in Christians, 3- nonmaleficence because of the obligation to do no harm (Foreman & Leonard, 2022), and 4- justice because of the hope to guarantee true justice for all individuals, including appropriate resource allocation and fair distribution of health care for all patients.
References:
Hoehner, P. (2020). Biomedical Ethics in the Christian Narrative. In Grand Canyon University (Ed.), Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3
Foreman, M., & Leonard, L. (2022). The principle of non-maleficence. Kregel Publications. https://kregelacademicblog.com/biblical-studies/th…
example 3 (Carmille)
I think that the four principles should be ranked depending on the situation. I would say the current laws do a good job of reflecting my beliefs. Currently, we are bound to patient confidentiality, unless the patient says they want to harm themselves or others, then we are mandated to report it (Hoehner, 2020). In this instance, beneficence and nonmaleficence are ranked above autonomy. However, if a patient with a terminal illness chooses to go on hospice instead of trying additional treatments, I think we should respect their wishes. In this instance, I would say autonomy is more important than beneficence. However I would say beneficence is a complicated principle. Hoehner defines it as an action that is done to benefit another person (2020). So in the case of discussing hospice vs treatment, one could argue that arguing for hospice would benefit the patient’s mental and spiritual health, whereas treatment may harm that, although treatment may benefit the patient’s physical health. In terms of justice, I think it’s harder to define because it’s so subjective. Justice means that something is done with fairness/impartiality, but I think that has so much room for interpretation.
I think that if we ordered the principles according to the Christian biblical narrative, it would be nonmaleficence and respect for autonomy as the first two, and justice/beneficence being equally important. I think that nonmaleficence is first because I think the most important rules to follow are the 10 Commandments, one of which is to not kill. Second I would say autonomy because God gave us free will when he created us, and the ability to do both good and bad. I think justice and beneficence are equally important. With justice defined as advocating for people with less, and beneficence as charity, we can clearly see how Jesus works to help those who are sick and poor. Though I do think it’s hard to rank them because they’re all important.
Reference
Hoehner, P. (2020). Biomedical Ethics in the Christian Narrative. Grand Canyon University (Ed.), Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care.
https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/home