Christian worldview
According to the Christian worldview, autonomy, of the four principles is most pressing in this case, and autonomy is the capacity of an individual to make sensible and right decisions. Autonomy in this case is one of the most pressing principle, the patient Mr. James suffering from acute glomerulonephritis, kidney failure, he was supposed to underwent immediate dialysis. James’ situation put his family and the nephrologist in a problematic position, which can be identified in the principle of autonomy. Autonomy happens when a person must make a choice among mutually exclusive alternatives. It always occurs when a moral problem involving two or more mutually exclusive, morally correct actions. In Mr James’ case, after the nephrologist discloses the dialysis attempt, the family has two exclusives, ethically right choices, either, placing James on dialysis or forego the dialysis and put their faith in God. However, the family’s decision may cause James’ death if they chose to take him back to dialysis. The nephrologist and the family would be involved in monitoring, prevention, and avoiding any possibility that might come as a result of the disease. Still, the patient’s autonomy, confidentiality would be violated. Therefore, the primary dilemma, in this case, can be identified as “if the family decides to take James for dialysis or place their faith in God.
That means according to this actual situation, the balance between placing James to dialysis and placing their faith, God explains the principle of autonomy.
According to the Christian worldview, the four principles can be rank on the following criterion;
In Mr James’ case, the laws of beneficence, non-maleficence, autonomy, justice and fairness can be applied equally, but none of them can be chosen without leaving the other one. The incompatibility between all the four principles, in this case, is the major reason which causes the dilemma. About ‘if the family should take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Moreover, the principle of non-maleficence is considered in this moral situation which breaches the autonomy principle but gives support to beneficence, justice and fairness principle. Therefore, when considering Mr James’ case, all the four principles conflict: Autonomy, non-maleficence, beneficence, justice and fairness.
Beneficence is defined as taking a positive step to help others. James’ case, the most critical responsibility of the family and the nephrologist are to make a decisive action to improve the health and wellbeing of James. It, therefore, means the family has to consider which choice will be better for James, in this case, beneficence is applied when the family decides to place their faith in God by taking James to the healing service.
Non-maleficence is the responsibility not to harm others. Therefore, in this case, this principle requires the family action to ensure the safety of James by subjecting him to the right medication.
Autonomy being a form of personal freedom of action in which a person determines his/her actions; therefore, in this case, the nephrologist is required to respect the family’s decision. Besides, James’s nephrologist showed fairness and justice when he schedules a private appointment with Mike and Joanne.