Describe The Difference Between A Nursing Practice Problem And A Medical Practice Problem
Nursing Practice Problem
PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.
Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.
Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke.
They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant.
Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
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Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.
| Medical IndicationsBeneficence and Nonmaleficence | Patient PreferencesAutonomy |
| Quality of LifeBeneficence, Nonmaleficence, Autonomy | Contextual FeaturesJustice and Fairness |
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Part 2: Evaluation
Answer each of the following questions about how principlism would be applied:
1. In 200-250 words answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)
2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)
References:
Submission Id: 9a35174e-695a-4a85-ad24-cb4f1249e067
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Liliana Faura
Case Study on Biomedical Ethics in the Christian Narrative.doc
Summary 990 Words
Case Study on Biomedical Ethics in the Christ ian Narrat ive
Liliana Faura
GCU
07/21/2019
Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Healing and Autonomy” case study, fill out all the relevant boxes
below. Provide the information by means of bullet points or a well-structured
paragraph in the box. Gather as much data as possible.
Medical Indications
Beneficence and Nonmaleficence
Patient Preferences
Autonomy
Immediate dialysis is needed to bring the health of James back. He is suffering from
high blood pressure and fluid buildup. When he missed dialysis, his condit ion worsened,
and it is only through a kidney transplant that can save him. With his twin brother as
the donor, he does not have to struggle to find a donor. However, he would also be
putt ing his brother in a risk.
In the first place, the physician respected the parent’s autonomy by allowing them to
believe that their son would be healed through God’s intervention. He allowed them
to take James to a church service with them. The parents are expected to decide
whether to enable Samuel to donate his kidney to James, and Mike is seemingly
leaning on the possibility of a miracle because of his belief in God.
In this case, respect for autonomy is the primary principle in practice. The physician
respected the strong faith and belief of the parents in God and allowed them time to
think about the best intervention for James treatment.
Quality of Life
Beneficence, Nonmaleficence, Autonomy
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Contextual Features
Just ice and Fairness
The only way to restore the health of James is through a kidney transplant. However,
his brother may be put in a difficult situation through the surgery, considering the
process of recovery. However, Mike should understand that failure to allow Samuel
donate his kidney to his brother would make James die and they will not forgive
themselves for allowing their son to die yet they had an opportunity to help.
Non-
maleficence is shown as Mike struggles with the choice to make between his faith in
God and to allow his son to go through a kidney transplant
Samuel could be allowed to donate his kidney to his twin brother, James. A question of
whether it was the sole decision of Mike could arise because Samuel could also make
a decision on the same. Joanne, his wife, is also on the picture as lit t le is given on her
inclusion in the decision-making process. It would be fair to include Joanne in decision
making. The beliefs and faith of Mike are what takes center stage. The life of James
solely lies in his faith.
Part 2: Evaluation
Answer each of the following questions about how principlism would be applied:
1. In 200-250 words answer the following: According to the Christ ian worldview, which
of the four principles is most pressing in this case? Explain why. (45 points)
The most pressing principle, in this case, is the principle of autonomy. Autonomy is
the process of giving patients the ability to make their own decision about their
health and medical attention. In this scenario, autonomy is evident as Mike opts to
forgo temporary dialysis for James to attend healing service for God’s miracle. The
physician gave the parents the autonomy to decide the fate of their child’s
treatment.
He allowed them to believe in their faith and belief in God for healing. But
when the condit ion of James becomes worse, the father has to make a decision of
whether to allow his son Samuel to donate his kidney to James or continue believing in
service healing. They argued that they did not want to subject their son through
mult iple dialyses, yet God is capable of healing him.
Because James is a child and is not
able to make appropriate decisions on his own, the parents assume the autonomy.
Patient autonomy is a significant element in medical decisions. The decision-making
abilit ies of autonomous people must be respected (Beauchamp & Childress, 2014).
The physician held a discussion with the mother of the patient about the diagnosis,
treatment approaches, risk of not being treated, and the risk of treatment.
2. In 200-250 words answer the following:
According to the Christ ian worldview, how
might a Christ ian rank the priority of the four principles? Explain why. (45 points)
A Christ ian can rank the priorit ies as 1) autonomy; 2) Nonmaleficence; 3) Beneficence,
and 4) Just ice.
In the Christ ian faith, respect is highly valued as well as the relat ionship between
humans and God. After creating humans¸, God gave man the opportunity of making
their own decisions. From the Christ ian perspective, the physician should respect the
decision of the parents.
The law of bioethics grants parents the power of deciding
the mode of treatment and the ability to decline certain treatments or medications
(Tom & James, 2014). Some decisions may not be in the best interest of the patient,
but the physician has an obligation of respecting them.
According to the principle of non-maleficence, humans should not be harmed.
Physicians should, therefore, make appropriate decisions and respect medical rules
and ethical conducts to safeguard the safety of patients.
The principle of beneficence is an ethical factor that involves the promotion of all that
is good. This implies doing everything to improve the health condit ion of patients. The
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principle of just ice calls for equal distribution of risks and benefit of research, and
there must be fair outcome and procedures (Beauchamp & Childress, 2014).
The order of the principles should appear like they are. Respect for autonomy should
appear ahead of the other tenets. Allowing patients to take part in their care and
make their own medical choices is crucial.
References:
Beauchamp, T. L., & Childress, J. F. (2014). Principles of biomedical ethics (7th ed.). New
York: Oxford University Press.
Tom L. & James F. (2014) Principles of Biomedical Ethics, 6th Edit ion. Oxford: Oxford
University Press, p. 417.
Reilly, D. (2006, Fall). Dr. Dan Reilly Twitter Facebook LinkedIn YouTube Vimeo Following
Christ ‘s example, I seek to serve those whose path crosses mine. Retrieved July 2019,
from http://danreilly.ca/
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