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 |
| The parents took the patient to the hospital for presenting symptoms related to A Streptococcus infection that led to Post-Streptococcal Glomerulonephritis (PSGN). The patient had an acute kidney injury and hypertension as a consequence of the PSGN. Part of the care plan was blood pressure control and dialysis. Because the initial condition was not treated early, the patient suffered complications such as chronic kidney disease. The patient required dialysis as a permanent treatment and a kidney transplant. | The patient’s relatives were the legal guardians who had the legal authority to make decisions related to treatment. According to the case study, the doctor discussed with the family the treatment required to treat the acute renal failure and the hypertension. However, it did not appear that the physician presented an informed choice to the relatives and did not emphasize the seriousness of the complications and the urgency of treating an acute condition that could be reversed with treatment. This lack of information from the doctor did not give the relatives the alternatives to choose the therapeutic options and they decided to appeal to their religious beliefs. The patient now requires a kidney transplant since the damage to the kidneys is irreversible. It seems that the autonomy of the relatives was violated again by not discussing the treatments to be chosen, such as hemodialysis and peritoneal dialysis, which allow the patient to lead a normal life until a good candidate for the transplant donation is found. This lack of information put the family in a dilemma to decide whether his brother would donate the kidney or not since he was the only match available at that time. |
| Quality of Life Beneficence, Nonmaleficence, Autonomy | Contextual Features Justice and Fairness |
| The patient could recover the kidney conditions by providing an early dialysis treatment and controlling the blood pressure. As a result of the lack of intervention, the patient acquired a chronic condition that required dialysis or kidney transplant. The new condition and the alternative of treatment could impact negatively the patient’s normal live. The parents opted for religious healing instead of dialysis with the consent of the doctor. This decision caused a delay to the necessary treatment leading to an irreversible damage to the patient, requiring a kidney transplant. Despite their religious faith, the parents doubted their decision, believing that the complications were derived from a sin. The physician had the legal responsibility to act in the best interests of the patient in order to provide value to the patient and to prevent the complications, but the parents were the legal guardians who had the legal authority to make decisions related to treatment |