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Rock Street, San Francisco

Rami Alhusari
Prof. Jenkins
Bioethics
5/08/2018
Prompt 2
The principle of Non maleficence is one of the biomedical ethics that apply in this case.
According to this principle, physicians are required not to act intentionally in a way that has the
capability of creating injury or harm to the patient. This may either happen through actions of
omission or commission. In the common language, physicians as well as all other people
involved should be considered negligent in the case where they or one of them imposes an
unreasonable or careless risk that could end up bringing in harm to the patient (Beauchamp &
James 10). In respect to this, physicians are required to be professional and careful in whatever
they do, and be ready to bear the responsibility in the case where a certain procedure they have
prescribed backfires. Provision of a standard and high quality level of care that reduces or avoids
any incidents of harm or risk to the patient is something that is supported by our normal moral
convictions, and the laws that apply to our societies as well. This is the principle that calls for
competence in the field of healthcare. Medical mistakes occur and this is a very common thing in
the field of healthcare (Pera 17). Even after taking into consideration the fact that medical
mistakes are common, the principle urges physicians to be committed to their profession since
their professional ethics requires them to give protection to the patients.
In relation to this case prompt, there is uncertainty of the medical procedure that will be
taken. This is confirmed by the healthcare professional who tells the father that he is not sure

whether the procedure will be successful in addressing the problem that the 5-year-old girl has
been undergoing. Even though compatibility between the father and his daughter has been
proved through some tests, there is no assurance on the success of this procedure. Looking at this
case in this manner, proceeding to carry out the kidney transplant is in a way risking the life of
both the father and his daughter. In order to avoid this kind of a confusion, the doctors should
have made sure that the medical procedure they are suggesting is something that has been tested
and are sure about its success.
Respect for autonomy is another key principle that applies in this case. This principle
applies in the case of decision making and makes an assumption that agents who are rational are
involved in voluntary and in the process of making decisions in general (Lawrence 38). In
healthcare settings, decisions are made on behalf of the patient in cases where the patient in not
in a position to make the decision on his/her own. This happens in cases where the patient in a
state where he/she is not able to make the decision on his/her own, or the age of that patient does
not give him/her the freedom of making decisions (Beauchamp & James 17). In this case, the girl
is very young and the reason as to why her parents were to be involved in the decision making
process. The principle as well as privacy in the case of donors is a reason as to why the
healthcare professional took the father of the young girl in privacy after knowing that the two are
compatible. He wanted to give him an environment where he is free to make his decision about
transplantation of his kidney. Determinant for whether the procedure will proceed lies in the
hands of the father who has the freedom of either accepting to or refusing to donate his kidney.
In the case of this prompt, the father is not willing to donate his kidney to her daughter. He goes
ahead to request the physician not to break the news to his family since he does not want them to
accuse him for being responsible for the death of her daughter.

Lastly, the principle of beneficence as well applies into this case prompt. The actual
meaning of this is that providers of healthcare have a responsibility of being beneficial to a
patient. In addition, they have a duty of making positive steps in order to remove or prevent harm
from the affected patient (Beauchamp 273). This is a biomedical principle that the healthcare
professional is struggling with in this case. He is determined to do all he can in order to ensure
that the young girl has fully recovered from the problem she has been struggling with for 3 years.
In attempts to achieve this, the healthcare professionals recommend that the girl should go for
kidney transplant as they see it as the only possible way through which the problem will be
addressed.
In this case, the biomedical principles I have discussed are in a conflict with certain moral
and ethical issues that apply in the field of healthcare. Truth telling is one of the ethical issues
that are in conflict with the biomedical principles applying to this case (Beauchamp 271). Truth
telling requires healthcare professional to always make sure that they have remained professional
and tell the truth always no matter how demanding the situation is. Truth telling as well requires
healthcare professionals to be open to their patients or the ones close to the patient and keep him
updated about the condition the patient is in. Looking into this case prompt, the father requires
the nephrologist not to tell his family to avoid conflicting them. Even though the nephrologist
wishes to make the decision made by the father a secret, ethics require him to be open and tell his
family members about the truth.
Truth telling as well conflicts with confidentiality in the field of healthcare. The issue of
confidentially in this case applies to the nephrologist who is in a dilemma of whether to keep the
decision made by the father confidential to him alone or to use the principle of truth telling and
tell the other family members about it. Due to the fact that a decision to donate an organ is

voluntary and is determined by the donor, it is wise for the nephrologist to keep the information
confidential since the father wishes for this. Even though ethics requires him to be of benefit to
the patient and do all that he can to save him, there is nothing he can do in a case like this one
(Lawrence 37). A physician cannot force the father to give out his organ to her daughter since
this is a decision determined by the donor depending on the care he/she has towards the patient.
Lastly, paternalism is an ethical issue that brings in a conflict into this case. From the past,
clinicians have been making decisions for the patients as there have been a very strong belief that
they are professionals, experienced and hence are the best when it comes to the choice on the
type of medication a patient will be given (Beauchamp 5). In the modern field of healthcare
however, application for this is not that much and currently patients are being allowed to
determine the course of action taken on matters concerning their health. In this case, kidney
transplant has been suggested by the healthcare professional. However, choice for the decision to
be taken lies to the patient and he/she should be the one determining the type of medication to be
taken.
After considering the ethical issues raised by the above conflicting ethical and moral
principles, the best way to address this problem is for the healthcare professional to look for an
alternate way of addressing this problem. He should forget about the choice for organ transplant
due to fact that the only compatible person is not willing to become a donor. This is done in
order to create a balance in the various principles applying into this case because each one has a
very strong basis that require it to be considered for such a case. Applying one results into a
conflict with another one that has a very strong argument as well. I consider looking for another
option rather than organ transplant as the best way to address this dilemma since the only
possible donor has already refused to donate his organ. Even if we conflict the principles by

applying one of them, it will be of no benefit as it will not solve the case. Taking moral theory
into consideration, such a decision is justifiable.

Works cited
Beauchamp, Tom L. “Methods and principles in biomedical ethics.” Journal of Medical ethics
29.5 (2003): 269-274.
Beauchamp, Tom L. "The ‘four principles’ approach to health care ethics." Principles of health
care ethics (2007): 3-10.
Beauchamp, Tom L., and James F. Childress. Principles of biomedical ethics. Oxford University
Press, USA, 2001.
Lawrence, Dana J. “The four principles of biomedical ethics: a foundation for current bioethical
debate.” Journal of Chiropractic Humanities 14 (2007): 34-40.
Pera, Silvia Angelina. Ethics in healthcare. Juta and Company Ltd, 2011.

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