Ethical and spiritual discussion response

please respond to the discussions with reference

Discussion 1

Principalism, or the four principle approach views that there are four ethical principles of bioethics. 1) Respect for autonomy – respecting the decision making of an autonomous person, 2) Nonmaleficence – do not cause harm to others, 3) Beneficence – preventing harm, providing a benefit which is greater than the risks and cost, and 4) Justice – fair distribution for risks and costs (Grand Canyon, 2015). The principles are abstract with no particular order. Determining which principle should be weighted higher is a constant balancing act and differs between patients.

I would rank them in the following order: Respect for Beneficence, Nonmaleficence, Justice, then Respect for Autonomy. I would want to ensure I am giving the patient all the options and risks first, ensuring I’m doing no harm, then allow them to make their decisions and respect those decisions.

I believe the Christian Narrative order would be the same. The Christian Ethical Approach states that “the Christian is to not only obey God’s commands, but to be transformed into his image. Jesus Christ is the perfect representatio of such a life; Christian’s thus ought to embody the virtues and character of Jesus himself (Grand Canyon, 2015). This will not only be knowledge of right and wrong, but surrendering and transforming by God’s own Holy Spirit.

Grand Canyon University (2015). PHI-413V Lecture 3. Biomedical ethics in the Christian narrative. Retrieved from

Discussion 2

Bioethics is the study of controversial ethical issues that emerge from situations that stem from biological research and advanced medical technology. Bioethical considerations are experienced throughout life, but are especially noted in healthcare, research, and medicine. On the other hand, principalism is, “a four-principal approach”, that frames bioethics. The principals of autonomy, beneficence, nonmaleficence and justice are utilized to balance, analyze, and answer ethical dilemmas that challenge the concept of right and wrong significantly. Moral principles and bioethics tend to clash religiously, intellectually and culturally. Worldviews must be considered when seeking ethical answers and the human life must always be respected. Different values and beliefs should be venerated, and the four moral principals must be considered to reach ethical decisions.

The first moral principal is autonomy. When I think of autonomy I think of respecting my patient’s right to make an informed consent without coercion. If my patient is of sound mind and is fully capable of making decisions, then the principal of autonomy must be respected despite conflicting differences that may be encountered.

The second moral principal is beneficence. This is the ethical concept that implies nurses will prevent harm to their patients. Researchers must balance the risks and benefits of their study to ensure the safety of the subjects involved. Nurses practice beneficence through best practices, compassion, and knowledge with the intent to do no harm to their patients by stabilizing the benefits and risks involved in the situation.

The third moral principal is non-maleficence. This ethical concept recognizes that human beings can cause harm and destruction. Non-maleficence implies that we do no harm. This means we respect human life and do absolutely nothing that can destroy human life maliciously.

Finally, the forth moral principal is justice. Justice means all living beings are treated fairly and equally. Nurses must be culturally competent to be just. Justice means we treat all patients justly and there are no VIP’s.

I feel non-maleficence is the most important moral principal followed by beneficence. Nurses must realize that they have the power to alter life at any given moment. If we fail to recognize this power, we can cause significant harm to our patients. For example, giving medications without understanding the risks, performing tasks we are not trained for, and utilizing equipment we have not been educated on. If we stick to the concept of beneficence, and we utilize best/safe practices, knowledge, and compassion, and the unthinkable happens, then I can leave my shift knowing I did everything morally possible to preserve my patient’s life. Justice follows beneficence. If I am not culturally competent then I will run the risk of causing my patient’s harm. I am doing my non-English-speaking patient justice by utilizing the interpreter video phone. I am also being just by treating all patients for pain. Justice implies I treat all my patient’s fairly. Lastly, autonomy follows justice. Not all my patients can make an informed consent. For example, dementia and Alzheimer’s disease leads to incapacity. A patient who is unconscious may not be able to make an immediate informed consent. We all run the risk of losing the ability to make an informed consent due to injury or illness, and nurses/physicians must be able to recognize when a patient lacks autonomy and deliver quality care to that patient ethically.

Grand Canyon University (2015). PHI-413V Lecture 3: Biomedical ethics in the Christian narrative . Retrieved from

Discussion 3

Bioethics in the United States was developed as a subfield of ethics as technology advances and the medical field is faced with new ethical issues (Grand Canyon, 2015). Principalism is based on the framework of four ethical principles, 1) respect for autonomy, 2) nonmaleficence, 3) beneficence, and 4) justice. The four principles of principalism only provide a guide for ethical decisions based what is right and wrong. Ethicist John Kilner describes a biblical ethic for health care that brings together the best of other ethical theories including “God-centered reality bounded and love impelled”. (Meilander, 2013). The problem with placing autonomy to the highest rank in principles arises in the situation when an individual is comatose or incapacitated. In this case that individual is unable to make an autonomous decision. The ranking order of these principles also would depend on the situation and who was involved.

If I had to rank the importance of each of the four principles, I would rand beneficence as the highest, followed by nonmaleficence, respect for autonomy, and justice. To me personally, preventing harm, providing benefits and balancing benefits against risks and costs mostly resembles the Christian narrative (Grand Canyon 2015).

The Christian biblical narrative begins with creation followed by fall, redemption and ending with restoration. I belive that the Christian biblical narrative would order the ethical principles by 1)beneficence, 2)nonmaleficence, 3)justice, and 4) autonomy. I believe that autonomy would rank the lowest position because in the beginning, Adam and Eve chose to reject God by making their own decisions and choosing to sin.


Grand Canyon University (2015). PHI-413V Lecture 3. Biomedical ethics in the Christian narrative. Retrieved from

Meilander, G. (2013). Bioethics: A primer for Christians (Third edition). Grand Rapids, MI. Eerdmans Publishing Co. Retrieved from

Discussion 4

Principalism is an ethics system based on the four moral principles of beneficence, justice, autonomy, and non-maleficence, and are influential in the field of medical ethics. They are the framework of bioethics, relating to moral dilemmas of medical practice and biological research. The definitions of each of these, according to the lecture are as follows:

Respect for autonomy − A principle that requires respect for the decision making capacities of autonomous persons.

Non-maleficence − A principle requiring that people not cause harm to others.

Beneficence − A group of principles requiring that people prevent harm, provide benefits, and balance benefits against risks and costs.

Justice − A group of principles requiring fair distribution of benefits, risks and costs.

Each one of these is very important and relevant on case-by-case circumstances, and it is difficult to decide the importance of each, as they are all important values to follow. In the context of the Christian Biblical narrative I think they would be ordered as, non-maleficence, beneficence, justice, and respect for autonomy.


Grand Canyon University (2015). PHI-413V Lecture 3: Biomedical ethics in the Christian narrative. Retrieved from

Discussion 5

The principles that each person holds as true are the measuring stick that guides the individual’s life (N.A., Principlism, n.d.). Standards are the measurement that others hold an individual to for a certain expectation connected with different jobs. The expectation that a doctor has a patient’s best interest at heart and not kickbacks from a company for order certain medications or procedures ordered. Working in the nursing field there are both expectations from the patient and the family they have the expectancy of a nurse with scruples and high principles, from the institution that employs them high standards are expected. These requirements are the things that still has nursing as the most respected profession. Mutuality principle is an area that disputes the possible area of a moral conflict due to two conflicting moral obligations (N.A., 2018).

Priniciplism is a term that is new and relates to moral dilemmas found in the culture of health care related to biomedical and moral ethics connected with patient care (Lawrence, 2007). The drawback is that there are no standards connected with Priniciplism (N.A., 2018). The lines between Priniciplism and standards may be blurred since some of the expectations could be under both headings. Do no harm would be expected under both headings. Ensuring the correct medication at the correct dosage with the correct route to the correct patient would also be found under both headings.

When a question of ranking anything in order according to the importance, the person is expected to place the most important item first as the most important. If the question is between Christian beliefs or nursing requirements, this seems like which came first the chicken or the egg. All the four principles are connected and by providing any of these another will be covered. If a patient is being providing justice then would this not also cover autonomy? If by providing nonmaleficence then beneficence and autonomy will be provided.

Nursing standards and Christian standards are the same in my eyes, taking care of others as I would if they were my own family members to me covers all the four principles. If forced to make a list it would go as nonmaleficence, beneficence, autonomy, and justice. One of these principles are no more important that the others. According to Katie Page with a study of 94 Psychology students the findings were as follows: nonmaleficence, justice, autonomy, beneficence and on this study, they also listed truth telling and last confidentiality (Page, 2012).


DeMarco, J. (2005). Principlism and moral dilemmas: a new principle. J Med Ethics.

Lawrence, D. (2007). The four principles of biomedical ethics: A foudation for current bioethical debate. Journal of Chiropractic Humanities.

N.A. (2018, may 15). Principlism and the moral principles. Retrieved from Regis University:…

N.A. (n.d.). Principlism. Retrieved from Encyclopedia of Ethics-Credo Reference: https://search-credoreference-com.lopes.idm.oclc.o…


Page, K. (2012). The four principles: Can they be measured and do they prdict ethical decision making? BMC Medical Ethics. Retrieved from

Discussion 6

As discussed in her article, “The four principles of biomedical ethics A foundation for current biomedical debate”, Dana Lawrence explains thatthe originators of the four principles, Thomas Beauchamp and James Childress, intended that none of the principles held any position over the other. (Lawrence, 2007) In theory this is true, however, critics from differing methods of ethics study point out that one or the other of the principles should be “weighted” heavier than the other, or that clearer definitions are needed in order for the principle to be useful in debate, for example; how much good must come out of an experiment or procedure for it to meet the requirement of beneficence?

Attempting to prioritize these principles in the context of how the Christian Bible would do so shall also serve as a personal ordering of the principles as this author attempts to view all things through the lens of Scriptural truths. Although God gave each of us free will and free will is vital in any true relationship, I do not believe that respect for autonomy would come before any of the other principles. Too many times in the Bible, Jesus talks about placing others before ourselves and having the heart of a servant. Therefore, I think the biblical order of the principles would place beneficence and nonmaleficence first as and inseparable coequals. Jesus said, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ In Matthew 25:40, when speaking of feeding, clothing, providing for or visiting the sick or imprisoned. For this reason, I would place justice next in order. Again, free will is given to us and Jesus values us as individuals so autonomy is important but not as important (in these human eyes) as the others. I place autonomy last in the list.

I will find it fascinating to see how others answer this question.


Lawrence, D. J. (2007). The four principles of biomedical ethics A foundation for current biomedical debate. Journal of Chriopractic Hummanities, 34-40. Retrieved from…

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