Bioethics is the the study of the position of ethics in a world of progressive technology and medicine. Bioethics is built upon four main principles which include: respect for autonomy, nonmaleficence, beneficence, and justice.
These four main principles create principlism. (Grand Canyon University, 2015). Every bioethical decision must be viewed through the light of these four principles along with the individual details of each case presented. The answers to these four principles will also be extremely different depending on the worldview of the investigator.
A Christian responding to these questions would have a different approach than a Hindu. Although these principles outline an approach to solving ethical issues in medicine are they truly unbiased? Probably not. As a Christian, we do all things and make all decisions based on the knowledge and authority of God. I would personally, as a Christian first and a nurse second, rank the importance of each of the four principles as stated below:
1. & 2. Nonmaleficence and beneficence - Do no harm and prevent harm are very similar and both rank as my number one priority. Mark 12:30-31 states one of the greatest commandments is to love your Lord with all your heart, soul, mind, and strength. The second greatest commandment is to love your neighbor as yourself. Based on these commandments is my decision to make nonmaleficence and beneficence the priority.
3. Respect for autonomy - Respecting the choices of a competent person. The definition of competent is at times hard to assume and can become a great legal debate I believe it is a high priority. I do not believe a Jehovah's witness is making the best medical decision to refuse blood, but I do respect their spiritual views and feel they have the right to make this decision.
Just as I feel I have the right to practice my faith according to the Bible, I believe they have the same rights to deny blood based on their faith. I do not want to have the right of autonomy jeopardized as Christians fall into the minority, and an oppressive society is a majority. It is a right of free will. God gives us all free will to choose Him or not. In Genesis 2:16-17 He gave Adam and Eve both free will to eat from any tree in the garden of Eden except the tree of good and evil.
4. Justice- Requires resources be given fairly and that all cases be treated similarly regardless of status, race or religion of the patient. Psalms state "Blessed are they who observe justice, who do righteousness at all times" (Psalms 106:3, English Standard Version). As a Christian and nurse, I believe this to be true.
In the ICU I have encountered many situations where these ethical principles are not followed. One particular case I can think of was the treatment of a "confidential, high authority" patient. Our hospital goes out of its way to cater to these individuals. We had a member of the house of representatives as a patient.
Extra care was given, a one to one nurse was assigned, visitor rules were ignored, and an extra bedside sitter was ordered to be in the room while the nurse was not able to in order to avoid having to put restraints on the patient. Justice was not displayed in this case as we do not do this with all of our homeless, suicide attempts, alcoholics, or drug overdose patients, but we did for this member of Congress.
References
Grand Canyon University. (2015). Bioethics in the Christian narrative [Lecture 3]. (2015). In Ethical and Spiritual Decision Making in Healthcare.
Meilaender, G. (2013). Bioethics: A primer for Christians (3rd ed.). Grand Rapids, MI: W.B. Eerdmans Pub. Co.
Reilly, D. (2006). Bioethics Chrisitanity & Medicine: A plea to relevance to daily practice.