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how shall we care for those who cannot afford health  insurance?


Ranking the four principles of biomedical ethics is a controversial  and multidimensional task, one that is both personal and  interdependent upon one’s worldview. According to the lecture,   “they do not have enough moral or concrete content on their own  apart from prior assumptions and worldview considerations” (GCU,  2018). It further explains that the principles themselves do not  represent a ‘common morality’ which would directly evoke  the right choice in any given ethical dilemma. The choice will never  be truly unbiased. An example is given of a Buddhist, Islamic, and  atheist worldview, proposing that using the principalist methodology  each of these individuals would come to a differing conclusion (GCU, 2018)

When taking a rudimentary look at how these principles should be  ranked, it is assumed that beneficence should rank as first priority.  Beneficence is the principle which states that the actions being  considered should contribute to the individuals welfare and generate  the best result. However, Lawrence argues that beneficence is  dependent upon true autonomy, stating “It is not possible to act  without the permission of a free moral agent without that  agent’s consent” (Lawrence, 2007). One cannot truly assess  what is in the best interest of the patient unless their true wishes  are heard and those wishes are met. Additionally, the patient’s  wishes may conflict with the provider’s perspective on what is  beneficial and in the provider’s opinion, cause harm to the  patient’s health or welfare. Is then nonmaleficence a priority  over both autonomy and beneficence? Today, the right to universal  healthcare is a tumultuous topic. Justice is the consideration of  resources available for all in light how much care an individual will  require. If a balanced withdrawal from these resources is most  ethical, is Justice the top priority? Lawrence argues if it is not a  right then how shall we care for those who cannot afford health  insurance? If healthcare is a human right, then how can we delineate  between what level care people can receive and who pays for that care?

I agree with Lawrence’s closing arguments. He reflects on an  paper published in the British Medical  Journal stating the principles “are not designed to  provide a method for choosing, but rather provide a set of moral  commitments, common language and a common set of moral issues. It is  necessary to view these in the context of scope in order to properly  utilize the principles” (Lawrence, 2007). He goes on to several  other authors who explain that ethical dilemmas should be approached  with these principles as a guide through each unique situation.


Lawrence DJ. (2007). The four principles of biomedical ethics: a  foundation for current bioethical debate. Journal of    Chiropractic Humanities, (14), 34–40. Retrieved from

GCU. (2018). Biomedical ethics in the Christian narrative

Comment #2

Principalism is a framework for bioethics which can be applied in all  areas in our lives and can be incorporated into our morals and values.  Ethical decision making can be achieved by considering four  principles: Respect for autonomy, nonmaleficence, beneficence, and  justice. In the healthcare setting it is important to apply these  principles when advocating for our patients and caring for them. The  order of importance can change based on the circumstances and factors  that are presented. In most cases I would rank the importance of the  four principles in the following order: Nonmaleficence, beneficence,  autonomy, and justice. I place nonmaleficence as a priority principal  because I feel it is our primary job as human beings to not cause  another person harm. As a nurse my primary job is to not cause any  harm to my patients when I am caring for them. I would place  beneficence as my second priority because it is also a principal in  which requires preventing harm while keeping a person’s best  interest in mind by being my patients advocate. In nursing we always  have our patients’ best interest in mind while caring for them  and guiding them through the healthcare process. Thirdly, autonomy  would be a principal that provides importance in bioethics because  respecting a person’s autonomy and independence regarding their  own healthcare decisions is an important ethical component in  healthcare. Lastly, justice is a principal to consider in bioethics  because treating people equally and fairly and distributing resources  fairly is important in ethics (GCU, 2015).

In consideration of the Christian biblical narrative, a Christian  vision is deontological because it considers principles of right and  wrong. The narrative gives us an idea of the big picture or Gods  mission for the way in which he wants us to lead our lives. I believe  the narrative speaks in this order regarding the four principles of  bioethics: Creation according to Christianity relates to the principal  of beneficence in which everything exists and is the way it is  supposed to be on purpose and is good. This benefits all and brings a  sense of peace to all things. The Fall is related to autonomy in that  God gave us free will and the opportunity to make our decisions  regarding how we choose to live our lives. Redemption relates to the  principle of justice. The death of Jesus Christ saves humanity and God  is able to forgive our sins. Salivation is able to restore our  relationship with God by bringing us together in unity. Lastly,  restoration in the Christian story connects with nonmaleficence  because God does not want to bring harm to humanity rather, he made  salvation available to all man, so we could return to a perfect state  of shalom (GCU, 2015).


Grand Canyon University. (2015).Biomedical ethics in the    christian narrative. [Lecture 3]. In Ethical and    spiritual decision making in health care. Retrieved from


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