Four Principles Approach In Nursing

In the prompt, we are given the case of a daughter who is conflicted over the decision to whether or not implement new cell-based treatments on her father who is suffering from Alzheimer’s disease. While new cell-based treatments offer potential cure for these patients, with the treatment still in experimental stages, concerns regarding their safety and impact on patients’ memories and identities have been raised. The “Four Principles Approach” provides an ethical framework for evaluating such moral decisions. The framework outlines four key values: respect for autonomy, beneficence, maleficence, and justice. Here, it will be argued that since the father is unable to formulate autonomous decisions under cognitive impairments, the daughter is

Respect for autonomy entails respecting a patient’s ability to independently make decisions. Importantly, it involves creating an environment in which the patient can make informed, intentional decisions. Thus, it is the physician’s duty to inform the patient of the potential benefits and risks of the treatment. This ensures that the patient understands his situation and decide on his future, fully aware of the implications. The problem with requesting consent from the father who is suffering from late-stage Alzheimer’s disease, however, lies in that he likely suffers from cognitive impairments in planning, problem solving, and judgement. Clinicians have observed that patients in in more advanced stages of the disease face difficulty speaking and requires help even with simple tasks such as eating (Neugroschl & Wang, 2011). Thus, even if the risks and benefits of the treatments are fully explained to the father, it appears that he will unable to fully understand the implications of his decisions. While some may argue that entrusting the daughter to make such decisions for him neglects the autonomy of the father, such argument will inevitably lead to two options: have the patient decide or refrain from treatment. As mentioned before, as these patients many times suffer from cognitive impairments, they are unlikely to fully comprehend the situation and thus be irrational to rely on them to evaluate such decisions. On the other hand, refraining from treatment altogether because the father is unable to make an autonomous decision will be neglecting the damage the disease will inflict on the father as it progresses. The cognitive abilities such as memory, planning, and reasoning that is lost in Alzheimer’s patients is in a sense what makes us human. Moreover, as the disease progresses, these