Jamie- In the movie, numerous ethical dilemmas were present. For the purpose of this post, I will focus on autonomy, nonmaleficence, and beneficence.

First, I will consider Anna’s request for medical emancipation and Kate’s wish to die. These situations highlight the ethical principal of autonomy. Patient autonomy is not clear cut when it concerns a minor. However, autonomy takes priority when the child is developmentally able to comprehend the situation. In addition, their wishes should always be considered with regard to their own care.

Next, the issue of Anna being “created” through IVF for the sole purpose of being an appropriate match for her ill sister. It could be considered as both promoting good (beneficence) and causing harm (maleficence). Throughout Anna’s life, she was subjected to pain and risks. On the other hand, these procedures prolonged Kate’s life. As a mother, I think beneficence takes priority; but after Kate’s situation became futile, nonmaleficence to both girls is priority.

Third, Kate expressed that she was prepared to die but Sara did not respect her autonomy. This also balances nonmaleficence and beneficence. Is prolonging life without regard to quality of life considered beneficence? In my opinion, it is to the contrary; particularly when the individual has accepted that death is inevitable. This can be considered doing harm.

These dilemmas truly elicit moral conflicts and numerous emotions. With regard to the movie, I agree with Terry that autonomy takes priority over other ethical principles. However, watching a movie and discussing principles is much easier than dealing with these situations in real life. They can be viewed through various perspectives and moral frameworks by different individuals, with varying conclusions. The overarching ethical principles described by the ANA (2015), as well as Clark’s (2010) model aid in assessing these difficult situations.
2)Terri-The 3 ethical principles that I thought were evident in this movie were autonomy, beneficence, and fidelity.

Autonomy is defined in the lecture by Dr. Schneider as an “agreement to respect another’s right to self determine a course of action and support independent decision making.” I believe that the majority of this movie could have been avoided if Kate was involved in the decision making process. It was always Kate’s will and desire to just stop with treatments. She was ready to die. Kate is the patient; however, nobody was asking what her wishes were.

Dr. Schneider described beneficence as the core principle of our patient advocacy. The one time that I noticed that anyone listened to Kate was when she stated that she wanted to go to the beach. To me this was an act of beneficence by allowing her to leave the hospital and take a day trip to the beach.

Fidelity is the last principle that I witnessed in this film. Fidelity is described as being loyal, fair, truthful, and dedicated to our patients. The example that I liked best was when Kate noticed Dr. Chance speaking to her mother, she called him over. She ask him if it was “not good.” Dr. Chance did not avoid the question, he sat down on the edge of the bed and looked her in the eye and told her “no, it’s not good.” He remained truthful to her.

In my opinion the principle that should take priority is autonomy. I understand that patient may not be able to legally make decisions on their own, but they should always be included. The medical team should always find out what the patient’s wishes, concerns and questions are. That is just good patient care.