The four principle are core principle to assist in making ethical decisions. Primarily, the best scenario is to be able to balance each principle against the others. However, I will provide the following ranking when one must be chosen over another.

Autonomy is my primary choice in when developing a hierarchy of the principles. Kanban Tools (2023) recognizes the power of a person’s autonomy for providing decision making and ownership of their responsibility in those decisions that offer self governance. Harm that their decisions that caused to others is a responsibility that must be reconciled. The reason I chose autonomy is back to the framework of my worldview. The fall occurred because we made a choice and had the power and authority to make that choice. Redemption is available to all due to the love and sacrifice that Jesus made. Yet we must choose to recognize that sacrifice, who made it, why we remain undeserving and could not achieve redemption on our own, and we are given the gift through faith alone. We can be part of the restoration if we make the right choices. Autonomy is about making choices that originate in the creation of human beings and carries through the millennia until the original question of sin is answered for we can not bring someone to God by the sword.

Beneficence is my secondary choice if the hierarchy must be employed over a balancing of the four principles. It is more than a random act of kindness or acting from a superior positions. It is doing good to others through moral obligation as witnessed in Imago Dei. This principle is required to establish the potential for distributive justice. By definition this eliminates malevolence. By recognizing the origins of why to express beneficence, we recognize innate value, dignity, rationality of humans, and the existence of our spirituality. Additionally, we are obligated to add to or increase to the well-being of our patients and the greater human experience.

Nonmalevolence is to do no harm. I strongly notate that this is knowing, or suspecting that our actions would lead to harm or detrimental effects. If the first two are employed, this is negated. Although I see it a a question to reinforce or remind us to question our decisions and choices while exploring if we are potentially harming or sacrificing the subjects in question.

Justice is too complex to provide simple answers. As a nurse,my concern would be concerned with distributive justice and fairness. The equitable access to necessary healthcare. Currently the wealthy have greater justice as they have more secure access, higher quality of care, and potential cannibalization of those who lack means or tools to secure or fight for justice. This dynamic will continue to exist and at best we can minimize the affects on the greater structure of society. Consider that we can potentially have unlimited desires but have limited resources to achieve those needs. Whose needs or desires are met before the basic needs of others remains the question for distributive justice which raises questions for restorative, procedural, personal, and retributive justice when distributive justice is not accomplished (Maiese & Burges, 2024).

Reference

Kanban Tool. (2023, September 4). The Power of Autonomy: Empowering individuals to drive results – kanban tool blog. https://kanbantool.com/blog/the-power-of-autonomy#:~:text=Autonomy%20is%20one’s%20ability%20to,take%20ownership%20of%20one’s%20responsibilities.

Maiese, M., & Burges, H. (2024, January 12). Types of justice. Beyond Intractability. https://www.beyondintractability.org/essay/types_of_justice#:~:text=This%20article%20points%20out%20that,All%20four%20of%20these%20are