PHI413V Ethical And Spiritual Decision Making In Health Care : Essay Fountain

Question:

Topic about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Case Study: Healing and Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.

The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.

Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.

James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.

Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview. respond to the following:

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy?

1. How ought the Christian think about sickness and health?

2. How should a Christian think about medical intervention?

3. What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

 

Answer:

Response to health and autonomy

Most Christians value their religions, and they expect that other people will  respect  what they believe. In the case study, there are essential principles used to elaborate more about spiritual needs for Christians and different choices made. The primary purpose of the response below is to outline decisions made on a medical intervention based on religious beliefs. Christians have different views about sickness and health, but they also play a significant role in healing and medication. The physician should not allow Mike to continue making decisions that would put their son James at risk. Based on how James’s parents decided on their son’s dialysis, they opt to use religious healing instead of going for the treatment. As a result, their son’s condition became worse and needed a kidney transplant urgently (Ernecoff, Curlin, Buddadhumaruk, & White, 2015). The outcome was unexpected, and there is a high chance that he might make the same mistake in making of choosing religious healing for his son James.The physician should use the principle of no maleficence, which is preventing any harm to the patient, James.

The physician has enough experience and knows that if James doesn’t get the transplant as soon as possible, his life will be in danger. Therefore, he needs to intervene in the decision making of James’s parents concerning their child’s kidney transplant. According to Chakraborty, El-Jawahri, Parnes, and Hashmi (2017), a person can survive with only one kidney and live a normal and healthy life because one kidney will function as two. Furthermore, the physician is in a better position to talk to both Mike and Joan and make them understand how the transplant is essential to their son. The doctor will also explain to them the danger their son will be if he does not get a transplant soon. Different religions have different views about health and sickness. For some Christian, they view it to be a temptation that is given by God to test their faith; to some, they see it as a punishment for their sins. Some also believe that sickness is used as a disruption of the function of the body; thus, they believe that doctors are just intended to assist with the whole process of the treatment.

 

As indicated in the case study, Mike is a devoted Christian; thus, he believes that sickness happened to his son as a test of his Faith in God. With his belief, he chose spiritual healing rather than medical treatment, which had negative results for his son. According to Schruba, Davis, Aten, Wang, and Boan, D. (2018), people like the Christian Scientist, believes that medical intervention is not essential, thus relying on their healing prayers of Christian scientist-practitioner. Christian should understand that medical intervention is critical, and when one becomes sick, they need to seek medical attention. Having Faith is essential to most Christians, and it’s due to their belief that one gets healing. However, they should also realize that getting medical intervention is necessary because one will be able to heal fast.

Despite Mike and Joan attachment to their religion and beliefs, they should think about what is best for their child and how he will get kidney transplants better soon. Mike should maintain his Faith and belief; and allow the physician to go ahead with the plans of performing the transplant for their child James ( Lulé, Kübler, & Ludolph, (2019). Mike’s decision should be based on medical intervention and involvement in the medical treatment of the organ transplant. Besides, he should also continue believing in spiritual healing where he should trust and have faith in God for his son healing, which will be through the kidney transplant. Trusting and believing in God is very important and maintain his Faith in trusting God. ( Hubbard, & Greenblum, 2019). The conclusion that Mike made before was based on the principle of autonomy. As a result, his son ended up to be in a worse situation, and there is another decision that needs to be made about the transplant. In the decision, Mike needs to honor the principles of beneficence and no maleficence. To achieve it, he needs to agree with the doctor because he knows James’ condition and knows what might happen if the transplant is delayed ( Colgrove, 2019). Despite the great faith that Mike has needs to think about what is best for his son. At the same time, he would be honoring no maleficence principle where he is going to do anything to protect his son against harm. Knowing all the danger, his son is his right decision would be showing trust in God and protection to his son.

Spiritual assessment is essential because it allows a person to identify spiritual practice, resources, and beliefs, which will have an impact on one health. In the case study, the physician should use spiritual assessment to help Mike determine the right intervention for James (Robert, Stavinoha, Jones, Robinson, Larson, Hicklen, & Weaver, 2019). Prayer is essential; however, the physician should not use it as a goal of spiritual assessment. Also, the physician should not make the patient agree with a specific type of faith. With the use of spiritual assessment, the physician will be able to incorporate the precepts of Mike’s faith tradition into treatment. Moreover, it encourages the use of resources of Mike’s spiritual wellness for the overall wellness of his son. The assessment will also strengthen the relationship between the physician and the family relationship, and as a result, the will base their decision will be based on the wellbeing of James’s health.

In conclusion, Christians have different views about sickness and health, but they also play a significant role in healing and medication. For some, their principles and value go against the ethic practice and in the process, denying medical attention, which, as a result, may cause a negative impact. Considering the explanation of the patient’s anatomy, which is based on respecting the religion of a person and decisions made, has some effect. The intervention of the physician is critical in the case study, which will be the only way that Mike and Joan will understand their child’s condition and make their next decision based on a medical intervention, which in the process they will be showing their faith in God.

 

References

Chakraborty, R., El-Jawahri, A. R., Parnes, A. D., & Hashmi, S. K. (2017). A systematic review of religious beliefs about major end-of-life issues in the five major world religions. Palliative & supportive care, 15(5), 609-622.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28901283

Colgrove, J. (2019). Immunization and Ethics: Beneficence, Coercion, Public Health, and the State. In The Oxford Handbook of Public Health Ethics (p. 435). Oxford University Press, USA.Retrieved from https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780190245191.001.0001/oxfordhb-9780190245191-e-3

Ernecoff, N. C., Curlin, F. A., Buddadhumaruk, P., & White, D. B. (2015). Health care professionals’ responses to religious or spiritual statements by surrogate decision makers during goals-of-care discussions. JAMA Internal Medicine, 175(10), 1662-1669.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26322823

Hatamipour, K., Rassouli, M., Yaghmaie, F., Zendedel, K., & Majd, H. A. (2018). Development and Psychometrics of a ‘Spiritual Needs Assessment Scale of Patients: A mixed exploratory study. International Journal of Cancer Management, 11(1).Retrieved from https://www.apjon.org/article.asp?issn=2347-5625;year=2019;volume=6;issue=2;spage=122;epage=129;aulast=Farahani

Hubbard, R., & Greenblum, J. (2019). Parental Decision Making: The Best Interest Principle, Child Autonomy, and Reasonableness. In HEC Forum (pp. 1-8). Springer Netherlands.Retrieved from https://jme.bmj.com/content/early/2019/10/10/medethics-2019-105790

Lulé, D., Kübler, A., & Ludolph, A. (2019). Ethical principles in patient-centered medical care to support quality of life in amyotrophic lateral sclerosis. Frontiers in Neurology, 10, 259.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439311/

Robert, R., Stavinoha, P., Jones, B. L., Robinson, J., Larson, K., Hicklen, R., … & Weaver, M. S. (2019). Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatric blood & cancer, e27764.Retrieved  from https://www.ncbi.nlm.nih.gov/pubmed/31033210

Schruba, A. N., Davis, E. B., Aten, J. D., Wang, D. C.., & Boan, D. (2018). Psychological first aid and the role of scientific evidence in Christians’ provision of disaster spiritual and emotional care. Journal of Psychology and Christianity, 37(1), 74-79.Retrieved from https://www.wheaton.edu/media/psychology/faculty-files/cv-ward-davis-fall2019.pdf

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