In 200-250 words 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?
| Benchmark – Patient‘s Spiritual Needs: Case Analysis |
In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.
Answer the following questions about a patient‘s spiritual needs in light of the Christian worldview.
- In 200-250 words 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? Explain your rationale.
- In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? 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?
- In 200-250 words, respond to the following: 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?
Remember to support your responses with the topic study materials.
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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?”
Expert Answer and Explanation
Ethical and Spiritual Decision Making
Question 1:
Whether the Physician should allow Mike to continue making Irrational Decisions that are Harmful to James
According to the Christian Worldview, one’s spiritual health depends on the health of their body. The bible teaches us that good health is critical to fulfillment of one’s spiritual potential. The physician should reason from this perspective when engaging Mike. Based on this worldview, the best thing the physician should do is to remind him that James’ health to worsen if he continues making unreasonable decisions (Timmins & Caldeira, 2017).
Given the physician’s knowledge about James’ kidney disorder including the complications that may arise if the treatment is delayed, and considering the principles of medical ethics such as harm reduction, the physician needs to intervene.
As a minor, James cannot make decisions regarding his own health. In this case, the parent is responsible of making decisions on his behalf. As much as the patient’s autonomy matters, the physician should persuade Mike to rethink his position about how to approach his son’s illness (Smebye, Kirkevold, & Engedal, 2016).
The physician’s role in this case would involve explaining to Mike the potential consequences of his actions. He should particularly remind Mike that a Christian should not engage in activities that hurt others or put the lives of others at risk. Therefore, intervening to stop Mike from denying James the opportunity to receive treatment is the best way the physician can address the issue.
Question 2:
How a Christian ought to think about Sickness and Health
Christians believe that health and sickness are aspects of human experience, and from the biblical perspective, sick people can gain good health through prayers, and appropriate interventions. God‘s love for humans manifests in different ways including giving people good health. If one is sick, according to the Christian worldview, one should keep on trusting in God because God has power over illness.
Illness, and suffering in general, provides a way in which God can test the degree of human faith in God. Job’s suffering including his ultimate redemption from illness and suffering is an example of how God can reveal his grace through human experience (Forouzi et al., 2017). However, a Christian ought to see sickness as a temporary experience.
How a Christian should think about Medical Intervention
Although it is important for a Christian to pray for healing, they should view illness as something manageable, and which can be managed with the correct clinical intervention. Humans fit well in God’s creation story because according to the biblical story of creation, human exist in God’s image.
Since God is all-knowing, humans have the wisdom to come up with interventions that bring healing to the sick. God’s divine instruction to human, still, is that humans should take care of the earth and everything found in it (Kørup et al., 2020). Essentially, it is imperative that Christians view the medical intervention as a manifestation of God’s work to bring healing to the inhabitants of the earth.
What Mike should do as a Christian
Given his Christian faith, Mike should opt for medical intervention even as he continues to pray for James. He should particularly draw inspiration from Jesus’ statement that “people go to see the doctor when they are sick” in reference to the question he was asked why he spends time with sinners in Mathew 9:12. The concept of love as featured in Lev. 19:18 should inform Mike’s actions. Mike should demonstrate that he loves James, just the way he loves himself.
How Mike should reason about Trusting God and treating James in relation to honoring the Principles of Beneficence and Nonmaleficence in James’s Care
As he keeps on trusting God, Mike should seek medical intervention by talking to the physician about the potential outcomes of the clinical intervention. While he considers the options, he should understand the consequences of his actions on James and Samuel because the decisions he makes in this case may affect the health and safety of the two children. Given his Christian faith, he should ensure that the decisions he makes are beneficial to the ailing child including Samuel, and it does not cause harm to either child (Cuellar De la Cruz & Robinson,2017).
Question 3
How Spiritual Needs Assessment help the Physician assist Mike determine appropriate Interventions for James and for his Family or Others involved in his Care
Spirituality plays a vital role in healing, and for this reason, the physician needs to incorporate aspects of Mike’s spirituality into the treatment of his child, James. To do this, the physician will need to perform spiritual needs assessment, and incorporate the same into the patient care process (Marin et al., 2017). Part of the assessment will involve asking Mike questions pertaining to the form of spiritual support he would like to be integrated into the treatment plan.
For the physician, exploring Mike’s spiritual needs can help provide insight into certain aspects of his beliefs that could affect James’ health. With this information, the physician is able to create a care plan, taking into account the values, views and perceptions of Mike. In this case, they would prioritize addressing the holistic needs of the patient instead of focusing only on their medical needs.
Prayer is a significant component of the holistic care, and when working with Mike, the physician would need to consider what kind of practices can help Mike be hopeful that his son will recover. Besides prayers, he may consider adding bible reading into the care plan which will involve performing organ transplant (Marin et al., 2017). Combining clinical intervention, and spiritual care, therefore, can be possible if the patient’s spiritual needs are assessed.
References
Cuellar De la Cruz, Y., & Robinson, S. (2017). Answering the call to accessible quality health care for all using a new model of local community not-for-profit charity clinics: A return to Christ-centered care of the past. The Linacre quarterly, 84(1), 44–56. https://doi.org/10.1080/00243639.2016.1274631.
Forouzi, M. A., Tirgari, B., Safarizadeh, M. H., & Jahani, Y. (2017). Spiritual Needs and Quality of Life of Patients with Cancer. Indian journal of palliative care, 23(4), 437–444. Doi: https://doi.org/10.4103/IJPC.IJPC_53_17.
Kørup, A. K., Søndergaard, J., Christensen, R. D., Nielsen, C. T., Lucchetti, G., Ramakrishnan, P., Baumann, K., Lee, E., Frick, E., Büssing, A., Alyousefi, N. A., Karimah, A., Schouten, E., Schulze, A., Wermuth, I., & Hvidt, N. C. (2020). Religious Values in Clinical Practice are Here to Stay. Journal of religion and health, 59(1), 188–194. https://doi.org/10.1007/s10943-018-0715-y.
Marin, D. B., Sharma, V., Powers, R., & Fleenor, D. (2017). Spiritual care and physicians: Understanding spirituality in medical practice. New York, NY: Health Care Chaplaincy Network.
Smebye, K. L., Kirkevold, M., & Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study. BMC health services research, 16, 21. Doi: https://doi.org/10.1186/s12913-015-1217-1.
Timmins, F., & Caldeira, S. (2017). Understanding spirituality and spiritual care in nursing. Nursing Standard, 31(22), 50-57. doi:10.7748/ns.2017.e10311.
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