Last Updated on 09/05/2023 by Admin

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.

1. 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.
2. 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?
3. 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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Understanding Patient Autonomy: Empowering Healthcare Decisions

In the ever-evolving landscape of healthcare, the concept of patient autonomy has emerged as a critical and empowering force. Patient autonomy refers to an individual’s right and ability to make informed decisions about their own medical care and treatment. It places the patient at the center of the healthcare journey, granting them the authority to choose their treatment options, participate in healthcare discussions, and ultimately, have a say in their own well-being.

The Significance of Patient Autonomy

Patient autonomy is more than just a buzzword; it’s a fundamental aspect of modern healthcare that seeks to respect and honor the individuality and agency of each patient. This concept has gained considerable recognition and support in recent years, and for good reason.

A Shift in Healthcare Paradigm

Historically, the healthcare industry has often been characterized by a paternalistic approach, where physicians and medical professionals held the authority in decision-making, often making choices for patients without extensive consultation. However, times have changed, and patient autonomy has ushered in a new era where patients are not mere recipients of care but active participants in their own health management.

Informed Decision-Making

One of the core principles of patient autonomy is ensuring that individuals have access to comprehensive and understandable information about their medical conditions, treatment options, and potential risks and benefits. Informed decision-making empowers patients to make choices that align with their values and preferences.

Ethical Foundations

Ethical principles underpin the concept of patient autonomy. Respect for a patient’s autonomy is rooted in ethical frameworks that emphasize the importance of respecting the rights and dignity of each individual. This ethical foundation reinforces the significance of patient autonomy in healthcare.

Key Components of Patient Autonomy

To fully understand patient autonomy, it’s essential to break down its key components, each of which plays a crucial role in empowering patients.

Informed Consent

Informed consent is a cornerstone of patient autonomy. It involves the process of providing patients with detailed information about their treatment options, including potential risks and benefits. Patients must have a clear understanding of what they are agreeing to before giving their consent for any medical procedure.

Shared Decision-Making

Shared decision-making is a collaborative approach where healthcare providers and patients work together to make healthcare choices. This process acknowledges the expertise of healthcare professionals while valuing the unique perspective and preferences of the patient.

Advance Care Planning

Advance care planning enables individuals to make decisions about their future medical care in advance. It includes creating documents like living wills and appointing healthcare proxies who can make decisions on behalf of the patient if they become unable to do so.

Respecting Cultural and Religious Beliefs

Patient autonomy extends to respecting cultural and religious beliefs that may influence a patient’s healthcare decisions. Healthcare providers must be sensitive to these factors and ensure that care aligns with the patient’s values.

The Role of Communication

Effective communication is at the heart of patient autonomy. Healthcare providers must communicate clearly and empathetically with patients to ensure that they understand their medical conditions, treatment options, and the potential consequences of their choices.

Establishing Trust

Building trust is essential in fostering patient autonomy. Patients are more likely to exercise their autonomy when they trust their healthcare providers. Trust is cultivated through open and honest communication, active listening, and a genuine commitment to the patient’s well-being.

Language and Health Literacy

To promote patient autonomy, healthcare information must be presented in a language that patients can comprehend. Health literacy plays a vital role in ensuring that patients can make informed decisions. Healthcare providers should strive to use plain language and avoid medical jargon.

Challenges in Upholding Patient Autonomy

While patient autonomy is a noble and necessary concept, it’s not without its challenges. Healthcare systems face several hurdles in fully implementing and supporting this principle.

Cultural and Ethical Conflicts

In some cases, cultural or ethical conflicts may arise between healthcare providers and patients. For instance, a patient’s religious beliefs may conflict with a recommended medical treatment. Balancing patient autonomy with ethical guidelines can be a complex task.

Health Disparities

Health disparities, such as unequal access to healthcare resources and information, can hinder patient autonomy. It’s crucial to address these disparities to ensure that all individuals have an equal opportunity to exercise their autonomy.

Legal Considerations

Legal considerations vary from one region to another, and healthcare providers must navigate these complexities when upholding patient autonomy. Understanding the legal framework surrounding informed consent and decision-making is essential.

Conclusion

In conclusion, patient autonomy is a pivotal concept in modern healthcare that empowers individuals to actively participate in their own medical decisions. It shifts the paradigm from a paternalistic approach to one that respects and values the autonomy, dignity, and preferences of each patient. By embracing the principles of informed consent, shared decision-making, advance care planning, and cultural sensitivity, healthcare providers can ensure that patients are at the center of their healthcare journey.

When can patient autonomy be overruled?

Patient autonomy can be overruled or limited in certain circumstances, primarily when there are ethical, legal, or medical considerations that may necessitate intervention. It’s essential to understand that overriding patient autonomy is not taken lightly and is typically done to ensure the patient’s best interests or the interests of society as a whole. Here are some situations where patient autonomy may be overruled:

1. Medical Emergency: In situations where a patient’s life is in immediate danger, healthcare providers may need to take immediate action without obtaining the patient’s consent. For example, if a patient is unconscious and requires life-saving treatment, healthcare professionals may proceed with treatment to preserve life.
2. Mental Incapacity: If a patient lacks the mental capacity to make informed decisions due to factors such as severe mental illness, dementia, or unconsciousness, healthcare providers may make decisions on their behalf. This is typically done while adhering to legal and ethical guidelines, including the appointment of a legal guardian or proxy.
3. Public Health Concerns: In some cases, public health concerns may override individual autonomy. For instance, during a contagious disease outbreak, patients may be required to undergo isolation or treatment to prevent the spread of the disease, even if they object.
4. Court-Ordered Treatment: In situations where a court deems a patient incapable of making sound medical decisions, the court may order specific treatments or interventions, even if they go against the patient’s wishes.
5. Age-Related Limitations: In cases involving minors, their autonomy may be limited due to their age and capacity for decision-making. Parents or legal guardians often make medical decisions on their behalf, but ethical considerations are still taken into account.
6. Psychiatric Emergencies: In cases of acute psychiatric emergencies where a patient poses a danger to themselves or others, involuntary psychiatric evaluation and treatment may be initiated to protect their well-being.

Why is autonomy important in ethics?

Autonomy is crucial in ethics for several reasons, and it plays a central role in the ethical principles that guide various aspects of human interaction, including healthcare, decision-making, and personal freedom. Here’s why autonomy is so important in ethics:

1. Respect for Individual Freedom: Autonomy represents an essential aspect of respecting individuals as moral agents with the freedom to make their own choices. It acknowledges and honors each person’s inherent worth and capacity for rational decision-making. In ethical systems like Kantian ethics, individual autonomy is a foundational principle.
2. Informed Consent: Autonomy is at the heart of informed consent, a fundamental ethical principle in healthcare and research. Informed consent ensures that individuals have the right to make decisions about their own bodies and participation in medical treatments or research studies. Healthcare professionals must provide patients with all relevant information, allowing them to make voluntary and informed choices.
3. Dignity and Self-Respect: Autonomy is closely tied to an individual’s sense of dignity and self-respect. Respecting a person’s autonomy means acknowledging their ability to make choices that align with their values, beliefs, and desires. It reinforces the idea that individuals should not be treated merely as means to an end but as ends in themselves, as emphasized by philosopher Immanuel Kant.
4. Personal Responsibility: Autonomy encourages personal responsibility for one’s actions and decisions. It holds individuals accountable for the choices they make, fostering a sense of ownership over one’s life and moral actions. This accountability is a key element of ethical behavior.
5. Cultural and Moral Diversity: Autonomy recognizes and accommodates the diverse range of moral and cultural beliefs held by individuals. It allows people to make choices that reflect their unique perspectives, traditions, and values, even if those choices differ from societal norms or the preferences of others.
6. Avoiding Paternalism: Autonomy serves as a counterbalance to paternalism, the idea that authorities should make decisions for individuals based on what they perceive as best. Autonomy allows individuals to resist unwanted interference in their lives and decisions, promoting a more egalitarian and just society.
7. Promoting Personal Growth: Autonomy encourages personal growth and self-discovery. When individuals have the freedom to make choices, they have the opportunity to learn from their experiences, both positive and negative, and develop as individuals.
8. Conflict Resolution: In ethical decision-making, respecting autonomy can help resolve conflicts and disputes by providing a framework for negotiation and compromise. It allows individuals to find common ground and make decisions that respect the rights and values of all parties involved.