Case Study: Healing and Autonomy
Mike and Joanne are the parents of James and Samuel, identical twins born 8years 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 matterand 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?”
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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Expert Answer and Explanation
Patient’s Spiritual Needs Assessment
Individuals’ beliefs influence their perceptions of care, and depending on one’s own beliefs, one can refuse or accept an intervention. For health care practitioners, working with a patient who refuses treatment because of their religious values and norms, can be a challenging experience. This kind of scenario presents an ethical issue in which the practitioner has to decide between respecting patient’s autonomy, and reducing harm. For a physician to resolve an issue of this nature, they need to rely on ethical theories to guide their decisions (Isaac, Hay, & Lubetkin, 2016). For this reason, it is imperative for the health care professionals to conduct spiritual needs assessment and provide spiritually sensitize care that fits the needs of the patient.
The Appropriate Decision Mike should make
It is imperative that the physician intervene if Mike continues to make decisions which could jeopardize James’ health. Given James’ age, James is not in a position to make sound decisions about his own health, and this is why Mike is the right persona to make treatment-related decisions on behalf of his son James. However, the Physician cannot go against Mike’s decision because they have to respect the autonomy of Mike as a parent. Because forcing treatment on James would compromise Mike’s position, and cause the breach of the autonomy, the physician should pursue legal options. When presenting this issue to the court, the physician would need to prepare and present ample details to serve as a proof that Mike’s decisions can cause harm to James (Dickens & Cook, 2015). For the Physician, opting for the legal process is important for certain key reasons. It would eliminate the legal implications which may occur if they fail to make decisions. It would also limit the risk of feeling guilty because of failing to act. Still, it would help save the life of James because James will receive treatment. In the event that the physician fails to act, there is a possibility that his inaction would lead to legal ramifications such as the revocation of practice license.
Christian’s View on Sickness and Health
The Christian faith offers a unique view on health and illness, and just like other faiths, it has beliefs which affect Christians’ views on a wide range of issues including sickness. The idea of redemption is part of these beliefs, and it is synonymous with the restoration of one’s physical and spiritual health. According to the teachings of this faith, healing occurs dramatically, and one can notice this in the way Jesus performed his miracles. Accordingly, Christians have to persistently pray for good health even irrespective of whether they are sick or healthy. Sickness, based on this faith, is a normal experience that people go through at different points in their lifetime, and God can heal individuals as a means of demonstrating God’s power over illnesses (Cuellar De la Cruz & Robinson, 2017). God is compassionate
Christian View on Medical Intervention
Christians generally accommodate the idea pertaining to the use of the modern medicine to manage health issues. God, based on the teachings of this faith, gave humans the wisdom to find solutions to the challenges they may face. Illness is part of these challenges. The concept of the imago Dei also supports the perspective which this faith holds when it comes to the modern medicine. According to this concept, God made humans to be like God in terms of image. Because God has the ultimate wisdom, humans can also have God-given wisdom. Therefore, humans use this wisdom to come up with methods to treat illnesses. It is this regard that Christians support the modern medicine (Gonçalves et al., 2017).
How Mike should act as a Christian
Christians have the obligation of helping others who are not in position to help themselves. A Christian would put the interests of others before theirs because Jesus calls for his followers to be servants of others. Accordingly, he has the responsibility as a Christian to present others from harm, and he can meet this obligation by having James receive treatment (Gonçalves et al., 2017). Mike would be compromising the values and teachings of his faith if he continues to refuse the treatment of James.
How Mike have to Reason
Being a Christian, Mike should re-consider how he reasons, and instead of refusing the treatment of his son, he should see himself as person whom God can use to help James heal. James should take into consideration the fact that as he prays, he should make necessary decisions, and take actions to help his child go through treatment. This the biblical teachings encourage individuals to act while they pray (Gonçalves et al., 2017).
Importance of Spiritual Needs Assessment
When patients present to the hospital with clinician issues, a provider has to first assess the patient prior to administering treatment. When assessing patients, the health care practitioner does not only perform a physiological assessment but they assess the spiritual needs of the patient as well. During this assessment, they ask a series of questions so that they can comprehensively understand the patient’s beliefs and their views about care. Considering Mike as an individual with the mandate of making decisions on behalf of the patient, he will answer these questions. Asking Mike whether his faith and beliefs give meaning to his life, for instance, provides a means of getting the connection between his faith and his perceptions about life and health. During the assessment, it would be important to ask if he is a member of a religious organization (Seddigh et al., 2016). Using the responses Mike provides, the physician can prepare an intervention plan which incorporate Mike’s views about health. For example, they may include in the plan a session for prayers so that Mike can pray for his son. If possible, they may involve a religious leader to pray for the healing of James as James receives physician intervention. Therefore, the assessment of the patient’s spiritual needs is important in the sense that it helps the interventionist identify Mike’s beliefs, and adapt intervention to reflect the patient’s needs.
In summary, the perceptions which people hold about care can affect the decisions they make in terms of seeking for the clinical solutions to the health issues. This is noticeable in Mike’s scenario considering that the decisions he makes stem from the beliefs he holds relative to his faith. Unfortunately, Mike seems to hold a distorted view of how Christians should act when presented with an issue of illness. Accordingly, he seems to not understand the perspective of the Christian faith when it comes to health and illness. This explains the reason why he refuses the treatment of James even though Christians accept the use of modern medicine to manage illness. Thus, conducting spiritual needs assessment is important in this case because it can help inform the kind of treatment which can be suitable for Jame’s case.
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.Doi: https://doi.org/10.1080/00243639.2016.1274631.
Dickens, B. M., & Cook, R. J. (2015). Patients’ refusal of recommended treatment. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 131(1), 105–108.Doi: https://doi.org/10.1016/j.ijgo.2015.07.001.
Gonçalves J.P., Lucchetti, G., Menezes, P.R., Vallada, H. (2017). Complementary Religious and Spiritual Interventions in Physical Health And Quality Of Life: A Systematic Review Of Randomized Controlled Clinical Trials. PLoS ONE, 12(10). .Doi: https://doi.org/10.1371/journal.pone.0186539.
Isaac, K. S., Hay, J. L., & Lubetkin, E. I. (2016). Incorporating Spirituality in Primary Care. Journal of religion and health, 55(3), 1065–1077. Doi: https://doi.org/10.1007/s10943-016-0190-2.
Seddigh, R., Keshavarz-Akhlaghi, A. A., & Azarnik, S. (2016). Questionnaires Measuring Patients’ Spiritual Needs: A Narrative Literature Review. Iranian journal of psychiatry and behavioral sciences, 10(1), e4011. https://doi.org/10.17795/ijpbs-4011.
Write a fully developed and detailed APA essay addressing each of the following points/questions. There is no required word count; be sure to completely answer all the questions for each question in detail.