PHI 413V Week 3 Healing and Autonomy
PHI 413V Week 3 Healing and Autonomy
The given case study is about Mike and Joanne. They are Samuel and James parents. James has been diagnosed with acute glomerulonephritis, kidney failure. According to James’s physician, James requires to undergo dialysis as a way of maintaining his kidney functions. However, James’s parents are of the opinion that he seeks religious healings from his pastor. The physician agrees to their decision only for James to be brought back two days later with worsening health status. He was started on dialysis and requires urgent kidney transplant. Therefore, this research paper examines the case study with a focus on the various aspects that should be considered for the health and wellbeing of James.
Good post. Bioethics is a subfield of ethics that concerns the ethics of medicine and ethical issues in the life sciences raised by the advance of technology. The issues dealt with tend to be complex and controversial (i.e., abortion, stem cell research, euthanasia, etc.). In addition, bieothics usually also involves questions of public policy and social justice. As such, the complexities of bioethical discussion in a pluralistic society are compounded. There have been several different approaches to bioethical questions put forth that have to do with the theory behind ethical decision making (Fathallah et al., 2020). Three positions have been prominent in the discussion principalism (also known as the four principle approach), virtue ethics, and casuistry. For this lecture, it will be useful to outline principalism and to describe the general contours of a Christian approach to bioethical issues
Should the Physician Allow Mike to Continue Making Decisions that Seem to him to be Irrational and Harmful to James?
The physician should not allow Mike to make decisions that irrational and harmful to James. Firstly, healthcare providers have the obligation of ensuring that the safety of the patient is protected. They make decisions that aim at optimizing the wellbeing, health, and recovery of the patients from their conditions (Scott, 2017). Healthcare providers also play the role of patient advocates. This implies that they fight for their patients in situations where their health and lives are at risk. An example is the case study where it is evident that Mike’s decisions are causing more harm to James than promoting his recovery.
The physician also has knowledge on issues that cause ethical dilemmas in his practice. An example of such issue is the conflict between respecting the autonomy of the caregivers and taking decisions that promote the health and wellbeing of the patient. In such situations, healthcare providers are expected to make ethical decisions that will not only protect the health of the vulnerable but also demonstrate prioritization of the health issues affecting the population. Consequently, the physician should not allow Mike to make decisions in a way that facilitates the understanding of the family. This includes explaining to the family about the prognosis of their son and possible outcomes if immediate interventions are not adopted.
The decision of not allowing Mike to make decisions concerning James’s health is not a violation of the autonomy of the patient. The physician will instead be promoting his autonomy by ensuring that the best interventions are used to promote his health. Healthcare providers often experiences ethical dilemmas in their practice. In such situations, they are expected to prioritize the needs of the patient, hence, the soundness of the decision made.
How Ought Christians 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?
There exist significant differences in the way in which Christians and physicians view or understand a disease. For healthcare providers, a disease arises from a change in the normal physiological processes in the body. However, this view might be different according to religion. For example, it can be seen from the case study that Mike and Joanne are strong believers of Christianity. They believe that everything that happens in their lives is attributed to God. According to some Christians, a disease is a symbol of God’s test of their faith or believes. They consider that a disease is something that God sent to them to know if they have strong faith in him. The best approach to an illness to such Christians is holding to a belief that the disease will heal by itself once God is through testing them. God is therefore the healer. Some Christians also perceive a disease to be God’s punishment. According to them, God sends a disease to human beings as a way of showing his dissatisfaction with their behaviors. As a result, they must live in ways that align with God’s teachings for the disease to be healed. The last group of Christians perceives physicians or healthcare providers to be sent by God to help them manage their diseases. In this case, the healthcare providers assist God in promoting the health and wellbeing of his creations. Mike’s family perceives James’s condition as God’s test of his faith in him. Therefore, the strongly believe that God will heal him once he has finished testing their faith.
It is therefore important that Christians consider medical interventions as part of the ways in which God’s efforts to promoting health and wellbeing are promoted. They should believe that medical interventions would enable them to see the doings of God through their recovery from the disease. Based on this, Mike should allow medical interventions to be utilized for the recovery and wellbeing of his son. He should have faith in God that the dialysis and kidney transplant will restore his son’s health. He should also consider the physician and other healthcare providers as part of the angels of God. Therefore, he should hold on the belief that God’s intentions will manifest through their medical interventions. Through this, Mike will be promoting beneficence and non-maleficence by ensuring that the safest care is given to his son. Furthermore, the decision will eliminate any future blames if medical interventions prove ineffective in promoting James’s recovery.
How Would Spiritual Needs Assessment Help the Physician Assist Mike Determine Interventions for James and for his Family or Others involved in his Care
Spiritual assessment is an important component in the provision of holistic care to the patients. Spiritual assessment would have benefited the effective management of James’s condition in a number of ways. Firstly, the physician could have learned about the spiritual needs of the family and their relationship with the care needed by the patient. It would have enabled him to explore the manner in which medical interventions can be used in a manner that does not conflict with the interests and expectations of the family. Spiritual assessment could have also enabled the physician to identify the teams that should be involved in making decisions on the care needed by the patient (Doreen, 2016). For example, he would have considered the need for incorporating the efforts of the family’s spiritual leader in deciding on the best treatment approach for the patient.
Spiritual needs assessment would have also enabled the physician to identify the family’s values, beliefs, and practices that are needed to ensure the adoption and sustainability of the adopted interventions. He could have also learned about the ways in which his values, beliefs, and practices are likely to influence the treatment decisions for the patient. For example, being medical personnel, he would have used biblical examples to increase the understanding of the family about the need for medical interventions (Doreen, 2016). Through it, he could have made them understand the interrelationship between medicine and religion.
In summary, the case study has shown the manner in which religion can influence the uptake of health interventions. It has revealed the manner in which the religious beliefs of the patients need to be incorporated into care for optimum health to be achieved. Therefore, it is important that healthcare providers incorporate spiritual assessment into their plans of care. This will enable them to provide care that promotes optimum health, wellbeing, and recovery of their patients.
Doreen, A. W. (2016). Spirituality in nursing practice: The basics and beyond. Springer Publishing Company.
Scott, P. A. (Ed.). (2017). Key concepts and issues in nursing ethics. Springer.
Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:
Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?
Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?
According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?
According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?
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The case study presents a frequent conflict between conventional medical treatment and spiritual beliefs that affect medical decision-making. In this case, Mike’s decision to opt for prayer healing instead of temporary dialysis has influenced his son’s condition and created a need for a kidney transplant. Mike is now contemplating whether to rely on religion or conventional, evidence-based medicine. The physician is also in conflict, as they need to decide on the recommended treatment and future communication with the child’s parents. The paper will seek to define the fundamental concepts involved in the case, explain the situation, and propose solutions based on biomedical ethics
Christian Narrative and Christian Vision
The Christian narrative and Christian vision are evident in the case study, as Mike openly expresses his beliefs about health care and the role of spirituality in it. The central concepts that arise in the case of Christianity are prayer healing, suffering, and abstinence from treatment. Firstly, prayer healing is a significant concept in Christianity, as many Christians believe that illnesses can be alleviated at God’s will (Alberta Health Services [AHS], 2015). Thus, it is not uncommon for Christians to rely on faith healers and prayers to achieve and maintain health. However, it is also notable that the Christian doctrine does not forbid conventional medical treatment (AHS, 2015). Thus, Mike’s decision to rely on prayers and faith healing is guided by his interpretation of Christianity rather than the Christian narrative itself.
Secondly, suffering is among the core tenets of the Christian narrative. The ultimate sacrifice made by Jesus is viewed positively, and thus people’s attitudes to suffering are different than in other religions. Christians often see hardship and suffering as a test of their faith rather than as a punishment for their sins (AHS, 2015). It is also believed that enduring hardship and suffering can help people to understand God’s ways, thus contributing to their spiritual journey. Therefore, the notion of turning to faith at times of suffering is a part of the Christian vision.
Finally, abstinence from medical treatment can be seen as a product of Christian beliefs about suffering and prayer healing. Instead of accepting treatment that provides immediate relief, people choose to experience suffering, thus relating to the image of Jesus. However, the attitude toward medical treatment and the comfort it gives also differs among the different branches of Christianity. For example, Catholicism argues for the rejection of therapy “due to it being too burdensome, risky, ineffective or disproportionate to the expected outcome” (AHS, 2015, p. 33). However, Catholicism encourages treatment that improves patients’ quality of life and longevity, including organ transplantation. In the Eastern Orthodox branch of Christianity, implantation of animal organs is forbidden, whereas interventions that improve health without causing harm to others are supported (AHS, 2015). Therefore, abstinence from medical treatment, including dialysis, is not part of the Christian faith.
Physicians and other health professionals have a significant impact on patients’ decisions, as they can provide information and guidance necessary to make choices regarding treatment and prevention. In the present case, the patient is Mike’s son, and thus the physician should seek to provide advice to Mike. Forbidding Mike to make faith-based treatment decisions would not be possible due to religious exemptions to child abuse and neglect laws (Antommaria et al., 2013). Instead, the physician should seek to share their knowledge about the treatment and advise Mike to proceed with kidney transplantation.
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As evident from the analysis of core issues, a treatment contradicts the Christian vision if it is harmful to others, has high risks, or is ineffective. Therefore, the physician should provide Mike with information about the risks and benefits of the treatment. Also, it would be useful to outline the effects of kidney donation on the patient’s brother to reassure Mike that it is a relatively safe procedure that would have few adverse effects on his quality of life. Indeed, although kidney donation is associated with regular surgery risks, the possibility of serious long-term risks is rather low (Maggiore et al., 2017). Apart from informing about the risks and benefits of the procedure, it would also be useful to analyze it from a spiritual point of view. Compassion, service, and charity are among the fundamental tenets of Christianity, and thus organ donation can be viewed as part of Mike’s son’s spiritual journey.
Analyzing the Case
To analyze the case, it is critical to consider the various options and viewpoints, as well as to investigate their sources. The physician’s position regarding treatment is clear and supported by clinical evidence. A kidney transplant will have a positive effect on James’ quality of life, health, and longevity, and is thus the preferred treatment option. Mike’s motives, on the other hand, are drawn not from the Christian doctrine itself, but a sermon by his pastor and anecdotal evidence. Treatment refusal based on such evidence will harm James, causing severe disability or death.
ints, as well as to investigate their sources. The physician’s position regarding treatment is clear and supported by clinical evidence. A kidney transplant will have a positive effect on James’ quality of life, health, and longevity, and is thus the preferred treatment option. Mike’s motives, on the other hand, are drawn not from the Christian doctrine itself, but a sermon by his pastor and anecdotal evidence. Treatment refusal based on such evidence will harm James, causing severe disability or death.
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The case also relates to the topic of patient autonomy, as discussed in the readings. Typically, patient autonomy is perceived as one of the primary values in culturally competent care (Louw, 2016). Care providers should respect patient autonomy as long as a patient is physically and mentally capable of making informed decisions about their health. In the present case, the patient is a minor, and he is represented by his parents. Therefore, one should also consider the issue of patient autonomy in the context of underage patients.
PHI 413V Week 3 Healing and AutonomyChristianity and Health
Christians’ beliefs about health and sickness are rather complex but can be narrowed down to three core ideas. First of all, life and health are a gift from God that should be maintained by the Christian Doctrine. Secondly, sickness is part of a person’s spiritual journey, as enduring hardship allows a Christian to relate to Jesus. Thirdly, medicine is part of God’s gift to humans, and should thus be used to promote health. According to Christian Enquiry Agency (2018), “Christians rejoice in all the things that bring health working together, whether they are natural, medical or prayerful” (para. 7). Therefore, as a Christian, Mike should rely on medical treatment while also praying for them to work and cause no harm to his second son. This option would allow Mike to save his son’s life while also conforming to the Christian vision of health and healing.
All in all, the case presents an example of a significant issue in biomedical efforts and allows reflecting on the role of spirituality in medical decision-making. Based on the analysis, it appears that Mike’s reasoning somewhat contradicts the Christian doctrine. Therefore, the physician should seek to provide information about treatment while also advising Mike that it adheres to the Christian vision. By cooperating with the parent and engaging in dialogue rather than taking radical action to oppose Mike’s judgment, the physician will be able to provide culturally competent care that serves the patient’s best interests.
Alberta Health Services (AHS). (2015). Health care and religious beliefs. Web.
Antommaria, A. H. M., Weise, K. L., Fallat, M. E., Katz, A. L., Mercurio, M. R., Moon, M. R., … Baker, A. (2013). Conflicts between religious or spiritual beliefs and pediatric care: Informed refusal, exemptions, and public funding. Pediatrics, 132(1), 962-965.
Christian Enquiry Agency. (2018). Illness. Web.
Louw, B. (2016). Cultural competence and ethical decision making for health care professionals. Humanities and Social Sciences, 4(2), 41-41.
Maggiore, U., Budde, K., Heemann, U., Hilbrands, L., Oberbauer, R., Oniscu, G. C.,… Abramowicz, D. (2017). Long-term risks of kidney living donation: Review and position paper by the ERA-EDTA DESCARTES working group. Nephrology Dialysis Transplantation, 32(2), 216-223.
Optional – Topic 3: Optional Resources
For additional information, see the “Topic 3: Optional Resources” that are recommended.
Read Scripture: TaNaK/Old Testament
View the online video, “Read Scripture: TaNaK/Old Testament,” from the Bible Project, located on the YouTube website (2
Word Study: Khata/Sin
View the online video, “Word Study: Khata/Sin,” from the Bible Project, located on the YouTube website (2018).
Understanding Health and Healing
View the “Understanding Health and Healing” media piece.
Incorporating Spirituality into Patient Care
Read “Incorporating Spirituality into Patient Care,” by Orr, from American Medical Association Journal of Ethics (2015).
Explore “The Messiah” webpage and watch the video on the Bible Project website (2018).
Sacrifice and Atonement
Explore “Sacrifice and Atonement” webpage and watch the video, on the Bible Project website (2018).
Word Study: Shalom/Peace
View the online video, “Word Study: Shalom/Peace,” from the Bible Project, located on the YouTube website (2017).
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 3 from Practicing Dignity.
New Testament Overview
View the online video, “New Testament Overview,” from the Bible Project, located on the YouTube website (2018
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?”