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.
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- 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.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
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Applying the Four Principles: Case Study
Part 1: Chart (60 points)
Based on the “Healing and
Autonomy
” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.
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Medical Indications
Beneficence and Nonmaleficence
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Patient Preferences
Autonomy
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From the case study, it can be noted that James’ health continues to deteriorate, and it worries since he missed his dialysis. As a result, his blood pressure has increased. The condition to the extent that he needs a kidney transplant. He has a potential donor in his twin brother. Kidney transplant can save the life of James, but it may also pose significant harm to Samuel, who is going to donate the kidney. However, it is the responsibility of medical practitioners to ensure that James regains his health.
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James’ parents were given the autonomy to have control over his health. The health care provider allowed them to believe in God’s miracle to restore their son’s health. James’ parents deliberately skipped his dialysis schedule for a church healing service. The parents also had the autonomy to decide whether Samuel can donate his kidney to James, his twin brother. Seemingly, James’ father (Mike) preferred believing in is faith for his son’s healing. This case is a perfect example of respect for autonomy. The health care practitioner respected the parents’ belief in God and gave them the opportunity of deciding the intervention that would help James restore his health.
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Quality of Life
Beneficence, Nonmaleficence, Autonomy
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Contextual Features
Justice and Fairness
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According to the doctor, James’ health can only be restored through a kidney transplant; otherwise, he would die. However, this move may put Samuel’s health into risk because of losing one kidney through surgery. But Mike should understand that this is the only chance to have James alive. James’ health lies in his hands. Failure to let Samuel donate a kidney may lead to James’ death. It is clear that Mike is struggling to decide between the kidney transplant and his faith in the healing service. He is taking long to decide, and this continues to worsen James’ health.
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Mike has the autonomy of making decisions on James’ medical intervention. The case gives him the sole responsibility of deciding whether James should get a kidney transplant. However, Joanne (James’ mother) is seemingly not part of the decision making process. Emphasis has been put on the belief and faith of Mike. It would be fair to include Joanne in decision making. At the same, Samuel may be young, but he should be consulted on whether he can donate his kidney to his brother to save his life.
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Part 2: Evaluation
Answer each of the following questions about how principlism would be applied:
1. In 200-250 words, answer the following: According to the Christian worldview, which of the four principles is most pressing in this case? Explain why. (45 points)
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Respect for autonomy is the principle that takes center stage in this case. According to this principle, patients should have the authority to make their own decision regarding the medical intervention they need (Beauchamp & Childress, 2014). In this case, Mike is given the autonomy to decide James’ next medical intervention. He opted to forgo James’ dialysis schedule to seek God’s miracle healing. The physician did not interfere with their choices. Mike argued that subjecting their son to multiple dialyses is not a lasting solution to the problem and believed that only God could heal. The physician sat down with James’ mother to explain to her about the importance of the dialysis, treatment options, risks involved, and dangers the child may experience if he does not get the right medical attention. He then left the final decision to them to make. Since James is still a minor, the parents assume autonomy responsibility. As a result, they acted by putting their belief in God’s healing first. However, this failed to bear fruits, and James’ health continued to worsen. He needed a kidney transplant; otherwise, he would die. The principle of autonomy plays a key role in medical decision making, and physicians must respect the decision of their patients (Beauchamp & Childress, 2014).
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2. In 200-250 words, answer the following: According to the Christian worldview, how might a Christian rank the priority of the four principles? Explain why. (45 points)
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Based on the Christian worldview, the four principles would be ranked based on their significance: Autonomy; b). Non-maleficence; c). Beneficence, and d). Justice.
Respect for autonomy is a major principle. Christians treat respect as a key component of relationship building with God and fellow humans. During creation, God provided man with the power to rule over the world and make their own choices. Christians expect physicians to respect patient autonomy. And according to the law of bioethics, patients have the authority of accepting or declining certain medical treatments, medications, or surgery (Lawrence, 2007). Some decisions may not serve the best medical interest of the patient, but physicians are expected to respect them.
As a Christian, I believe that the four principles should appear just as they are. Autonomy would form my first and major principle. Patients should have the chance to take part in their care and make decisions about their treatment interventions. I also value the principle of non-maleficence, and it would come second because I believe that humans should not be harmed. Physicians should make decisions that improve the health of patients (Ediger, 2015). The principle of maleficence, which promotes all that is good, would be ranked third. The principle of justice would be last. Among the four, it is the least applicable principle even though its significance in medical care cannot be ignored.
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References:
Beauchamp, T. L., & Childress, J. F. (2014). Principles of biomedical ethics (7th ed.). New York: Oxford University Press.
Ediger, M. J. (2015). Teaching Clinical Ethics Using the Four Topic Method. International Journal of Athletic Therapy and Training, 20(6), 10-13.
Lawrence, D. J. (2007). The four principles of biomedical ethics: a foundation for current bioethical debate. Journal of Chiropractic Humanities, 14, 34-40.
©2019. Grand Canyon University. All Rights Reserved.
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?”
© 2019. Grand Canyon University. All Rights Reserved.
