Case Study: Healing and Autonomy

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Case Study: Healing and Autonomy

Ethics and Spirituality are crucial concepts when it comes to decision making in healthcare settings. Often, patients or their immediate families require healthcare interventions that conform to their religion or spiritual affiliations. However, the medical personnel do not always consider religious or spiritual beliefs when dealing with acute situations. This paper evaluates a clinical scenario involving a parent who insists on religious instead of medical intervention for his child with acute kidney failure.

Should Mike Continue to Make Irrational and Harmful Decisions to James?

Mike should not continue making decisions that are harming James.  In medical ethics, every patient has the right to informed consent for their health care intervention – patient’s autonomy (Beauchamp and Childress, 2009). The concept of autonomy allows for decision-making on medical treatment, which does not cause subjected to harm (Beauchamp and Childress, 2009). In this sense, why would the physician allow Mike to continue making irrational and harmful to James? Although medical personnel should uphold parental decisions regarding their child’s care, the physician had the legal and ethical responsibility of intervening in situations that are possibly harmful to the child (Katz & Webb, 2016).

It is clear that Mike’s decisions are irrational and will further adverse James’s health outcomes. A physician’s fiduciary duty to protect and support an infant’s health needs is also embedded in the fiduciary physician-nurse relationship in paediatrics care (Katz & Webb, 2016). In this sense, a physician has the right to protect a child from potential harm, from irrational surrogate decision-making, setting a starting point for intermediation in instances of abuse and neglect. Allowing Mike to postpone James kidney transplant is by all facets irrational religious belief (Clarke, 2018).

How Should A Christian Think About Sickness and Health?

The Christian explanation of sickness and health is quite divergent. The Bible asserts that illness and sin are inextricably linked (NKJV, 1982, Romans 8:28). Death, sickness, and health deterioration were not God’s original plan for humanity. Paul says that sin and death entered the world through Adam, extending to every person since all are deemed sinners (NKJV, 1982, Romans 5.12).

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Beyond viewing sickness as a direct consequence of sin, it is difficult to speculate that certain illnesses are caused by sin. However, it is crucial to note that God punishes a sinner to the third and fourth generation. This means that it does not matter whether we have sinned or not, for the Bible say that all have sinned (NKJV, 1982, Romans 3:23), thus punishable. Some Christians believe in seeking medical help, whereas others view medical intervention as a lack of faith in God. It is wrong to believe that medical intervention is not right for a Christian.

Although the Bible mentions that God is all-knowing, all-powerful and perfectly good, the same Bible speak of using medical treatments. The Pharisees asked Jesus why he spent time with sinners, and he replied that only a sick patient could see a doctor (NKJV, 1982, Matthew 9:12).  In this sense, as the centre of the Christian faith, Jesus acknowledged the role of doctors in treating sick people. God created his people as intelligent beings. God consequently gave people the ability to create interventions and use them to heal different body illnesses. This way, physician and nurse practitioners are used by God to bring healing to His people.

As a Christian, Mike should allow James to undergo the required medical intervention to believe that God uses health care professionals to heal people. Further, Mike should ask God for direction, equally opening his spiritual eyes to not reason for himself but based on God’s direct communication. The Bible says that when a Christian calls upon the Lord, He will hear and answer and tell of great and unsearchable thing that is not known (NKJV, 1982, Jeremiah 33:3). In this sense, Mike will be able to make decisions, which are of interest to God in a Christian’s life.

Mike should reason that God provides knowledge and understanding to man (NKJV, 1982, Proverbs 2:6). Through this, Mike should reflect on the ethical concept of beneficence, to good as a moral obligation. Whichever the case, the Bible teaches about doing well to others (NKJV, 1982, Mark 3:4). Consider, for example, the incident where the Good Samaritan helped a stranger (NKJV, 1982, Luke 10:25-37), consequently saving his life. In this case, the transplant is the only option and the right thing to do to help James recover. Life is sacred, and the parents should consider saving James’. Besides, Mike should consider the ethical concept of nonmaleficence. In this sense, his son would undergo a kidney transplant and receive healing. This will not mean that God has not contributed to his son’s healing, but it means that God can use relevant sources to breathe more life into his children and of those who diligently serve him.

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Spiritual Needs Assessment

A spiritual needs assessment is crucial eliciting patient and surrogates thoughts on Spirituality matters (Saguil & Phelps, 2012). Physicians can help patients by emphasizing empathetic care, recording spiritual expectations for future experiences, integrating the patients’ religious precepts into clinical plans. Besides, a physician can use spiritual assessment as an empowerment tool to achieve positive health outcomes for their loved ones. Undertaking a spiritual assessment will also improve the doctor-patient connection and provide professional regeneration, adaptability, and development tools.

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Case Study: Healing and Autonomy
Case Study: Healing and Autonomy

In this case, a spiritual assessment would allow James’s physician to involve his parents in a holistic discussion on the clinical situation. A spiritual assessment offers a context for discussing patients and their family’s experiences in coping with diseases and beliefs that may contradict medical decisions (Isaac et al., 2016). In this sense, a physician might engage a chaplain to offer more information on medical situations and religious beliefs. Such a discussion would help James accept the physician medical intervention for James without coercion.

Conclusion

Ethics and Spirituality are crucial concepts that influence decision making in healthcare. Although autonomy is a provision to allow patients to make informed consent regarding their health, complexity arises when a clinical situation involves a minor. This way, a surrogate decision should have the child’s best interest, without which a physician can intervene when they are convinced a child is abused or neglected. Consequently, a spiritual needs assessment is crucial in providing solutions to clinical instances involving irrational and rebellious clinical decisions, which can put a patient’s life at a significant health risk.

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References

Beauchamp, T. L., & Childress, J. F. (2009). Principles of Biomedical Ethics. http://christweedt.com/MoralDilemmas.pdf

Clarke, S. (2018). Miracles, scarce resources, and fairness. American Journal of Bioethics18(5). https://doi.10.1080/15265161.2018.1431716 

Isaac, K., Hay, J., & Lubetkin, E.  (2016) Incorporating Spirituality in primary care.   Journal of Religion and Health, 55(3), 1065-1077. https://doi.org/10.1007/s10943-016-0190-2

Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Paediatrics138(2). https://doi.10.1542/peds.2016-1485

New King James Version (NKJV). (1982). https://www.biblegateway.com/versions/New-King-James-Version-NKJV-Bible/

Saguil, A., & Phelps, K. (2012). The spiritual assessment. American family physician86(6), 546-550. https://www.aafp.org/afp/2012/0915/p546.html

Question

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.

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.This benchmark assignment assesses the following programmatic competencies:

BS in Health Sciences 1.2; BS Nursing (RN to BSN ) 5.2

Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups. 

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