Weekly discussion

 1) What is your definition of spiritual care? How does it differ or accord with the description given in the topic readings? Explain. (150-250 words)

2) When it comes to facilitating spiritual care for patients with worldviews different from your own, what are your strengths and weaknesses? If you were the patient, who would have the final say in terms of ethical decision-making and intervention in the event of a difficult situation? (150-250 words)

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3)  In addition to the topic Resources, use the chart you completed and questions you answered in  “Case Study: Healing and Autonomy” as the basis for your responses in this assignment. (3-4 sources)

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

a) 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.

b) 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?

C) In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike to determine appropriate interventions for James and for his family or others involved in his care.

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?”

© 2020. Grand Canyon University. All Rights Reserved.

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.

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

James has kidney failure. Initially, a dialysis was the best option to alleviate his problem according to the doctor. However, the parents felt the best option was to take James for prayers in a healing service. Currently, the best option is for James to have a kidney transplant.

James is a minor. Therefore, h has no autonomy over his healthcare. This responsibility is held by his parents. The parents initially forewent a dialysis in favor of prayer. They have now agreed for a kidney transplant. However, they have to make a decision if they are ready to let Samuel donate his kidney to his brother. Samuel also lacks autonomy in the scenario.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Currently, only Samuel seems to be the viable kidney donor. If he donates his kidney to his brother, there is a likelihood that his quality of life will drop. Since he has no choice on the matter, a kidney transplant my harm his health and not be in his best interest. On the other hand, if James receives the kidney, the quality of his life will improve. However, there is no guarantee of this happening. The parents have to make a decision on whether to risk the lives of both their children or commit to ensuring Samuel lives the best life possible without asking him to sacrifice his kidney.

Taking Samuel’s kidney without his consent would be unfair to him. It would be putting his life in danger for his brother. Although this would be a noble action, there is no guarantee that the transplant will be successful. Therefore, it will be unfair and unjust to risk Samuel’s life for the sake of James.

Vu 0

©2020. Grand Canyon University. All Rights Reserved.

Part 2: Evaluation

Answer each of the following questions about how the four principles and four boxes approach would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)

First, there is the principle of non-maleficence. This refers to act of doing no harm. The doctor is required to appraise the scenario before making decisions. He is supposed to be aware of how his decisions will harm the patient or not. In the scenario, the doctor is always suggesting the best option for the patient. He asked for a dialysis, which was initially the best option. Eventually, he asked for a transplant, which is currently the most viable option. Non-maleficence would rank first when it comes to weighing the principles.

Second, there is the principle of justice. This refers to treating and offering care fairly to all patients regardless of their situation (Torry, 2018). The doctor has not shown any unfair treatment to the patient and his family. He has always been professional and done his best to offer the right care. He has done so while incorporating the parents into the decision-making process. Justice would rank second when it comes to weighing the principles.

Third, there is the principle of beneficence. This refers to ensuring that the choices made for a patient should be done with the intention of doing good (Andersson et al., 2020). It points to the act of showing mercy or kindness. In the scenario, the parents thought they were showing kindness to their son by foregoing dialysis and taking him for prayers. However, they later realized this was a mistake and took him for dialysis. It was already too late leading the doctor to call for a kidney transplant. After exhausting all avenues for a kidney donor, the doctor suggested that Samuel would likely be the best kidney donor. Although this is not a desirable solution, it may be a choice made with the intent to good for the patient. Beneficence would rank third when it comes to weighing the principles.

Finally, there is the principle of autonomy. This refers to the freedom or right of a patient to have control of their body. The doctor is required to respect the patient’s freedom to choose what is appropriate or right for them. In the scenario, the patient is a minor. Therefore, the patient has no autonomy and decision making is left for the parent. The autonomy of the patient would rank last when it comes to weighing the principles.

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)

In the context of the Christian biblical narrative, I believe the four principles would be ordered as follows non-maleficence, justice, beneficence, and autonomy. Christianity values the principle of doing no harm (Fosarelli, 2019). The Book of Romans 13:10 states, “love does no harm to a neighbor; therefore, love is the fulfillment of the law.” The principle of non-maleficence is promoted in Christianity in the context of people’s relationships with others in daily life. By doing no harm to others, a person will be treating others the same way he/she would like to be treated. Nevertheless, although each of these principles has a distinct objective, they all combine to empower healthcare practitioners while promoting ethical, safe, and high-quality healthcare for patients.

To balance each of the four principles in the case, the parents and the doctors should discuss the impact of Samuel donating his kidney to his brother. Currently, only Samuel seems to be the viable kidney donor. If he donates his kidney to his brother, there is a likelihood that his quality of life will drop. Since he has no choice on the matter, a kidney transplant my harm his health and not be in his best interest. On the other hand, if James receives the kidney, the quality of his life will improve. However, there is no guarantee of this happening. The parents have to make a decision on whether to risk the lives of both their children or commit to ensuring Samuel lives the best life possible without asking him to sacrifice his kidney.

References:

Andersson, G. B., Chapman, J. R., Dekutoski, M. B., Dettori, J., Fehlings, M. G., Fourney, D. R., … & Weinstein, J. N. (2020). Do no harm: the balance of “beneficence” and “non-maleficence.” Spine, 35(9S), S2-S8.

Fosarelli, P. (2019). Medicine and health care in early Christianity. The Linacre Quarterly, 78(2), 235.

Torry, M. (2018). Ethical religion in primary care. London Journal of Primary Care, 9(4), 49-53.

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