Week 5 Patient’s Spiritual Needs: Case Analysis
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 400-450 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. You are required to submit this assignment to LopesWrite.
Rubric:
1. Decisions that need to be made by the physician and the father are analyzed from both perspectives with a deep understanding of the complexity of the principle of autonomy. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%
2. Decisions that need to be made by the physician and the father are analyzed with deep understanding of the complexity of the Christian perspective, as well as with the principles of beneficence and nonmaleficence. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%
3. How a spiritual needs assessment would help the physician assist the father determine appropriate interventions for his son, his family, or others involved in the care of his son is clearly analyzed with a deep understanding of the connection between a spiritual needs assessment and providing appropriate interventions. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 30%
4. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
5. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
6. Writer is clearly in command of standard, written, academic English. 5%
7. All format elements are correct. 5%
8. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5%
There are three different parts to this paper:
· Part one deals with Mike’s decision-making capabilities.
· Part two deals with how to think issues related to sickness and health.
· Part three deals with a spiritual assessment.
Read “Doing a Culturally Sensitive Spiritual Assessment: Recognizing Spiritual Themes and Using the HOPE Questions,” by Anandarajah, from AMA Journal of Ethics(2005).
https://journalofethics.ama-assn.org/article/doing-culturally-sensitive-spiritual-assessment-recognizing-spiritual-themes-and-using-hope/2005-05
Read “End of Life and Sanctity of Life,” by Reichman, from American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).
http://journalofethics.ama-assn.org/2005/05/ccas2-0505.html
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?”
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
Medical indications are the clinical data that is required to diagnose a patient and the extent of severity relating the medical problem thus determining the treatment options. Beneficence indicates acting with the best intentions in mind while non-beneficence emphasizes on do not harm. The parents of James were acting in his best interests despite the medical indications that James’s conditions would get worse if not treated. They had no intention of harming him and came back when his condition did not improve. Patient preferences refer to the expressed choice of the patient or the substitute decision maker. Autonomy emphasizes on the right of a person to make his/her own decision (Beever, 2016). James is an underage kid that is 8 years old thus cannot exercise autonomy rights. However, the parents should have consulted James before making their decision despite his age to know whether he was comfortable with their decision. The physician could hardly impact this decision but could have at least talked to the parents.
Quality of Life
Beneficence, Nonmaleficence, Autonomy Contextual Features
Justice and Fairness
Quality of life refers to the relevant medical features of the life of a patient before and after the treatment. James condition before treatment was worse but after constantly undergoing dialysis his condition improved. However, he needs a kidney transplant to effectively address his condition and his father is thinking his brother should give him the kidney or they should rely on faith. Based on the previous encounter, the parents should first consult James and listen to his views regarding the issue. The last time they depended on their faith, the condition of James got worse, thus they should act with his best interests in mind and allow him to get a kidney transplant from his brother. Contextual features determine the legal, social and familial setting that influences one’s medical decisions (Gillon, 2018). The faith of James’s parents that he can be healed through prayers influenced their medical decisions. They are also considering on depending on their faith instead of allowing James to have a kidney transplant from his brother. Justice and fairness emphasizes on equality. The conflict of interest came up when the ideal tissue match was identified as that of his brother. The parents therefore were willing to allow other people including themselves to donate a kidney for James but are not willing for his brother to do so.
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)
According to the Christian worldview, beneficence is the principle that is most pressing. This is because the parents are acting with the best of intentions in mind about their son. They have faith that their son will be healed through intensive prayers. They therefore prefer prayers more compared to treatment because of the faith. We cannot put a blame on them because of the deteriorating health of their son because they acted in good faith and as soon as they noticed his condition was getting worse they brought him back to the hospital.
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)
A Christian can rank the priority of the four principles in such a manner that beneficence comes first then non-maleficence followed by justice and fairness and lastly autonomy. This is because according to Christians, parents should show love to their children by acting in their best interests which is associated to the principle of autonomy. Parents should also ensure that no matter what, they should not harm their children which relates to the principle of non-maleficence (Carr, 2017). Christians are supposed to practice justice and fairness in all their encounters and experiences. Lastly, Christians should also give one another a chance to indicate they thought regarding a certain decision which is associated with the principle of autonomy.
References:
Beever, J., & Brightman, A. O. (2016). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and engineering ethics, 22(1), 275-291.
Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and Professionalism (pp. 45-59). Routledge.
Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for Healthcare Professionals (pp. 31-45). Routledge.
Topic 5: Optional Study Materials
Advance Directives
“Advance Directives,” by Hanson and Doukas, from The Penn Center Guide to Bioethics (2009).
https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/sppbioeth/advance_directives/0?institutionId=5865
Palliative Care
“Palliative Care,” by Weigand, from The Penn Center Guide to Bioethics (2009).
https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/sppbioeth/palliative_care/0?institutionId=5865
Part One: Analyzing Mike’s Decision-Making
Decisions regarding a patient’s autonomy and the physician’s role in respecting it can be challenging, particularly when a patient’s choice seems irrational and harmful. In the case of Mike’s decision not to proceed with immediate dialysis for his son James, a conflict arises between respecting patient autonomy and the principle of beneficence, which advocates for acting in the patient’s best interest (Beever & Brightman, 2016).
From a Christian worldview, where faith and spirituality play a significant role, Mike’s decision can be viewed as an expression of his belief in divine healing. In this context, it is essential to consider James’s age and capacity for autonomous decision-making, as he is an 8-year-old child. Although autonomy is a fundamental principle, it may not apply directly to a minor patient. Instead, the decision-making responsibility falls primarily on the parents or legal guardians (Carr & Winslow, 2017).
Analyzing this situation, Mike’s decision can be seen as a well-intentioned attempt to honor his Christian beliefs and exercise his authority as a parent, acting in James’s best interests as he perceived them. While the initial decision to rely on faith healing may have seemed irrational from a medical standpoint, Mike’s intention was not to harm James but to seek divine intervention.
However, when James’s condition worsened, Mike and Joanne promptly returned to conventional medical care, indicating their willingness to consider the best medical interventions for their son. In such cases, the physician should respect the parents’ decisions while continuously providing information and support, ensuring that the patient’s best interests remain a top priority (Gillon, 2018).
Part Two: The Christian Perspective on Sickness, Health, and Medical Intervention
From a Christian perspective, the Christian worldview emphasizes the principles of beneficence, nonmaleficence, and the sanctity of life. Sickness is viewed as a manifestation of the fallen world, and the pursuit of healing aligns with the Christian duty to care for one another (Reichman, 2005). Medical intervention is considered a means of fulfilling the principle of beneficence, as it aims to alleviate suffering and restore health, which are seen as acts of compassion.
In Mike’s situation, his decision to rely on faith healing can be understood as an expression of his Christian beliefs. He saw faith as a valid path to healing, which is consistent with the Christian perspective. However, when it became clear that conventional medical treatment was necessary to save James’s life, the Christian worldview would support pursuing medical intervention as an act of beneficence.
The Christian perspective also upholds the principle of nonmaleficence, which means avoiding harm. While the initial decision may have been rooted in faith, Mike and Joanne’s willingness to return to medical care demonstrates their commitment to not causing harm and ensuring the best possible outcome for James.
As a Christian, Mike should reason about trusting God in conjunction with medical treatment, recognizing that both faith and medicine can work together to achieve healing. This approach aligns with the principles of beneficence and nonmaleficence in James’s care, as it seeks to provide the best possible care while respecting the family’s faith-based beliefs.
Part Three: The Role of Spiritual Needs Assessment
A spiritual needs assessment can play a crucial role in assisting Mike in determining appropriate interventions for James and the family. Such an assessment involves understanding the spiritual beliefs and values of the patient and their family, which can significantly impact medical decision-making (Anandarajah, 2005).
Through conducting a spiritual needs assessment, the physician can gain insight into Mike and Joanne’s religious beliefs, their understanding of illness and healing, and their preferences regarding medical care. This information can help the physician offer more personalized and culturally sensitive care, bridging the gap between medical treatment and the family’s faith-based worldview.
The assessment can also aid in identifying any potential conflicts or concerns related to spirituality and medical care. It can facilitate open and respectful communication between the healthcare team and the family, enabling them to collaboratively make informed decisions that honor both medical best practices and the family’s spiritual values.
In conclusion, considering the Christian worldview, the physician should approach the situation with empathy and respect for Mike’s faith-based decisions while ensuring that James’s best interests are at the forefront. Through effective communication and a spiritual needs assessment, the physician can help guide the family towards appropriate interventions that honor their faith and prioritize James’s health. This approach ensures a balance between autonomy, beneficence, and nonmaleficence in James’s care, acknowledging the complexity of this case.
