Case Study on Biomedical Ethics in the Christian Narrative
Part 1: Chart
Beneficence and Nonmaleficence
In order to make a diagnosis and determine treatment options, there is a need to assess medical indications exhibited by a patient. Beneficence refers to a health professional acting with best intentions to provide care to patients whereas non-beneficence encourages care providers not to do harm (Gillon, 2018). As per the case study, the surrogates of James acted in the best interest of the patient even the medical condition of James would still be worse even when treated.
Autonomy refers to the right of patients to express their choice or make a decision of care yet to be administered to them (Gillon, 2018). Even though James is an underage child, his right to autonomy must be upheld. The parents ought to have consulted the patient before making a decision on care. The physician had limited influence to alter the decisions made by the parents.
|Quality of Life
Beneficence, Nonmaleficence, Autonomy
In the healthcare setting, quality of life entail the medical features of a patient after a therapy has been administered (Gillon, 2018). As per the case study, the health condition of James was worst but improved significantly after dialysis. Conversely, the patient needs a renal replacement therapy involving a kidney transplant to improve the quality of his life. His brother can donate to him his kidney but his father has an opinion to rely on faith regarding the health status of James. The parents, however, should consult James regarding the issue because the last time they relied on faith his condition worsened (Gillon, 2018). The parents should act in the best interest so that the brother can donate the kidney to optimize the quality of health for James.
Justice and Fairness
Medical decision can greatly be influenced by familial and social factors as well as legal considerations. In the case study, James’ parents relied on faith when making decision for the health status of their son (Gillon, 2018). They focused more on religious beliefs for healing rather than receiving kidney from his bother. However, the conflict of interest arose when there was a mismatch of cells between James and his brother meaning that the latter could not donate his kidney. This made the parents were therefore willing to donate the kidney and even appealed for the goodwill of well-wishers to offer this vital organ.
Part 2: Evaluation
Four Principles most Pressing according to Christian worldview
In the Christian perspectives, beneficence emerge as the principle with the most pressing issue pertaining to the health of a patient. The argument is guided by the premise that James’ parents made decision in the interest of their ailing son. They blindly believed that James would be healed with the support from their daily prayers (SSorajjakool et al., 2017). In this context, the parents relied more on prayers rather than providing kidney to support the life of James. Other than medical support, the parents had faith that prayers also work. No one can criticize their approach and perception in life considering that they made attempts to address the health of their son despite his deteriorating health (Hubbell, Kauschinger & Oermann, 2017). They were also against the idea about the brother donating one of his kidneys to the ailing James. All these actions affirm that the parents cared for the health status of their children. In fact, when the health status of James deteriorated while receiving homecare, they took him back to the care facility for further examination. With this, the parents aimed at addressing the health of their son despite wrong decisions that they sometimes made with regard to his care.
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How a Christian might rank the Priority of the Four Principles
In an approach of health, a Christian can give priority to the four principles by starting with beneficence as it is based on one’s goodwill regarding the health of others. According to Christian teachings, parents need to provide love to their children and this is consistent with the principle of beneficence (SSorajjakool et al., 2017). The second priority goes to nonmaleficence which points as doing no harm to patients. Christian parents should not intend or initiate activities that harm their children. The principle is based on the Christian teaching that human life is sacred and that it should be protected by everyone. Justice and fairness are ranked the third as they ensure that health service delivery is provided without preferential treatment to anyone. In Christian teaching, every human being is equal before God and this should be demonstrated during provision of care. The last ranking on the list will be autonomy which ensures that patients make decisions on medical services provided to them. Christians need to allow their patients to choose their option of care and this decision must be respected (Hubbell, Kauschinger & Oermann, 2017). The premise ensures that the dignity of every person is upheld so that one receives quality service to improve on their well-being.
Gillon, R. (2018). Principlism, virtuism, and the spirit of oneness. In Healthcare Ethics, Law and Professionalism (pp. 45-59). Routledge.
Hubbell, S. L., Kauschinger, E., & Oermann, M. (2017). Development and Implementation of an Educational Module to Increase Nurses’ Comfort With Spiritual Care in an Inpatient Setting. The Journal of Continuing Education in Nursing, 48(8), 358-364.
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (2017). World religions for healthcare professionals. Routledge.
Case Study on Biomedical Ethics in the Christian Narrative
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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?”
With the roe vs wade, my office has run into some complications with women who have elected to terminate their pregnancy due to medical abnormalities. The provider has to jump through several hoops in order to help assist a patient with a termination. In Florida the state law makes it illegal for a women to terminate after 15 weeks, however most of the ones we consult on are around 18-20 weeks along. These women find out at their anatomy ultrasound that the baby has a major medical abnormality and it would be best to terminate due to the baby not serving after delivery. So instead of caring full term and allowing the baby to suffer until it passes, they make the decision to terminate. The providers must plea a strong case with the state that terminating the pregnancy is necessary.
Thank you for your response! I find the healthcare field is not being able to carry out healthcare. With the new law I feel providers should not have to jump through loopholes to terminate a pregnancy especially if the fetus is not medical viable. Insurance companies also makes healthcare difficult for providers to provide care. I can imagine insurance policies are now changing their polices on abortion.
Good post. Abortion is thought to be a classic example of morality politics, which emphasizes the importance of values, identity, and beliefs in shaping policy attitudes. Embryonic stem cell (ESC) research, in which scientists conduct medical research on donated human embryos, is also frequently placed in this category. A significant body of scholarship examines attitudes about both of these issues, emphasizing the importance of both religiosity, or strength of religious feelings, and religious denomination in shaping public opinion. In contrast, our understanding of the extent to which religion influences attitudes about IVF is more limited (Melillo, 2017).
Melillo, T. R. (2017). Gene editing and the rise of designer babies. Vand. J. Transnat’l L., 50, 757.
Alycia, thank you for your informative post. As an ICU nurse, I have limited contact with the OBGYN world. I admire what you do. You have such an important job. I agree with your thoughts on judgement-free care. I cannot imagine what those mother’s are going through when they decide to terminate the pregnancy due to severe complications. As a christian nurse, the only job I have is to try and alleviate human suffering and provide hope (Rieg, et al., 2018). It must be so difficult to comfort the grieving mothers during that time. I saw another response to your post and was also curious about how abortions are handled in your facility after the overturning of Roe-vs-Wade. Thank you for clarifying this in your response!
Rieg, L.S., Newbanks, R.S., & Sprunger, R. (2018). Caring from a christian worldview: Exploring nurses’ source of caring, faith practices, and view of nursing. Journal of christian nursing. 35(3), 168-173. doi: 10.1097/CNJ.0000000000000474