PHI413V Healing and Autonomy Case Study Discussion

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 400-500 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?

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.

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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Case Study: Healing and Autonomy Mike and Joanne are theparents 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?PHI413V Healing and Autonomy Case Study Discussion

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 Patient Preferences Beneficence and Nonmaleficence Autonomy ➢ James, an 8-year-old twin brother is suffering from acute glomerulonephritis, kidney failure. ➢ Normally the condition does not require medication but James condition was very acute and required immediate treatment. The goal of the treatment is to relieve elevated blood pressure and require temporary dialysis. ➢ There is usually a 90% chances of success in treatment. ➢ Medical and nursing care is important since it helps a specialist to monitor to condition and perform dialysis when necessary. ➢ The patient is only 8 years old and not in a position to understand what he’s going through. ➢ However, his parents Mike and Joanne understands the benefits and risks, they have also understood all the information provided to them and have given consent (Werth & Blevins, 2017). ➢ The patient is not mentally capable and legally competent enough because of his age. ➢ The patient does not have any preferences but his parents at first preferred to take him to a healing service at their local church. ➢ Much of the decisions related to treatment is made by the patient’s parents. Quality of Life Contextual Features Beneficence, Nonmaleficence, Autonomy Justice and Fairness ➢ This is a serious condition that requires urgent treatment. ➢ A patient has a 4% chances of survival without treatment, but with treatment the patient has an 85% chances of returning to his normal life. ➢ Even when treatment succeeds, it’s not possible for the patient to get back fully to their normal lives. ➢ More than 10% of patients who succeed in treatment end up experiencing serious mental issues and more than ➢ There are professional, business, and interprofessional interests might in any way create a conflict of interest in the clinical treatment of the patient. ➢ It’s more likely that the facility would prefer James to remain in the hospital until a compatible donor is found so that the facility might make money. ➢ The patient’s parents have so much interest in the entire treatment program and they are actually the sole decision makers in this case. ©2019. Grand Canyon University. All Rights Reserved. ➢ ➢ ➢ ➢ ➢ ➢ PHI413V Healing and Autonomy Case Study Discussion

23% are in one or another affected and cannot perform some tasks as they used to (Sperry, 2017). The patient is required to be kept under constant care and placed under a special diet depending on his condition. This is the criteria for judging the quality of care but there are biases that might prejudice the provider’s evaluation of care such as family medical history. Some kidney conditions are hereditary and providers’ might solely consider that factor. There are some issues that might arise in improving the patient’s quality of life such as lack of a compatible kidney donor during transplant and patient’s age. The need to sacrifice a kidney so as to help one patient is very a serious ethical issue and is likely to affect the patient’s life-sustaining program (Werth & Blevins, 2017). A kidney transplant is the only plan that can guarantee a patient a life-sustaining program. ➢ There are confidentiality limits on how much information the parents can access considering that the parents is still a minor. ➢ Buying a kidney from another person is very expensive and this is a financial factor that the parents are considering, this is why a donor is more appropriate. ➢ There is also a concern on who will donate the kidney and the health issues or complications that might arise after the donation. ➢ There are no religious issues that might in whichever way affect the clinical decisions. ©2019. Grand Canyon University. All Rights Reserved. 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) Ethical choices, whether major or minor is something that confronts us each day. The principle of respect for autonomy according to the Christian worldview is the most pressing in this case. This is a principle that advocates for moral decision-making with patients being required to make informed and voluntary decisions. A patient should be allowed to make decisions that they feel are appropriate and good to them and under no circumstance should a decision should be made against the patient’s consent (Maville & Huerta, 2018). In health care decisions, this principle implies that a patient has the capacity to act intentionally and with an understanding of what they are about to give into. This is a principle that promotes the concept of informed consent.PHI413V Healing and Autonomy Case Study Discussion

The physician should provide the patient and any other relevant third part with all relevant information so that they can make the right decision. In this case, James is a minor of only 8 years and so it’s most probably that has no capacity to understand the information provided to him but his parents Mike and Joanne can help in making critical decisions. The patients and his parents need to be told all relevant information including the risks of a kidney transplant as well as the probable outcome of the operations. There is also a donor and the patient should know what might happen to the donor and the risks of donating a kidney. Both the donor and the patient also need to be informed of their chances of survival after the transplant and the expected mental and social implications thereafter. ©2019. Grand Canyon University. All Rights Reserved. 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) The four principles are non-hierarchical and, therefore, none of the principles can trump another. This is a general principle governing the four principles but in reality, Christians believe that there is the concept of a lesser evil. In this sense, some principle carries more weight than the other and are likely to be considered first or prioritized in the event a decision need to be made (Sperry, 2017). When two or more principles conflict with each other, it is more likely that Christians will apply their common knowledge based on Christian teachings to decide which principle should trump over the other. The principle of justice is the most important principle according to the Christian worldview. This is a principle that requires all patients who are equal to get equal opportunity for treatment. No patient should be considered more special than the other and no one should be denied the opportunity to qualify for equal treatment. This is the most important principle because it rhymes with Christian teachings that all people are equal before the eyes of the lord. The principle of nonmaleficence is the second most important principle according to the Christian view, this principle requires us not to intentionally harm or injure a patient intentionally. Patients should be exposed to minimal risk at all time, this principle is important to Christians because the Bible requires us to treat each other as we would want to be treated. The principle of respect for autonomy is the third most important principle and lastly, the principle of beneficence is the least important according to the Christian view. ©2019. Grand Canyon University. PHI413V Healing and Autonomy Case Study Discussion

All Rights Reserved. References: Maville, J. A., & Huerta, C. G. (2018). Health promotion in nursing. Clifton Park, NY: Thomson Delmar Learning. Sperry, L. (2017). The ethical and professional practice of counseling and psychotherapy. Boston: Pearson/Allyn and Bacon. Werth, J. L., & Blevins, D. (2017). Decision making near the end of life: Issues, developments, and future directions. New York: Routledge. ©2019. Grand Canyon University. All Rights Reserved. Course Code PHI-413V Class Code PHI-413V-O501 Criteria Content Percentage 70.0% Decision-Making and Principle of Autonomy 20.0% Decision-Making, Christian Perspective, and the Principles of Beneficence and Nonmaleficence 20.0% Spiritual Needs Assessment and Intervention (CoNHCP 5.2) 30.0% Organization, Effectiveness, and Format 30.0% Thesis Development and Purpose 7.0% Argument Logic and Construction 8.0% Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Paper Format (use of appropriate style for the major and assignment) 5.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Total Weightage 100% Assignment Title Benchmark – Patient’s Spiritual Needs: Case Analysis Unsatisfactory (0.00%) Decisions that need to be made by the physician and the father are not analyzed according to the principle of autonomy.PHI413V Healing and Autonomy Case Study Discussion