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PHI413V Ethical And Spiritual Decision Making In Health Care

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PHI413V Ethical And Spiritual Decision Making In Health Care Question: Case Study: Healing And Autonomy Mike and Joanne are the parents of James and Samuel, identical twins born eight 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’ 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 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’ 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’ 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? “This time around, it is a matter of life and death, what could require greater faith than that?” Mike reasons. Autonomy.” In light of the readings, be sure to address the following questions: Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study? Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James? According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case? According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James? Answer: According to Koopmans (2016), miracles of healing existed since the early church. From the bible, Jesus performed many miracles to those who were suffering. He healed the sick, restored sight to the blind, the lame he made them walk and even cured the lepers. Christians also believed that suffering is how their faith is being tested and that it brings transformation to their lives (Zaki.et.al 2016). Jesus died on the cross so as to safe man from sin. He suffered a lot before he died. Even though Jesus went through all the suffering, he still had compassion to those who were suffering regardless of being a Christian or not. Jesus performed all the miracles of healing so as to alleviate suffering and pain of those involved. This shows that Christians should use any means available to alleviate suffering and pain so that the sick do not suffer. The bible also emphasizes on the issue of love. According to Kok (2015), Christians should love their neighbors as they love themselves. Therefore, they should be of help to anyone who needs their help. The most pressing issue from this case study is the issue of decision making basing on religion (Graham-brown.et.al 2017). Mike and Joanne are rooted in their religion that they disregard other interventions that could be helpful to their son. They fail to recognize that even the disciples did not just preach the gospel but they also healed the sick. Mike could have employed the medical intervention for his son condition especially after an explanation by the medical physician. This poor decision has been shown to bring much suffering to their son James instead of making him better. This is not allowed in Christianity as even Jesus never allowed anyone to suffer for His sake instead, he made mane sacrifices so that others can benefit. Mike should have therefore placed his son’s illness and suffering first before deciding anything. Mike has not used his freedom of autonomy in a good way. According to scriptures, Christians are not owners of themselves but they are owned by God. They are therefore not allowed to make any decision they feel like especially if they are disadvantaging others. They should not abuse their freedom from the demands of the law for salvation but are to use that freedom to pursue love not their own selfish desires (Hockenberry and Wilson 2018). Basing on the outcomes, Mike and Joanne should not be allowed to continue making decisions for James. James is an eight year old boy and he is still young to make his own decisions concerning his health. Even if Mike and Joanne are his close decision makers, the physician should not allow for harmful decisions to be made (Coyne, Hallstorm and soderback 2016). Parents should not deny treatment for their children especially if religion is involved. If a parent denies his or her child treatment, it is considered as child neglect especially if there is treatment available for that condition. If mike and Joanne could have accepted to start James on dialysis immediately, further kidney deterioration could not have occurred. Dialysis is helpful in eliminating excess water and waste products such as urea when the kidney is not functioning well. Accumulation of toxic products especially urea in the kidney for some days damages the nephrons of the kidney and therefore further deterioration. When certain percentages of the nephrons are damaged the kidney fails and waste products accumulate systemically and can cause death due to uremia. Kidney transplant will help replace the function of the failed kidney and has to be done promptly. If Mike is allowed to continue making decisions for James, then fatal outcomes may occur especially with continued delay (Voscamp.et.al 2018). According to ethics in medicine, a parent is allowed to make decisions for their children if they are young or unable to make their own decisions (Rothman 2017). Ethics also allows medical practitioners to challenge parent’s decisions especially if the decisions place the child at significant risk of serious harm. The caretaker and the parent should reach a satisfactory resolution and if they don’t, child protection agency or a court order may be required. Mike refusing treatment for His son is unethical. The refusal should be considered as neglect or imprudent and appropriate action taken accordingly. Patient autonomy is an act of allowing patient to make their own decisions concerning their health without a healthcare provider trying to influence them (Murgic.et.al 2015). Health care provider should just educate them and inform them about their condition but should not decide for them. In an event of a minor, a parent is allowed to make decisions for his or her child. In the contrary, medical practitioners have been allowed to overrule and interfere with patients preferences with the aim of securing patient benefit or preventing harm. Therefore, patient autonomy is not satisfactory if it does not promote beneficence. In the case study, the decisions made by Mike and Joanne are not of any benefit to James instead, they are causing more harm to the patient. Mike is therefore not practicing patient autonomy even after being told about the dialysis which could have been helpful to James. Mike has also been informed about organ transplant but he is still rigid on giving in to the benefits to his son. His faith on supernatural healing has clouded him enough to deny his son’s medical rights basing on biomedical ethics. According to Fox (2017), organ donation is a process of removing an organ surgically from one person and placing it into another person. This is necessary especially when the organ of the recipient has failed to function. Kidney transplant is the most common form of organ transplant. For organ transplant to occur the tissue match of the donor and recipient should match so that rejection cannot occur. Most of the time, organs match runs among family members and relatives. Sometimes, donors may not be related in blood. From the case study, Mike should not be the one deciding whether Samuel should donate his kidney to his brother or not. Healthcare practitioners should weigh the benefits and disadvantages of organ transplant to both James and Samuel and the best solution to be brought out. If the parents do not agree and the solution is of benefits to both children then the court should be involved. This is mainly if the parents denied basing on their religion. From this case, mike and Joanne have not followed ethical considerations on their decision making on James health. They have placed a lot of emphasis on their faith without considering the suffering their son is going through. They have also neglected their son’s right to medical attention (Hvidt.et.al 2016). According to Linzey (2016), Christians should not see pain and hardship as a value to a potentially transformative effect on the religious adherent. Early church believed that suffering brings an individual closer to God who suffered with and for them on the cross. This should not be the case for the Christians of this generation. They should continue trusting in God but employ measures that are right in their health conditions. They should appreciate the benefits of medical science and incorporate them into their lives (Hedman.et.al 2015). They are called to embrace science and its biomedical applications to prevent and alleviate unnecessary suffering. They should do this while also respecting the sanctity of human life. Mike and Joanne should have accepted the medical intervention by starting their son on dialysis. This could have prevented further suffering and complications and organ transplant could have been avoided. They should have also involved God by praying that God would heal their son through the intervention used. They should have had faith in the medical practitioners treating their son and also involve their pastor in praying for him (Kabayashi.et.al 2015). References Coyne, I., Hallström, I., & Söderbäck, M. (2016). Reframing the focus from a family-centred to a child-centred care approach for children’s healthcare. Journal of Child Health Care, 20(4), 494-502. Fox, R. C. (2017). Spare parts: Organ replacement in American society. Routledge. Graham-Brown, M. P., Vasilica, C., Oates, T., Light, B., Clausner, C., Antonacoloulos, A., … & Barratt, J. (2017). Study protocol: responding to the needs of patients with IgA nephropathy, a social media approach. Clinical Kidney Journal. Hedman, E., Lekander, M., Ljótsson, B., Lindefors, N., Rück, C., Andersson, G., & Andersson, E. (2015). Optimal cut-off points on the health anxiety inventory, illness attitude scales and whiteley index to identify severe health anxiety. PLoS One, 10(4), e0123412. Hockenberry, M. J., & Wilson, D. (2018). Wong’s nursing care of infants and children. Elsevier Health Sciences. Hvidt, N. C., Mayr, B., Paal, P., Frick, E., Forsberg, A., & Büssing, A. (2016). For and against organ donation and transplantation: intricate facilitators and barriers in organ donation perceived by German nurses and doctors. Journal of transplantation, 2016. Kobayashi, L. C., Wardle, J., & von Wagner, C. (2015). Internet use, social engagement and health literacy decline during ageing in a longitudinal cohort of older English adults. J Epidemiol Community Health, 69(3), 278-283. Kok, J. K. (2015). The radicality of early Christian oikodome: A theology that edifies insiders and outsiders. Verbum et Ecclesia, 36(3), 1-12.

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