In addition to the topic study materials, use the chart you completed and questions you answered

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?

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. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Benchmark Information

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
The principle of beneficence obliges a physician to act for the patient's benefit, while the principle of Nonmaleficence obliges the physician not to harm the patient. The two principles are supported by moral rules like do not kill, do not cause harm, pain, suffering, and incapacitation (Jahn, 2011). For instance, after James was diagnosed with kidney failure, the attending physician requested immediate dialysis to relieve pain and fluid buildup in the body. After the healing sermon, James' condition deteriorated. He was in much pain and no longer required a dialysis only but also a kidney transplant. To avoid causing further harm, the nephrologist rejected multiple kidney donations.	In the nursing profession, the principle of autonomy requires medical practitioners to respect self-determination or decisions made by adults who have decision-making capacity. The conditions of Understanding, intentionality, and absence of controlling influence that determine the adults' action must exist for any autonomous action (Jahn, 2011). For instance, the medical practitioner respected Mike and Joanne's decision to take James to a church's healing service instead of undergoing dialysis to treat the elevated blood pressure and fluid buildup in the body. The physician had informed Mike and Joanne that James needs quick dialysis to avoid increased health problems, but the parents decided that placing James in the faith of God was better, n autonomous decision the physician was obliged to respect.
Quality of Life Beneficence, Nonmaleficence, Autonomy	Contextual Features Justice and Fairness
The three principles of beneficence, Nonmaleficence, and autonomy have moral significance to the patients' life. As much as doctors have an obligation not to cause harm, pain, or suffering, act for the patient's benefit and respect the decisions the patient's parents make, there must be balance in the quality of life (Jahn, 2011). Mike and Joanne choosing a healing sermon jeopardize James's health. At first, the dialysis and antibiotic could have relieved the fluid buildup, and acute glomerulonephritis and James would be stable after the dialysis. However, the delay caused by Mike and Joanne by delivering James to a healing sermon made his illness deteriorate to the extent of requiring a kidney transplant.	Justice and fairness principle call for equitable, fair, and appropriate treatment of persons without discrimination. Distributive justice influences physicians' decisions on a patient through moral requirements such as need, effort, equal share, merit, contribution, and according to market free exchanges (Jahn, 2011). According to James’s case, the physicians are obliged to continue treating James well, even after parents had previously discarded the doctor's dialysis advice in favor of a healing sermon. Healthcare ethics and legal rules require a doctor to provide fair treatment for the good of the patient. The doctor had to call Mike and Joanne again to discuss James's situation and what they can do to save his life and neutralize the suffering. Justice and fairness principles guide the doctor's goodwill towards the patients' health.

Part 2: Evaluation

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

1. In 245-250 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)

The principle of autonomy requires adults to make treatment decisions prudently. According to the Christian worldview, actions must accompany faith. According to James 2:26, "For as the body without spirit is dead, so faith without work is dead" (King James Bible, 1970). Mike and Joanne misinterpreted the biblical teachings about faith and healing. Some Christians believe that seeking medical treatment shows a lack of faith in God. According to the beneficence principle on medical ethics, physicians must be kind by not inflicting harm (Rasoal et al., 2017). According to Matthew 22:39, “and the second is like unto it, Thou shalt love thy neighbor as thyself” (King James Bible, 1970). Every doctor should put the patient's benefit before their own. According to the Nonmaleficence principle, the bible teaches us that a Christian should not harm their neighbor. The doctors are obliged by legal and professional code of conduct to protect patients' health at all costs. According to Romans 13:10, “Love worketh no ill to his neighbor: therefore, love is the fulfilling of the law” (King James Bible, 1970). This gives doctors the responsibility of protecting the patients from harm. Physicians should be cautious about errors of omission and commission that can jeopardize or deteriorate health. Finally, according to justice principle, physicians and patients must treat each other fairly within the institutional and societal realms. According to Psalms 82.3, “Do justice to the afflicted and needy” (King James Bible, 1970). Physicians should uphold justice and fairness in whatever they do.

2. In 245-250 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)

A good Christian should be able to balance the principles of autonomy, justice, Nonmaleficence, and beneficence (Ashcroft et al., 2007). All the four principles, just like God's ten commandments, are bound by one biblical teaching in Matthew 22:39 that says, “and the second is like unto it, Thou shalt love thy neighbor as thyself” (King James Bible, 1970). Every human being must have kindness, love, faithfulness, and passion. Although some of the principles like autonomy may contravene biblical teachings, Christians should show faith by seeking treatment and waiting for God's healing. Just like when an automobile breaks down and taken to the mechanic with the faith that it will be better, Christians should also seek treatment with the faith they will become healthy. On the other side, doctors should be dedicated to healing, not harming, treating, not destroying, and giving hope, not to dishearten. Doctors should be guided by humanity principles of the holy spirit as dictated in Galatians 5:22, "But the fruit of the Spirit is love, joy, peace, longsuffering, gentleness, goodness, faith…” (King James Bible, 1970). Further, physicians should guide their patients to make wise treatment decisions that will improve their health. Doctors should not participate in unnecessary abortions and kill patients since taking away human beings' lives is against Christianity values(Rasoal et al., 2017).Physicians should be dedicated to saving a life and promote good health. Doctors should be just and provide good treatment without endangering life or compromising resources due to selfishness.

References:

Ashcroft, R. E., Dawson, A., Draper, H., & McMillan, J. (Eds.). (2007). Principles of health care ethics. John Wiley & Sons.

Jahn, W. T. (2011). The four basic ethical principles that apply to forensic activities are respect for autonomy, beneficence, Nonmaleficence, and justice. Journal of Chiropractic Medicine, 10(3), 225-226. https://doi.org/10.1016/j.jcm.2011.08.004

King James Bible. (1970). The Holy Bible. Camden, New Jersey. Thomas Nelson, Inc.

Rasoal, D., Skovdahl, K., Gifford, M., & Kihlgren, A. (2017). Clinical ethics support for healthcare personnel: An integrative literature review. HEC Forum, 29(4), 313-346. https://doi.org/10.1007/s10730-017-9325-4

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?”

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