Posted: February 11th, 2023

“Case Study: Healing and Autonomy”

In addition to the topic Resources, use the chart you completed and questions you answered in the Homework Help – 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.
1. 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.
2. 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?
3. 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 Resources.
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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?”

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As a physician, respecting a patient’s autonomy is a key principle in medical ethics. However, when a patient’s decisions seem to be irrational and harmful to the patient or others, it may be necessary for the physician to intervene. In the case of James, his parents’ decision to forego dialysis and instead rely on faith healing was a decision that could potentially have led to James’ death. The physician must weigh the principle of autonomy against the principle of nonmaleficence, which states that one should not cause harm to others. In this case, the physician has a duty to ensure that James receives appropriate medical care to preserve his life. The physician could have respectfully discussed the potential consequences of not starting dialysis with Mike and Joanne and provided education on the importance of medical intervention in this situation. Ultimately, the physician may have needed to make the difficult decision to override the parents’ objections if James’ life was at risk.

As a Christian, one’s beliefs about sickness and health should be informed by their faith. Christians believe in the power of prayer and the healing that can come through faith. However, Christians also believe in the value of medicine and the role it can play in preserving life. Medical intervention is seen as a gift from God that should be used to the fullest extent possible. In this case, Mike as a Christian must consider what is truly honoring the principles of decency and nonmaleficence in James’ care. He must weigh his faith in God’s healing power against the reality that James needs medical intervention to survive. He must also consider the fact that God works through the hands of medical professionals to bring healing to those who are sick. Trusting God means trusting in His plan and allowing Him to work through all circumstances, including medical intervention.

A spiritual needs assessment can help the physician assist Mike in determining appropriate interventions for James and his family. The assessment would consider Mike’s spiritual beliefs and how they impact his decision-making. The physician could discuss with Mike the role of faith and prayer in healing, as well as the importance of medical intervention in preserving life. The physician could also provide education on the potential risks and benefits of each decision, helping Mike to make a fully informed decision that is consistent with his spiritual beliefs. Additionally, the physician could connect Mike with spiritual support resources, such as a chaplain or faith leader, who could provide comfort and guidance during this difficult time. A spiritual needs assessment would help the physician provide holistic care for Mike and James, ensuring that both their physical and spiritual needs are met.

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