Benchmark - Patient's Spiritual Needs: Case Analysis

Medical Indications

Beneficence and Nonmaleficence

Patient Preferences

Autonomy

To help James from the high blood pressure and fluid buildup, immediate dialysis is required. The condition of James has worsened when he missed dialysis. The only thing that can save him is a kidney transplant and the matching donor is his twin brother, Samuel. Even though a kidney transplant can save the life of James, it may as well pose a significant threat to Samuel through surgery and the recovery process.

The physician respected the autonomy of the parents in using their belief in God and faith that through a religious service, their son’s health condition can be restored. The parents are faced with the possibility of having Samuel donate his kidney to James. Mike seems to struggle with this reality and believes in the possibility of a miracle happening since it is a test of true faith.

Respect for autonomy was the primary principle used in this case. The physician respected the strong belief and faith of the parents in God and gave them an opportunity to make a decision.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Medical treatment will benefit James by restoring his kidney functioning and save his life. But there may be temporary discomfort resulting from the dialysis. It is important for the renal functioning of James to go back to normal but he did not get the treatment due to autonomy and the decision made by the parents to depend on their faith and belief in God. The condition of James has deteriorated and he now requires a kidney transplant. He will need kidney dialyses that can impact his quality of life because this procedure is physically draining since one needs to go through this procedure, normally thrice a week. He must have a kidney transplant or will lose his life. Getting a kidney transplant will improve James’ quality of life but his brother will experience a decline in functioning if surgery is done with regard to the recovery process. And in case he loses the one kidney he has, he would too require a transplant. Donating his kidney would save his twin brother’s life; as a result, it would improve their relationship and their lives because at least he would have a brother. Failure to donate his kidney would lead James to death and Samuel would live with lifetime guilt for not saving his brother’s life. Non-maleficence is indicated when Mike struggles with the idea of why he has to put Samuel through this situation.

James’ parents (Mike and Joanne) are faced with the decision of whether to allow Samuel donate his kidney to save James’s life. Some people could argue that it may not be Mike and Joanne’s decision but Samuel’s. Considering the close relationship between the twin brothers, it may be better for Samuel to donate his kidney rather than losing his brother. I believe that it is their choice to make. But the thoughts and beliefs of Mike are taking the center stage, seemingly putting the life of James solely on his faith. Mike wonders whether it is just to put Samuel through the process of surgery and the risk of remaining with one kidney. However, little is seen regarding the stance of Joanne. It may be argued that she is not included in decision making.

From a Christian Worldview, I believe that the principle of autonomy is the most pressing. Autonomy refers to the ability of patients to make their own decisions regarding their health and medical treatments. In this case, autonomy is seen where Mike decides to forgo temporary dialysis for their son and turn to faith healing service. The parents acted autonomously for their son and placed the health of their son on the fate of their faith. When James condition worsens, his father tends to struggles with the idea of allowing his son through the medical procedure of donating a kidney. He hopes that his faith in God will change the situation.

Patient autonomy is a significant factor in medical decisions. This principle requires respect for the decision making abilities of the autonomous people (Beauchamp & Childress, 2014). In this case, the attending physician held a discussion with the mother regarding the diagnosis, treatment and risk of treatment and the risk without treatment. Mike informed the physician of their decision of not attending the dialysis for some time as they seek God’s healing. They didn’t want to subject their son to multiple cases of dialysis as they believed that their faith in God could do miracles and relieve their son. In a situation where the associated party is a child, the parent assumes the autonomy of making choices for medical treatment.

Christians will tend to rank to rank the priorities based on their faith. They may rank them as 1) Autonomy; 2) Nonmaleficence; 3) Beneficence; and 4) Justice.

Respect is a key aspect in the Christian faith and the relationship between God and humans. When God created man, he gave him the authority to make his own decisions. As a Christian physician, he is expected to inform and respect the choices of the parents. Under the laws of bioethics, patients have the power to decide the mode of treatment they want and have a right to refuse certain treatments, surgeries, or medications (Tom & James, 2014). The decision may not be in the best interest of the patient, but it is something that medical practitioners must respect.

The principle of non-maleficence stipulates that human subjects should not be harmed. This means that nursing practitioners must make the best medical decisions and adhere to the medical rules and regulations and ethics to ensure that patients are safe. The third is the principle of beneficence which is an ethical perspective that involves promoting all that is good. It entails trying to improve the health condition of the patients. The principle of justice campaigns for the equal distribution of benefits and risks of research (Beauchamp & Childress, 2014). In the selection of research subjects both socially and ethically, there must be fair procedures and outcomes.

In the context of Christian biblical narrative, I believe that the order of these principles should appear just as they are. Respect for autonomy should appear ahead of other principles. Allowing patients to take part in their care and make their own medical choices is crucial. This gives room for an equal diplomatic approach to the provision of healthcare. Respect for autonomy would be considered first because based on the Christian biblical story of creation, fall, and redemption of man, God allowed us to be on earth and make a choice between the right and wrong. Even though God wants us to choose the right, He gives us the room to choose the path we want to take in life.