1) What is your definition of spiritual care? How does it differ or accord with the description given in the topic readings? Explain. (150-250 words)

2) When it comes to facilitating spiritual care for patients with worldviews different from your own, what are your strengths and weaknesses? If you were the patient, who would have the final say in terms of ethical decision-making and intervention in the event of a difficult situation? (150-250 words)

3)  In addition to the topic Resources, use the chart you completed and questions you answered in  “Case Study: Healing and Autonomy” as the basis for your responses in this assignment. (3-4 sources)

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

a) 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.

b) 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?

C) In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike to determine appropriate interventions for James and for his family or others involved in his care.

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?”

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

James has kidney failure. Initially, a dialysis was the best option to alleviate his problem according to the doctor. However, the parents felt the best option was to take James for prayers in a healing service. Currently, the best option is for James to have a kidney transplant.

James is a minor. Therefore, h has no autonomy over his healthcare. This responsibility is held by his parents. The parents initially forewent a dialysis in favor of prayer. They have now agreed for a kidney transplant. However, they have to make a decision if they are ready to let Samuel donate his kidney to his brother. Samuel also lacks autonomy in the scenario.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness

Currently, only Samuel seems to be the viable kidney donor. If he donates his kidney to his brother, there is a likelihood that his quality of life will drop. Since he has no choice on the matter, a kidney transplant my harm his health and not be in his best interest. On the other hand, if James receives the kidney, the quality of his life will improve. However, there is no guarantee of this happening. The parents have to make a decision on whether to risk the lives of both their children or commit to ensuring Samuel lives the best life possible without asking him to sacrifice his kidney.

Taking Samuel’s kidney without his consent would be unfair to him. It would be putting his life in danger for his brother. Although this would be a noble action, there is no guarantee that the transplant will be successful. Therefore, it will be unfair and unjust to risk Samuel’s life for the sake of James.

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Part 2: Evaluation

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

1. In 200-250 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)

First, there is the principle of non-maleficenc