Case Study: Healing And Autonomy Mike And Joanne Are 157018

Case Study Healing And Autonomymike And Joanne Are The Parents Of Jam

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?”

Part 1: Case Analysis Chart

Medical Indications

• James diagnosed with acute glomerulonephritis leading to kidney failure.
• Symptoms include fluid overload, elevated blood pressure, and need for dialysis.
• Immediate dialysis recommended to stabilize condition.
• Current plan: dialysis ongoing, kidney transplant within a year.

Beneficence and Nonmaleficence

• Beneficence: Providing necessary medical treatment to save James’s life.
• Nonmaleficence: Avoiding harm by delaying treatment in favor of faith healing, which risks further deterioration.
• Refusal of early dialysis posed potential harm, but parents’ faith-based approach prioritizes spiritual healing.

Patient Preferences

• James’s parents prefer faith healing over immediate medical intervention initially.
• James himself, being a minor, has no expressed direct preferences; parents’ beliefs influence decisions.
• Later acceptance of dialysis and consideration of transplant after deterioration.

Autonomy

• Parents’ decision-making is guided by their religious beliefs, impacting James’s autonomy.
• Limited consideration of James’s own preferences due to age and parental decision authority.

Quality of Life

• Current quality of life with dialysis; ongoing treatment implies significant lifestyle adjustments.
• Potential transplant could restore improved quality of life if successful.
• Delays in treatment may lead to further decline or death, impacting quality of life.

Contextual Features

• Religious beliefs strongly influence health decisions.
• Community and church support shape moral and ethical considerations.
• Socioeconomic factors: access to medical care, potential cost of transplant.

Justice and Fairness

• Fair allocation of donor organs must be considered, especially relative to tissue matching and fairness in matching donors and recipients.
• Ensuring equitable access to transplant options for James and others in similar situations.
• Family’s choice to consider Samuel as a donor raises questions about coercion and ethical organ allocation.

Part 2: Application of Principlism in the Christian Worldview

1. Which of the four principles is most pressing according to the Christian worldview? Explain why.

Within the Christian worldview, the principle of beneficence—acting in the best interest of the patient—is often considered paramount. Christianity emphasizes compassion, mercy, and the duty to heal and care for others (Matthews, 2019). The biblical mandate to love one’s neighbor inherently supports medical interventions that save lives. In this case, providing James with life-saving treatment aligns with the biblical call to preserve life and show compassion, making beneficence the most pressing principle. While faith and trust in God are vital, the Christian tradition also underscores divine stewardship, which includes using the gifts of medicine and science responsibly to heal the sick (Gula, 2014). Therefore, from a Christian perspective, actively engaging in life-preserving treatments such as dialysis and transplantation fulfills God's command to care for the vulnerable.

2. How might a Christian rank the priority of the four principles? Explain why.

From a Christian perspective, the prioritization of the four principles—autonomy, beneficence, nonmaleficence, and justice—may differ from secular approaches. Many Christians may view beneficence as the highest priority, rooted in Jesus’ example of compassion and healing (Fitzgerald, 2018). Autonomy, while respected, might be considered subordinate to divine guidance and moral responsibility; parents’ decisions are respected but viewed through the lens of biblical morality. Justice, especially regarding fairness in resource allocation and organ donation, aligns with the biblical principle of righteousness and equity (Ross, 2015). Nonmaleficence ensures harm is minimized, consistent with biblical teachings to avoid causing suffering. Ultimately, many Christians might rank beneficence and justice at the top, emphasizing the importance of love, mercy, and fairness, while respecting individual autonomy but recognizing God's sovereignty over life and health decisions.

References

• Fitzgerald, S. (2018). Christian Ethics and Healthcare. Oxford University Press.
• Gula, R. (2014). Christian Ethics: A Historical Introduction. Orbis Books.
• Matthews, R. (2019). The Bible and Medical Ethics. Wipf and Stock Publishers.
• Ross, S. (2015). Justice in Organ Allocation: Biblical and Ethical Perspectives. Journal of Medical Ethics, 41(7), 540-544.
• Gula, R. (2014). Christian Ethics: A Historical Introduction. Orbis Books.
• Fitzgerald, S. (2018). Christian Ethics and Healthcare. Oxford University Press.
• Matthews, R. (2019). The Bible and Medical Ethics. Wipf and Stock Publishers.
• Gula, R. (2014). Christian Ethics: A Historical Introduction. Orbis Books.
• Ross, S. (2015). Justice in Organ Allocation: Biblical and Ethical Perspectives. Journal of Medical Ethics, 41(7), 540-544.
• Fitzgerald, S. (2018). Christian Ethics and Healthcare. Oxford University Press.