The case study of ‘Healing and Autonomy’ demonstrates how Christians can make inappropriate decisions regarding the treatment of their children. In the case study, Mike and Joanne are parents who have an ailing son, James. The parents contemplate providing the best care for their son, according to their Christian beliefs and principles. James has acute glomerulonephritis coupled with hypertension and build-up of fluid in the body, which predisposes him to kidney failure.
Although the doctor advised Mike and Joanne that immediate dialysis was critical to remove excess fluid and alleviate blood pressure, they opted for the healing faith service in line with their Christian beliefs and principles. Owing to delayed dialysis, the kidney of James deteriorated to an extent where kidney transplant was the only viable treatment option. In the analysis of the case study, this essay examines pressing issues from the Christian perspective, the inappropriateness of Mike’s decisions, medical ethics, and relevant recommendation.
Pressing Issues from a Christian Perspective
Faith in God is one of the pressing issues from the Christian perspective since it affects the way the parents treat their son. From the case study, the doctor informed the parents about the condition of James and advised them that he requires immediate dialysis to remove excess fluid and alleviate blood pressure. Although James required immediate dialysis, the parents opted to trust in God for they believe God is all-powerful, which is a prime reality of Christians. As the existence of God with infinite powers is the prime reality of Christians, Mike and Joanne prioritized to God’s intervention. Even though their faith in God did not help in improving the condition of their son, parents vacillate on whether to consent to kidney transplant or continue having faith in God.
The healing service in their church is another pressing issue from a Christian perspective, which persuades parents to delay medical treatment for their son. From the case study, it is apparent that the parents witnessed their close friend regaining mobility during the faith healing service when their pastor prayed for him, and thus, they expect the same experience of the miracle to happen to their son. Based on the miracle experience, the parents insist that their son requires the faith healing service despite the medical persuasion that their son needs urgent dialysis to remove excess fluid and alleviate blood pressure. Hence, the experience of miracle is the premise that persuades the parents to choose the faith healing service as the best alternative treatment.
Christian ethics is another pressing issue that is evident in the case study. From the Christian worldview, Christians believe that what is wrong has a punishment and what is good has a blessing. In the case study, parents placed their faith in God, and they had great hopes that their son would heal. However, disappointment comes when parents noted that their son did not heal, as per their expectation, instead, his condition deteriorated further. From their Christian perspective, the parents perceived that God did not heal their son because God was punishing him and them for not having adequate faith. Thus, Christian ethics is an issue because it dissuades the parents from attributing the deteriorating condition of their son to their decisions and actions.
The inappropriateness of Mike’s Decisions
The analysis of Mike’s decisions shows that they are inappropriate because they are not only irrational but also harmful to James. One of the irrational and harmful decisions that Mike made is delaying the dialysis of James and seeking the treatment of the faith healing service. After an analysis of James’ condition, the doctor informed Mike that he needs urgent dialysis to remove excess fluid and alleviate blood pressure to prevent kidney failure.
With the understanding of the condition of James and potential consequences, Mike perceived that it was prudent to have faith in God, and thus, he sought treatment from the faith-healing service. In this view, Mike’s decision was irrational for it overlooked medical advice, and it was harmful, a consequence that made James’s kidney deteriorate.
Further analysis of the decisions that Mike makes shows that they are random based on prevailing conditions, and thus, irrational. As Mike sought treatment from the faith-healing service based on his faith and belief, he expected miracle healing. However, when the healing failed, and the condition of James deteriorated, Mike was desperate for he had no option except bringing James to the hospital. In this view, the decision to bring James to the hospital constitutes an irrational act of desperation for Mike to have no medical and scientific reason to do so.
Moreover, Mike attributes the failure to heal his son through the faith healing service to the insufficient faith and divine chastisement. Mike’s attribution shows he has not accepted his faults, and thus, he will continue improving his faith and seeking divine redemption to save his son.
As Mike is indecisive, the doctor should not continue permitting him to make decisions regarding the treatment of James. Even after making irrational decisions and causing grave harm to James, Mike is still indecisive. In the case study, the doctor informed Mike about the condition of James and recommended for urgent dialysis, but James overlooked. As a consequence, James’ kidneys deteriorated to an extent where the transplant is the only visible medical option. However, Mike is yet to consent to kidney transplant for he believes that sufficient faith in God and abolition of punishment through prayer would heal his son.
The analysis of the case study reveals that treatment refusal is an ethical issue that stands out. The right to refuse treatment stems from the ethical principle of autonomy, which gives patients the right to make informed decisions regarding their health (Chagani, 2012). As James is too young to exercise the right of autonomy, his parents exercise it on his behalf. Parents have the right to exercise the autonomy of their children so long they decisions and actions are in line with their best interests and wishes (Parsapoor, Parsapoor, Rezaei, & Asghari, 2014). The assessment of the case study shows that parents did not exercise the autonomy of their son appropriately for their decisions and actions had their basis on religious beliefs and experiences.
The decisions and actions of parents, in the case study, contradicted that of the doctor. According to Parsapoor et al. (2014), even though parents have the right to exercise autonomy of their children in refusing treatment, their decisions and actions are limited to the realm of beneficence and nonmaleficence. Fundamentally, the ethical principle of beneficence allows the healthcare providers to overrule the autonomous decision of treatment refusal of the parents and provide sensible treatment while the ethical principle of nonmaleficence protects the patients from undue harm from decisions and actions of other people (Macklin, 2003).
The case study demonstrates that the parents violated the ethical principles of beneficence and nonmaleficence for they acted against medical advice given by the doctor. Moreover, in respecting the autonomy of patients, Chagani (2012) advises healthcare providers to obey the ethical principles of beneficence and nonmaleficence, and provide appropriate treatment irrespective of the refusal of treatment.
In the aspect of organ donation, the case study demonstrates that Christians permit their use in saving lives. Seeing that the condition of their son is a matter of life and death, the parents are willing to donate their kidneys. Church members and friends are also willing to donate their kidneys to save the life of James. Therefore, their willingness shows that Christian beliefs do not bar parents, church members, and friends from donating their kidneys to save lives. Oliver, Ahmed, and Woywodt (2012) argue that organ donation and the transplant is ethical when there is no compulsion for it breaches the ethical principles of autonomy and self-determination. However, religious beliefs and an informed consent cloud the requirements of organ donation in the case study.
Due to the irrational and harmful effects of decisions in the case study, Christians ought to change their worldview and take sickness as a physical state instead of a spiritual state. From the physical perspective, James became sick because of bacterial infection resulting in glomerulonephritis while excess fluid and hypertension caused deterioration of the kidney. Given that factors that contributed to the condition emanate from known physical causes, Christians should not relate them to inadequate faith in God or divine punishment, which are spiritual factors. As a Christian, Mike should consider advice from healthcare providers and pray for divine intervention.
Furthermore, Mike should reason that God has given human beings knowledge and skills of treating diseases, which religious beliefs should not contradict.
The case study demonstrates how religious beliefs, in this case, Christian beliefs have a negative influence on the treatment of a patient. The Christians beliefs made parents violate the ethical principles of autonomy, beneficence, and nonmaleficence. Therefore, the study recommends that Mike should consider medical advice while exercising autonomy on behalf of James and ensuring that his actions and decisions comply with the ethical principles of beneficence and nonmaleficence.
Chagani, S. (2012). Telling the truth: A tussle between four principles of ethics. Clinical Research & Bioethics, 5(2), 1-2.
Macklin, R. (2003). Applying the four principles. Journal of Medical Ethics, 19(1), 275-280.
Orr, R., Novotny, W., & Perkin, R. (2005). Faith-based decisions: Parents who refuse appropriate care for their children. American Medical Association Journal of Ethics, 5(8), 1-5.
Parsapoor, A., Parsapoor, M., Rezaei, N., & Asghari, F. (2014). Autonomy of children and adolescents in consent to treatment: Ethical, jurisprudential, and legal considerations. Iranian Journal of Pediatrics, 24(3), 241-248.