Case Summary
Mike and Joanne’s eight-year-old son James developed acute kidney failure after a strep infection and required urgent dialysis. Believing in faith healing, his parents initially refused treatment, hoping prayer would heal him. James’s condition worsened, forcing him to undergo dialysis, which became permanent and left him needing a kidney transplant. Neither parent nor willing friends were compatible donors. James’s doctor then identified his twin brother, Samuel, as an ideal match, leaving Mike torn between consenting to the transplant or waiting for divine intervention, which he now views as a profound test of faith.
Physician Authority, Parental Autonomy, and the Child’s Best Interests
Given the specifics of the case study, the doctor should allow Mike to continue making decisions on behalf of his son, James. Since James is under 18, this condition puts his parents in a position to make all medical decisions for him. In this case, it is unclear whether James had a conversation with his parents about his wishes in the event of his death. Given that James is only eight years old, he may be intellectually advanced for his age and know how he would like to proceed (Stavleu et al., 2022). However, not allowing Mike to make decisions for his son would disrespect the guardian’s autonomy.
On the one hand, it may seem that Mike is behaving irrationally and harming James, but he is acting in accordance with his worldview, which is based on faith, religious beliefs, and a moral code. Mike’s worldview does not negatively affect his competence to make decisions for his son. In addition, health professionals have a duty to respect the autonomy of carers in making their own decisions (Stavleu et al., 2022). Their primary concern is presenting the facts and communicating the risks and benefits of any possible options. Therefore, an 8-year-old patient lacks autonomy considering their age; therefore, the doctor can offer their expertise and opinion until the patient is discharged.
Christian Perspectives on Illness, Medical Intervention, and Ethical Responsibility
Christians often view illness as a form of God’s permission or punishment for their sins. However, Christians are sure that despite the illness, God does not leave them, and constant prayer will enable them to remain in contact with God and not lose faith in a quick recovery. From a Christian worldview, the family would view the child’s illness as something God allowed to strengthen their relationships (Kørup et al., 2018). Mike’s family believed their child’s illness was part of God’s plan for their son.
From a Christian perspective, illness does not mean that it is the end of James’ life or that James must suffer. The Christian worldview does not deny the importance of timely medical intervention. Christians believe that God has guided the development of science and education to help people in their time of need (Kørup et al., 2018). Through medical intervention, doctors and other healthcare professionals can convey their emotional compassion and care for others in times of need.
Mike, being a Christian, may believe that the power of prayer can heal his son, but he can use the power of prayer in combination with medical intervention. In this way, he will be able to achieve maximum healing with minimum suffering. Beneficence is an opportunity to prevent harm and achieve maximum benefit for the patient.
Non-maleficence refers to the principle of not causing harm to the patient, and both terms are somewhat subjective. The reason is that what one person may consider harmless, another may consider harmful. Thus, Mike believes that his son will achieve well-being and recover from acute glomerulonephritis and prevent his health from deteriorating through the power of prayer; he puts his faith in God to heal him and not resort to medical intervention. Such a belief can be identified by a doctor, who will see that untimely care can harm the patient, but this is the right of a father who decides for his son. Such an act is a testament to Mike’s faith in charity.
Both Mike and Joann demonstrate their capacity for independence and kindness for their son by treating James in the way they think is best for him. With this scenario in mind, if the family is Christian, they will look to God for guidance and direction in their choices. Mike can trust that God will lead the family first to a prayer group and then to medical intervention.
The Role of Spiritual Needs Assessment in Clinical Decision-Making
A spiritual assessment should have been performed during the patient’s hospitalization. If the evaluation had not been done before Mike expressed a desire for his son to attend a healing prayer group, a spiritual evaluation should have been done. In this way, the medical facility could organize days when the spiritual director came and spoke with the doctor, the patient, and his family. Such an assessment could help Mike understand the importance of temporary dialysis as well as the use of bedside prayer to help heal his son. In this case, the priest could provide spiritual support to the family and the patient. This practice would help them work through their feelings between decisions.
Often, the patient can seek advice and answers to questions from their spiritual advisor. Due to this practice, patients can make more informed decisions and work more effectively with the medical staff (Bradford, 2023). Therefore, spiritual assessment is an integral part of the treatment plan and can help patients achieve positive outcomes by addressing these needs in conjunction with medical treatment. Moreover, if the family and the patient receive spiritual help and James does not respond to treatment, the chaplain can offer them psychological support (Bradford, 2023). Therefore, the nurse must continually assess the patient’s spiritual needs in conjunction with physicians’ assessments of medical needs.
References
Bradford, K. L. (2023). The nature of religious and spiritual needs in palliative care patients, carers, and families and how they can be addressed from a specialist spiritual care perspective. Religions, 14(1), 125.
Kørup, A. K., Søndergaard, J., Christensen, R. dePont, Nielsen, C. T., Lucchetti, G., Ramakrishnan, P., Baumann, K., Lee, E., Frick, E., Büssing, A., Alyousefi, N. A., Karimah, A., Schouten, E., Schulze, A., Wermuth, I., & Hvidt, N. C. (2018). Religious values in clinical practice are here to stay. Journal of Religion and Health, 59(1), 188–194.
Stavleu, D. C., Peter de Winter, J., Veenstra, X., van Stralen, K. J., De Coninck, D., Matthijs, K., & Toelen, J. (2022). Parental opinions on medical decision-making in adolescence: A case-based survey. Journal of Developmental and Behavioral Pediatrics: JDBP, 43(1), 17–22.