Ethical and spiritual discussion 5

Read the lecture and respond to the discussion questions with reference

Intervention and Ethical Decision Making

The application of bioethical principles in the context of different worldviews and religions will be the goal of this topic. Different models of ethical decision making suggest different steps and priorities, but the important thing to note is that all models are attempting to organize all of the relevant information in a case so that nothing is left out of consideration. Still, the way in which all of the relevant details in a case are considered will always take place within the context of a worldview. As such, the most important determinant of a bioethical decision is not a methodology but the worldview context in which the the methodology is functioning. Consider then how the Christian biblical narrative determines the values that are deemed relevant or important in a case and how different worldviews would impact the decision making in different cases.

Consider the following analysis from a Christian perspecive of the case study “End of Life and Sanctity of Life” in the American Medical Associations Journal of Ethics (Available in Loud Cloud readings). That case is analyzed from a Jewish and Buddhist perspective by different commentators. This case will be analyzed by addressing the four principles in the principalist approach, and then consider that data in light of the Christian worldview in order to recommend a course of action in accordance to Christian values and biblical principles.

Recall that the four principles of principalism include (1) autonomy, (2) beneficence, (3) nonmaleficence, and (4) justice. Depending on the case, different principles will come to have greater prominence in deciding an ethical course of action. At times there may be conflicts among the principles themselves, in which it will have to be determined which principle will have the greater priority. For example, a common conflict is that between a patients autonomy and what a physician considers to be beneficent, or in the best interests of the patient. A physician might see that a particular course of treatment will be beneficial for a patient (beneficence), and yet the patient refuses the treatment (autonomy). Should the physician simpy allow the patient to choose for themselves a course of action that will knowingly bring them harm? Is it right for the physician to coerce or force a patient to undergo a treatment against his or her will, and violate their autonomy, even if it will bring about some medical benefit?

How do the four principles apply to the case of 82 year old Mrs. Jones?

Autonomy: In this case, Mrs. Jones is incapacitated; she has been unconscious for two days and has no ability to communicate her desires for or against treatment. This is further complicated by the fact that she left no advance directive (a legal document that details her wishes for or against certain kinds of medical treatment should she ever become incapacitated such as a living will or a healthcare power of attorney). While Mrs. Jones’ family and the physian disagree about the appropriate treatment for her, it seems that determining what Mrs. Jones would have wanted is not possible. Thus, while her autonomy is certainly to be respected, in this case it is not something that is able to be obtained, given her condition (she would technically be considered incompetent and unable to exercise autonomy in her current condition).

Beneficence: Dr. Rosenberg believes that it will be in Mrs. Jones best interest medically to be put on temporary dialysis. He believes it to be the beneficent course of action; that which will bring about her good. Mrs. Jones’ family believes that dialysis will be a cause of undue suffering for her, and thus do not consider it to be the beneficent course of action. The fundamental disagreement lies here. Two parties, who are not Mrs. Jones’ herself, and who presumably do not have information about how she would have decided for herself, disagree about whether or not an action is truly beneficent for her. The principle of non-maleficence is closely related.

Nonmaleficence: Not only does Dr. Rosenberg have a moral duty to promote Mrs. Jones’ good, but he has a corresponding negative duty to not inflict evil or harm upon her. Mrs. Jones’ family believes that to place her on dialysis would inflict harm and suffering on her. Dr. Rosenberg believes it to be his duty to place her on dialysis, and that to not do so would be harmful to her. Dr. Rosenberg’s dilemma involves the belief that withholding treatment that has a good chance of restoring Mrs. Jones back to health with little risk is immoral.

Justice: Questions of justice usually come to the forefront in terms of the equal and fair distribution/allocation of medical goods and services (i.e., organ donation, health insurance, etc). In this case this principles does not play a major role. It might be said that it is unjust or unfair for Mrs. Jones to not decide for herself. But in the terms of this class, that concern would more appropriately be a question of autonomy, beneficence and nonmaleficence.

The above discussion sketches out how each principle would be relevant to or apply to Mrs. Jones’ case. But notice that you do not automatically have an answer to this dilemma. What should be done ethically? To answer this question, it is necessary to consider the four principles in light of an overarching worldview. Thus, how ought a Christian think about this dilemma?

To begin with, it is important to note that the Bible holds that all life is sacred (Gen. 2:7, Ps. 139:13-16, Exod. 20:13). Thus, whether a life is at its begging or end, it is valuable and sacred.

The dilemma in Mrs. Jones’ case is directly related to her perceived quality of life. Her family (presumably if they are being honest) does not desire that she remain alive and suffer. They perceive it better for her to stop living, than for her to continue living in a poor quality of life in which she would suffer. Dr. Rosenberg believes that her life is sacred, and that her quality of life is not so bad as to warrant ending her life early, if it can be saved with reasonable effort and low risk. For the Christian, while quality of life certainly matters, it does not determine the value of a life, or the worthiness of living for a person.

You might ask why exactly Mrs. Jones’ family is so ready to give up on a treatment modality (temporary dialysis) that will likely succeed? Meilander notes the importance of taking care of those in need and accepting their dependence upon those who love them and vice versa, accepting your own dependence when you are incapacitated, upon those who love you (2013, pp. 85-88). The reticence on the part of Mrs. Jones’ family seems to communicate a lack of willingness to deal with her care. It seems as if they want it to be over with, instead of fulfilling their duty to care for her and be active partners with Dr. Rosenberg in decididng what is in her best interest.

From the Christian perspective, it would be true that if Mrs. Jones had a personal relationship with Christ, her quality of life or existence would be improved dramatically were she to enter into God’s presence directly by way of her earthly passing. However, it would be radically mistaken to believe that it is up to some one other than God when that time would be. Does a refusal of dialysis constitute a reasonable decision? Or does it constitute a decision that functionally denies the opportunity for healing and thus denies God’s prerogative? It seems more likely that it is the latter.

In brief, it seems that Dr. Rosenberg is justified in his refusal to refuse reasonable and low risk treatment for Mrs. Jones. Ultimately, it seems that Mrs. Jones’ family does not want to take responsibility for her care, and is instead opting to determine her worth or value based upon a perceived quality of life.

In your own case study, consider how each of the four principles apply, and analyze those facts in terms of a wider worldview or religion. All ethical decision making takes palced within a worldview. The content of a worldview will determine what is valuable and what is not, as well as how a person would engage in decision making given those values.

Reference

Meilaender, G. (2013). Bioethics: A primer for Christians. (3rd ed.). Grand Rapids, MI: Wm. B. Eerdmans Publishing Company.

Discussion 1

What is your definition of “spiritual care?” How does it differ or accord with the description given in the topic readings? Explain.

Discussion 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?

Expert Solution Preview

Introduction: In this lecture, we will discuss intervention and ethical decision-making in the medical field. Various models of ethical decision-making have different steps and priorities, but all aim to consider all relevant information in a case. The most critical factor in bioethical decisions is the worldview context in which the methodology is functioning. We will analyze a case study, “End of Life and Sanctity of Life,” from a Christian perspective, taking into account the four principles of principalism – autonomy, beneficence, non-maleficence, and justice.

Discussion:

1. How do the four principles apply to the case of 82-year-old Mrs. Jones?

Autonomy: Mrs. Jones is incapacitated and cannot communicate her desires for or against treatment. Since she did not leave any advance directive detailing her wishes for or against certain medical treatment, determining her autonomy is not possible. Therefore, respecting her autonomy is not possible in this case.

Beneficence: Dr. Rosenberg believes that temporary dialysis will be the beneficent course of action for Mrs. Jones. However, Mrs. Jones’ family believes that it will cause undue suffering and do not consider it to be beneficent. There is a fundamental disagreement between two parties, neither of whom have information about how Mrs. Jones would have decided for herself.

Non-maleficence: Dr. Rosenberg has a moral duty to promote Mrs. Jones’ good and not inflict evil or harm upon her. However, Mrs. Jones’ family believes that placing her on dialysis would inflict harm and suffering on her.

Justice: Justice does not play a significant role in this case.

2. How ought a Christian think about this dilemma?

According to the Bible, all life is sacred, and whether a life is at its beginning or end, it is valuable and sacred. In Mrs. Jones’ case, her family perceives her quality of life as poor, and they do not desire for her to continue living and suffering. Dr. Rosenberg, on the other hand, believes that her life is sacred and must not be ended prematurely. For Christians, quality of life is essential, but it does not determine the value of life or the worthiness of living.

Mrs. Jones’ family’s reticence to accept the temporary dialysis treatment seems to communicate a lack of willingness to care for her. From a Christian perspective, caring for those in need and accepting their dependence on those who love them is pivotal. Thus, Dr. Rosenberg is justified in his refusal to refuse reasonable and low-risk treatment for Mrs. Jones. Refusing treatment may desist from the opportunity for healing and thus denies God’s prerogative.

Conclusion: In conclusion, applying ethical decision-making to a medical case involves considering the four principles of principalism. While each principle provides guidance, a wider worldview context is necessary to determine an ethical course of action. In Mrs. Jones’ case, the Christian worldview holds that all life is sacred, and it would be more justified to treat her with reasonable and low-risk treatment.

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

EHHA 501 Patient Journey Flow Chart

Develop an existing patient journey that crosses the three sectors of care in your organization (the organization is military hospital) Hwo could this be improved ? As a chart flow  You are a medical professor in charge of creating college assignments and answers for medical college students. You design and

MDC Gabapentin in the Context of Bipolar Disorder

A new patient presents to your office for treatment of bipolar disorder. In his medical history, he reports that he takes gabapentin prescribed by his primary care provider, but he is not sure what he takes it for. He states he is almost out of his gabapentin and is asking

KEMUL Health & Medical Using Technology to Prevent Patient

Using Technology To Prevent Patient Falls Review the concepts of technology application as presented in the Resources. Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies. In a project proposal

KEMUL Organizational Conflict and Effectiveness

1. Conflict  2.Relationship Between Organizational Conflict and Effectiveness  3.Common Sources of Organizational Conflict 4.Managerial Response to Conflict 5.Categories of Conflict 6.Stages of Conflict 7.Conflict Resolution Outcomes 8.Common Conflict Resolution Strategies. 9.Compromising 10.Competing 11.Cooperating/Accommodating 12.Common Causes of Organizational Conflict 13.Helpful Tips in Conflict Resolution. 14.Negotiation 15.Types of Alternative Dispute Resolution (ADR)

HSA 405 SU?Healthcare Quality Case Study

Overview In order to complete this case study, refer to this week’s readings for policy information required to analyze and make recommendations on this case. As a healthcare quality fraud analyst, you are responsible for identification of root causes and providing recommendations in an action plan to ensure compliance with

Needs to be 3 paragraphs You are the sole psychologist on

Needs to be 3 paragraphs  You are the sole psychologist on what is considered a small-sized base, with a population of approximately 6,000 people, including civilians, dependents, reservists, and active duty personnel. You have an appointment scheduled today with a patient whom you know works within the MTF (Military Treatment

Homework Content ScenarioThe administrator’s presentation,

Homework Content Scenario The administrator’s presentation, based on your briefing, was so well received by the board members that they asked to see a proposal for a hospital-based outpatient facility. In fact, the board suggested that the administrator ask you to take the lead in the project. Your administrator is

The CEO of a health care system has asked you, the system’s

The CEO of a health care system has asked you, the system’s strategic planner, to explain the factors they must consider when deciding the resources that should be devoted to a new facility project. List and describe the factors that determine the location, physical size, projected staffing, and effective décor

AMU HIMA 410 Hospital Data Modeling and Entity Relationship

A data model provides a view of how the data is structured throughout an organization. You’ve been provided with a set of data points from a local hospital. Instructions: Using the data points provided, create a model. Your data model should structure the data to support the business practices of

HIMA 360 AMU Encoder Selection for HIM Director Report

Case Scenario: Part 1: You are the HIM Director at Community General Hospital. As the director, you are in charge of purchasing an encoder for your 20 coders. You have identified the criteria that you will use to make the determination and put it in the grid below. Vendor 1

NUR 3846 BCC Deep Vein Thrombosis Questions

Using the video from Episode 2 on Samantha, answer the following prompts: Prompt 1: Explain in detail the pathogenesis of a DVT (Deep Vein Thrombosis) and how it can lead to a PE (Pulmonary Embolism). Prompt 2: Research and list all the possible treatment options for a DVT. Please correlate

MDC Key Elements of Psychiatric Assessment Discussion Reply

response to post: Discuss the Key elements of Psychiatric assessment and Interviewing of children. Assessing children and adolescents is challenging.  A psychiatric assessment can determine if a child is experiencing a disorder or if there are other factors that may be causing their difficulties. Establishing rapport is the first and

MDC Conducting Psychiatric Assessments Discussion Reply

Respond to Ste: Discuss the Key Elements of Psychiatric Assessment and Interviewing of Children When conducting psychiatric assessments and interviewing of children, there are several important elements to consider. According to Sharma et al. (2019), creating a rapport is crucial to building a relationship of trust with children while encouraging

MDC Assessing Childrens Mental Health Discussion Reply

post response Mari: Assessing children and adolescents is challenging. Generally, the child/adolescent in question would not have initiated the consultation or may not be in agreement with the need for a consultation. The consultation may or may not even be sought for the most impairing problem at hand. While children

MU African American Counselors in Training Project

Task summary: You are to do Exploring clinical supervision with African American counselors in Training editing Full description: please write Exploring clinical supervision with African American counselors in Training   You are a medical professor in charge of creating college assignments and answers for medical college students. You design and

Few people have not heard about the Food and Drug

Few people have not heard about the Food and Drug Administration (FDA). The COVID pandemic has placed a renewed focus on its role in assuring safety of drug approval. It is not nearly as well known that the FDA is tasked with regulating multiple categories of products. One cannot work in healthcare

MHA 543 UP Health & Medical Generational Work Trait

Work traits vary considerably between various generations. Each individual has a unique manner for interacting with others and solving problems or addressing issues that arise. In this assignment, you will address work trait differences and how these differences might impact the organizational culture and succession planning.  Part I: Individual Work

Health & Medical Health Screening Tests Issues and Concerns

Describe what you already know about the module’s topics (if anything) With your limited understanding, how you would answer the module’s guiding question: “Do you think most people undergoing a screening test understand how to assess the benefits and risks of the test?” What other questions does the guiding question