In light of Christian narrative and Christian vision, the case given has some outstanding issues. According to Christian doctrine, healing comes from God who is the ultimate Physician. Christians believe that having faith in God to heal will make one well. There are many occasions in the bible where Jesus healed people just because they had faith in Him.
In the case given, Mike and Joanne have two eight-year-old twin sons, James and Samuel. James suffers from acute glomerulonephritis as a sequella of a streptococcus infection. Unlike most cases which resolve on its own or improves on the administration of antibiotics, James condition did not. His condition worsened with symptoms like fluid retention and high blood pressure being presented. The attending physician recommends immediate dialysis, but the parents decide James will forego the dialysis and they place their faith in God to heal their son. After two days, they come back to the hospital to have the dialysis done. By now James condition has worsened, and on further examination, it is determined the kidney failure is permanent, and James will have to be on dialysis until he can get a kidney transplant. Mike blames himself for this. He believes it is lack of enough faith that caused it. In searching for a donor, the only compatible donor is James twin, Samuel. Mike is again at crossroads on whether to trust in God to heal James or to have Samuel donate one of his kidneys to his brother.
The main issues are the question of what occasions do we need to just rely on faith for healing, and in which occasion should we take medical solutions. If Mike and Joanne had agreed to the dialysis in the first place, there is a great chance James acute kidney failure would have been resolved. Also, whether or not they decide to have the transplant done could be a matter of life or death for their son.
The physician should allow Mike to continue making the decisions on the treatment of his son. The reason is that James is not old enough to make decisions on his own and his father is the one to decide for him. First, autonomy is a principle of ethics and takes a particular level of respect of people and their ability to have a say in matters that affect their health. Informed consent is an ethical issue because it necessitates respect for an individuals autonomy and their right to having a say in what is done to their bodies. Failure to obtain this consent can comprise negligence or even result in medical malpractice actions. Mike who is in charge of making the decisions for James is under no influence from anyone but is acting on his own free will. It is his personal opinion that having faith in God heals and that ought to be respected. Mike has a right to hold views that are incongruent with that of people of the healthcare establishment. He has a right to the contrary opinion that faith and not a kidney transplant will be the solution to his sons kidney failure (Beauchamp & Childress, 2016).
The decision of Mike to have his son forego dialysis can be justified to a limited extent by Christian belief in God as the healer. There are many examples given in the bible where God healed people spontaneously just for believing in His power to do so. Mike had faith the same thing would happen with his son. Unfortunately, this did not happen. Mike believes it is because he did not have sufficient faith in God. According to Christian teachings on healing, Mike ought to have followed the recommendation by health professionals. Whereas his belief in God can be justified, following proper medical advice will not be a violation of his faith in God. He should pray for his son and at the same time allow his son to receive the necessary treatment. Mike was competent when deciding for his son to forego dialysis. He decided although he understood the consequences of failure to have dialysis done and his reasons were rational, given that Christianity is not delusional.
Treatment refusal by a patient goes against the principle of beneficence which states that one ought to prevent or remove harm and promote good. A patient has the right to decide whether or not he/she should partake any form of treatment. In some cases, however, the patients choice may not be the best choice. By mike refusing to have his son undergo dialysis, the healthcare professionals are unable to do anything to help with James condition. The healthcare professionals violated the principle of beneficence in this case. In this scenario, medical paternalism trumps the principle of autonomy. The health practitioners ought to override Mikes choice with the justification that doing so will benefit James (Beauchamp & Childress, 2016).
On organ donation and transplantation there are objections by Christian beliefs. Most will allow the donation and receiving of replaceable tissues such as blood and bone marrow. On organs such as the heart which require the donor to be at least dead or brain dead, there is a lot of controversies. The permissive Christian belief that will allow organ donation is the exhortation to love our neighbors. In donating ones organs, the neighbor who is described in the bible as someone in need gets to live. The notion that when Christians resurrect they will need their full body parts will is a reason for Christians not donating their organs. Another reason why Christians will donate organs is the principle of totality. The principle encourages Christians to maintain the wholeness of their bodies but allows removal of a body part for the individuals benefit or as an act of charity.
Christians should have science in mind when thinking about sickness and health. Although Christians believe that it is God who gives us good health and that God can heal the sick spontaneously, the same God is also permissive of science. Christians ought to trust in God to heal and the healthcare professionals to treat. Christians should not refuse treatment on account of expecting a miraculous healing from God. It does not show lack of faith in God to seek medical treatment, but it is in line with the popular Christian belief that God helps those that help themselves. Christians should, therefore, regard health and sickness as a physical problem rather than a spiritual problem (Pellegrino, 1999).
Mike as a Christian should have allowed his son James to undergo dialysis. He should have trusted in Gods ability to heal James, not through a miracle but the treatment offered by the healthcare establishment. Although God is capable of healing him miraculously, he ought to have considered the available option as God helps those that help themselves. Even in bible cases, God did heal people by having them do something to get well. An example is Naman who had to be immersed in river Jordan in to be healed from leprosy. He should have prayed for his sons wellbeing but at the same time have him undergo dialysis.
On whether his son Samuel should donate one of his kidneys to save his twin brother James, as a Christian Mike should consent to this. Although it is true this is a greater test of his faith; it does not mean that he should exclude the medical options of treatment available. Mike should trust in God to heal his son through a successful kidney transplant and also trust in God that his son Samuel will be alright. He ought to have faith that the whole process will be a success as opposed to expecting a spontaneous miraculous healing. This is not a demonstration of lack of faith in God to solve the situation but is an act of faith. It is a show of his trust in God to heal his son, only that God is doing so through the treatment procedure.
In conclusion, the issue of autonomy and healing is a sensitive field in practice. The choices patients make at times is not in their best interest, and this places a healthcare practitioner at a quandary on whether to ignore the patients wishes and help them or to heed their wishes and see them die, in the worst case scenario. Christians should find a balance between having trust in God and getting the appropriate medical care. The principle of autonomy from the surface appears like a fundamental principle that should remain inviolate. In practice, however, some situations and relationships challenge this principle and make it difficult to follow on a consistent basis.
Beauchamp, T. L., & Childress, J. F. (2016). Principles of biomedical ethics.
Pellegrino, E. D. (1999). Christ, Physician and Patient, The Model for Christian Healing. The Linacre Quarterly, 66(3), 70-78. doi:10.1080/20508549.1999.11877550
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