Case Study: Healing and Autonomy

This case study explores the ethical issues involved in the decision-making process of parents who are strong Christian believers and rely on God's miracles in healing. It discusses the principles of Autonomy, Beneficence, and Nonmaleficence and the teleological theory. The case also highlights the emerging issue of organ transplant and how Christians perceive health and sickness. The physician and parents should work together to find the best course of action to save the life of James.

Running head: CASE STUDY: HEALING AND AUTONOMY 1
Case Study: Healing and Autonomy
Name
Institution

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Case Study: Healing and Autonomy
Ethics entails the moral principles that govern the behavior of a person on behaviors and
philosophies of what is right or wrong a certain situation (Denecke et al., 2015). They can be
applied to anyone else despite the difference in ideologies. The “case study: Healing and
Autonomy”, Joanne and Mike who are the parents of James and Samuel falls under the category
of the Christian and Biblical Narrative visions by what we can call as strict followers. Their strict
adherence to these narrative visions has put them in the most difficult situation to make a moral
and ethical decision to assist their son James who is in a critical situation. Both parents of James
are strong Christian believers that have given them faith to believe in God’s miracles in healing.
James who is eight years old was initially diagnosed with streptococcus infection and had high
blood pressure which was a condition that could be treated immediately. However, his parents
link James’s condition to a case where their close friend who had a stroke was healed by a pastor
during a sermon. They decide to forego the dialysis and after two days later, they return with a
deteriorated condition of James. Their religious autonomy makes it difficult for them to decide
whether they should keep waiting for God’s miracles to take place or they should let James to be
treated with the physician.
Issues that are most pressing
There are various issues involved in this case which prompts for application of ethics to
make the right the right decision. The first pressing issue is whether one should indulge in
believing in God’s miracles in the healing or should allow for treatment from a physician under
proven scientific methods. These issues are most experienced under Christian vision and
narrative, which puts Joanne and Mike under a difficult dilemma. After James was diagnosed
with a streptococcus infection, his parents hoped that God would heal him. Their decisions are

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based on the bible and Christian teachings which are further influenced by what they saw
happening to their close friend. Later on, after they found that his condition was getting worse,
they come back to the physician to seek medical attention. Christians who believe in God’s
interventions typically practice healing through faith. Some of them do not accept to be treated
by physicians while others do not seek medical care when sick. The same scenario depicted by
Joanne and Mike who forego the dialysis of James, which led to further deterioration of his
health. Their decision is solely unethical due to its detrimental effects on James’s life who all this
time had been relying on the decisions made by his parents regarding his health condition.
The case can be attributed to the principles of Autonomy, Beneficence, and Non-
maleficence with regard to ethical and moral issues. It can also be linked to the teleological
theory that states that the nature of the outcomes rely on whether the action taken is right or
wrong (Baumane, Cals & Sumilo, 2016). Under the principle of beneficence, the doctor is
mandated with the right of keeping the patient away from harm, emphasize on the benefits and
risks to parents as well as respecting the parents’ autonomy regarding the choices of healthcare
for James. The principle of autonomy requires the capacities of making decisions to be respected
with regard to the person’s autonomy (Entwistle, Carter, Cribb & McCaffery, 2010). Therefore,
the physician has the responsibility of respecting the decision made by James’ parents of relying
on God for healing and treat James. However, it led to further deterioration of James’s status of
health.
According to Christen, Ineichen & Tanner (2014) the principle of Non-maleficence
requires that people should not cause harm to others which comes into play when the
deterioration of James’s status of health. The suggestions and recommendations made between
James’ parents and the physician would have worked out for greater advantage of James.

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However, this does not work out as the physician suggests for treatment immediately but the
parents disputed and opted for seeking God’s intervention based on their Christian beliefs. It
leads to an emergence of tension between the recommendations of the physician and the
decisions of James’ parents over Christian visions and values.
Another emerging issue in this case study is that of organ transplant regarding the kidney.
Some Christian faith does not accept organ transplant at all and to them it a controversial issue
because they believe that such transplants are usurping the role of God and can ignore the
sanctity of life. After further deterioration James’ health, the only option left for him is for a
kidney transplant in order for him to keep surviving. It is an option that relied on the decision of
his parents on whether they should allow it or not. Based on their Christian faith, this action
would be unethical if they could allow the organ transplant. Furthermore, Mike is in a dilemma
of whether this round he would have to rely on or ignore his God. Further dilemma escalates
with the doctor’s suggestion that the only compatible donor for a kidney transplant is James’s
twin brother Samuel. The issue is that both parents in dilemma of whether they should allow
their other son to lose one kidney to save the other child James.
The Process of Decision Making
Generally, parents have the right of making decisions on the welfare of the children until
they are mature enough to make their own decisions. However, from this case study, Mike seems
to be making irrational decisions that have led to further deterioration of their sick child. At the
end of the case study, Mike seems to be ignoring the physician’s recommendation of a kidney
transplant that should be donated by James’s brother Samuel and argues that it might be God
testing his faith. The physician has the responsibility of ensuring that a patient is well treated and
quality care is taken on health on an individual.

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Healthcare professionals should be able to resolve conflicts of interest for the safety
assurance of the patient and ensure that professional integrity is maintained throughout (Hickey
& Lyckholm, 2004). In this case, the action of Mike is out of negligence and hence it requires the
action of the physician to avoid further escalation of James’s condition. Mike has right to make a
decision over the autonomy of his son, should not be allowed to be exercised to an extent that it
endangers and threatens the life of James. Therefore, the physician and the parents of James
should work together to find the best course of action to save the life of James.
Analysis of the Case according to the Narrative of Christians
In the case, Mike foregoes dialysis in the first scenario opting for religious interventions
rather than perceiving the real benefits. In the end, he also argues that it might be God’s test for
his faith. Several questions arise from this case regarding the principles of bioethics rendering it
a clinical dilemma that requires ethical considerations. Mike might be perceiving the high cost
incurred during the procedure of kidney transplant forcing him to forego the whole procedure.
As argued by Musto, Rodney & Vanderheide (2014) the physician in this case, should be able to
analyze the whole situation, determine the benefits and effects of a kidney transplant to the
involved parties, and advise them appropriately.
Christians believe that God views them the way he wants them to be and hence to them it
is unethical in this case and should not acceptable before the Lord (Ankeny, Jordens, Kerridge,
Clifford & Benson, 2018). James requires kidney within a year and the only donor compatible in
this case is his brother Samuel. However, his parents should not be coerced to accept the kidney
transplant because medical practitioners are guided by the autonomy principle of the patient.
Hence, the physician can only persuade Mike by trying to depict the positive outcomes but not
making decisions on his behalf.

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How Christians think about Health and Sickness
Christians perceive sickness and suffering as God’s punishment for sin and one of the
ways, that God manifests himself in their life (Dein & Cook, 2015). It is the reason why at the
end Mike thinks that the illness of his son might be God’s test on his faith. Christian teachings
are that one should always trust in God without giving up especially when it comes to sickness.
They believe that God provided healing to those who are faithful in him what is observed in
Mike’s actions. In this case, Mike should not perceive the sickness of his child as a punishment
from God or test of his faith but should allow the procedure of kidney transplant to proceed and
should accept Samuel to donate one of his kidneys.
Conclusion
The case study has various ethical issues, which requires the contribution of the
physician, and both parents. My personal opinion is that I do not think whether it was the right
decision for the physician to allow James’s parent to take him away without having the kidney
dialysis. All the decision of mike all this time were wrong which led to further health
deterioration of their eight-year-old boy who ended up losing all his kidney. This time, the
physician and the parents should mutually work together for the better benefit of James’s health
condition.

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References
Ankeny, R., Jordens, C., Kerridge, I., Clifford, R., & Benson, R. (2018). Religious perspectives
on withdrawal of treatment from patients with multiple organ failure. Retrieved from
https://www.mja.com.au/journal/2005/183/11/religious-perspectives-withdrawal-treatment-
patients-multiple-organ-failure
Baumane-Vitolina, I., Cals, I., & Sumilo, E. (2016). Is Ethics Rational? Teleological,
Deontological and Virtue Ethics Theories Reconciled in the Context of Traditional
Economic Decision Making. Procedia Economics and Finance, 39, 108-114.
Christen, M., Ineichen, C., & Tanner, C. (2014). How “moral” are the principles of biomedical
ethics? – A cross-domain evaluation of the common morality hypothesis. BMC Medical
Ethics, 15(1).
Dein, S., & Cook, C. (2015). God put a thought into my mind: the charismatic Christian
experience of receiving communications from God. Mental Health, Religion &
Culture, 18(2), 97-113.
Denecke, K., Bamidis, P., Bond, C., Gabarron, E., Househ, M., Lau, A. Y. . . . Hansen, M.
(2015). Ethical Issues of Social Media Usage in Healthcare. IMIA Yearbook, 10(1), 137-147.
Entwistle, V., Carter, S., Cribb, A., & McCaffery, K. (2010). Supporting Patient Autonomy: The
Importance of Clinician-patient Relationships. Journal of General Internal Medicine, 25(7),
741-745.
Hickey, K., & Lyckholm, L. (2004). Child Welfare versus Parental Autonomy: Medical Ethics,
the Law, and Faith-Based Healing. Theoretical Medicine and Bioethics, 25(4), 265-276.

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Musto, L., Rodney, P., & Vanderheide, R. (2014). Toward interventions to address moral
distress. Nursing Ethics, 22(1), 91-102.