Nursing Case Study: Bioethics in Christian Narrative and Patient Care

This case study analyzes the ethical dilemmas presented in the case of James, a patient with acute glomerulonephritis, and his parents' reliance on faith healing over medical treatment. The paper explores the conflict between Christian values and bioethics, focusing on issues of treatment refusal, patient autonomy, and organ donation. It examines the physician's perspective on intervening in the parents' decisions, highlighting the importance of beneficence in patient care. The case study also delves into the Christian narrative surrounding sickness, health, and the acceptance of medical interventions, including organ donation. The analysis concludes that while patient autonomy should be respected, healthcare professionals have a legal obligation to prioritize patient beneficence, especially in life-threatening situations.

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Introduction:
In the field of health, bioethics often comes up against religion leading to challenging
situations where life of a patients is threatened because of sacred and secular values (De Vries,
2015). This paper takes uses the case study ‘Biomedical ethics in the Christian Narrative’ to
understand how Christian vision and bioethics can challenge medical decisions and life of a
patient. Through the analysis of the medical condition of James, who is in need of dialysis
because of acute glomerulonephritis and fluid build-up, the paper gives an insight into the most
pressing issues in the case study and evaluates whether the physician should allow Mike, Jame’s
father to continue making irrational decisions. The case study will be analysed according to
Christian narrative and issues related to patient autonomy and treatment refusal. The decision of
Mike as a Christian will be explored too.
Pressing issues:
The case study is about James, who is suffering from acute glomerulonephritis kidney
failure. The key issues that has been found in the case study is that despite physician’s
suggestion of immediate dialysis for Mr. James, James’s parents Mike and Joanne decided to
forego the dialysis and put their faith on God for her son’s recovery. They relied on a sermon by
the pastor by which they were convinced that their son will regain fitness and health. Hence, the
issues identified in the case study are the dependence on Christian vision and values to go against
medical decisions. The parents in the case study relied on spiritual healing and faith healing so to
achieve recovery from health and deny medical treatment. According to the Christian narrative,
there is a belief God cares about their sufferings and only they can prevent them from sufferings.
This value lead many people to avoid medical treatment and refuse prescribed treatment for

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patients (McTavish, 2016). There are too dilemma associated with the decision. Firstly, adhering
with the values of spiritual healing preserve spiritual values of an individual. However, it
interferes with the medical ethics of patient’s beneficence. If reliance om religious treatment
prevents death, then it protects child’s health and future autonomies. However, religious values
and dependence on spiritual healing also increases the challenges of patient harm and confusion
regarding medical decisions and the duty to provide medical treatments (Committee on
Bioethics, 2013). All these pressing issues have been confronted by the Jame’s parent and the
physician too. As situations of conflict between health care and spiritual beliefs illegitimizes
practice, critically analyzing the ethics and risk associated with such decisions are important.
Physician’s perspective:
Although James required immediate dialysis, however Mike went with the decision to
visiting faith healing services. The problem emerging after this decision was that Jame’s kidney
deteriorated and instead of temporary dialysis, now he was in need to kidney transplant. As Mike
is still having dilemma whether he should lose a kidney of his identical twin Samuels or wait for
God’s miracle, there is a need for the physician to intervene now. The physician should not allow
Mike to continue making irrational and harmful decisions for James. This is because according
to medical ethics, it is the duty of Mike to take actions that promote good of patients and prevent
patient from any harm which is known as beneficence in bioethics (Lee, 2017). Hence, the belief
of expecting God’s miracle is irrational from the perspective of medical science and as part of
ethical duty towards patient, it is necessary for the physician to explain Mike regarding the risk
associated with the decision. Although according to patient autonomy, it might be difficult for
the physician to completely convince Mike. However, as beneficence is superior to autonomy in

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the context of patient’s life, it is essential that the physicians advocate for the health and safety of
James.
The need for the physician to prevent Mike from taking any irrational decision also
emerge because of the professional obligating of providing positive benefits to patient and
preventing any harm during the care of patients. Although in other situations, preference is given
to patient’s autonomy in place of beneficence, however in situations where a decision would lead
to death of patient, it is necessary that the physicians and other involves parties take active
interest in the deliberation of the controversial issues (Mawere, 2012).
Christian narrative:
The critical review of the case study suggests that the medical decision for James is
linked to the topic of treatment refusal, patient autonomy and organ donation. There are many
patients who refuse treatment on ground of religion. From the Christianity perspective, treatment
refusal is not wrong as it allows them to exercise their religious values and establish a connect
with God. Based on Christian, there is a belief that death was not originally intended for
humanity. It was defeated by Jesus Christ and the event of dying will follow by the judgment of
God (Lobo et al., 2017). This belief motivates many Christians to refuse treatment and favour’s
God course of action on death and life. Treatment refusal is right according to this perspective.
Patient autonomy and the power to take decisions is favoured by health care consumers.
From the Christian perspective, there is a perspective that God does not makes any individual
independent and no one should act in isolation. Hence, it supports that any decisions should not
be taken alone. Instead, there is a need to take account of the needs when taking decision.

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Therefore, autonomy is supported in Christianity based on relational dynamic. Therefore, they
may accept a decision on autonomy based on moral accountability.
Another topic that has emerged from the issue presented in the case study is related to
organ donation. The controversy surrounding organ donation in the case study is that Mike needs
to endanger health of his other son or find other compatible donor who could donate kidney to
James. From the Christian perspective, organ donation is seen as positive thing as Christianity is
based on the theme of sacrifice and helping others (Muñoz, 2018). Hence, there is a likelihood
that Mike may allow Samuel to donate organ based on religious value that organ donation is an
act of love.
Treatment refusal:
From the analysis of topic, it can be said that Christian think about sickness and health as
part of God’s will to cause suffering or protect an individual. Mike as a Christian can take the
decision of allowing Samuel to donate his kidney to James. This is because organ donation is
viewed as an act of kindness in Christianity. Hence, he would love his son to engage in an act of
good and save his other son from sufferings too. This decision will not cause any conflict too
because it would minimize risk for his son and not cause any religious conflict too.
Conclusion:
To conclude, the paper gave an overview about the conflict between treatment refusal and
bioethics on ground on Christianity values and narratives. The analysis of case study raised the
topic of organ donation, treatment refusal, spirituality and patient autonomy. The conclusion
from the paper is that although patient autonomy should be respected in medical care, however

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there is a need for health care professionals to fulfil their legal obligation of patient beneficence
as it can save lives of patient in critical situation.

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References:
Committee on Bioethics. (2013). Conflicts between religious or spiritual beliefs and pediatric
care: informed refusal, exemptions, and public funding. Pediatrics, 132(5), 962-965.
De Vries, R. (2015). Good Without God: Bioethics and the Sacred. Society, 52(5), 438-447.
Lee, L. M. (2017). A bridge back to the future: Public health ethics, bioethics, and environmental
ethics. The American Journal of Bioethics, 17(9), 5-12.
Lobo, S. M., De Simoni, F. H., Jakob, S. M., Estella, A., Vadi, S., Bluethgen, A., ... & Vincent,
J. L. (2017). Decision-making on withholding or withdrawing life support in the ICU: a
worldwide perspective. Chest, 152(2), 321-329.
Mawere, M. (2012). Critical reflections on the principle of beneficence in biomedicine. Pan
African Medical Journal, 11(1).
McTavish, F. J. (2016). Suffering, death, and eternal life. The Linacre Quarterly, 83(2), 134-141.
Muñoz, M. G. (2018). Christian bioethics, brain death, and vital organ donation. Christian
bioethics: Non-Ecumenical Studies in Medical Morality, 24(1), 79-94.