Nursing Assessment of Patients' Spiritual Needs: Respect & Autonomy - Essay Sample

Introduction

With the growth of family medicine, nurses face diverse topics in their encounters with different patients, ranging from economic issues, spiritual beliefs and many more. The process of nursing applies to the needs of spirit as well as body and mind. There are several guidelines set on the assessment of a patient's spiritual need.

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Based on the principle of Autonomy, the attending physician is required to respect the patient's right to make their own decisions regarding their treatment and wellbeing. This means that the attending physician cannot make decisions on a patient's treatment without his or a legal guardian's, informed consent. The principle further explains that for permission to be informed the attending physician must be competent enough, thereby be able to understand the consequences of their approval and ready to make that decision freely (Highfield, 1992). The patient should also be able to understand the effects of the treatment about their health, values, lifestyle, religious beliefs and all other factors tied to their consent.

In the case of Mike and Joanne, the physician could not stop Mike from making such decision for the following reasons; First, Mike and Joanne had the right to make their own decisions regarding James' treatment, and that was to be respected by the attending physician. Secondly, they were competent enough to understand the risks involved and the consequences of their decisions. Thirdly they were able to make their decision freely without undue influence (Soeken & Carson, 1987). Lastly, the fact that Mike's values are different from those of the practicing physician does not prove in any way that Mike was incompetent.

However, the Autonomy principle gives the attending physician the right to recommend what they think to be the most optimal option and is free to persuade them, without pressuring, of these options.

Christianity is no doubt the most popular religion in the world, with diverse representation, beliefs, and practices (Galek, Flannelly, Vane, & Galek, 2005). Although some Christian churches may have different views on various sensitive matters, such as sickness and health, and medical intervention, they still share one faith that is based on the life and teachings of Jesus Christ. The Bible continually reminds Christians that confidence is key, as depicted in the book of Mark 11:23 where Jesus tells his disciples that faith can move a mountain. This explains Mike's decision to take James to the faith healing service instead of putting him through dialysis. However, Most verses in the Old Testament, such as the story of the ten plagues sent to the Egyptians, stated that sickness was used as a form of punishment due to lack of faith or obedience to God whereas health was a form of blessing due to compliance and trust (Highfield, 1992). This also justifies why Mike felt like he was being punished for not having enough faith.

Christians should know what Christianity is about; that is, it generally focuses on the importance of the well-being of an individual. They ought to know that Healthy practice, in turn, improves their spiritual, physical and mental well-being. They should be able to understand that Christian values and practices indirectly affect health and sickness by influencing their health behaviors, social relations and psychological states, which in turn change their physical state. Because of religion influences health, they act in an indirect way on health.

Christians depend on God's teaching when making most of their decisions, even on matters of health and medical treatment. In The Bible, there is no verse forbidding medical intervention in any direct way. It is stated that Luke, the Evangelist, was referred to as a physician. Due to the current diversity of Christianity, different churches have different view and teachings on medical intervention. For instance, new churches such as the Christian Science movement teach that illness is but a mental illusion that could be cured with prayers and right thinking. In the Bible, Jesus heals an epileptic boy by casting out an evil spirit, Mark 9:14-29. It is evident that the text does not directly or indirectly forbid or promote medical intervention (Galek et al., 2005). Different religions have different views and exceptions for therapeutic intervention. The Catholic Church, for instance, views life as transitory and needs not to be sustained by all means possible, hence not supporting the use of life support.

Furthermore, it teaches that the duties of a faithful can shift from that of avoiding death to that of providing comfort and hope as death approaches as a Christian one has to understand that they have the right to choose whether or not to seek medical health and that their consent will always be respected. That, much as they should base their decision on their religious teaching, the decision should be at the best interest of the patient.

Mike should, therefore, take into account his responsibility as a parent to James, his duty as a Christian and a faithful to God and the available treatment options as presented by the attending physician and make an informed consent that is of the best interest to Him, his sons, and family at large.

The principle of beneficence entails doing well or that which will further the patient's well-being. The Non-maleficence principle, on the other hand, involves avoiding causing harm to the patient or that which is against their interests (Highfield, 1992). By not putting James through dialysis as advised by the doctor, Mike and Joanne had violated the Non-maleficence principle by causing more harm to James. He now finds himself at a crossroad where on the one hand, based on the beneficence principle, he has the responsibility to do good for James by consenting to the kidney transplant between the twins. On the other hand, based on the Non-maleficence principle, he has the responsibility of not causing harm to his son Samuel.

Faith is based on complete trust in someone or something. This means that Mike trusts in his God enough to the point of taking James to a spiritual healing service (Soeken & Carson, 1987). Christianity as religion brings people together by connecting them through faith and teachings, making them share common values. The willingness of some of the church members to offer to donate a kidney to James shows the social impact of religion in society. Through his faith, Mike has a greater chance of upholding the beneficence and non-maleficence principle and still find a kidney for James.

Before conducting a spiritual assessment, it is advised that the physician should consider the patient's faith, attitude towards religion, beliefs and religious practices. This helps them understand the patient spiritual needs and support needed. After determining the spiritual needs, the attending physician may include the results of the patient's care (Galek et al., 2005).

Just by listening to the patient the physician shows that he cares about James' spirituality and that he understands the weight of the decision Mike has to make. Listening may be the support that Mike needed. The information gathered may be of great use to the physician when readdressing the subject in the future, which will be useful in future treatment plans or a case of a crisis. The attending physician will also be able to make advice Mike on how some Christian practices, such as fasting could affect James conditions either positively or negatively thereby making treatment option better. In a case where the physician may share the same faith with Mike, the offering of faith specific advice will be of great help to James' treatment.

Conclusion

In conclusion, the principles of biomedical ethics are highly dependent on the ability of both parties to converse about the needs and desires of the patient. They are structured to guide the conversation to find the right treatment options for the patient in question.

References

Galek, K., Flannelly, K. J., Vane, A., & Galek, R. M. (2005). Assessing a patient's spiritual needs: a comprehensive instrument. Holistic Nursing Practice, 19(2), 62-69. Retrieved from https://journals.lww.com/hnpjournal/Abstract/2005/03000/Assessing_a_Patient_s_Spiritual_Needs__A.6.aspx

Highfield, M. F. (1992). Spiritual health of oncology patients. Nurse and patient perspectives. Cancer Nursing, 15(1), 1-8. Retrieved from https://europepmc.org/abstract/med/1544127

Soeken, K. L., & Carson, V. J. (1987). Responding to the spiritual needs of the chronically ill. The Nursing Clinics of North America, 22(3), 603-611. Retrieved from https://europepmc.org/abstract/med/3649794