Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study? Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study? Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

Medical Indications: Beneficence and Nonmaleficence

James, an eight-year-old boy, was accepted to a medical facility with kidney failure and elevated blood pressure. The condition was acute enough to suggest immediate dialysis as a temporary measure. The boy’s parents decided to forego the treatment, and the patient was let go. After two days, James was readmitted to the facility as his kidneys deteriorated. He was put on dialysis that was no longer a temporary measure. The family was informed that the boy needed a kidney transplant within a year, and the only tissue match was his identical twin, Samuel.

Patient Preferences: Autonomy

The patient’s preferences were expressed by the boy’s parents and included several crucial points. First, Mike and Joanne decided to forego the dialyzes, causing the deterioration of the boys’ condition. Second, they preferred that either Mike’s or Joanne’s kidney was transplanted, but none of them were matches. Third, they were forced to decide if they wanted Samuel, their second son, to donate a kidney to his brother. In short, the patients were given the autonomy to balance their beliefs with the recommendations provided by physicians.

Quality of Life: Beneficence, Nonmaleficence, Autonomy

The condition described in the case scenario has implications for James’s and possibly Samuel’s quality of life. First, James is forced to go through occasional dialysis to ensure the stability of his condition. Second, James is required to have a kidney transplant, which will result in standard limitations in eating and physical activity before and after the surgery. Additionally, James and Samuel, if Mike and Joanne decide so, will have to live with one kidney. Even though it is generally considered that living the condition does not have considerable implications, Schreuder (2017) states that living with one kidney can lead to “lead to renal injury with hypertension and albuminuria” (p. 596). In short, the situation has two clear implications for the twin’s quality of life.

Contextual Features: Justice and Fairness

The contextual features described in the case include three aspects. On the one hand, the patient’s parents are Christians and strongly believe in healing by prayer. This fact has led to the deterioration of James’s condition and can influence Mike and Joanne’s decision about kidney transplantation. Second, James has a twin brother who is the ideal match for being a donor. Additionally, even though not mentioned in the scenario, the cost of intensive therapy, dialysis sessions, and possible surgery are not insignificant and may influence the parents’ decisions. In summary, the contextual features influence the patient’s condition both positively and negatively.