Religion and Spiritual Care in Pediatric Intensive Care Unit

Introduction

Contradictions arising among participants in the treatment process may cause dangerous consequences. As an example, the case of James, a boy suffering from chronic kidney disease, will be considered. His parents deliberately slow the course of treatment and count on God’s help in healing; however, despite their belief, the child feels bad, and the need for kidney transplantation becomes inevitable. Nevertheless, even in this case, the boy’s father intends to seek help from a local pastor to save the child. Despite the doctors’ assurance of the surgery urgency and the possibility of intervening due to the presence of a donor organ from James’s twin brother, the parents are in no hurry to give their consent. Such a commitment to religious beliefs is contrary to medical prescriptions, and the deliberate abandonment of physicians’ help is fraught with fatal consequences for the sick child.

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Issues under the Christian Vision

When considering this case from the perspective of the Christian vision, the issues of disagreement among the parents of the child and medical specialists relate primarily to doubts about faith. Despite the doctors’ assurances of the need for medical care, James’s parents are ready to entrust the child to the hands of the pastor who heals even hopelessly sick people. In this case, the position of the father and mother can be explained by a strong faith in the God’s power and mercy. That is why they are afraid to agree to surgery and expect to prove their faith, relying on prayers. However, even from the standpoint of Christianity, such blind worship is not correct. Zuzak et al. (2016) in their study note that “3 of 15 parents indicated seeking alternative treatments, two parents indicated religious reasons for treatment refusal” (p. 1801). This ratio is frightening and alarming, and in the case of James, it is the Christian beliefs of the parents that do not give the boy a chance to receive appropriate help.

According to religion, a person should not give up the help of others if it does not contradict God’s commandments and can help to recover. The father and mother of the boy refer to the need for treatment as something that can make them doubt their faith. However, these beliefs are groundless, and along with prayers, the child can also rely on the help of physicians. Therefore, these issues related to religion are the most pressing in the case described.

Physician’s Position

Despite the fact that the boy’s parents have the right to decide on the hospitalization of their son independently, James’s attending physician faces a serious ethical problem. On the one hand, he cannot prohibit adherence to faith in God and seek help from the pastor purposefully. However, on the other hand, the duty of the doctor is to inform the parents about the need for emergency measures and potentially dangerous consequences in case of the non-observance of medical prescriptions. Even though Winters (2018) argues that “disagreements between parents and medical providers about proposed treatments can usually be avoided or reconciled via thoughtful communication,” the case demonstrates the inability to reach a consensus (p. 20). Therefore, this issue requires finding an opportunity to convince the parents to reconsider their views.

No doctor can allow parents to kill their child, even not intentionally, while ignoring medical advice and recommendations. It applies not only to professional but also ethical issues. Therefore, the physician should not stop trying to persuade James’s parents to agree to an operation and allow them to save their son. Otherwise, it is likely that the medical staff of the clinic will be punished for inaction in relation to the patient, and it will be difficult to prove that the parents refused to provide all the necessary assistance. Consequently, persuading is necessary to prevent the death of the boy and, at the same time, to save the reputation of the medical institution.

Correlation Between the Christian Narrative and Treatment Peculiarities

While taking into account the Christian vision and the practical position of doctors regarding the urgent need to help the sick child, the case can be interpreted in favor of emergency medical care. As Gillam (2016) argues, parents’ refusal of treatment “may well be influenced by their religious views,” but it is not to concern the child who is not able to make a conscious choice and is forced to rely solely on the will of adults (p. 6). It may be noted that the correlation between the Christian narrative and treatment peculiarities exists; however, one position cannot deny another, and all the actions should be directed primarily to the benefit of the boy.

The urgent need for kidney transplantation is proven scientifically, and the main discussion that the parents will have to face is whether they are willing to sacrifice the organ of James’s brother in order to save the other child. The analysis of this case may be based on the concepts of morality and religion, but the health of children should certainly be a key and determining factor. Therefore, having the data presented, preference should be given to doctors who fight for the life of the boy and are not ready to entrust care to parents.

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Recommendation Regarding the Case

Referring to the auxiliary readings, it can be noted that, despite the belief in God, Christians should not neglect doctors’ engagement and refuse the possibility of their assistance. As a believer, James’s father should agree to help his child and possibly sacrifice the other son’s kidney. Otherwise, he and his wife may lose the child, which will be a tragedy both from an ethical and religious point of view. Turning to God, he should not deny the possibility of medical intervention, taking into account that it may be the only way to help James. Therefore, contrary to their conviction, the parents should agree to an operation in order not to suffer in the future.

Decisions in favor of religion instead of medicine are a frequent phenomenon, as Arutyunyan, Odetola, Swieringa, and Niedner (2018) remark. In their research, “62% of those who identified themselves as moderate to very spiritual or religious stated that their beliefs influenced the decisions they made about their child’s medical care” (Arutyunyan et al., 2018, p. 28). Contrary to personal beliefs, medical assistance can be the only way to restore the boy’s health, and his parents should accept this fact with hope.

Conclusion

The deliberate denial of doctors’ prescriptions in favor of religious beliefs may be fraught with dangerous health consequences, and the case of James’s family is the proof of this assumption. Even in the context of Christianity, faith does not prohibit seeking help from other people for the good of the child. The parents of the boy can lose their son if they adhere to a religious position exclusively and count on a miracle. The ethical side of the issue for the child’s attending physician prohibits him from stopping attempts to convince parents to agree to an operation; therefore, the efforts made by medical specialists are justified.

References

Arutyunyan, T., Odetola, F., Swieringa, R., & Niedner, M. (2018). Religion and spiritual care in pediatric intensive care unit: Parental attitudes regarding physician spiritual and religious inquiry. American Journal of Hospice and Palliative Medicine, 35(1), 28-33. Web.

Gillam, L. (2016). The zone of parental discretion: An ethical tool for dealing with disagreement between parents and doctors about medical treatment for a child. Clinical Ethics, 11(1), 1-8. Web.

Winters, J. P. (2018). When parents refuse: Resolving entrenched disagreements between parents and clinicians in situations of uncertainty and complexity. The American Journal of Bioethics, 18(8), 20-31. Web.

Zuzak, T. J., Kameda, G., Schütze, T., Kaatsch, P., Seifert, G., Bailey, R., & Längler, A. (2016). Contributing factors and outcomes of treatment refusal in pediatric oncology in Germany. Pediatric Blood & Cancer, 63(10), 1800-1805. Web.

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