Case Study: End of Life Decisions

George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for amyotrophic lateral sclerosis (ALS), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS.

ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between 3 and 4 years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing.

George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound and be unable to move, eat, speak, or even breathe on his own.

In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia.

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Case Study: Death and Dying

Case Study: Death and Dying

In nursing practice, healthcare professionals encounter people from different cultures and demographic settings with contrasting beliefs and ideologies. For this reason, understanding diversity in everyday clinical practices is crucial for providers to administer quality care to patients. Besides improving the overall patient outcome, the knowledge of different expressions in faith and religious affiliation increases the awareness of the patient’s needs and preferences, creating a collaborative effort culminating in favorable diagnosis and treatment. Resultantly, this enhances patient satisfaction through effective communication. Nurses and other medical professionals must incorporate an individual’s understanding of their experience, society, and the world at large, alongside taking into account their religious affiliation. For this discussion, the paper aims to delve into the indispensable relationship between clinical practice and the Christian Worldview. Concisely, the essay focuses on the case study, End of Life Decisions, involving George, a successful attorney diagnosed with Amyotrophic Lateral Sclerosis (ALS). 

Christian Narrative: Emphasis on Fallenness of the World

On balance, George is diagnosed with Amyotrophic Lateral Sclerosis (ALS) and is left wondering what steps to take regarding his later life. In light of the Christian Narrative, much can be deduced regarding the patient’s condition, informing treatment. According to Bogue et al. (2020), numerous biblical notions inform the clinical practices, beginning from creation. The Christian Worldview dictates that when God created humans, they possessed no trace of decay, illness, or death. Humans were made immortal and in perfect health. However, when they disobeyed God and transgressed His Law, which was inclusive of health laws, they subjected themselves to diseases and death as the ultimate results.

Therefore, the Fallenness of humans from Holiness and Perfection is the cause of unnumbered disease experienced in the contemporary world. Based on Cherry’s (2018) explanations, George can interpret that his suffering is a result of sin and wickedness in the world. Markedly, the Christian Worldview emphasizes that sickness and disease are connected to sin, which results in suffering and eventually death. Therefore, when the first humans sinned against God, they alienated themselves from the source of their life and health. In that case, they could only experience disease and death. However, through His Love and Mercy, God provided a solution by sending Jesus Christ to die for the transgressions of all inhabitants of the world, thus offering a light of hope at the end of the tunnel.

Christian Narrative: Emphasis on Hope of Resurrection

Subsequently, the Christian Narrative interprets George’s situation by pinpointing the cause of his problem and provides a solution, even when the Christian comes to the edge of death. According to Brown & Al-Chalabi (2017), Amyotrophic Lateral Sclerosis is a non-reversible condition like many other illnesses such as Alzheimer’s disease. Often, many people experience such incurable conditions during their old age due to the human body’s deteriorating condition; this is as discussed by Pesut et al. (2020). Since humans are in a state of Fallenness, their health progressively declines as they grow older and older. However, based on the Christian Worldview, God in His great Love provided His Son’s sacrifices, Jesus, as a remedy to sin and death.

When Christ died on the cross, He instead took upon Himself the curse of Sin and Death, offering humans a better destiny. Henceforth, human beings were again connected to their only source of health and life through the sacrifice of Jesus Christ (Bogue et al. 2020). Regarding George’s suffering, although humans may succumb to death, there is hope for resurrection, besides the promise of receiving healing. Based on the same Christian Narrative, in giving His Son as a remedy for sin, God is said to have again purchased man from the slavery of Satan (Sinful Life). In doing so, human beings are required to accept God’s grace, which enables them to obey the Laws of God. Equally, they are required to live as temples of God’s Holy Spirit, who shall heal and restore their health. Therefore, through such submission, even though they suffer illness to the point of death, God offers hope for resurrection.Christian Worldview Informing the Value of Life

Human life, even from a general worldview perspective, is considered invaluable. The loss of an individual affects their friends and loved ones and has a significant impact on society and the complex web of humanity. In explaining the core values inculcated into nursing ethics, Butts & Rich (2019) believe that these values share a common fact regarding the value of human life. For instance, ethical values ranging from human dignity, honesty, altruism, social justice, and Integrity reflect both the nursing and Christian Worldview approach to the value of human life. Christians believe that human life in its simplicity is a precious gift from God, which should be treated with uncompromising respect (Bogue et al. 2020). Often, the doctrines on the sanctity of life teach that every individual is created in the image of God, and their lives must be respected and protected.

As George contemplates living with this condition (ALS), there are chances that he may be forced to weigh his value in society. In this case, he thinks he could be a burden to them that should take care of him. Notably, Gamble (2018) argues that because disease brings about discomfort, stress, and anxiety, George could be forced to contemplate Euthanasia as a possible treatment. However, from a Christian informed perspective, Euthanasia is classified as disregard of human life. Conferring to the Christian Worldview, humans must place their faith in God since they are His purchased property. Their free will is disqualified, but because they can do nothing to change their condition, unreserved surrender to God is paramount. With the same regard that God upholds human life, even to the extent of giving His Son to die and save, this informs George to disregard any choices that influence him to devalue his life or any other.

Values and Considerations in the Christian Worldview

Christian values like the nursing values advocate the priceless nature of human life. One of the most prominent yet indispensable values is Love. In the Bible, Love is expressed as the greatest commandment, which even governs the unfallen beings in heaven (Bogue et al. 2020). When Christ was pursuing His mission on earth, there are many instances where He insisted on the significance of inculcating the principle of Love in the life of a Christians. On one occasion, when approached with the most crucial commandment question, He emphasized that unreserved Love for God and unselfish Love for fellow human beings is the most acceptable and most outstanding value a Christian can express. Besides guiding the actions and practices of Christians, the principle of Love also inspires men and women to act from a pure and unselfish motive.

Successively, it such a motive that constraints Christians to esteem another’s life, thus disqualifying Euthanasia. Respect is another value of consideration. From the scriptures, God requires that Christians respect all people, granted that everyone is created equal and in His Image and Likeness. By living peacefully with all men, loving the brotherhood, fearing God, and honoring authorities, this principle dictates that all persons. Resultantly, opting for Euthanasia for George’s case is a violation of this principle and other Christian values. Honesty and Integrity are other values connected with valuing human life. Honesty requires that Christians avoid all forms of misinformation, deception, and lying. In that case, opting for Euthanasia means that George is not honest with himself, his family, and God. Honesty binds the Christian to remain faithful to the laws of God, which disqualifies mercy killing. Equally, it shows a lack of faith in God’s power to heal and restore. Like honesty, Integrity emphasizes the need to remain faithful to God’s promises while remaining congruent to His commandments. Such and more values inevitably argue against voluntary Euthanasia.

Christian Worldview and Moral Justification

Undoubtedly, the Christian Worldview aligns itself with every possible option intended to bring relief and offer the cure to George’s condition. The Christian Worldview’s understanding morally justifies options that tend to work for the benefit of enhancing his wellbeing. The fact that Amyotrophic Lateral Sclerosis has a cure does not validate Euthanasia as the only possible option (Cherry, 2018). Arguing on the Christian Worldview grounds, treatment options available congruent to the principles dictated by God can only thus be justified. In this case, one option morally justifiable is treatment through medications. For example, the Food and Drug Administration approves Riluzole (Rilutek) and Edaravone (Radicava) as treatment options that enhance life expectancy and reduce symptoms’ escalation. Such options are morally justified in the Christian Worldview. The practitioner can also prescribe medications to relieve symptoms such as fatigue, pain, depression, constipation, and sleep problems.

Similarly, therapy options such as breathing care are morally justified since they help patients in their regular breathing. Practitioners can provide George with an assistive device to aid their breathing, choose mechanical ventilation machines, or insert a tube in a surgery created at the front of the patient’s neck leading to the windpipe. Physical therapy is a justifiable option that practitioners can incorporate into George’s treatment to reduce pain, fatigue, and walking aid. Regular exercise also improves the sense of wellbeing, thus inspiring the patient to live longer. Assistive devices like ramps can be given to the patient to get around and reach the place when no assistant or caregiver is available.

Personal Decision: George’s Situation

Based on my worldview, George’s situation calls for critical decision making, informed by various aspects of life. As one with high regard for human life, I would opt for every available treatment option that could bring relief, help lead a good life, and extend life. Having been diagnosed with ALS does not necessarily imply that it is the end of life. On the contrary, owing to the continued advancement in technology, medical progress offers a light at the end of the road. Notably, with the doctor, family, and friends’ support, the journey can be manageable with the hope of providers discovering a cure.

Conclusion

 In conclusion, the relationship between clinical practice and the Christian Worldview perspective is crucial for providing better patient care. Focus particularly on the Case Study involving George. The essay has outlined the vitality of assimilating the Christian narrative into the diagnosis of Amyotrophic Lateral Sclerosis. With attention to the Christian Worldview, sin is considered as the causative of disease and illnesses. The Fallenness of the World, where the first human beings disobeyed God, disconnected them from the source of their health and life.

Further, despite the incurable nature of ALS, the Christian Worldview upholds the hope of resurrection, even when patients succumb to death. Not to mention, this view highly regards human life by adhering to values like Love, Integrity, and respect. In light of the above, the Christian Worldview disqualifies Euthanasia as the possible solution for a most incurable illness, even in this case for ALS. The Christian Worldview does not abrogate nursing ethics and clinical practices; instead, it hallows and provides a happy ending for both practitioners and patients.

Reference

Bogue, D., Hogan, M., White, N., Hoehner, P., Self, C., & Evans, K. (2020). Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care (1st Ed.). Phoenix: Grand Canyon University.

Brown, R. H., & Al-Chalabi, A. (2017). Amyotrophic lateral sclerosis. New England Journal of Medicine377(2), 162-172.

Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.

Cherry, M. J. (2018). Physician-assisted suicide and voluntary euthanasia: How not to die as a Christian.

Gamble, N. (2018). Can euthanasia be classified as a medically beneficial treatment? Ethics & Medicine: An International Journal of Bioethics34(2).

Pesut, B., Greig, M., Thorne, S., Storch, J., Burgess, M., Tishelman, C., & Janke, R. (2020). Nursing and euthanasia: A narrative review of the nursing ethics literature. Nursing ethics27(1), 152-167.

Sprung, C. L., Somerville, M. A., Radbruch, L., Collet, N. S., Duttge, G., Piva, J. P., … & Ely, E. W. (2018). Physician-assisted suicide and euthanasia: emerging issues from a global perspective. Journal of palliative care33(4), 197-203.