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In their book, Called to Care: A Christian Worldview of Nursing, Shelly and Miller discuss what it means to be human and elaborates on the descriiption of who we are and possibly what we see in our patients. Spirituality and Culture are defined as part of who the patient is and are foundations for the decisions they make and can, in part, play a role in the ethical decisions we face as healthcare providers. PART 1: Extrapolate two different concepts, one from chapter 4 and one from chapter 5 or 6. Discuss them as they apply to the patient and how it affects personal healthcare decisions. PART 2: Apply this discussion to ONE of the patient scenarios listed down below: What are your thoughts? Christian struggles? How can Culture and Spirituality play a role in the ethical decisions we face with any of these scenarios. What Christian ethics and medical ethics are in conflict here?
Patient Scenario #3: A 34-year-old female, “Sally,” comes to the homeless clinic you volunteer for. She keeps to herself and doesn’t exchange pleasantries with others except for a few short words. She has type 2 diabetes, which is not very well controlled (last A1C was 8.5% approximately six months ago). She is overweight, and appears partially unkempt. She reports an address as a close relative that she lives with, but reports she is out on her own most of the time (homeless), doing what she can to get by. She walks to her appointments and her diet is irregular. Must have Bible quotes.
She is here today for follow up and is requesting medication refills for raltegravir and maraviroc, which you recognize as HIV medications. Her history reveals she has been HIV + for the past 3 years. She has a history of drug use and remains sexually active, “doing what she needs to do” in order to obtain drugs or drug money. People have tried to help her in the past with finding jobs or places to stay, but she does not maintain it very long. When others have tried to talk to her about using protection, she indicates she is not interested and becomes very belligerent about it. You notice her befriending a new visitor to the clinic who is another patient, “Bob”. Bob is someone who visits the clinic in need of assistance, but he sees another provider. Your concern is for both Sally and Bob and the ability to be involved in a health relationship and what Sally may be intending (Unprotected intercourse with Bob). (Guidance: Students who have chosen this scenario in the past have discussed the legal components of this scenario. These will also play a part, but I would like for us to focus on the ethical issues related to this course if we can).
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