Nurses must be open to culture and various belief systems their patients possess and respect them. In this paper, I will analyze two different religions on world-wide principles and the case study of George provided. The two religions are Christianity and Buddhism. The paper will also discuss the differences raised by the two concerning religions and explain the worldview principle difference as well as the ethical advice on the analysis of George, a man who is developing a terminal illness that would result in severe suffering and death. According to Tackett, recovery and healing is said to occur at a faster rate if spirituality and medical are both integrated into the provision of care through the various worldviews (Tackett, 2016).Worldview Principles
Christian’s prime reality is God– the Creator who exists and is self-sufficient. There is both good and evil in the world. During the difficult situations, one will pray for strength; guidance is sought, and entrusts belief in God’s hands. God is omnipresent, and His presence surrounds each individual in the world. God is an eternal being who has the ability to restore and preserve all things. For those who are Buddhist, there is no external god. Their reality is more eternal; compounded as an impersonal being and be defined as a force, energy, or presence. External reality refers to the belief on how earth was created and the materials that surrounds human beings. Christianity sets forth the belief that God created the entire universe in seven days only with a purpose. Christians believe that there is a holy spirit that helps them make a connection to gods’ will for them, it is a guide to lead them when they seek it out and listen to the promptings.
Buddhism sets a belief that the world is of no value and they believe absconding this world to go to Nirvana is the principle of their purpose. Hawter described Buddhism as “much more of philosophy than it is a religion” (Hawter, 1995) because it explains a way of life or of being. The writer further summed up the path of a Buddhist as “to lead a moral life; to be mindful and aware of thoughts and actions; and to develop wisdom and understanding” (Hawter, 1995). The worldview principle shows that human beings can create purpose or just “be”. Buddhism follows a cycle of reincarnation and rebirth and is based essentially on the acts and behavior of a person that they commit or not in their present life. In Christianity, “human beings were created in the reflection of God with a purpose to spread the bible word of God to secure more souls for heaven” (Tackett, 2016). Whereas in Buddhism, human beings are one living with god, that is, can be achieved through meditation and negating worldly pleasure. “Buddhism follows the cycle of rebirth and reincarnation based on the individual’s behavior and deeds” (Hawter, 1995).
Considering George’s bill of health, and that he is in an incapacitated state where being able to move normally, speak eat and breath are affected, his level of autonomy is inhibited. He is not able to communicate his desires for treatment or against to proceed with euthanasia. This is revealed further when he fell and he was forced to seek medical attention. Although, George is incapitated, he is still able to see, touch, taste and even smell. For this reason, he knows that the significance of treatment options is just meant to reduce the degeneration of the disease only but with time the symptoms will come and ultimately will be bound to a wheelchair and permanent ventilator care to promote effective gas exchange.
The physician is faced with the dilemma of balancing patient autonomy and the principle of beneficence in this case; conflict exists between the two. Given that ALS malady has no treatment at this time, George’s family (as well as George’s) decisions will clash with those of the physicians’ obligation and advocacy for his overall health. The physician believes that it will be the beneficial course of action for George to be bound to a wheelchair, as well as being medically placed on a permanent ventilator to assist in ventilation and perfusion. However, George’s devastating condition compels him to think of euthanasia because he thinks that his conditions will cause further undue suffering in a permanent ventilator support due to the progressive deterioration of his illness; he considers not of any beneficence course of action to him.
Given that George’s conditions cannot allow him to express his decisions about his wish for euthanasia, he would be considered incompetent and will be unable to exercise autonomy. This rests a fundamental dilemma between the principles of beneficence and patient autonomy. The physician and George’s family (not including George) who is not able to execute his autonomy, may disagree about whether or not an action is truly beneficent. The physician is restricted to obligations which are beneficent to the patient to prevent more harm and to weigh and balance the best decisions against possible risks, as well as defending the persons with disabilities and incompetence.
In George’s case, the principle of nonmaleficence comes in where the physician is obliged to prevent more suffering of the patient, George. However, he has a conforming obligation not to cause more harm on the patient. George and his family believe that the treatment for the degenerative disease only slows down its progression and placing him a permanent support care would inflict more suffering on George. On the other hand, the physician believes it is his obligation to put him on a ventilator so as to reduce pain and prevent further harm. The dilemma here is in regards to the physician; to either initiate or withhold certain treatments that would be beneficial to George and his family while acting immorally in assisted euthanasia.
Religious Interpretation of George’s Illness and Suffering
Christian’s belief that illness and suffering are God’s plan to test one’s faith towards him. During hard times, Christians pray to God to end their suffering and undeniably God answers their prayers. According to Christianity religion, “through sickness and suffering, God reveals to us his intentions through manifestation, to teach some lesson in our lives” (Tackett, 2016). Through sickness, individual’s get to understand God’s mystery and endless wonders when we are healed in His grace. Christians have a strong faith in God because with God’s presents everything is possible and they value their relationship with God since through constant prayers, God gives guidance on the challenges and difficulties humans face in their daily lives.
For Buddhism, physical suffering is an inevitable and one should not mitigate pain through available medical intervention but rather individual suffering should admit and mindfully endure it. Like few other religions, Buddhists believe that sickness and woe is an unavoidable part of life; that illness is destined to produce some degree of distress, emotionally and mentally. According to Hawter, it is believed that “problems or illnesses are like clouds that block the sun, they are temporary and can be removed from the mind by eliminating negative thoughts and replacing them with positive thoughts” (Hawter, 1995). Buddhists believe in the power of karma; with any wrong-doing, can result in negative event within their lives. Within the Buddhist religion, physical pain and illness “provides an occurrence for the cultivation of healthy and mental states including forbearance and patience” (Hawter, 1995) thus it is not illness, but our response which has spiritual value. In Buddha’s teachings, self-mortification and ill-treatment of either the body or mind is condemned, however one should seek meditation techniques to inhibit and address physical and mental sickness.
Values and Considerations
George is contemplating about the future, fearing that he would be losing is dignity and power due progressive ALS symptoms which is a terminal disease. With the thought of an imminent end, most people would experience similar thoughts as George; ending his life before it becomes worse. Christian religion believes that individual dignity is a sacred gift from God, and dignity of life which is rooted in God’s creation. From Christian worldview perspective, life is an exceptional gift from God and it belongs to Him. Therefore, no human has the autonomy over their personal lives instead they are stewards of the life given during the God creation. “The Christian bible teaches that physical death is undeniable for all humans” (Tackett, 2016). Normally, dying process is accompanied by sickness, suffering and pain. During this process people may seek to eliminate end-of-life suffering through euthanasia. Christianity proclaims that no one is allowed to kill or take his own life; “You shall not kill”- Gen.2. Similar with the intent to kill one-self by means of suicide, or even suicidal ideation. Christians are totally against any form euthanasia but under reasonable circumstance it is thought that a person should be allowed to die if there are reasonable risks of recovery and improvement of the quality of life.
Given the diagnosis of ALS, George’s health will deteriorate progressively with time. Ultimately, his ability to move independently will be gone due to degeneration within the nervous system. Opting for euthanasia because of fear of a socioeconomic dependence of others, along with a physical, emotional and spiritual dependence is an unacceptable outlet from a Buddhist standpoint. Though, euthanasia is seen to end suffering in the case of George’s condition, the Buddhist religion respect the life value of George and view grief as a test of his faith.
As a christian nurse, I do believe that it is our duty as health care professionals should educate and advocate for our patients well being, and help to comfort them through modern equipment and medicine. George’s decision is not only final, but would also have a great impact on his family (and himself) for the rest of time. As Christians, it is important to respect God’s will and treat our bodies with dignity and allow health care providers to assess and treat our concerns/needs. I believe it is vital to foster trust and understanding; nurses should not allow their views or beliefs supersede those of the patients by respecting their religion and beliefs.