Reflection Paper Anon. Moral Reasoning and Worldview October 24, 2011 Summary This paper will summarize the Christian worldview perspective, while offering an overview of my own worldview; a Christian perspective with a spin I like to say. The ANA Code of Ethics, Provision 2 will be looked at in relation to an issue experienced in my personal practice and I will apply the Christian perspective as well as a Modern worldview perspective and explore how the application of each could affect the possible outcomes. Title of the Paper (Level 1)
As nurses we need to take into account each patient’s worldview perspective and support their views, even in the face of clinical evidence that that decision may not be feasible. Because each person carries their own worldview, one that is subjective, to impose our own view on them is to show disrespect for the nature of their being. Ethical behavior demands that although we may not agree with the perspective of the patient we are treating, we need to be cognizant of their view and honor their wishes even if it is in opposition to our own view, so long as it does not bring harm upon self or others.
The Christian Worldview Summarized According to Sire (2009), Prime Reality from a Christian perspective is, “the infinite, personal God revealed in the Holy Scriptures. ” (p. 28) Sire continues to explain in more detail that God is infinite, personal transcendent, omniscient, sovereign and good. J. Woodward, (http://www. sortingbeans. com) states that, “God, the really real, then remains propositional to the person believing. In spite of all this, the believing person continues in his belief and begins to align everything else alongside, or in contrast with, this propositional God. ” (n. d. If we are to understand the Christian worldview from Woodward’s point of philosophy, it would be that as Christians, our belief in God as infinite, personal, all knowing and loving is propositional and subjective. Woodward tells us that “God is a proposition taken by faith alone since no empirical evidence gives reason for faith in an eternal, almighty Creator. ” (n. d) The nature of the world around us consists of matter, according to the website Exploring Christianity. “The universe is the creation of this God and is dependent on him for its existence. It had a beginning and, in its present form, will have an end.
Matter is real and good. God himself shared in created human nature in the person of Jesus Christ. Though God maintains the created universe, he is distinct from it. He himself is beyond space and time. ” (n. d. ) According to Sire, “God created the cosmos ex nihilo,” (p. 31) out of nothing – he spoke it into existence. He created the cosmos “as a uniformity of cause and effect in an open system. ” (p. 31) Sire explains that the universe is orderly, without confusion. The universe is open to change based on our actions, such as pollution or conservation efforts.
Fundamental to Christianity is the idea that man was created in the image of God as is stated in Genesis 1:26 where it states, “Then God said, ‘Let us make mankind in our image, in our likeness, so that they may rule over the fish in the sea and the birds in the sky, over the livestock and all the wild animals, and over all the creatures that move along the ground. ’ “ (Genesis 1:26, New International Version) Being created in God’s image gives us a significant relationship with Him, allowing us to enter into a loving, personal relationship with Him.
Sire states, “each person reflects (as an image) the transcendence of God over his universe. ” (p. 33) The website Exploring Christianity states, “God has created humans “in his own likeness” with self-consciousness, freedom to make choices, moral accountability, intelligence, and spiritual qualities that enable us to relate personally to him. ”(n. d) Death is a difficult topic to broach, even as a Christian. We all wonder what happens when we die. This perception, or belief, varies even among Christians.
Most believe, as Sire tells us, that “death is either the gate to life with God and his people or the gate to eternal separation from the only thing that will ultimately fulfill human aspirations. ” (p. 41) B. A. Robinson with the group Ontario Consultants of Religious Tolerance (http://www. religioustolerance. org/chr_deat. htm), tells us that Roman Catholics believe there is Heaven and that, “Those few people whose ‘love for God has been perfected in this life’ have their bodies “glorified” and taken immediately to their eternal reward in Heaven.
Perhaps the Virgin Mary, the Apostles, the saints and some others will qualify for this path. ” Hell is reserved for those who “have committed a mortal sin which has not been forgiven, or have rejected God, then they are taken immediately to Hell where they will be tortured forever without any hope of relief or mercy. ” And finally, there is Purgatory. This is where a person goes “If the person dies in a state of grace, but loves God “imperfectly,” then their souls immediately enter Purgatory. Here, they suffer for a time in order to cleanse themselves of their accumulated imperfections, venial sins and faults.
Any mortal sins that they have committed, and for which they have been forgiven in the Sacrament of Penance, may have some residual temporal punishment still remaining; this has to be discharged as well. ” (2010) Mormons feel that there are levels of heaven a person can attain based on their religious belief and acts on earth. These beliefs are explained in detail on the website Mormon Beliefs (http://www. mormonbeliefs. org/mormon_beliefs/mormon-beliefs-the-plan-of-salvation/the-plan-of-salvation-the-degrees-of-glory). The Three Degrees of Glory, as discussed in mormonbeliefs. rg, are the Celestial Kingdom, Terrestrial Kingdom, and Telestial Kingdom. Those eligible for Celestial Glory are those Latter-day Saints who have been baptized, kept the commandments, and taken the Temple oaths, and have been sealed in the Temple to their spouse. The Terrestrial Kingdom is for those who “may have died without learning the laws of Christ. They are those who inherited spirit prison rather than spirit paradise in the Spirit World. They are those who were preached to in the Spirit World, and who, though they did not receive the testimony of Jesus while on earth, were willing to receive it in the Spirit World.
They are the honorable men of the earth, who were ‘blinded by the craftiness of men. ’ “(2011) The lowest of the three kingdoms, known as the Telestial Kingdom is reserved for “those who would not receive the gospel of Christ or the testimony of Jesus. But they have not denied the Holy Spirit, as those who are sent to ”outer darkness. ” Because they have chosen not to repent while on earth, there is some degree of suffering involved in the Spirit World before inheriting this kingdom. The people who inherit this kingdom will not be resurrected until Christ finishes His work, in other words, until the last resurrection.
Christ does not visit this kingdom. ” (2011) The final place a person can go, according to the Mormon faith is Outer Darkness. “This is the only kingdom without glory and is where the devil and his angels will be cast out to after the Millennium. The only people who will inherit this kingdom are those who commit the unpardonable sin, which is called “the sin against the Holy Ghost. ” The sin against the Holy Ghost is to have a perfect knowledge of Christ … and then to deny Him, crucifying Him anew. ” (2011) Author Randy Alcorn, in his book Heaven, tells us, “Heaven is not our default destination.
No one goes there automatically. Unless our sin problem is resolved, the only place we will go is our true default destination . . . Hell. ” (Alcorn, 2004, p. 23) As you can see, there are many versions of what will happen to a person after death. Ultimately the understanding of what happens after death it is left to a person’s faith. Woodward (http://www. sortingbeans. com) asserts “That God has created humans, that they are created in His image, it is therefore possible to obtain knowledge. ” (n. d) He also states, “God is the giver of the ethical law, but this ethical law can look quite different between persons.
Since belief is significant only to the person believing, it is subjective and holds no one else accountable to its suppositions other than the believing person. ” (n. d) Sire tells it this way, “… our sense of morality has been flawed by the Fall, and now we only brokenly reflect the truly good. Yet even in our moral relativity, we cannot get rid of the sense that some things are “right” or “natural” and others not. ” (p. 42) So perhaps knowing what is right or wrong is in a sense a spiritually programmed trait. “History is the divine purpose of God in concrete form,” Sire tells us. Sire, 2009, p. 43) Through history God shows his hand in the lives of his creation. Sire states that history is linear, non-reversible, non-repeatable and that history is directed toward a known end. “History is the result of those choices that, under the sovereignty of God, bring about God’s purpose for this world. ” (Sire,2009, p. 44) Christianity, in summary, believes God is the sovereign creator of all. Man was created in the image of God and therefore puts man in relationship with God. God has shown himself to humanity through history and through divine acts in bringing about his purposes.
Ultimately God wants his creation to return to live with him in eternal paradise, or Heaven. This was not possible due to the Fallen state of mankind, so God sent Jesus Christ to atone for the sin of man, making it possible for God and his creation to be reunited and share in a personal relationship. Personal Experience The ANA Code of Ethics, provision 2 states “The nurse’s primary commitment is to the patient, whether an individual, family, group, or community. ” (ANA Code of Ethics, 2010, provision 2) Sam came to my hospital with a diagnosis of Multiple Myeloma. He was a strong man in every sense of the word!
Physically sturdy and emotionally strong he was determined to win this battle. As time went on, his physical health declined, but his mental stability remained intact. There came a time in the progression of his disease that it was apparent he was not going to improve. He and I spent many hours talking about his feelings on life and death and what his final wishes were. He insisted on remaining a full code and told me, “Under NO circumstances, at ANY time do I want Hospice brought in. ” Sam’s wife Mary, sadly, is a very selfish, manipulative woman with her own agenda.
Things are done HER way, on HER terms without regard for how it affects anyone else, including her dying husband. I went with another nurse to visit Sam one day while he was a patient at another hospital. He was in a very poor state of health and had difficulty staying awake, or remembering much of what was happening around him. The doctor came into the room and started talking to me as if I were his wife. I stopped her and explained I was his nurse from another facility, but we’d come to check on him. She pulled me into the hall and told me that he had one week to live at best and that he needed to go to hospice.
I explained that his wishes had been all along to never have hospice care. The doctor stated, “He HAS to go! He is dying and won’t live out a week once we stop giving him blood products. ” She then said to me, “You need to go explain to him what he has to do. ” I was appalled! First, it troubled me that the doctor continued to talk to me when I had no rights to make any decisions. But to try to convince me to talk him into hospice when that was clearly not what he wanted disgusted me. I went back into the room. Sam asked me what had just happened.
I thought about it for a minute, contemplating whether or not I should tell him about the conversation. I said, “the doctor wants me to talk you into hospice. ” He opened his eyes and looked at me. “No hospice” he said. “I know. I told her that. ” He said, “don’t tell Mary. ” I agreed that I would keep it between us because we both knew that if Mary had any idea how bad it was she would call hospice. My commitment was to the patient first and foremost, as is set forth in Provision 2, and I honored his wish to not let anyone else know how bad he was or try to convince him to go to hospice.
Ironically, 6 weeks later, when he did finally pass, he was in the nursing home and had taken a turn for the worse. He was not responsive as far as anyone could tell, but I know that he knew what was going on. While sitting at his bedside, his wife made an appointment for hospice to come to the nursing home on Saturday at 2:30 p. m. Sam passed Saturday at 1p. m. , bypassing hospice. When I told the other nurses who had cared for him for the previous two years, who also knew his wishes, we laughed knowing he went on HIS terms, the same way he lived his life.
Worldviews Applied “Man is an autonomous body and soul, a genetic and chemical process. ” (Shelly & Miller, 2006, p. 65) Looking at Sam’s situation from a Modern point of view, where science is the basis of all knowledge, we might think that his being given one week to live, as the doctor had stated, was written in stone. All clinical signs pointed to his rapid demise. The physician was looking at his situation from a Modern perspective, but failed to consider the strength and power of the human spirit.
From a Christian perspective, all things happen in God’s time. He is able to perform miracles, heal the sick and bring comfort to those in need. If we are to look at this situation purely from a Modern standpoint, then we are dismissing the patient and his needs, desires and goals for a purely scientific process. In reading from the Psychiatric Bulletin, Laugharne “argues that the underlying philosophy of EBM (evidence based medicine – italics added) is modernist, because it assumes that medical interventions always can be rational and measurable. ” (1999, pp. 41-643) From a Christian perspective the patient is not viewed as a process, but rather as a divine creation, a reflection of God. Giving a person an allotted time to live is to question God’s divinity and power. Proverbs 18:14 says, “The human spirit can endure in sickness, but a crushed spirit who can bear? ” The WILL of a person to live, the belief in God’s power to heal can overcome odds that medical science cannot explain. Isaiah 55:8-9 says, “For my thoughts are not your thoughts, neither are your ways my ways,” declares the LORD. “As the heavens are higher than the