PHI-413V Topic 5 Benchmark: Patient’s Spiritual Needs Case Analysis (Grand Canyon University)

Analyze the “Healing and Autonomy” case through the four principles of principlism and the Christian worldview, then propose a spiritual needs assessment for the family. The assignment carries benchmark weight in GCU’s RN-to-BSN sequence and requires three structured sections with fixed word ranges.

Assessment Context

Grand Canyon University runs PHI-413V Ethical and Spiritual Decision Making in Health Care as a required course in the RN-to-BSN program and in several allied health pathways. Topic 5 carries the benchmark designation, which means the submission is scored against a program competency rather than a single course rubric. The case presents Mike, a Christian father whose eight-year-old son James has kidney failure. Mike delays dialysis to pursue spiritual healing, and James’s condition worsens. Students apply the four principles of principlism, developed by Beauchamp and Childress, alongside the Christian narrative of sickness, health, and medical intervention. The deliverable uses three sections with prescribed word ranges: 200 to 250 words on autonomy, 400 to 500 words on the Christian worldview, and 200 to 250 words proposing a spiritual needs assessment. APA 7th edition governs citations, and the submission closes in the GCU LMS at the end of Topic 5.

Learning Outcomes

Completing this benchmark allows students to:

• Apply all four principles of principlism (autonomy, beneficence, nonmaleficence, justice) to a pediatric case involving parental faith-based decision-making.
• State and defend a position on whether the physician should honor Mike’s autonomy or intervene to protect James’s welfare.
• Integrate specific Scripture references into an argument about sickness, medical intervention, and Christian stewardship.
• Propose a structured spiritual needs assessment tool that transforms clinician-parent conflict into shared decision-making.
• Document sources in APA 7th edition and meet prescribed word ranges without padding or omission.

Task Instructions

Address three sections in order. Use the “Healing and Autonomy” case as the basis for every response.

Section 1: Autonomy Analysis (200 to 250 words)

Respond to the following question: Should the physician allow Mike to continue making decisions that appear irrational and harmful to James, or would that constitute disrespect for patient autonomy? State a clear position and defend it with the principle of respect for autonomy as Beauchamp and Childress define it. Acknowledge the tension between Mike’s decisional authority as legal guardian and James’s welfare. Explain what the physician should do in practice, not only what the principle permits in theory.

Section 2: Christian Worldview (400 to 500 words)

Address three sub-questions with specific Scripture references:

1. How should a Christian think about sickness and health?
2. How should a Christian think about medical intervention?
3. What should Mike do as a Christian?

Frame sickness within the creation-fall-redemption narrative rather than treating it as individual punishment. Connect the body as temple (1 Corinthians 6:19–20) to a stewardship obligation. Cite biblical examples of God working through medical means, such as Isaiah’s poultice for Hezekiah (2 Kings 20:7) and Jesus’s affirmation of physicians (Mark 2:17). Argue whether faith and medicine are mutually exclusive or integrated. This section carries the most weight, so develop the theological reasoning rather than listing verses.

Section 3: Spiritual Needs Assessment (200 to 250 words)

Propose a structured tool the physician can use to understand Mike’s beliefs and identify common ground. Name the tool, explain how it works, and state what it would reveal in this case. The FICA Spiritual History (Faith, Importance, Community, Address) is an acceptable choice, as are comparable instruments. Explain how the assessment changes the clinician-parent dynamic and how it supports James’s holistic care. Identify at least one concrete intervention the care team could implement after the assessment.

Marking Criteria

The benchmark rubric rewards depth of ethical analysis, quality of theological engagement, and adherence to the prescribed structure.

• Autonomy position: A clear stance is stated and defended with principlist reasoning. The response distinguishes parental authority from the child’s welfare without collapsing one into the other.
• Christian worldview integration: Scripture references are specific and tied to the argument. Sickness is framed within the fall rather than as punishment. The relationship between faith and medical intervention is argued, not assumed.
• Spiritual needs assessment: A named tool is described accurately. The proposal explains what the tool reveals and how it changes clinical practice.
• Use of all four principles: Beneficence, nonmaleficence, and justice appear alongside autonomy, and each is applied to case facts rather than defined abstractly.
• Word range compliance: Each section falls within its prescribed range. Substantial overage or underage signals a structural problem.
• APA documentation: In-text citations and references follow APA 7th edition. Scripture is cited by book, chapter, and verse.

Example Student Response

Mike holds decisional authority as James’s legal guardian, and the principle of respect for autonomy obligates the physician to take that authority seriously. Autonomy is not unlimited, however, especially when the patient is a child who cannot consent independently and when delay produces measurable harm. James’s worsening condition establishes a threshold at which parental discretion yields to the child’s interest in life-sustaining care. The physician should not override Mike unilaterally; the better course is structured engagement that honors Mike’s faith while communicating urgency. A spiritual needs assessment at this point would reveal whether Mike’s reluctance stems from a theological conviction that medicine signals a lack of faith, or from fear, misinformation, or pressure from a faith community. The distinction matters because the clinical response differs. Respect for autonomy in pediatrics is relational rather than absolutist, and the physician’s obligation is to preserve Mike’s decision-making role while refusing to let James absorb avoidable risk (Beauchamp & Childress, 2025).

The Christian narrative frames sickness as a consequence of the fall, not as punishment for a particular sin. Jesus corrected that inference directly when his disciples asked whose sin caused a man’s blindness (John 9:1–3). The body as temple (1 Corinthians 6:19–20) creates a stewardship obligation that includes seeking effective treatment. Scripture shows God working through medical means: Isaiah prescribed a fig poultice for Hezekiah (2 Kings 20:7), and Jesus said that the sick need a physician (Mark 2:17). Faith and medicine therefore cooperate rather than compete. Mike can pray for James’s healing while authorizing dialysis, and a mature Christian theology treats medical care as one of the instruments through which God acts. Delaying treatment does not demonstrate greater faith; it substitutes one means of grace for another and places James at risk that the principle of nonmaleficence forbids (Canavera et al., 2024).

Why the Autonomy Section Fails Without a Threshold

Weak submissions state that autonomy matters and then leave the principle floating without a decision rule. The rubric does not reward a summary of what autonomy means; it rewards a position on what the physician should do when parental autonomy and pediatric welfare diverge. A threshold argument works because it specifies the condition under which the default shifts. James’s clinical trajectory supplies that condition: measurable deterioration after a treatment delay. Once the threshold is identified, the physician’s obligation becomes concrete rather than abstract. The same logic appears in pediatric ethics literature, where decision-making authority is described as graded rather than binary, and where the child’s developing interests acquire weight as risk increases (Polakova et al., 2023).

Common Rubric Gaps Students Miss

A frequent question concerns whether the spiritual needs assessment section can simply list FICA without explaining its application. The rubric expects the student to show what the tool would reveal in Mike’s specific situation. Naming FICA earns little; explaining that it would surface whether Mike’s faith community supports or discourages treatment earns credit. Another gap is Scripture citation. Generic references to “the Bible” do not satisfy the requirement for specific book, chapter, and verse tied to the argument. Students also overlook justice. The four principles are not a menu; the benchmark expects all four to appear, and justice applies when resource allocation or fair access becomes relevant to James’s transplant candidacy. A response that covers autonomy and beneficence but omits nonmaleficence and justice leaves rubric points unearned regardless of how elegant the prose is.

Conclusion

This benchmark tests whether a student can hold a philosophical framework and a theological framework in the same analysis without letting either one dissolve the other. Principlism supplies the structure: autonomy, beneficence, nonmaleficence, justice. The Christian narrative supplies the content that makes Mike’s decision intelligible rather than irrational. A strong submission moves between the two, showing where they converge and where the physician must act because convergence has not occurred. The word ranges exist because each section does a different job. Autonomy requires a position. The Christian worldview section requires argument, not devotional assertion. The spiritual needs assessment requires a tool and a practice change. Students who treat the ranges as ceilings rather than floors tend to produce tighter, more defensible work.

References

• Beauchamp, T. L., & Childress, J. F. (2025). Principles of biomedical ethics (9th ed.). Oxford University Press.
• Canavera, K., Eshleman, K., Crochet, E., & Ciesielski, H. (2024). Faith, medical decision making, and coping: Bioethics considerations for pediatric psychologists. Clinical Practice in Pediatric Psychology, 12(4), 361–373. https://doi.org/10.1037/cpp0000533
• Polakova, K., Ahmed, F., Vlckova, K., & Brearley, S. G. (2023). Parents’ experiences of being involved in medical decision-making for their child with a life-limiting condition: A systematic review with narrative synthesis. Palliative Medicine, 38(1), 85–101. https://doi.org/10.1177/02692163231214414
• Puchalski, C. M., et al. (2024). Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine, 27(2), 145–158. https://doi.org/10.1089/jpm.2023.0293

PHI-413V Topic 5 Benchmark: Patient’s Spiritual Needs Case Analysis

Autonomy Analysis

Mike holds decisional authority as James’s legal guardian, and the physician must respect that authority rather than dismiss it as irrational. Respect for autonomy requires clinicians to understand a patient’s or surrogate’s values, provide relevant information, and protect voluntary choice (Beauchamp & Childress, 2025). In pediatric care, however, autonomy is not an unlimited parental entitlement. James is eight years old, cannot consent to dialysis himself, and depends on adults to protect his immediate welfare.

The case presents a clear ethical threshold. Mike’s decision has already contributed to James’s deterioration, and continued delay may expose him to preventable death or serious disability. Under the principle of nonmaleficence, the physician must avoid allowing avoidable harm; under beneficence, the physician must act to secure James’s best available clinical outcome. The American Academy of Pediatrics similarly holds that, when treatment is likely to prevent death, serious disability, or severe pain, the child’s health and future autonomy take priority over parental refusal (American Academy of Pediatrics, 2013).

The physician should not begin by overriding Mike. The appropriate response is urgent, respectful engagement: explain James’s prognosis, correct misunderstandings about faith and medicine, invite spiritual-care support, and seek a mutually acceptable treatment plan. If Mike continues to refuse necessary dialysis despite informed discussion, the care team should pursue ethics consultation and, where legally available, child-protection or court intervention. Respecting Mike’s autonomy therefore means hearing him, not surrendering James’s welfare to a decision that foreseeably harms him.

Christian Worldview

A Christian understanding of sickness begins with creation, fall, and redemption rather than with the idea that illness necessarily punishes a particular sin. Human bodies are created good, yet disease, decay, and death entered a world marked by brokenness. Jesus rejected the assumption that a man’s blindness resulted from either his sin or his parents’ sin; he declared that the man’s condition existed so that God’s works might be revealed in him (John 9:1–3, New International Version). James’s kidney failure should therefore not be interpreted as divine punishment directed at Mike or his son. It is a serious medical condition that calls for compassionate action, prayer, and responsible treatment.

Christian teaching also gives the body moral significance. Paul describes believers’ bodies as temples of the Holy Spirit and calls Christians to glorify God in their bodies (1 Corinthians 6:19–20). That claim does not mean that sickness reflects spiritual failure. It means that care for the body is an act of stewardship. Mike has a responsibility to protect James’s life and health because James is a child entrusted to his care, not merely an extension of Mike’s own religious convictions. Seeking effective treatment honors that responsibility.

Medical intervention and faith are not mutually exclusive. Scripture presents God as working through ordinary human means as well as through extraordinary events. Isaiah instructed Hezekiah to place a poultice of figs on his boil, and Hezekiah recovered (2 Kings 20:7). Jesus also affirmed the proper role of physicians when he said that those who are well do not need a physician, but those who are sick do (Mark 2:17). These passages do not reduce healing to medicine, but they show that medical care can function as a means through which God sustains life and restores health.

Mike’s Christian duty is therefore to integrate prayer with treatment, not to treat them as rivals. He may pray for James’s healing, seek pastoral encouragement, and ask his faith community to support the family. At the same time, he should authorize dialysis and follow the nephrology team’s recommendations. Refusing proven treatment does not demonstrate greater faith; it may place James at unnecessary risk and confuse trust in God with neglect of a God-given duty to care for one’s child. Christian bioethics similarly places sickness, suffering, and healing within redemption rather than treating medical care as spiritually inferior (Kornu, 2014).

The other principles reinforce this conclusion. Beneficence requires the care team to pursue dialysis because it offers James a realistic chance of survival and improved function. Nonmaleficence forbids allowing a treatable condition to worsen when effective therapy is available. Justice requires fair access to dialysis, transplant evaluation, and supportive services, without allowing religious belief or family circumstances to determine whether James receives standard care. Mike’s faith deserves respect, but James’s need for life-sustaining treatment carries greater moral weight when the two conflict (American Academy of Pediatrics, 2013).

Spiritual Needs Assessment

The physician should use the FICA Spiritual History Tool to understand Mike’s beliefs and identify common ground. FICA asks about Faith, the Importance of spirituality, Community, and how the clinician can Address spiritual needs (Puchalski et al., 2009). The tool is brief, open-ended, and suitable for use during an urgent clinical conversation because it invites the family to explain beliefs in their own words rather than forcing a choice between faith and medicine (Borneman et al., 2010).

In Mike’s case, the physician might ask: “Do you have a faith or spiritual belief that helps you cope with James’s illness?” “How important is that belief to the decisions you are making?” “Is there a faith community whose support would help your family?” and “How can the care team address your spiritual concerns while treating James?” The answers could reveal whether Mike believes that accepting dialysis would show weak faith, whether a pastor or congregation is influencing his decision, and what forms of prayer, scripture, or pastoral presence would make treatment acceptable.

The assessment changes the clinical relationship. Instead of framing Mike as an obstacle to care, the physician treats his spirituality as relevant to James’s holistic treatment. The care team can then arrange a chaplain visit, invite Mike’s pastor or trusted faith leader to join a family meeting, and explain that dialysis can proceed alongside continued prayer. If Mike remains unwilling to consent to necessary treatment, the team should involve ethics consultation, social work, palliative care, and legal or child-protection resources as required (American Academy of Pediatrics, 2013). Spiritual assessment does not replace clinical judgment; it creates a path toward shared decision-making while preserving James’s claim to necessary care.

References

American Academy of Pediatrics, Committee on Bioethics. (2013). Conflicts between religious or spiritual beliefs and pediatric care: Informed refusal, exemptions, and public funding. Pediatrics, 132(5), 962–965. https://doi.org/10.1542/peds.2013-2716

Beauchamp, T. L., & Childress, J. F. (2025). Principles of biomedical ethics (9th ed.). Oxford University Press.

Borneman, T., Ferrell, B., & Puchalski, C. M. (2010). Evaluation of the FICA tool for spiritual assessment. Journal of Pain and Symptom Management, 40(2), 163–173. https://doi.org/10.1016/j.jpainsymman.2009.12.019

Canavera, K., Eshleman, K., Crochet, E., & Ciesielski, H. (2024). Faith, medical decision making, and coping: Bioethics considerations for pediatric psychologists. Clinical Practice in Pediatric Psychology, 12(4), 361–373. https://doi.org/10.1037/cpp0000533

Kornu, K. (2014). Beauty of healing: Covenant, eschatology, and Jonathan Edwards’ theological aesthetics toward a theology of medicine. Christian Bioethics, 20(1), 43–58. https://doi.org/10.1093/cb/cbu007

Puchalski, C. M., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., Chochinov, H., Handzo, G., Nelson-Becker, H., Prince-Paul, M., Pugliese, K., & Sulmasy, D. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12(10), 885–904. https://doi.org/10.1089/jpm.2009.0142