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DOES THE BIBLE really hold the answers to today's complex ethical questions in nursing? Can we find help for the dilemmas we face in everyday nursing practice, or direction for larger ethical questions about euthanasia, genomics and stem cell research? Does Scripture help us understand what to do?


No, not if you expect to find magically simple answers in a verse or two of Scripture.


Yes, however, if you understand that the whole of Scripture is a faithful record of God's unfailing, loving commitment to his chosen people, called to live in holy, healing relationships.


In this new column, we're going to look at real-life ethical issues that Christian nurses experience in all dimensions of practice. We'll tackle stressful problems for those actually living them. And we'll explore Scripture to discover more about how God would have us look at these dilemmas.


For starters, let's look at a case study about a nurse's ethical duty to care for a difficult patient. In this situation, you are assigned a patient who was just admitted to the hospital through the ER.You read the following on the ER assessment and history:


"Male patient in his early 30s, poorly dressed, unshaven, non-Caucasian, appears to be of Middle-Eastern ethnic origin. Patient is unemployed with no health insurance. History obtained from male companions, who brought patient to the ER after aggressive episode of agitated, manic behavior at a local church. Patient apparently damaged church property after violent verbal outburst. Has history of gang-related activity and conflict with authority figures, including taunting and name-calling."


"Companions report prior episodes of complete social withdrawal, with at least one episode of extreme anorexia. Has history of disordered thoughts extending from childhood, with extreme religiosity, preoccupation with voices and visions of God, angels, the devil, demons and the dead. Patient was cited on several occasions for involvement in satanic practices but denies devil-worship. Has some limited vocational experience in manual labor. Is unmarried with no close relationships with the opposite sex, although has several close same-sex associates. Patient has no known dependents and little in the way of a viable family support system; he has been at odds with siblings, and whereabouts of father is unknown. Patient did not graduate from high school and has little or no formal schooling. Patient is currently homeless and transient, with no personal assets or possessions of value."


What are your personal feelings about working with this man? Would you want to care for him? What ethical issues affect care for this patient? What does it mean to be a Christian called to care for difficult, even scary, patients?


I'm not going break confidentiality or violate HIPAA laws in telling you the name of this patient. Actually, every detail of this case is public knowledge. The patient is Jesus Christ!! In today's society, Jesus could have been brought to the emergency room by church leaders following his cleansing of the temple (Mt 21:12-13). If we look at Jesus' arrest and trial, we see that the religious leaders and public officials were convinced he was deranged (Mt 26:65-68).


What's the point of this illustration? Our clinical perspectives, assessments and terminology should help us communicate effectively with other caregivers. But sometimes ordinary, therapeutic communication can introduce a subtle bias and prejudice toward patients, even a we versus they mentality. Problem-based documentation can become prejudicial if we are not careful about how we present information, or if we don't equally assess patients' strengths. Patients who need our care can sometimes become difficult because of the way we communicate about them to others.


Sometimes we care for patients that are just plain difficult. What helps you, as a Christian and a nurse, to see and love each patient as God does? Perhaps Jesus' words help us the most when he said, "Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me" (Mt 25:40).