Issues Of Biomedical Ethics In The Christian Narrative And Christian Vision Essay Example

Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?

The given case study describes rather a controversial situation, in which Christian vision comes into conflict with common sense, ethics, and medical science. The most pressing issue here is the fact that human life is at stake. Furthermore, it depends upon the decisions of people who are persistent in their unwillingness to view the situation from another perspective since their religion does not allow them to do so.

It can be deduced from the case that the family of James (the boy, who is about to die since his parents forego an operation because of their religious views) belongs to a denomination condemning any manipulations with the human body if they do not come from God. This is an extreme case since not all versions of Christianity would interpret the situation in the same way (followers of some confessions believe that medicine also exists due to God’s will, which means that medical interventions should not be perceived as contradictory to His guidance) (Bakken, 2015). Since we do not know the details about Mike and their wife’s religion, it can only be supposed that the most acute problem for them is to decide whether it would be a sin to accept medical assistance when their son is about to die without it.

Judging by Mike’s actions, it is evident that he would prefer to reject any intervention and rely entirely on the power of his faith and prayer. As the condition of the boy aggravated, his father began doubting if his faith was strong enough to cure him. Since he will probably persist in his decision, another issue of concern is who will be responsible for the child’s death, both from the legal and religious points of view.

There is also the second child, whose presence, in this case, cannot be ignored either. The point is that he has to donate his kidney to the dying brother–this is another intervention going against Christian morality. At the same time, the boy is a victim of his own parents’ stubbornness and blind faith and should be protected by God from their follies from the Christian point of view (leaving alone protection of his human rights).

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

It is indeed hard to say whether the physician should leave Mike his paternal right to decide what is best for his son even if it is already quite evident that his decisions will end up in the boy’s death. The biggest problem is not even whether the doctor should make this decision from the professional and ethical point of view but whether he actually can prohibit this or that religious practice to the parents even knowing their consequences and outcomes for the patient.

Currently, the prevailing majority of states protect parents’ autonomy of decisions, which implies that if James dies, they are not likely to be prosecuted for homicide. Furthermore, if the physician still insists on an operation (which is dangerous for both twins) and one of the children dies (or even both of them), it is also possible that their parents may start legal proceedings accusing the doctor of unintended murder as it was him who insists on the rejection of religious practices in favor of medicine. Thus, it may be fraught with consequences for him to insist on an operation (Humber, 2013).

The most reasonable option, in this case, is to invite a lawyer to a personal meeting with parents and to make the boy’s parents sign a paper confirming that they forego the operation having been informed about all possible consequences of their refusal. In this case, the physician will feel secure knowing that he did everything for saving James’s life (Humber, 2013).

On the other hand, the best outcome (yet, hardly possible one) would be to convince the parents to continue their faith healing practices in combination with the traditional methods of treatment. In this case, faith healing is not harmful and can even provide certain spiritual support to the whole family. The placebo effect is created, which can help James cope with stress (since he is sure to be no less religious than his father).

It has been proven by extensive research that practices of faith healing (when they are complementary to the traditional treatment) are able not only to give the patient peace of mind to get prepared emotionally for an operation but also relieve physical pain (Bakken, 2015). Thus, allowing Mike to continue his practices would benefit the boy in case the physician manages to persuade him into the continuation of medical treatment. This will certainly not be harmful or irrational.

According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?

If we attempt to analyze the case simultaneously from the position of the Christian narrative and the modern issues of patient autonomy, organ donation, and treatment refusal, the results will be rather perplexing since plenty of controversies and ethical dilemmas immediately arise. On the one hand, Christians perceive human life as sacred, which implies that it must be saved using all means. Moreover, in the given case, we are speaking about the life of a child, and children are considered to be innocent, beloved God’s creatures (Ferngren, 2014). However, on the other hand, organ donation is regarded as interference into the creation process since only God can shape a human body. Thus, this step corresponds to and contradicts Christian morality simultaneously (Bakken, 2015).

As far as treatment refusal is concerned, it is violated from both perspectives. Christians would say that patient autonomy is normal since no one except God can decide if a person will live or die. From the medical point of view, neither James nor his brother can sign an informed consent or refusal as their parents are legally responsible for them. From the religious prism, it means that they assume the role of God in deciding other people’s destiny. From the point of law, these children cannot act independently from their parents and will have to obey any decision they will make, which, violates their human rights. Moreover, even if the child says that he agrees to rely on God’s mercy instead of being operated on, it may indicate that his father’s influence in the family is overwhelming.

The same dilemmas can be applied to the other brother, who may become an invalid if he is made to donate a kidney to James. On the one hand, this act would be truly Christian as he will sacrifice his well-being for the sake of another person. On the other hand, this involves psychological and physical violence as the child is certainly subject to constant pressure about his role in the situation. Therefore, his decision is hardly voluntary and fully adequate.

According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?

According to the Holy Scripture, all sicknesses should be perceived as punishments for our sins. If we address the Old Testament, we can find numerous examples of people affected by intolerable pains and diseases when they indulge in lust, gluttony, arrogance, idleness, or any other of the deadly sins. This understanding of illnesses is supported by the fact that Jesus Christ never suffered from any health problems whatsoever even though his flesh is unquestionably human.

He feels pain when they torture him before the crucifixion, he is weak and exhausted. Yet, no disease ever affects him, which again proves that he does not have to pay for any sins. However, there is another way to understand sicknesses. In some cases, God used diseases to test his most faithful followers who did not have any sins (e.g. Job’s patience was tested in such a way). In the New Testament, martyrs repeated their fate (Ferngren, 2014).

Thus, Mike’s perception of the situation seems to be determined by both interpretations. He may think that God punishes him for the lack of faith and this punishment is severe but just. At the same time, it is also possible that he may see his misery as a challenge to his faith, which he must overcome to prove that he is a true Christian. In any case, it is much more probable that he will rely on prayers to save his son and demonstrate his devotion to God rather than that he will use his common sense and agree to an operation.


Bakken, K. L. (2015). The journey into God: Healing and Christian faith. Eugene, OR: Wipf and Stock Publishers.

Ferngren, G. B. (2014). Medicine and religion: A historical introduction. Baltimore, MD: JHU Press.

Humber, J. M. (2013). Biomedical ethics and the law. Berlin, Germany: Springer Science & Business Media.

Contrastive Discourse Markers Of Saudi English Learners


Expressing negation through conversational exchanges can serve many functions (Gönen, 2011, p. 253). At this point, the exchange of information between speakers can be improved through the presence of Contrastive Discourse Markers (CDMs) (Khatib & Safari, 2011, p. 243). An actual engagement of Saudi college English learners in a conversational exchange to negate can reflect their inadequate knowledge of the pragmatic functions of CDMs in spoken discourse (Lewis, 2011, p. 416). The way they frequently negate using either directly stating “NO” or affixing the word “NOT” to auxiliaries and modals (Min, & Yan, 2012, p. 66) expecting that they have successfully carried out a pragmatic contrastive function can in effect show how Saudi English college learners are unaware of the various pragmatic functions of CDMs (Shanru, 2011, p. 897; Williams, 2010, p. 214). Khan points out that commonly in Arabic there are two patterns of making opposites e.g. prefix chair (that means non or not) (Khan, 2011, p. 105).

Besides, the recurrent and limited usage of the DM “No” could be as some studies revealed it as having a relatively narrow range of uses (Jianfeng, 2012, p. 50; Abdulhafeed, 2012, p. 58; Xiao, 2010, p. 28), or explicitly concentrated on one or two uses (Karaata, Çepik & Çetin, 2012, p. 12). Additionally, the flexibility of English discourse demonstrates that Saudi college learners of English grasp a variety of devices in expressing negation in different ways to perform various functions (Modhish, 2012, p. 57; Delaney, 2012, p. 471). Besides, the inefficient instructional approach of CDMs in spoken discourse accounts for the unawareness of English learners in Saudi universities about the various pragmatic functions of CDMs. Such an instructional approach has resulted in the fact that learners can figure out the connective function of using different CDMs in written discourse without actual employment of various CDMs upon undertaking a conversational exchange. Accordingly, misinterpreting the contextual uses of CDMs in oral discourse is more likely to be faced. As such, the importance of mapping the pragmatic functions of English CDMs in oral discourse arises. Being in a cartographer’s shoes for mapping this topic in the presented proposal, a thorough investigation that seeks to tap on the various pragmatic functions that can be conveyed in spoken discourse using CDMs will be undertaken. Moreover, this topic will be thoroughly sought in an attempt to provide a developmental approach to the current ways of teaching oral discourse for English learners in Saudi universities.

Samples of natural oral discourse for several Saudi college English learners will be presented and analyzed to further ascertain the learners’ insufficient knowledge of the pragmatic functions of CDMs. A review of some existing pedagogical ways of teaching CDMs will be qualitatively reported.

Research Problem

Upon engaging in a conversational exchange where an interlocutor is to negate, a lot of English learners in Saudi universities employ a very limited number of contrastive markers, namely, no or not and sometimes but, which indicates their insufficient knowledge of the various pragmatic functions of CDMs in oral discourse (Taboada & de Los-Angeles Gomez-Gonzalez, 2012, p. 19). Therefore, this proposal suggests an in-depth analysis of the pragmatic functions of NO, NOT, and SOMETIMES as discourse contrastive makers. To be more exact, the research paper is going to answer the question:

What are the key CDMs that Saudi EFL learners of English use in their conversational intercourse? Is there a connection between the use of CDMs and the level of comprehension between speakers?

Providing answers to the given question is the core aim of the proposal; however, it is necessary to indicate that several objectives are going to be targeted thoroughly to scrutinize the research topic.

Research Questions

  • What are the key CDMs that Saudi EFL learners of English use in their conversational intercourse?
  • Is there a connection between the use of CDMs and the level of comprehension between speakers?
  • How are CDMs being taught in Saudi classrooms?
  • How are CDMs being used by Saudi English college learners?


The inefficient instructional approach of CDMs in spoken discourse accounts for the unawareness of Saudi English college learners of the various pragmatic functions of CDMs. As a result, learners can figure out the connective function of using different CDMs in written discourse without actual employment of various CDMs upon undertaking a conversational exchange.

Objectives of the Study

This study aims at investigating the pragmatic functions of English contrastive discourse markers (CDMs) as being taught by teachers and learned by learners in Saudi universities. Besides, its object is the illustration of the communicative functions of contrastive discourse markers in an attempt to illuminate a developmental approach for the current teaching methodologies of English oral discourse as used in Saudi classrooms. As such, providing answers to the abovementioned research questions is the core aim of the proposal. However, it is necessary to indicate that there will be scrutiny of several objectives for the exhaustion of the research topic.

Significance of the Study

The study will address an in-depth analysis of important elements of discourse such as contrastive makers. It will highlight the properties of CDMs based on naturally occurring data. The findings of my proposed research will be of great help to both teachers as well as learners in Saudi universities (Taboada & de Los-Angeles Gomez-Gonzalez, 2012, p. 18). Concerning teachers, remarkable attention will be provoked to teaching discourse for communicative purposes. Respectively, Saudi English college learners will consider learning how to correctly interpret and relate to negative utterances in conversational exchanges as well as establish coherent and relevant discourse to fulfill their communicative needs.

In conclusion, the topic I propose will elaborate on the pragmatic functions which can be carried out by CDMs and have not received considerable attention in the literature. Furthermore, it will offer a recommended approach of how the teaching of English oral discourse can be developed to meet the current ongoing changes in the scope of English discourse (Btoosh & Taweel, 2011, p. 208).

Limitations of the Study

The literature on the same topic is inadequate and that may not give enough room for effective exploration of the topic. Misinterpreting the contextual uses of CDMs in oral discourse is more likely to be faced. As such, the importance of mapping the pragmatic functions of English CDMs in oral discourse arises. Additionally, the population of the experimental group might not represent the majority of the students, as well as teachers’ reports, which might not provide enough evidence of all the current used teaching approaches.

Operational Definitions of Terms

CDMs in oral exchanges means that interlocutors verbally use ‘but’,’yet’ ‘however’, ‘in comparison’, ‘conversely’, ‘instead’, ‘despite’, ‘nevertheless’, ’on the other hand’, ‘on the contrary’ when they want to negate. Using CDMs in conversational interaction by Saudi English learners means that Speaker B replies with different contrastive markers in the following conversational exchange to carry out several functions:

  • Speaker A: Sneezing, sneezing, sneezing! It’s winter again. I hate the weather those days it is very cold.
  • Speaker B: Cold weather and winter sicknesses go hand in hand but there are a lot of things you can do despite the unusual cold. Instead of blaming the season, you can get the most out of it. Just dress heavily and enjoy the beauty of winter.


There will be a thorough investigation to tap on the various pragmatic functions of CDMs in spoken discourse. A sample of 40 students divided into groups will be provided. Twenty students will be randomly selected from the 7th as well as 20 from the 8th level. They will be placed in groups and that will create a cohesive relationship because the students will be able to select group members they can be comfortable being around during discussions. They will have group discussions based on expressing negation from which a report will be generated. Therefore, a presentation and analysis of samples of natural oral discourse for 40 English college students will be conducted to ascertain the learners’ insufficient knowledge of the pragmatic functions of CDMs. Lastly, teachers will be asked to provide a qualitative report of their pedagogical ways of teaching CDMs. A report of findings and conclusions will be presented.


Abdulhafeed, S. M. (2012). Use of discourse markers in the composition writings of arab EFL learners. English Language Teaching, 5(5), 56-61

Btoosh, M. A., & Taweel, A. Q. (2011). Contrastive Rhetoric: Inflation, Verbal Voices and Polyphonic Visibility in Learners and Native Speakers’ Academic Writing. Asian EFL Journal, 13(3), 205-228.

Delaney, T. (2012). Quality and quantity of oral participation and English proficiency gains. Language Teaching Research, 16(4), 467-482.

Gönen, S. (2011). A Neo-Humean Analysis of Turkish Discourse Markers “ama” and “fakat”. Journal Of Graduate School Of Social Sciences, 15(1), 253-278.

Jianfeng, Z. (2012). Discourse Markers in College English Listening Instruction: An Empirical Study of Chinese Learners. English Language Teaching, 5(3), 46-61.

Karaata, C., Çepik, Ş., & Çetin, Y. (2012). Enhancing the Use of Discourse Markers In Academic Writing: The Combination Of Incidental Acquisition And Explicit Instruction. Electronic Journal Of Social Sciences, 11(40), 11-29.

Khan, Intakhab Alam. (2011). Role of Applied Linguistics in the Teaching of English in Saudi Arabia. International Journal of English Linguistics 1(1), 105-114.

Khatib, M., & Safari, M. (2011). Comprehension of discourse markers and reading comprehension. English Language Teaching, 4(3), 243-250.

Lewis, D. M. (2011). A discourse-constructional approach to the emergence of discoursemarkers in English. Linguistics, 49(2), 415-443.

Min, L., & Yan, X. (2012). A Comparative Study on the Use of the Discourse Marker “Well” by Chinese Learners of English and Native English Speakers. International Journal Of English Linguistics, 2(5), 65-71.

Modhish, A. (2012). Use of Discourse Markers in the Composition Writings of Arab EFLLearners. English Language Teaching, 5(5), 56-61.

Shanru, Y. (2011). Investigating Discourse Markers In Pedagogical Settings: A LiteratureReview. Annual Review Of Education, Communication & Language Sciences, 895-108.

Taboada, M. & M. de Los-Angeles Gomez-Gonzalez (2012). Discourse Markers and Coherent Relations: Comparison Across Markers, Languages and Modalities. Linguistics and the Human Sciences. 6(3)3, 17-42.

Williams, I. A. (2010). Cultural differences in academic discourse: Evidence from first-person verb use in the methods sections of medical research articles. International Journal Of Corpus Linguistics, 15(2), 214-239.

Xiao, Y. (2010). Discourse markers in Chinese conversational narrative. (Dissertation, University of Hawai’i at Manoa, USA) 227.

Assessment Of Spiritual Needs And Life Philosophy


Q.1. Who or what provides you with strength and hope?

Well, I suppose that my greatest support is my family. My husband makes me stronger, children make me feel needed, and a tiny granddaughter is my inspiration. I want them to be happy, so I try not to focus on my disease. Of course, God gives me hope in the most difficult periods. A silent prayer makes me feel calm and peaceful.

Q.2. How would you describe your philosophy of life?

I am not much of a philosopher, you know. I believe that the best philosophy is to be grateful for every new day you live. I try to face life problems as something that will end early or late. If I can change the situation, I do my best. In case I cannot, I will wait till it changes to good.

Q.3. What type of spiritual/religious support do you usually desire?

Well, I think that church and a good word of a pastor are important for every person of my age. We already value spirituality more than physical. I need my Sunday visits to the church. They give me ideas to think and questions to ask.

Q.4. How do you keep going day after day?

I just wake up and say thanks for it. I have my rituals due to the disease. I have to take medications at certain times to avoid acute conditions. I cannot say I feel well every day but I can see, walk, talk to my beloved people and I cannot desire more.

Q.5. How has illness affected you and your family?

We became closer to each other. We realized that life is so fragile. Well, they also follow my healthy diet, it was their choice. But it is also supportive. They do a lot for me to feel like a healthy person. It is the best help I can desire, I feel better when they are near.


The patient I have interviewed is my neighbor, a 78-year-old woman. She was diagnosed with diabetes six years ago. In addition, she has had asthma since she was ten. Moreover, age-related conditions such as hypertension influence her daily life. She lives with her big family, a husband, three daughters with their husbands, and a granddaughter. As a nurse, I was interested in how she manages her conditions and her spiritual needs. Moreover, I wanted to figure out about the care practice at home because many carers consider it a problem (Ewing & Grande, 2012).

I think the interview was successful. The patient feels positive about her conditions and provides perfect self-management. She was eager to answer the questions.

I did not notice any barriers during the assessment. The assessment tool was developed based on the medical record of The Joint Commission (The Joint Commission. (n.d.). Moreover, the selection of questions was fulfilled with the consideration of the patient’s characteristics (Sharma, Astrow, Texeria, & Sulmasy, 2012). For any similar assessment, it is important to consider the patient’s age, gender, education, race, etc. It would be helpful to have some information on the patient’s religious preferences before the assessment to adjust the questionnaire.

A spiritual needs assessment is crucial for planning appropriate interventions to meet the needs of every patient. For example, if the patient is religious, the visit of a pastor for a talk can inspire a person to more successful treatment. In addition, a nurse can suggest suitable literature from the hospital library to support the patient. Some people consider themselves spiritual but not religious and can find help in other sources. It is the task of a nurse to reveal these sources through the assessment of spiritual needs. For example, in case the patient finds support in the family, a nurse can invite the family members to be near the ill person.

I suppose that illness and stress slightly changed the spiritual concerns and needs of my interviewee. On the whole, I have noticed that elderly people have more diverse spiritual needs than youth. They already understand their condition and the possible outcomes of the illness. Thus, they usually realize what they need. My patient has always been religious but the disease changed her attitude to God from demanding to more calm and thoughtful.

Her life philosophy, for example, is more positive than it is among many young people. The patient believes that any negative events in her life will end, and it helps her to stay positive. She accepted her diseases as inevitable things that she cannot change. However, she knows how to help herself and follows the doctor’s recommendations, and takes the prescribed medications. Possibly due to her attitude, she is still active and cheerful. I think she is a highly spiritual person. She values her life and tries to improve its quality. She is aware of her spiritual needs and does her best to satisfy them. Her case is an example of a successful patient home-care.


Ewing, G., & Grande, G. (2012). Development of carer support needs assessment tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliative Medicine, 0(0), 1-13. Web.

Sharma, R.K., Astrow, A.B., Texeria, K., & Sulmasy, D.P. (2012). The spiritual needs assessment for patients (SNAP): Development and validation of a comprehensive instrument to assess unmet spiritual needs. Journal of Pain and Symptom Management, 44(1), 44-51. Web.

The Joint Commission. (n.d.). Medical record – Spiritual assessment. Web.

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