A Healing Claim and the Hospital Ethics Committee
At a district hospital in the North West Region, a 19-year-old woman with epilepsy is brought in after four seizures in ten days. Her family says she stopped taking carbamazepine six weeks earlier after an evangelist prayed for her at a crusade; for the first six weeks she had no seizure, and the family calls this a miracle. The evangelist has invited her to a second crusade three hours away, and the family asks for immediate discharge. The doctor says the seizures are consistent with untreated epilepsy and that the six-week gap is not medically extraordinary. The five-member ethics committee - doctor, chaplain, nurse, patient representative and administrator - meets for 30 minutes. The patient says she feels pressured by her family but also fears the medication makes her 'doubt God'. The committee must decide whether to permit discharge, and how to describe the event without either mocking faith or endorsing a medical claim it cannot verify.
1. Using Hume's and Swinburne's accounts of miracles, assess whether the family's claim is rationally justified.
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The claim needs precision. The family says a miracle occurred because the young woman had no seizure for six weeks after prayer and stopped medication. But the observed sequence is: medication stopped, six weeks without a seizure, then four seizures in ten days. A miracle claim in the philosophical sense requires (a) an event contrary to the laws of nature and (b) a religious cause. The six-week remission is unusual but not a violation of a natural law; epilepsy can vary, and some patients have spontaneous periods without seizures. The recurrence after stopping medication is exactly what the doctor would predict. There is no objective before-and-after medical documentation in the setup, and no independent verification that no natural cause was at work.
Hume defines a miracle as a violation of a law of nature by a particular volition of the Deity. His argument is that testimony for a miracle must be weighed against the uniform experience of nature; we should not accept a miracle unless the falsehood of the testimony would be more miraculous than the event. On this case, the natural explanation is more probable, so Hume would reject the claim as not rationally justified. His argument is not a knockdown proof - it depends on the evidence and on background beliefs - but it sets a high bar that this case does not meet.
Swinburne is more open: miracles are events beyond the powers of nature, and testimony plus background evidence can make them probable. He would ask whether the event is really beyond natural powers and whether the religious context supports it. A six-week remission does not clearly qualify; 'answered prayer' or 'a period of improvement' is a more defensible description. The family's experience is sincere, but the specific claim 'miracle' is not rationally established on the available evidence.
2. What should the committee recommend? Show how you weigh patient autonomy, medical duty, and respect for religious experience.
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The committee should not simply permit or refuse; it should first assess capacity and then manage risk. The patient is 19, so in law she is an adult, but she is post-seizure, in pain, and under family pressure. A capacity assessment when she is lucid should test whether she understands the risks of stopping medication, can weigh them, and can communicate a consistent choice. If she has capacity, the committee cannot force treatment; it can advise, document, and offer follow-up. If she lacks capacity, decisions must be made in her best interests, with family involvement but not family control.
Medically, the duty is not to abandon her. The doctor should explain the risks - further seizures, injury, status epilepticus, and the danger of driving or cooking - and offer a clear restart plan. A joint meeting with the chaplain and doctor is better than a chaplain-only meeting, because it separates spiritual support from medical advice. The committee should not endorse the crusade as treatment, but it should not mock it either. It can say: 'We cannot verify a miracle; we can respect your faith and still recommend treatment.'
Recommendation: permit discharge only with a documented safety plan - prescription, a named contact, a follow-up appointment within one week, and written warning signs. If she refuses, record informed refusal and keep the door open. The committee should also ask the evangelist, through the family, not to advise stopping medication. This respects autonomy, maintains medical duty, and takes religious experience seriously without turning it into a clinical test.