11Cancer is the uncontrollable growth of abnormal cells

1
1
Cancer is the uncontrollable growth of abnormal cells in the
human body. It is defined by a malfunction in cellular
mechanisms that control cell growth. Cells evade checkpoint
controls and begin growing uncontrollably which resulting in an
increase in abnormal cells, cancer cells. These cancer cells form
a mass tissue known as a tumor. In the United States of
America, cancer has been determined to be among the leading
causes of mortality rates after cardiovascular conditions, where
one in every four deaths is caused by cancer. The most common
types of cancer include prostate cancer, lung cancer, and breast
cancer. Risk factors for cancer include excess smoking,
radiation exposure, genetics, and environmental pollution.
Colon cancer, or colorectal cancer, affects the distal third of the
large intestine, the colon, as well as the rectum, chamber in
which feces is stored for elimination. Colorectal cancer is the
third leading cause of death in cancer-related issues in the
United States in both males and females (Beadnell et al., 2018).
This essay explores the physiology and pathophysiology of
colon cancer.
Polyps are tissue growths that generally look like small, flat
bumps and are generally less than half an inch wide. They are
generally non-cancerous growths that can develop with age on
the inner wall of the colon or rectum. There are several types of
polyps, such as hyperplastic. They are common and have a low
risk of turning cancerous. Hyperplastic polyps found in the
colon will be removed and biopsied. Pseudo polyps also referred
to as inflammatory polyps, usually occur in people suffering
from inflammatory bowel disease and are unlike other polyps.
This type of polyp occurs due to chronic inflammation as seen
in Crohn's disease and ulcerative colitis. However, a polyp cells

which can turn out to be malignant. Villous adenoma or
tubulovillous adenoma polyps carry a high risk of turning
cancerous. They are sessile and develop flat on the tissue lining
the organs. They might blend within the organ, making polyps
not easily identifiable and difficult to locate for treatment.
Adenomatous or tubular adenoma polyps have a high chance of
being cancerous. When a polyp is found, it must be biopsied,
and then will regular screenings and polyp removal will follow.
An adenocarcinoma is a cancer formed in a gland that lines an
organ. This cancer impacts the epithelial cells, which are
spread throughout the human body. Adenocarcinomas of the
colon and rectum make up ninety-five percent of all colon
cancers (Chang, 2020). Colon adenocarcinomas usually begin in
the mucous lining the spread to different layers. Two subtypes
of adenocarcinomas are mucinous adenocarcinoma and signet
ring cells. Mucinous adenocarcinomas contain about sixty
percent mucus which can cause cancer cells to spread faster and
become more hostile than typical adenocarcinomas. Signet ring
cell adenocarcinoma is responsible for less than one percent of
all colon cancer. It is given this name because of how it appears
under a microscope. These cells are aggressive and are more
challenging to treat. The symptoms of colorectal
adenocarcinoma are abdominal pain, blood in stool, constipation
or diarrhea, and weight loss. The standard treatment for
colorectal adenocarcinomas is chemotherapy, surgery, targeted
therapy, and radiation.
Gastrointestinal carcinoid tumors are another type of cancer that
affects the rectum. These cells grow in nerve cells known as
neuroendocrine cells which help in regulating hormonal
production. Carcinoid tumor cells grow slowly and can also
develop in the lungs and other parts of the gastrointestinal tract.
They cause about one percent of all colon cancers and half of
cancer found in the small intestines. Symptoms are different
depending on the growth location of the tumor (Falanga et al.,
2019). A tumor in the appendix usually has no symptoms unless
it starts to obstruct the path from the appendix to the intestines,

causing appendicitis symptoms such as fever, vomiting, and
nausea. Carcinoid tumors sometimes make hormones that might
lead to a variety of symptoms that are dependent on produced
hormones. Patients suffering from these tumors can experience
flushing in the face, wheezing, quick heartbeats, and diarrhea.
Tumors in the colon can cause weight loss, tiredness, stomach
cramps, and pain. Gastrointestinal carcinoid tumor treatment
options are similar to those of the aforementioned treatments.
Anorectal melanoma is a rare cancer that starts in the anus or
rectum. This cancer can develop anywhere in the large
intestines or rectum and spread aggressively. Melanomas are
estimated to affect less than two percent of colon cancer. It
rarely occurs; however, it is very aggressive and challenging to
treat. This type of cancer can be easily missed during initial and
follow-up diagnoses because it is rarely seen.
Familial adenomatous polyposis (FAP) accounts for almost one
percent of all cancers in the rectum or colon. FAP is an
inherited disorder distinguished from colon cancer, but some
people can develop the abnormal gene that leads to this
condition. People having this syndrome can create a lot of
polyps in the colon as early as their teenage age. The patient's
colon has to be removed to stop the polyps from becoming
cancerous. People with familial adenomatous polyposis keep
increasing as they age because hundreds or thousands of polyps
can grow in the colon as they age (Freidman et al., 2020).
Patients with it may not have any symptoms at the early stages
of the disease until it is in the advanced settings. The symptoms
of familial adenomatous polyposis are abdominal cramps,
unexpected weight loss, cysts of the skin, and lamps on the
bones of the legs, arms, skull, and jaw. Treatment for this
cancer can be the removal of the colon to curb the spread of the
polyps which can cause cancer.

Pathophysiology of Colorectal Cancer
Pathophysiology is the combination of pathology and
physiology. The study of the disordered physiological process
associated with an injury or disease. Pathophysiology aims to
explain the functional differences occurring within a person
because of being sick. Colorectal Cancer or CRC can be
sporadic, hereditary, or inflammatory bowel disease.
Sporadic colorectal cancer develops from the colorectum
without known contribution from germline causes. Different
mutations occur, which lead to CRC. Sporadic CRC is a somatic
cell mutation that is a natural developmental process in the
immune system. A bodily genetic disease might be caused by
the local colonic environment and a person's background
genetic makeup (Ju et al., 2019). Two-thirds of all colon
cancers are this type and are primarily seen in clinical practice.
In sporadic CRC, we have mutations such as microsatellite
instability or mutator pathway dysfunction. Microsatellite
instability or MSI is a hypermutable phenotype resulting from
DNA mismatch repair activity loss. MSI is found in about
fifteen percent of colon cancers. Twelve percent are associated
with sporadic and the other three percent with Lynch syndrome.
This instability is caused by germline mutations in mismatch
repair or MMR genes. MMR system proofreads as DNA is
formed when it identifies an abnormality in sequence repairs to
the DNA are made. MMR gene dysfunction allows DNA to
increase at high speed. These mutations confer a selective
advantage on the cells, leading to the cancer spreading. CpG
Island Methylator Phenotype or CIMP is another mutation that
happens. CpG Island Methylator Phenotype is brought by DNA
methyltransferases that support hypomethylation in promoter-
associated CpG enough regions with tumor suppressor genes
turned off. The switching off the CIMP pathway, abnormal cells
can develop, and malignant cells develop, which leads to the
spread of colon cancer in the body.
Hereditary is another war cancer is spread. It is an inheri ted
disorder with a high chance of contracting some cancers.

Changes or mutations bring about hereditary cancer symptoms
in specific genes passed from parents to children. In this case,
similar cancers might be seen in the same family members who
are close such as a father, son, and brother having the same
cancer and developing it from early stages. Hereditary cancer
includes Lynch Syndrome or LS. LS is an inherited disorder that
increases the chance of contracting particular colon cancer.
Patients with Lynch syndrome have a high probability of having
stomach, brain, and skin cancer. There is an attempt to repair
defective cells in the body. They form mismatch repair genes as
these genes continue to accumulate errors. As the abnormal
cells increase, this can lead to abnormal growth of cells and
possibly cancer. Familial Adenomatous Polyposis or FAP is also
caused by Adenomatous Polyposis Coli or APC gene mutation.
APC gene issues instructions for developing APC protein. These
mutations cause the production of abnormally short non-
function APC proteins. The fast APC protein cannot prevent the
cellular overgrowth that causes the formation of polyps in the
large intestines which can become cancerous. People who have
inherited FAP have a lot of polyps in their colons, and all those
with this genetic disorder will have colorectal cancer. The
patients must undergo early examination because the number of
polyps in their colons might increase, and they have a high
chance of getting cancer.
Inflammatory Bowel Disease or IBD is a common term given to
describe disorders that involve chronic inflammation of the
digestive tract. Types of IDs include ulcerative colitis,
inflammation, and sores or ulcers along the superficial lining of
the large intestines. Crohn's disease is identified by
inflammation of the lining in the digestive tract, including the
deeper layers of the digestive tract (Szekanecz et al., 2019).
Chronic inflation is caused by cytokines and chemokines. These
are secreted proteins with development and activation functions
that control and decide the nature of immune response and
control immune cell trafficking at the cellular arrangement of
immune organs. Patients suffering from IDB have a high chance

of contracting colon cancer if they have contracted an IBD l iver
complication known as primary sclerosing cholangitis. Before
sclerosing cholangitis inflammation that causes scars within the
bile ducts, the spots make the ducts hard and narrow, causing
severe liver damage.
Providing Care to Patients in a Holistic Manner
The provision of care in a holistic manner means providing
care to patients who are majored in a mutual understanding of
their physical, psychological, emotional, and spiritual
dimensions. Nursers are in charge of health promotion. Nurses
working with colorectal cancer or CRC patients can promote
health by mobilizing patients to take screening for colon cancer.
Nurses should have a bond with patients, which will help them
communicate about screening and its importance. The patients
who connect with the nurses can also be taught ways to prevent
them from getting CRC and symptoms of the disease. A nurse
should be compassionate to patients, understand their problems,
and be present. CRC can be contracted because of a patient's
background. You have to ask them about their background, what
they eat, and their overall lifestyle (Verkhratsky & Nedergaard,
2018). CRCs can also be inherited through genes asking patients
if any conditions exist in their families to help find if that is the
problem. There are rapid changes in health care, allowing
nurses to identify patients likely to have CRC. Advancements
have shown that CRC appears when a person is aging. It will
help nurses talk to patients encouraging them to take screening
to check if they have CRC. A holistic manner can work well if a
nurse creates a good rapport with the patients and communicates
effectively.
Cancer is spreading and becoming a significant health
issue in society. Awareness has to be raised on cancer and how
it affects people, the patients, and those close to them. There
are many causes of cancer, such as pollution or exposition to
radiation. These issues have to be looked into to help in
reducing the spread of cancer. Colon cancer can be inherited
genetically to avoid further spread, screening has to be done,

and those having it undergo treatment with their children. To
ensure that someone can grow without being worried about
contracting cancer. Screening of people over forty years old
should be started as some of these colon cancers start turning
into cancerous tumors. It will help control the number of people
affected with cancer and help them to get treatment before their
condition becomes worse. Nurses should also be able to
communicate with patients with colon cancers and form a good
rapport with them to help each other out. Nursers should also
figure out a colon cancer patient's background, diet, and
activities to help diagnose the patient. Nurses play a vital role
in helping patients who have colon cancer.
References
Alahmad, M. (2020). Strengths and Weaknesses of Cognitive
Theory. Budapest International Research and Critics Institute
(BIRCI-Journal): Humanities and Social Sciences, 3(3), 1584-
1593.
Beadnell, T., Scheid, A., Vivian, C., & Welch, D. (2018). Roles
of the mitochondrial genetics in cancer metastasis: not to be
ignored any longer. Cancer And Metastasis Reviews, 37(4),
615-632. https://doi.org/10.1007/s10555-018-9772-7
Chang, J. (2020). Pathophysiology of Inflammatory Bowel
Diseases. New England Journal Of Medicine, 383(27), 2652-
2664. https://doi.org/10.1056/nejmra2002697
Falanga, A., Schieppati, F., & Russo, L. (2019).
Pathophysiology 1. Mechanisms of Thrombosis in Cancer
Patients. Thrombosis And Hemostasis In Cancer, 11-36.
https://doi.org/10.1007/978-3-030-20315-3_2
Freidman, N., Chen, I., Wu, Q., Briot, C., Holst, J., & Font, J.
et al. (2020). Amino Acid Transporters and Exchangers from the
SLC1A Family: Structure, Mechanism, and Roles in Physiology
and Cancer. Neurochemical Research, 45(6), 1268-1286.
https://doi.org/10.1007/s11064-019-02934-x
Ju, H., Zhao, Q., Wang, F., Lan, P., Wang, Z., & Zuo, Z. et al.
(2019). A circRNA signature predicts postoperative recurrence

in stage II/III colon cancer. EMBO Molecular Medicine, 11(10).
https://doi.org/10.15252/emmm.201810168
Kaplan, D. E. (2018). Piagetian Theory in Online Teacher
Education. Creative Education, 9(6), 831-837.
Moheghi, M., Ghorbanzadeh, M., & Abedi, J. (2020). The
Investigation and Criticism Moral Development Ideas of
Kohlberg, Piaget, and Gilligan. International Journal of
Multicultural and Multireligious Understanding, 7(2), 362-374.
Szekanecz, Z., Raterman, H., Pethő, Z., & Lems, W. (2019).
Common mechanisms and holistic care in atherosclerosis and
osteoporosis. Arthritis Research &Amp; Therapy, 21(1).
https://doi.org/10.1186/s13075-018-1805-7
Verkhratsky, A., & Nedergaard, M. (2018). Physiology of
Astroglia. Physiological Reviews, 98(1), 239-389.
https://doi.org/10.1152/physrev.00042.2016
PHI-413V: Ethical and Spiritual
Decision Making in Health Care
God, Humanity, and Human Dignity
1
Meet
The Family
Myself (Steve) with my wife Patty and our children Brent and
Carah and her husband Jason
2

The Rest of the Family
Duffy Sheldon Bailey
3
How should we think about human beings?
So what makes the rest of my family different or more valuable
than Duffy, Sheldon, and Bailey?
Why do human beings have special worth or value we call
human dignity?
What is it about you that makes you, “you” and stays the same
through change in your life?
4
On what basis are we truly equal?
Why do we believe there are such things as human rights?
5
Moral status - Which sorts of beings or entities are valuable and
have rights to be treated in certain ways?
What kind of a thing is a human person?
In other words, on what basis are we considered valuable or
worthy of dignity and respect?
What (if anything) makes a human being valuable and worthy of
dignity and respect?

6
What It Means to Be a Human Being
(This is not fundamentally a scientific question, but rather a
philosophical question.)
Moral Status
(Question to consider: Does my worldview provide an adequate
explanation for my beliefs about human dignity?)
What does it mean to be a human being?
Anthropological axiology (the basis upon which human beings
are assigned value in relation to other kinds of beings) contra
relativism, cannot be simply dependent upon culture or personal
preference but rooted in the nature of what it means to be a
human being. Contra scientism, the value and dignity of human
beings stands over and above that of other species and cannot be
simply reduced to a person's abilities or function, or the
person's physical constituents. (PHI-413V Lecture 2, GCU)
While it has a been a perennial challenge for secularism to find
a basis upon which to assign human beings intrinsic worth and
dignity, the concept of human "dignity" and intrinsic value
(including its implied ethical principles such as respect for
persons, etc.) is inherent in Biblical teaching and Christian
tradition. An appreciation and grasp of this question is
fundamental for understanding the contemporary religious
context and the goals and virtues of medicine. (PHI-413V
Lecture 2, GCU)

The question of “personhood” (i.e., the fundamental nature,
value, and identity of what it means to be a person) is not
fundamentally a scientific question, but rather a philosophical
question. One's answer to this question (which will in some
sense be part of a worldview) will determine the person's
definition of other related and common concepts in health care.
Primarily, the concepts of “dignity” and “care” are closely
connected. Briefly, upon what basis humans should be valued
over and above other types of beings or species? Can one's
worldview explain the intrinsic value of human beings?
Secondly, the very concept of “care” implicit in health care
assumes that its primary object of concern is persons (not,
scientific knowledge, or money, notoriety, etc.).
Moral Status
Briefly, the concept of moral status concerns which sorts of
beings or entities have rights (in the sense that a moral agent
has obligations toward this being or entity). Human rights, for
example, are considered to be a prime example of descriptions
of obligations a moral agent has to any human being.
Furthermore, human beings are taken to have these obligations
due to them simply in virtue of being human beings. Another
way to describe the concept of a beings moral status is to talk
about its value or worth. Thus, to talk about a beings moral
status is to talk about a beings value, as well as why it has that
value. (PHI-413V Lecture 2, GCU)
Key Point
While there seems to be an innate sense of what it means to be a
human being that most people have, one needs to stop and
actually think about what this means. It might be assumed that
healing and caring are good things because human beings are
valuable and ought to be respected, but the question is whether
one's worldview provides an adequate explanation for these
beliefs? Are they in some sense relative? Pay attention to how
the Christian narrative answers these questions and begin to ask

yourself how you would answer them.
7
Moral Status
Five views or theories commonly used by bioethicists:
Human Properties
Cognitive Properties
Moral Agency
Sentience
Relationships
From PHI-413V Topic 2 Overview
Human Properties
The theory based on human properties holds that it is only and
distinctively human properties that confer moral status upon a
human being. It follows that all and only human beings, or
Homo sapiens, have full moral status. Some of the
characteristics that would endow a human being with moral
status would include being conceived from human parents, or
having a human genetic code. In this view, one only needs to be
a human being to count as having full moral status.
Cognitive Properties
The theory based on cognitive properties holds that it is not any
sort of biological criteria or species membership (such as the
theory based on human properties) that endows a human being
with moral status. Rather, it is cognitive properties that confer
moral status upon a human being. In this context "cognition
refers to processes or awareness such as perception, memory,
understanding, and thinking...[and] does not assume that only
humans have such properties, although the starting model for
these properties is again the competent human adult"
(Beauchamp & Childress, 2013, p. 69). Notice carefully this is

claiming that if a human being does not have these properties, it
follows that such a human being does not have moral status or
value.
Moral Agency
The theory based on moral agency holds that "moral status
derives from the capacity to act as a moral agent"; in this view a
human being is considered a moral agent if they "are capable of
making judgments about the rightness or wrongness of actions
and has motives that can be judged morally" (Beauchamp &
Childress, 2013, p. 72).
Sentience
The theory based on sentience holds that
having sentience confers moral status on a being. Sentience in
this context is "consciousness in the form of feeling, especially
the capacity to feel pain and pleasure, as distinguished from
consciousness as perception or thought." (Beauchamp &
Childress, 2013, p. 73). According to this theory the capacity of
sentience is sufficient for moral status (i.e., the ability to feel
pain and pleasure confer moral status to a human being).
Relationships
The theory based on relationships holds that relationships
between human beings account for a human being's moral
status. In other words, a human being has moral status only if
he or she has a relationship with others who value him or her.
Usually these are relationships that establish roles and
obligations such as a patient-physician relationship or a parent-
child relationship. Of course, there are many types of
relationships (family, genetic, legal, work, etc.), even ones in
which one party in the relationship does not desire or value the
other party. In such a case, a person who holds this theory may
be forced to concede that a being's moral status may change,
depending on the other party.

Key Point
Each of these theories will take shape in the context of a
particular worldview and may be applied differently based on an
individual’s worldview. There may also be considerations for a
particular worldview that would not allow one to hold one or
more of these theories.
So a person with Christian worldview might apply the human
properties theory based on the understanding that humans are
made in the image of God and have value or worth because life
is sacred, where a person from another worldview may apply the
human properties theory based on having a distinct human
genetic code.
8
Christian imago dei vs. Scientism vs. Postmodern Relativism
9
Imago Dei
Then God said, “Let us make man in our image, after our
likeness. And let them have dominion over the fish of the sea
and over the birds of the heavens and over the livestock and
over all the earth and over every creeping thing that creeps on
the earth.” So God created man in his own image, in the image
of God he created him; male and female he created them.
(Genesis 1:26-27 ESV)
The Imago Dei – “image of God”
Class Discussion: What is the Christian concept of the imago

dei? How might it be relevant to healthcare, and why is it
important?
According to Called to Care by Shelly and Miller, p. 77 -
We are created and distinct from the Creator
We somehow reflect the nature of this God – reason, morality,
language, relationships, creativity, etc
God gives us a position of responsibility and authority over
creation
According to Dignity and Destiny: Humanity in the Image of
God by John Kilner
Jesus is the image, not us: 2 Corinthians 4:4; Colossians 1:15,
and he was the prototype for humanity before Adam and Eve:
Romans 8:29
We are created in his image: Genesis 1:26-27, and continued to
be made according to God’s image after the fall: Genesis 9:6
Sin cannot erase the image: Genesis 5:1; 9:6
Humanity as royalty: Psalm 8:4-6
We have a destiny through the Gospel. We are restored and
renewed progressively to conform to the image of Christ, God’s
image. We are moving towards him: Colossians 3:9-10; 2
Corinthians 3:18; Romans 8:29
10
Imago Dei
All human beings equally have inherent value and dignity:
“there is no indication that the image is present in one person to
a greater degree than in another. Superior natural endowments,
such as high intelligence, are not evidence of the presence or
degree of the image. [Furthermore], the image is not correlated
with any variable...[but is] something in the very nature of
humans, in the way in which they were made. It refers to
something a human being is rather than something a human

being has or does.”
(Erickson, 1998, pp. 557-558)
See Practicing Dignity, chp 2
11
Scientism
Materialism
The doctrine that everything that exists is material. To a
materialist there is really only one substance in the universe,
and such things as intelligence, feeling, conscience,* volitions,
and dispositions are but modified properties of matter. Instead
of intelligence creating matter, matter evolved into intelli gence.
Thus materialism is the antithesis of idealism* and antagonistic
to all theism.
Cairns, A. (2002). In Dictionary of Theological Terms (p. 274).
Belfast; Greenville, SC: Ambassador Emerald International.
12
Scientism
Materialism
The view that only material objects exist. Materialism is
sometimes used as a synonym for physicalism, but some
thinkers distinguish the two by allowing that physicalism holds
that only matter and energy exist. Some materialists define their
view in terms of science and claim that ultimate reality consists
of whatever particles or entities are discovered by physicists.
See also eliminative materialism; nonreductive materialism.
Evans, C. S. (2002). In Pocket dictionary of apologetics &
philosophy of religion (pp. 73–74). Downers Grove, IL:

InterVarsity Press.
13
Naturalism
Naturalism
Philosophical or metaphysical naturalism refers to the view that
nature is the “whole show.” There is no supernatural realm
and/or intervention in the world (see Materialism; Miracles,
Arguments Against). In the strict sense, all forms of nontheisms
are naturalistic, including atheism, pantheism, deism, and
agnosticism.
Geisler, N. L. (1999). Naturalism. In Baker encyclopedia of
Christian apologetics (p. 521). Grand Rapids, MI: Baker Books.
14
Postmodern Relativism
The postmodern argument with viewing persons as the image of
God (imago Dei) takes a different tack. Drawing from an
eclectic array of ancient and newly constructed religions and
philosophies, as we have seen, many are beginning to view the
earth as a living organism. Kleffel explains, “Humans are one
functioning part of the totality and act in harmony within the
organism.” In other words, human life is no more valuable than
a rock or a raccoon. The philosophy reveals itself i n the T-shirt
slogan borne by Margie, a junior student: “Save the rats,
experiment on people.”
Shelly and Miller (2006). Called to Care (p. 76). InterVarsity
Press.

15
Personhood
What does it mean according to:
Christian imago dei
Scientism (Naturalism/Materialism)
Postmodern Relativism
The main point here is to understand that each worldview has
it’s own set of assumptions about the fundamental nature of
what it means to be human.
16
Case Study: Fetal Abnormality
Central Question: Upon what basis (moral status theory) does or
doesn’t the fetus have moral status according to each adult?
Case Study Clarification
In identifying the theories used by the four individuals in the
case study you are applying the theory used BY the adult to
determine whether or not the fetus has moral status (value or
worth). So the theories are applied towards the fetus NOT
applied towards the adults.

For example:
If I were to say, “It makes me feel bad to think I could be
causing my unborn child to suffer pain from an abortion, so I
have to keep my child”, I would be using the theory of
Sentience because of my belief that it would be wrong to harm
my child who can feel pain (therefore having moral status), not
because I myself would feel the emotional pain about going
through with the abortion.
Again, if I were to reason that my unborn child wouldn’t be able
to live a normal life, creating unnecessary hardship and
suffering for both the child and myself due to a condition that
would leave the child mentally impaired for life, I would be
applying the Cognitive theory based on the child’s assumed lack
of cognitive ability, not because I am using my own cognitive
ability to reason what I think is best with the medical
information I have.
Be careful to use clear reasoning and defend your
interpretations logically based on the theory being applied in
the study.
Case studies are not always clear and there may be more than
one interpretation or how a theory is applied. Do not assume too
much about each characters’ psychological states or motivations
or read too much into the case.
Pay attention to the last paragraph.
17
Case Study: Four Objectives
What is the Christian view of the nature of human persons, and
which theory of moral status is it compatible with? How is this
related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco,

Maria, and Dr. Wilson to determine the moral status of the
fetus? What from the case study specifically leads you to
believe that they hold the theory you selected?
How does the theory determine or influence each of their
recommendations for action?
What theory do you agree with? Why? How would that theory
determine or influence the recommendation for action?
18
Optional – Joni and Friends
For additional information, the Joni and Friends website is
recommended:
https://www.joniandfriends.org/
Optional – Topic 2: Optional Resources
For additional information, see the "Topic 2: Optional Study
Resources" that are recommended.
PHI-413V-RS-T2OptionalResources.docx
The Image of God, Bioethics, and Persons with Profound
Intellectual Disabilities
Read the attached article, "The Image of God, Bioethics, and
Persons With Profound Intellectual Disabilities," by Devan
Stahl and
... Read More
JCID 6.1-6.2 - Article - D. Stahl_J.Kilner - Image of God
Bioethics and PWIDs.pdf
Practicing Dignity: An Introduction to Christian Values and
Decision-Making in Health Care
Read Chapters 2 from Practicing Dignity.
https://www.gcumedia.com/digital-resources/grand-canyon-

university/2020/practicing-dignity_an-introduction-to-christian-
values-and-decision-making-in-health-care_1e.php
Philosophy - Ethics: Moral Status
View the video "Philosophy - Ethics: Moral Status," by Jeff
Sebo, from Wireless Philosophy.
https://youtu.be/smuhAjyRbw0
Case Study on Moral Status - Rubric
Collapse All Case Study On Moral Status - RubricCollapse All
Christian View of the Nature of Human Persons and Compatible
Theory of Moral Status
60 points
Criteria Description
Christian View of the Nature of Human Persons and Compatible
Theory of Moral Status
5. Excellent
60 points
Explanation of the Christian view of the nature of human
persons and the theory of moral status that it is compatible with
is clear, thorough, and explained with a deep understanding of
the relationship to intrinsic human value and dignity.
Explanation is supported by topic study materials.
4. Good
51 points
persons and the theory of moral status that it is compatible w ith
is clear, thorough, and and explains the relationship to intrinsic
human value and dignity. Explanation is supported by topic
study materials.
3. Satisfactory
45 points
is clear and explains the basic relationship to intrinsic human

value and dignity. Explanation is supported by topic study
materials.
2. Less Than Satisfactory
39 points
is unclear. Explanation is not clearly supported by topic study
materials.
1. Unsatisfactory
0 points
is insufficient. Explanation is not supported by topic study
materials.
Determination of Moral Status
40 points
Determination of Moral Status
5. Excellent
40 points
The theory or theories that are used by each person to determine
the moral status of the fetus is explained clearly and draws
insightful relevant conclusions. Rationale for choices made is
clearly supported by topic study materials and case study
examples.
4. Good
34 points
the moral status of the fetus is explained clearly and draws
relevant conclusions. Rationale for choices made is clearly
supported by topic study materials and case study examples.
3. Satisfactory
30 points
the moral status of the fetus is explained and draws relevant
conclusions. Rationale for choices made is supported by topic

study materials and case study examples.
26 points
the moral status of the fetus is not clearly explained. Rationale
for choices made is unclearly supported by topic study materials
or case study examples.
1. Unsatisfactory
0 points
the moral status of the fetus is not adequately explained.
Rationale for choices made is not supported by topic study
materials or case study examples.
Recommendation for Action
40 points
Recommendation for Action
5. Excellent
40 points
Explanation of how the theory determines or influences each of
their recommendations for action is clear, insightful, and
demonstrates a deep understanding of the theory and its impact
on recommendation for action. Explanation is supported by
topic study materials.
4. Good
34 points
their recommendations for action is clear and demonstrates an
understanding of the theory. Explanation is supported by topic
study materials.
3. Satisfactory
30 points
their recommendations for action is clear. Explanation is
supported by topic study materials.

26 points
their recommendations for action is unclear. Explanation
unclearly supported by topic study materials.
1. Unsatisfactory
0 points
their recommendations for action is insufficient. Explanation is
not supported by topic study materials.
Personal Response to Case Study
40 points
Personal Response to Case Study
5. Excellent
40 points
Evaluation of which theory is preferable within personal
practice along with how that theory would influence personal
recommendations for action is clear, relevant, and insightful.
4. Good
34 points
recommendations for action is clear and relevant.
3. Satisfactory
30 points
recommendations for action is clear.
26 points
Evaluation of which theory is preferable along with how that
theory would influence personal recommendations for action is
lacking a personal connection.
1. Unsatisfactory
0 points
Evaluation of which theory is personally preferable along with

how that theory would influence personal recommendations for
action is inadequate.
Organization, Effectiveness, and Format
10 points
Organization, Effectiveness, and Format
5. Excellent
10 points
Writer is clearly in command of standard, written, academic
English.
4. Good
8.5 points
Prose is largely free of mechanical errors, although a few may
be present. The writer uses a variety of effective sentence
structures and figures of speech.
3. Satisfactory
7.5 points
Some mechanical errors or typos are present, but they are not
overly distracting to the reader. Correct and varied sentence
structure and audience-appropriate language are employed.
6.5 points
Frequent and repetitive mechanical errors distract the reader.
Inconsistencies in language choice (register) or word choice are
present. Sentence structure is correct but not varied.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.
Documentation of Sources
10 points
Documentation of Sources (citations, footnotes, references,
bibliography, etc., as appropriate to assignment and style)
5. Excellent

10 points
Sources are completely and correctly documented, as
appropriate to assignment and style, and format is free of error.
4. Good
8.5 points
Sources are documented, as appropriate to assignment and style,
and format is mostly correct.
3. Satisfactory
7.5 points
Sources are documented, as appropriate to assignment and style,
although some formatting errors may be present.
6.5 points
Documentation of sources is inconsistent or incorrect, as
appropriate to assignment and style, with numerous formatting
errors.
1. Unsatisfactory
0 points
Sources are not documented.
Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and
her husband Marco have been in the United States for the last
three years and have finally earned enough money to move out
of their Aunt Maria’s home and into an apartment of their own.
They are both hard workers. Jessica works 50 hours a week at a
local restaurant and Marco has been contracting side jobs in
construction. Six months before their move to an apartment,
Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county
hospital, a large, public, nonteaching hospital. A preliminary
ultrasound indicates a possible abnormality with the fetus.
Further scans are conducted, and it is determined that the fetus
has a rare condition in which it has not developed any arms and
will not likely develop them. There is also a 25% chance that
the fetus may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica
for the first time, since she and Marco did not receive earlier
prenatal care over concerns about finances. Marco insists that
Dr. Wilson refrain from telling Jessica the scan results, assuring
him that he will tell his wife himself when she is emotionally
ready for the news. While Marco and Dr. Wilson are talking in
another room, Aunt Maria walks into the room with a distressed
look on her face. She can tell that something is wrong and
inquires of Dr. Wilson. After hearing of the diagnosis, she
walks out of the room wailing loudly and praying aloud.
Marco and Dr. Wilson continue their discussion, and Dr. Wilson
insists that he has an obligation to Jessica as his patient and that
she has a right to know the diagnosis of the fetus. He
furthermore is intent on discussing all relevant factors and
options regarding the next step, including abortion. Marco
insists on taking some time to think of how to break the news to
Jessica, but Dr. Wilson, frustrated with the direction of the
conversation, informs the husband that such a choice is not his
to make. Dr. Wilson proceeds back across the hall, where he
walks in on Aunt Maria awkwardly praying with Jessica and
phoning the priest. At that point, Dr. Wilson gently but briefly
informs Jessica of the diagnosis and lays out the option for
abortion as a responsible medical alternative, given the quality
of life such a child would have. Jessica looks at him and
struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic
position and increased independence, along with her conviction
that all life is sacred. Marco will support Jessica in whatever
decision she makes but is finding it difficult not to view the

pregnancy and the prospects of a disabled child as a burden and
a barrier to their economic security and plans. Dr. Wilson lays
out all of the options but clearly makes his view known that
abortion is “scientifically” and medically a wise choice in this
situation. Aunt Maria pleads with Jessica to follow through with
the pregnancy and allow what “God intends” to take place and
urges Jessica to think of her responsibility as a mother.
© 2020. Grand Canyon University. All Rights Reserved.
Case Study on Moral Status
Assessment Traits
Requires Lopeswrite
Assessment Description
Based on "Case Study: Fetal Abnormality" and the required
topic Resources, write a 750-1,000-word reflection that answers
the following questions:
1. What is the Christian view of the nature of human persons,
and which theory of moral status is it compatible with? How is
this related to the intrinsic human value and dignity?
2. Which theory or theories are being used by Jessica, Marco,
Maria, and Dr. Wilson to determine the moral status of the
fetus? What from the case study specifically leads you to
believe that they hold the theory you selected?
3. How does the theory determine or influence each of their
recommendations for action?
4. What theory do you agree with? Why? How would that theory
determine or influence the recommendation for action?
Remember to support your responses with the topic Resources.
While APA style is not required for the body of this assignment,
solid academic writing is expected, and documentation of
sources should be presented using APA formatting guidelines,
which can be found in the APA Style Guide, located in the
Student Success Center.
This assignment uses a rubric. Please review the rubric prior to
beginning the assignment to become familiar with the

expectations for successful completion.
You are required to submit this assignment to LopesWrite. A
link to the LopesWrite technical support articles is located in
Class Resources if you need assistance.
Attachments
Neoplasm/ Neoplastic Process Paper
Introduction
“Cancer is the second leading cause of death in the United
States, exceeded only by heart disease. One in every four deaths
is due to cancer” (CDC, 2016) As nurses, it is essential t be
familiar with the most common types of cancer and the patient
presentations.
Assessment Outcomes
1. Analyzes how the physiology and pathophysiology impacts
the patient presentation- explain this in detail in terms of
pathophysiology.
2. Explores how this presentation will influence your practice in
providing care to the patient in a holistic manner. in a rapidly
changing health care environment.
3. Articulately describes the concepts, in the patient context.
4. Communicates effectively using graduate writing concepts.
Directions: Written Paper
For the purpose of this assessment, you will develop a 7-10
page paper, exclusive of the abstract and reference pages.
All papers are to be written using current APA citation and
reference format.
Audience for this analysis: The primary audience for this
presentation is that of your colleagues in the Master of Science
in Nursing program.

11Cancer is the uncontrollable growth of abnormal cells

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