FILM REVIEW1
Ethical Film Review
A paper submitted in partial fulfillment of the course requirements of NURS 4135 D
by:
001127339
Isabel Wilde
University of Lethbridge
7 October 2010
Ethical Film Review
“You have terminal cancer.” Hearing these few words would make anyone feel fearful, just as Vivian Bearing did in the film, Wit. As nurses, we will come across many patients who have heard these words and as nurses we need to ensure we can protect and promote the well-being of our patients. We may come across ethical dilemmas which may make it difficult to morally decide on the correct action to take, but by following professional guidelines we can ensure correct decision making. By recognizing the Nursing Code of Ethics (Canadian Nursing Association, 2009) as an essential tool in the nursing profession, we can use it to help guide nurses in making ethical decisions and ensure patients are receiving the care and treatment which is morally right.
Wit, directed by Mike Nichols portrays an English professor, Vivian Bearing who is diagnosed with stage IV ovarian cancer. The film takes us through the cycle the cancer takes on Vivian, and the treatment she endures over the eight months of aggressive experimental chemotherapy (Bosanquet & Nichols, 2001). As the story unfolds, ethical issues arisewhich are relevant to the nursing profession regarding the ethics behind experimental medical research and nurses advocating to ensure appropriate treatment measures are taken to minimize suffering and promote the patients health and well-being by involving and following the code of ethics.
Film Overview
The film opens with Vivian’s doctor informing her about the diagnosis of ovarian cancer where he recommends she be involved in eight months of aggressive, full-dose, experimental chemotherapy. As the month’sprogressand the cancer worsens, the side effects from the experimental chemotherapy become unbearable. However, Vivian continues the full-dose of treatment her doctor insists upon, even though he fails to explain what the experimental chemotherapy entails.This leaves Vivian wishing she would have asked more questions before allowing herself to undergo such treatment (Bosanquet & Nichols, 2001).
As the film continues, Vivian’s health diminishes further, and she relies more on her nurse Susiewho advocates for her best interests. As her cancer worsens, she becomes too weak and can no longer tolerate the full dose of chemotherapy her doctor insists upon, and passes away. When the doctor realizes she has passed away he tries to resuscitate her against her wishes because “she’s research!” Susie, because she respects Vivian’s wishes as a patient, helps to uphold her rights to refuse further treatment, and allows her to die with dignity (Bosanquet & Nichols, 2001).
Ethical Nursing Issues
The film Wit portrays many different ethical issues which can be seen within the nursing profession. The author brings up the ethical issue regarding patient safety when it comes to medical research. Nurses are ethically responsible to ensure the highest level of care and treatment is provided and advocate when they see unfit practice (Canadian Nurses Association, 2008). In the movie, the doctors seen Vivian as research, but Susie advocates to ensurethe most beneficial care and treatment is provided for her, even when she must intervene in medical treatment(Bosanquet & Nichols, 2001). This filmdepicts the importance of advocating for patients in the nursing profession and how it is in our practice to make sure patient are receiving optimal medical treatment.
Nurses are ethically responsible to act as an advocate to promote and protect patients rights, and “provide care directed first and foremost toward the health and well-being of the person, family or community in their care” (CNA, 2008, p. 10). To the doctors, Vivian was seen more as a research assignment instead of a patient. However, her nurse Susie advocated and saw her as a person by providing competent, compassionate care throughout her whole treatment. Susie not only advocated for Vivian, but also questioned and intervened when the care provided was not in the best interest for her. This is seen when Vivian becomes extremely ill from the chemotherapy and Susie advocates to decrease the treatment dosage to ensure patient safety and comfort, however, the doctors disagree because they want to continue with their research. Even with the disagreement from the doctors, Susie has a moral obligation as a healthcare professional to do no harm and “advocate for persons in their care if they believe that the health of those persons is being compromised by factors beyond their control, including the decision-making of other” (CNA, 2009, p. 11). This film helps depict the importance of advocating for patient safety and well-being, even though advocating for a patient’s rights can sometimes be controversial because of disagreements among healthcare professionals. This film has helped me realize every person in the healthcare team is an important aspect when it comes to patient care. Each professional has something beneficial to offer and all information should be taken into consideration when preparing a plan for care and treatment. As a student, I have witnessed in the clinical setting that healthcare professionals do not always make sound medical judgments, and have seen firsthand nurses being the ones who most often recognize and intervene in ethical dilemmas. This film brings attention to the important role nurses play within the healthcare system as they are closely involved in patient care and can quickly see if the health of the patient is being compromised. As nurses, it is our professional obligation to take action when we see other healthcare professionals not following the code of ethics, and report when necessary to ensure ethical decision making takes place. Nurses can fulfill their professional obligation by taking action and reporting ethical dilemmas to the floor manager and if need bringing it up to CARNA to ensure the principles of justice are followed and the highest level of health and well-being is achieved (CNA, 2009). In the nursing career we need to take responsibility and “protect patient’s rights to dignity by advocating for appropriate use of interventions in order to minimize suffering…and work to promote health and social conditions that allow people to live and die in dignity” (Bouchal & Ecker, 2006, p.100).
Another ethical line is crossed when the doctors try to resuscitate Vivian immediately after she is found dead, disregarding the wishes of the patient’s code status of “do not resuscitate”. Like the doctors portrayed in this film, Birthwistle and Nielson (1998) says it is not uncommon for some health care professionals disregard the wishes of their patients when it comes to resuscitation. “Many doctors feel it is inappropriate to involve patients in the resuscitation decision-making process” and “some doctors would still resuscitate patients with incurable malignancy…even when most patients who undergo CPR have not been asked whether they wish to be resuscitated, and have not consented to the procedure”(Birthwistle & Nielson, 1998, p. 546). When looking at this issue in a nursing perspective we see the importance of advocacy and client dignity. As nurses, we must intervene if other healthcare providers fail to respect the dignity of the client or choose not to follow their wishes when it comes to their decisions. Patient autonomy and the rights of the individual are values all nurses and healthcare professionals must respect and uphold. Patients, such as Vivian, have the right to refuse treatment, and nurses have the legal obligation to respect their decision, and make sure the principle of autonomy is respected even if refusing treatment could result in death (CNA, 2009). Nursesmust recognize, respect and promote a patient’s right to make decisions regarding treatment. When a patient is terminally ill like Vivian, nurses must relieve pain and suffering and allow the patient to live and die with dignity and refuse treatment if it is in their best interest (CNA, 2009).
“Nurses must respect and promote the autonomy of individuals and help the patients to express their needs and values and obtain appropriate care and dignity” (Sanazaro & Brown, 2006, p.521). Susie portrayed a nurse who respected Vivian’s decisions, and was able to carry out her ethical obligation as she constantly challenged the doctors on what the best plan of action would be to benefit herwell-being. She sees Vivian as an individual, not just as research, and made sure her individual values and decisions were respected until the end of life. Throughout the film, I see Susie portrayed as a positive nursing figure as she was professional and followed the code of ethics to ensure moral care and treatment was provided even when treatment became controversial. Nurses encounter ethical issues on a daily basis, but by following the code of ethics I believe we can continue to advocate and do what is in the best interest for patients.
Importance in the Nursing Profession
Throughout the film Wit, we clearly can see the importance in understanding the code of ethics, and upholding the ethical principles in the nursing profession. The author portrays the nurses’ role well when how to deal with ethical dilemmas, and reassures how important it is to follow the code of ethics in our everyday nursing practice. It is in the foundation for the nursing profession, and when dealing with ethical dilemmas, there is a need as a nurse to ensure we follow these guidelines to guarantee safe, competent, and ethical care is being provided to patients by all healthcare individuals (CNA, 2009).
In the nursing profession, ethical dilemmas arise continuously. The film Wit can be seen as a valuable learning resource for students and nurses throughout their careers. It portrays the nurse as a patient advocate, and reinforces the importance of the code of ethics in regards to ethical dilemmas and decision-making.It allows us to follow the guidelines to ensure moral care and treatment is provided and that we are fulfilling our professional obligation to make sure patients are receiving the most ethical care available.
References
Birtwistle, J., & Nielson, A. (1998). Do not resuscitate: an ethical dilemma for the decision-maker. British Journal of Nursing, 7(9), p 543-549.
Bosanquet, S. (Producer), & Nichols, M. (Director). (2001). Wit [Motion picture]. United States: Avenue Pictures Productions.
Bouchal, S., & Ecker, M. (2006). Nursing values and ethics. In P. Perry & A. Perry (Eds.), Canadian fundamentals of nursing (3rd ed.) (pp. 95-111). Toronto, ON: Elsevier.
Canadian Nurses Association. (2008). Code of ethics for registered nurses. Retrieved from
Canadian Nurses Association. (2009).Code of ethics for registered nurses. Retrieved from
Potter, P.A., & Perry A. G. (2006). Canadian fundamentals of nursing (3rd ed.). Toronto, ON: Elsevier Canada.
Sanazaro, D., & Brown, B. (2006). The experience of loss, death, and grief. In P. Perry & A. Perry (Eds.), Canadian fundamentals of nursing (3rd ed.) (pp. 510-538). Toronto, ON: Elsevier.
Book/Film/Performance Review Rubric
Student ID#
Minimum Marks ------ Maximum Marks
Content of Review/75 /
Does not meet minimum standard / Introduction provides little direction for paper
Description of work lacks flow or coherence
Summary of work dominates with minimal critique
Relevance of work to nursing issue unclear or weak
Examples to support review awkward or not logically linked to critique
Conclusion very weak / Introduction vague or unclear
Description of work present but awkward
Summary of work wordy or awkward or links to critique vague or unclear
Relevance of work to nursing issue present but the link is awkward or nursing topic unclear
Examples to support review are present & links to critique are adequate
Conclusion vague / Introduction present & clear
Description of work present & clear
Summary of work succinct with logical links to support critique
Relevance of work clearly linked to nursing issue
Key examples to support review present, are logically linked, & illuminate critique
Conclusion clear / Introduction clear & compelling
Description of work well synthesized
Summary of work succinct with logical links & creative arguments to support critique
Relevance of work insightfully linked to clearly identified nursing issue
Key examples provide rich context to illuminate critique
Conclusion clear and well synthesized
Organization & Expression of Ideas
/25 / Does not meet minimum standard / Frequent grammatical errors including colloquial expressions, incomplete sentence structure, poor usage of terms and spelling errors
Logical flow or ideas difficult to follow at times with unnecessary wordiness and awkward expression
Citations and references incomplete or with major errors
More than 300 words short/in excess of word limit
Rubric not attached as directed / Occasional grammatical, sentence structure errors including colloquial expressions, incomplete sentence structure, poor usage of terms and spelling errors
Generally clear, logical expression of ideas. Some awkwardness present
Frequent errors in citations and references / Minor grammatical and sentence structure errors present
Clear, logical and meaningful expression of ideas; words are well chosen
Occasional errors in citations and references / No grammatical or spelling errors
Development of ideas, arguments and conclusions represents creativity and exceptional depth
No errors in citations and references
Within 200 words of word limit
Rubric attached as directed
Total grade /100 = /40
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