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Running head: FILM REVIEW
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
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FILM REVIEW
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 wellbeing 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 arise which 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’s progress and 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
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FILM REVIEW
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 Susie who 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 ensure the most
beneficial care and treatment is provided for her, even when she must intervene in medical
treatment (Bosanquet & Nichols, 2001). This film depicts 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
FILM REVIEW
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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-
FILM REVIEW
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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).
Nurses must 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).
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FILM REVIEW
“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 her well-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
FILM REVIEW
and treatment is provided and that we are fulfilling our professional obligation to make sure
patients are receiving the most ethical care available.
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FILM REVIEW
References
Birtwistle, J., & Nielson, A. (1998). Do not resuscitate: an ethical dilemma for the decisionmaker. 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
http://www.cna-nurse.ca/CNA/socuments/pdf/publications/Code_of_Ethics_2008_epdf
Canadian Nurses Association. (2009). Code of ethics for registered nurses. Retrieved from
http://www.cna-aiic.ca/CNA/documents/pdf/publications/CodeofEthics2002_e.pdf
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.
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FILM REVIEW
Book/Film/Performance Review Rubric
Student ID#
Minimum Marks --------------------------------------------------------------------------------------------------- Maximum Marks
Content of
Review
Introduction provides
little direction for paper
Introduction vague or
unclear
Introduction present &
clear
Introduction clear &
compelling
Description of work lacks
flow or coherence
Description of work
present but awkward
Description of work
present & clear
Description of work well
synthesized
Summary of work
dominates with minimal
critique
Summary of work wordy
or awkward or links to
critique vague or unclear
succinct with logical links to
support critique
Summary of work succinct
with logical links & creative
arguments to support critique
Relevance of work to
nursing issue unclear or weak
/75
Does not
meet
minimum
standard
Examples to support
review awkward or not
logically linked to critique
Conclusion very weak
Relevance of work
insightfully linked to clearly
identified nursing issue
nursing issue present but the
link is awkward or nursing
topic unclear
linked to nursing issue
Examples to support
review are present & links to
critique are adequate
Key examples to support
review present, are logically
linked, & illuminate critique
Conclusion vague
Key examples provide rich
context to illuminate critique
Conclusion clear and well
synthesized
Conclusion clear
grammatical or spelling
errors including colloquial
expressions, incomplete
sentence structure, poor
usage of terms and spelling
errors
Organization
& Expression
of Ideas
difficult to follow at times
with unnecessary wordiness
and awkward expression
/25
meet
minimum
standard
incomplete or with major
errors
More than 300 words
short/in excess of word limit
Rubric not attached as
directed
Total grade
Comments:
/100 =
/40
sentence structure errors
including colloquial
expressions, incomplete
sentence structure, poor
usage of terms and spelling
errors
expression of ideas. Some
awkwardness present
rrors in
citations and references
sentence structure errors
present
errors
meaningful expression of
ideas; words are well chosen
arguments and conclusions
represents creativity and
exceptional depth
ors in
citations and references
references
Within 200 words of word
limit
Rubric attached as directed