Short Story : ' Wit '

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

The process of deciding when a terminally ill patient should die lies within the patient, family members, and the

All medical providers have a duty to protect the health and dignity of their patients. Even if that is the intention of the provider, specific ethical dilemmas in healthcare may arise making it difficult for the provider to make an ethically appropriate choice. Wit, directed by Mike Nichols, takes the viewer through the healthcare of Dr. Vivian Bearing, an English professor, as she embarks on an eight-month experimental treatment to hopefully cure her stage IV ovarian cancer. As Dr. Bearing undergoes this treatment, ethical issues arise regarding her healthcare that compromises her well-being and dignity. George D. Pozgar points out that ethics is concerned with values relating to human conduct that focuses on the rightness and wrongness of actions, as well as the goodness and badness of motives and ends.1 It is clear in the film that the actions taken by the medical providers, violated ethical principles within the scope of health care such as patient dignity and respect, patient autonomy, and consent to research/treatment.

The film WIT, produced by Simon Bosanquet, clearly defines poor bedside manner in all levels of medicine, from the radiologist who performed the x-ray to the physicians in charge of the patient’s care. The film is based on a seventeenth century poet professor, Vivian Bearing, who gets diagnosed with stage IV ovarian cancer that has already metastasized. Professor Bearing goes through intense series of experimental chemotherapy agents that are detrimental to her health, yet everyone in the medical team seems to ask the question, “how are you feeling today?” In reality no one seems to really show true interest to what she is going through. The film portrays a lack of empathy for Professor Bearing, giving a sense of loneliness and hopelessness. The professors’ rights seem to be taken from her and the medical professional fail to treat her with the dignity and respect she deserves.

The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

Very often, deliberate decisions are made which results in the end of a life. For example, a person could be kept on life support, but instead, a family member or other significant person might choose to switch off the life support machine resulting in the official death of a patient. There is also the case that resuscitation of a patient may eventually prove to be trivial and a doctor might suggest just making the patient as comfortable as possible until their eventual passing. In the above situations, a medical professional’s decisions would not be questioned or doubted. It is conventional practice (Warnock and MacDonald 2008).

Human-kind has a complicated relationship with death. We intellectually regard it as something inevitable, but that doesn’t stop us from feeling baffled or victimized by it. Wit by Margaret Edson portrays an attempt at understanding this relationship. Its main character, Vivian Bearing, is an accomplished literature professor who is facing the last stage of ovarian cancer. Following Vivian’s last days of life, the work explores mortality by examining one’s personal relationship with death through literature and society’s responsibility toward the dying through characterization.

The movie “The Doctor” captures the shortcomings of a mechanized health care industry. Dr. Jack McKee is a gifted, however, arrogant, and self centered surgeon who cares little about the emotional welfare of his patients; treating them with a callous attitude, and examining them as specimen. Out of the four models of physician/patient relationship, Dr. McKee exemplified the Paternalistic model, the least ideal model for physician/patient interactions. He makes decisions for the patient

In the play “Wit”, written by Margaret Edson, the author includes many characters in her work that have their own distinct characteristics that make them unique and valuable to the play. Vivian Bearing, the main character in the play, has been diagnosed with stage four ovarian cancer. Due to her diagnosis, she becomes part of a clinical trial for a new drug regimen to fight ovarian cancer. The doctors working with Vivian are very insensitive and lack compassion while interacting with her. One character in the play who displayed a great amount of compassion for Vivian was her primary nurse, Susie Monahan. Susie was the only staff member in the hospital who reached out to Vivian, was kind to her, and cared for wellbeing. She did whatever she could to make Vivian’s stay at the hospital as comfortable as possible. Vivian at first was taken by surprise and rejected

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.