Palliative care has gone under a lot of changes as the years have progressed. Just like how general care has been advanced for the sick in areas such as pharmacology and medical engineering, palliative care has also been given much importance. Palliative care has been recognized as a specialty in many countries. There has been evidence that a care outlook that takes note of psychosocial, psychological and spiritual support is very effective and holds great importance in the eyes of those who are sick and their families. (Beaver et al., 2000) In simpler terms, palliative care means to relieve the sufferings of the sick and not really to make the treatment effective. (Macpherson, 2002)
Watching the movie Wit, I was truly saddened and affected by the degree of importance that is given to research these days. Research for a horrible disease like cancer should be carried out but not on the cost of human beings being treated like guinea pigs. Vivian as smart and clever as she is shown to be very strong and capable. She is totally aware of the negative sentiments that Dr. Harvey Kelekian and Dr. Jason Posner have towards her.
Just as the movie starts, it is seen that when the nurse comes in and puts the object on the table, she does not even greet Vivian. Vivian being a patient of chemotherapy and affected with cancer goes on to greet her. The nurse doesn't greet her or ask her how she is, puts whatever she came to put and then just goes away. Thus, as the movie starts it is revealed that a lot of nurses and health care professionals do lack the fundamental manners that are required. Regardless of what state a person is in, if they are sick or healthy, old or young, all the patients want to be treated with courtesy and politeness.
In my opinion, Doctor Kelekian and Posner were more concerned with their research project going on as opposed to the health of the patient. Even in the beginning of the movie, the way Kelekian explains it to Vivian is no way in which someone should be told that they have cancer. Even though she portrays to be strong, surely this news would have impacted her at a great level. After telling her that, he goes on to explain how they are willing to treat her with the full dose and the complete cycle. Even though in his thinking, he is not making it very obvious. However, the tone of his conversation and the way he presents the entire case to Vivian makes it quite obvious that they will use her for research. Thus, the concept of beneficence was totally ignored and the doctors gave more relevance to the research as opposed to Vivian's welfare.
As the movie continues, it is seen that Vivian is quite sarcastic and clever towards her treatment by the doctors there. Even though she makes fun of them and tries to make a crude humor out of it, we notice that her quality of life begins diminishing just as the movie continues. This aspect of the movie will be discussed below in much more detail.
A major theme of palliative care was ignored in this movie is informing the patient about what is going on. Vivian was directed about where to go and what to do. However, no one took notice to explain to her regarding what is happening or what was going to happen. The first instance is when she was taken for the x ray. The doctor did not introduce himself nor did he till Vivian what he was about to do. Just because a person does not have medical knowledge, it doesn't mean that he or she should not be told what is done with him. When she goes in there, she is totally lost about what is about to happen. In that same scene, it shown that the doctor is extremely rude and does not exhibit polite manners. The way he bluntly shouts 'name', is very straight forward and not exhibit manners. The patient doesn't feel comfortable or open in these sorts of settings.
Another instance is when Vivian was taken in for an examination by Dr. Posner. Dr. Posner showed interest in Vivian and tried talking to her about being in her class; however he seemed very nervous and irritated in the procedure as well. This was unethical and not professional at all. He left the patient in a compromised position on the table with anyone able to walk in on her. Dr. Posner did not take care of and didn't respect patient privacy at all.
Palliative care includes that the patient is withdrawn from pain and other distressing symptoms. (WHO, 2009) This guideline was not followed and it was clearly depicted when Vivian was puking alone in a room. No team or staff member was there to assist her or to ease her pain. In palliative care, it is important for the members of the hospital and the nurses to enhance the quality of life. It is understood that the patient will die in a matter of months, thus emphasis is given to make their remaining time good and as active as possible. Even in the movie, Vivian says that she is suffering more from Cancer treatment than she is suffering from the disease. She is locked up in one room where the television doesn't work either. Her room is boring and she has nothing to do. She isn't taken out of her room to see the sun or enjoy the weather. This makes her life dull and even more depressing than it is. She even says in the movie that time passes very slowly. This totally goes against palliative care and shows that the staff there should have paid more attention to patient's quality of life. The doctors in the movie would rather keep her as an experiment than give importance to her feelings or what she wants.
There is no support system offered in the movie where Vivian can talk to anyone about her condition. The people that do come and inquire her do so very coldly. Palliative care requires there to be a support system that ensures the patients needs and queries regarding their course of illness. (WHO, 2009)
Susie Monahan is the only character in the movie that seems to follow the principles of palliates care. She offers support and is sympathetic. She goes on to support a major principle that states that death should not be hastened or postponed. (WHO, 2009) Susie explains to Vivian that her cancer is not getting cured and talks to her about it. She sympathizes and presents her with options that she has. Vivian tells her that she doesn't want to be resuscitated and that is what Susie then follows when Vivian dies.
As mentioned earlier, regardless of how distressed a patient is, a doctor or a nurse can relive a patient by telling her what is about to happen. Even if these acts cannot reduce the pain, it would most definitely reduce their anxiety. He performed the examination without even telling her what would happen. During the examination, he was hurrying the procedure and surely hurting the patient in the process. The doctor did not show any sympathy or any etiquettes what so ever. After the patient was over, he did not tell Vivian anything nor inform about what the results of his test were. Furthermore, the doctor kept referring to Vivian as she or her instead of taking her full name. This belittles the patient and makes her feel more like an object as opposed to a person.
In addition, a big ethical mistakes was made when the scene of the big round was shown. It showed a bunch of students and doctors just coming in and examining the patient. There was introduction and the patient was basically exposed in front of people she doesn't even know. Surely, the patient would have felt uncomfortable. The patient was not inquired about any pain or suffering rather she was used as another cancer case and the history was rather presented. Posner and the other students touched and poked Vivian's abdomen without even asking her to do so in the first place. Even the expressions that Vivian was making showed that she did not approve of it and was actually not comfortable.
General care and sympathy was ignored for Vivian by all except Susie Monahan, who was her nurse in the hospital. Whenever Kelekian or Posner would come, they would do their normal check up and just leave in a hurry. To complete the requirements and the protocol, they would ask how you are doing. However, the way that they would inquire in would instantaneously show that they lack any sympathy for Vivian. Vivian being the witty scholar she is, would guess how much they really care about her and reply with a fine.…