Wit (2001)

Last modified: November 8, 2018

This movie is about dr. Vivian Bearing who is diagnosed with cancer (stage four, metastatic ovarian cancer). Because the type of cancer Mrs Bearing is suffering from is not treatable with the available medical resources at that time, she decides to participate in an early stage cancer treatment research. Gradually Mrs Bearing realizes that the ambition and drive to succeed, something, which characterized her through her life, wasn’t applicable for the situation she now found herself. It is with this realization that fear and insecurity gain the upper hand. This movie shows in a confrontational matter the changes of peace of mind during the different stages of the experimental treatment. Furthermore, it shows the importance of the role played by the nurses and doctors in such situations.

Relevance

The research integrity topics discussed in this movie are: the importance of being informed as patient about the nature of the research you are about to participate in, the moral significance of the differences of ambitions and goals between a research participant and a researcher, the recognition of a person as a human being and the possible loss of this cardinal fact during research with human subjects, and the frustrating force of personal goals and interest on conducting integer research

This movie is included in the Fiction movies for RCR education.

Key words: Research waste
Medium: YouTube (This link was last checked on 15-08-2016)
Fragments: 2

Internet Movie Database (IMDb) about this movie: IMDb
Drama / playing time: 90 min.

Content and context

This movie is about dr. Vivian Bearing who is diagnosed with cancer (stage four, metastatic ovarian cancer). Because the type of cancer Mrs Bearing is suffering from is not treatable with the available medical resources at that time, she decides to participate in an early stage cancer treatment research. Gradually Mrs Bearing realizes that the ambition and drive to succeed, something, which characterized her through her life, wasn’t applicable for the situation she now found herself, a hopeless situation in which she will, sooner or later will come to die. It is with this realization that fear and insecurity gain the upper hand. This movie shows in a confrontational matter the changes of peace of mind during the different stages of the experimental treatment. Furthermore, it shows the importance of the role played by the nurses and doctors in such situations.

Wit is performed in one act with very a minimal set and painstaking detail in each movement. During her time in the hospital, her oncologist, dr. Harvey Kelekian, his assistant, Dr. Jason Posner, and Susie Monahan, her nurse, visits Bearing. As dr. Bearing goes through the journey, the audience sees her become less of a patient and more of a medical experiment. The only person that seems to show compassion or genuine interest is Nurse Monahan. As she talks to the nurse and understands that death could be a reality sooner than later, she decides to sign a DNR, or Do Not Resuscitate order. That order means that if Bearing loses consciousness no extraordinary means should be used to keep her alive. After signing the order, she begins to examine her life.

The next day Bearing has a heart attack and is dying, but dr. Posner doesn’t want to lose all of the research and calls in a Code Blue. Code Blue is the signal to quickly work to save a dying person’s life. After a brief scuffle, Nurse Monahan is finally able to convince the doctor of his mistake and they allow Bearing to transition peacefully.

Fragments

In this section, there are 4 fragments that were selected for use in education. Each fragment has its own ethics section. The fragments may be used combined or in combination.

Fragment 1: [4:00 – 4:15]

This fragment shows the moment in which Mrs Bearing is purposely not well informed about the content of the research that is being used to try out new medicines. Clearly Mrs Bearing is used as mean and not as end in itself, which is morally questionable. This fragment can be used for education on the importance of informant consent.
Ethics of fragment 1

It shows a situation in which a patient gives her consent to participate in a research without being informed about the true nature of the experiment, for instance what the exact consequences of the experiment are on her well-being, but also the lack of any realistic hope for recovery because of the treatment. Clearly the head of the research department is not so much concerned about the health of Mrs Bearing but is mainly focussed on getting enough, or more participant for his medical research. On this ground on could say that Mrs Bearing is not recognized as a human being, but is seen as object for research. It is for this reason that this movie can be used as an educational tool for clarifying what the moral significance is of informed consent.

Fragment 2: [32:00 – 34:00]

This fragment shows in what manner medical research puts pressure on the patient and how the patient experiences this. This fragment is also indicative for how the researchers are looking at the patient who is participating in a medical research. It shows the moment where the dimension of respect for a human being is lost or denied.
Ethics of fragment 2

What is most interesting about this movie and especially this fragment is that it also shows the perspective of the researcher, and his search for knowledge, his goal of improving medical treatments for future patients, which is in itself a noble cause. What is important though is not losing sight of the fact that it remains research with human subject, with have emotions and feelings.

Fragment 3: [57:00-57:20]

This fragment shows in a clear manner the two different worlds in medical research of having on one side human affection and feelings, and on the other, specific research purpose and goals which has to demarcate and secure research results from any kind of human emotional variability’s.
Ethics of fragment 3

The fragment shows the negative effect on a patient when a research team is mainly focused on their research goals. As motioned above I consider the denial of seeing Mrs Bearing as a human morally condemnable. In what actions or behaviour this denial comes about can be extracted from this fragment. Moreover, the fragment illustrates for instance the importance of language therein, for it shows how different medical language for describing certain procedures, feelings, complication etc. can be from the common language used to describe such things. This leads to a feeling of loneliness, mistrust, and misunderstanding.

Fragment 4: [64:40 – 65:30]

This fragment shows the moment when it turns out that although the tumour has decreased in size new ones arisen. The researchers want to continue the treatment solely for the reason of acquiring more results about the drugs. By doing so, placing the purpose of the medical research above the wishes of the Mrs Bearing, and also above what is, although this is hard to say, best for her.
Ethics of fragment 4

It shows how personal urge for recognition and success can have a frustrating force on respecting moral boundaries in medical research with human subjects.

Furthermore, the movie shows how dying is a natural aspect of life; something one doesn’t have to fear. One of the key sentences in this movie is: “Dead thou shalt die”, referring to the possibility of letting go of your fears for dying, and by doing so, letting “evil” dead die. Although this central theme of the movie hasn’t got much to do with research integrity is can be very insightful for doctors and medical researcher in having a better understanding of the acceptance of dying by patients.

Realism

This movie is very realistic. It shows a personal story of a woman dying without exaggerating this process at any moment. For this reason, the movie gives good insight into how patients can experience treatment and or medical research in a hospital. Also, it shows in a confrontational way what the effects of a treatment are on the experience of the body. For the main character describes in a well-formulated way what she is feeling and what she is emotionally going through.

Suggested use for education

This movie is particular useful for medical students, for it shows the other side of the bed perspective. Apart from informed consent in oncology phase -1 experimental phase, and the permission the patients, sometimes unwillingly or not fully understanding, gives, this movie discusses what the effect is of the attitude of a researcher towards a patient has on him or her.

This movie can be used as educational tool for students as for researchers. For students, it can be insightful what is a good way of patient – researcher interaction. For researchers, it also can be insightful but from them in a more confrontational way, for the movie shows from the perspective of the patient how certain routine or standard procedures and ways of behaving can have a negative effect on his or her feeling.

The fragments or movie can for instance in de following way be integrated into a lecture: A teacher could give his students the task to in reference to the movie think about different ways of interacting that potentially could prevent the negative effects from taking place. So the student analyse a fragment and have to find an answer to the question what exactly goes wrong, and subsequently, think of a possible better alternative. Furthermore, one could use this movie in a refreshment course for researchers. On the basis of the fragments, researcher could together or alone reflect on their day – to –day routines, and think about possible improvements.

Ending

The movie ends with dr. Bearing walking nude into a bright light.

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