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In the film “Awakenings,” Dr. Sayer’s journey with his patients illustrates profound ethical dilemmas and principles. Beneficence shines through as Dr. Sayer, driven by a deep sense of compassion, embarks on a quest to revive his catatonic patients using the experimental drug L-Dopa. His actions epitomize the desire to do good, to alleviate suffering, and to bring a semblance of life back to those who have been in a vegetative state for decades.

However, this quest is not without its challenges. The principle of non-maleficence, the duty to do no harm, weighs heavily on Dr. Sayer’s conscience. He meticulously monitors the patients, constantly adjusting dosages and vigilantly watching for adverse reactions. The film poignantly portrays his inner turmoil as he grapples with the potential harm of the treatment, underscoring the delicate balance between hope and risk in medical experimentation.

Justice is another key principle that Dr. Sayer strives to uphold. He ensures that all his patients have equal access to the experimental treatment, advocating tirelessly despite limited resources and skepticism from his peers. Yet, the film subtly highlights the broader systemic issues, where the allocation of resources and the cost of experimental treatment pose ethical dilemmas for the healthcare system.

Autonomy, the right of patients to make informed decisions about their own care, is a particularly complex issue in “Awakenings.” Initially, the patients’ catatonic states render them incapable of providing consent. Dr. Sayer makes decisions on their behalf, guided by his compassionate understanding of what he believes to be in their best interest. As the patients awaken, their autonomy becomes the focal point. They are now able to voice their own wishes, fears, and hopes, and Dr. Sayer respects their newfound ability to participate in their care decisions.

Spiritual Care in “Awakenings” and Chapter 10 Reflections

Reflecting on Chapter 10, the film “Awakenings” offers a nuanced portrayal of spiritual care in a healthcare setting. Dr. Sayer, while primarily focused on the medical aspects of his patients’ conditions, inherently provides spiritual care through his deep empathy and dedication. He respects the humanity of each patient, offering not just medical intervention but emotional and spiritual support.

For Leonard, his mother, and the other awakened patients, the hospital becomes more than just a place of medical treatment. It transforms into a sanctuary where patients reconnect with loved ones, rediscover their passions, and experience moments of joy. This holistic approach aligns with the principles discussed in Chapter 10, emphasizing the importance of addressing the spiritual and emotional needs of patients alongside their physical care.

The film beautifully captures these moments of spiritual care, whether its Leonard’s poignant interactions with his mother, the joy of patients experiencing life’s simple pleasures, or the supportive community that forms among patients, families, and staff. These elements highlight the critical role of compassion, empathy, and human connection in holistic patient care.

Research Misconduct in “Awakenings”

Despite the film’s uplifting moments, it also depicts ethical challenges and instances of research misconduct. One of the most glaring issues is the lack of informed consent. The patients, in their catatonic states, are unable to provide consent for the experimental treatment. While Dr. Sayer’s intentions are noble, the process lacks the necessary ethical protocols for informed consent.

Furthermore, the experimental nature of the treatment raises concerns. The use of L-Dopa on such a vulnerable population without comprehensive clinical trials exemplifies a deviation from the rigorous scientific and ethical standards required in research. These actions underscore the ethical complexities in balancing hope for a cure with the responsibilities of conducting ethically sound research.

High-Profile Case Analysis: Andrew Wakefield, UK

The case of Andrew Wakefield stands as a stark reminder of the devastating consequences of research misconduct. In 1998, Wakefield published a study suggesting a link between the MMR vaccine and autism, sparking widespread fear and a significant decline in vaccination rates. This case exemplifies the profound impact that unethical research can have on public health.

Subsequent investigations revealed that Wakefield had manipulated data and violated ethical research standards. His actions led to legal repercussions, including the revocation of his medical license and the retraction of his paper. The misinformation propagated by Wakefield’s study resulted in public health crises, with decreased vaccination rates leading to outbreaks of preventable diseases.

For advanced practice nurses, avoiding involvement in research misconduct is paramount. Adhering to ethical guidelines, ensuring transparency, and maintaining integrity in research is critical. Rigorous peer review processes, proper documentation, and obtaining informed consent are essential practices. Moreover, fostering a culture of accountability within healthcare organizations and continuous education on ethical research practices can help prevent misconduct. Collaboration with multidisciplinary teams can provide checks and balances, ensuring that research is conducted ethically and responsibly, ultimately safeguarding public trust and health.

 

References

Morrison, E. E., & Furlong, E. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.). Jones & Bartlett Learning.

Marshal, P. and Murphy, N. (1990). Awakenings [Film].

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After viewing the Hospital Ethics Committee—Who Gets the Heart? (7:48 minutes)Links to an external site. presentation, answer the following questions in a numbered list in your original response:

1.     Your vote decides who gets the heart. Who would you choose and why?

2.     How did health inequality and inequities affect your decision?

3.     What ethics would you use to back up your decision?

4.     Why did you not choose the other candidates?

5.     Was this an easy or a difficult decision for you?

6.     Would you want to serve on an ethics committee in the future? Why or why not?

In your responses to peers, provide at least one reference with in-text citations to current literature and assigned readings to support your assertions. If you copy and paste references from the course into your discussion, be sure to confirm APA formatting before submitting.

PEER TO RESPOND TO:

 

1.     Your vote decides who gets the heart. Who would you choose and why? 

·        I would choose Quentin West to receive the heart. Despite his history of substance abuse and a high BMI, Quentin has a compelling case for several reasons: he is relatively young, has a family depending on him, and his condition resulted from his time as a professional athlete, suggesting a commitment to physical health earlier in life. Also, Quentin’s substance abuse history is in the past, indicating he has made efforts to improve his health for his family’s sake. His potential for a longer lifespan and the significant positive impact on his family’s well-being make him the most suitable candidate. 

1.     How did health inequality and inequities affect your decision? 

·        Health inequalities and inequities play a crucial role in this decision. Quentin’s circumstances highlight the challenges faced by individuals who have experienced professional sports physical toll, coupled with a history of substance abuse. Providing him with the heart transplant could help address some of the inequities he faces, offering him a second chance to support his family and improve his quality of life. Moreover, prioritizing a candidate who has overcome significant challenges aligns with principles of justice and fairness in healthcare. 

1.     What ethics would you use to back up your decision? 

·        The ethical principles of beneficence, non-maleficence, and justice support my decision. Beneficence requires us to act in the best interest of the patient, and Quentin’s potential for a longer life and the ability to care for his family aligns with this principle. Non-maleficence involves avoiding harm, and giving the heart to Quentin avoids the potential harm of neglecting his family’s well-being. Justice emphasizes fairness and equity, and choosing Quentin helps address disparities and provides him with an opportunity to overcome his health challenges. 

1.     Why did you not choose the other candidates? 

·        Helen Adams: Helen’s hesitation about the transplant and lack of family support, coupled with her older age and history of smoking, made her a less optimal candidate. Her ambivalence about the transplant suggests she may not be fully committed to the post-transplant lifestyle changes required for success. 

·        Ear Hope Eubanks IV: Despite the potential financial benefits to the hospital, ethical considerations regarding fairness and substance abuse disqualify Earl. His recent cardiac arrest, history of cocaine use, and inconclusive drug screen raise significant concerns about his suitability for a transplant. Additionally, making a decision influenced by potential donations would compromise the integrity of the committee’s decision-making process. 

1.     Was this an easy or a difficult decision for you? 

·        This was a difficult decision because it involved weighing the lives and potential outcomes for three individuals, each with their unique circumstances and challenges. The ethical complexities and potential consequences of the decision required careful consideration of all factors involved. 

1.     Would you want to serve on an ethics committee in the future? Why or why not? 

·        Yes, I would want to serve on an ethics committee in the future. While challenging, these decisions are critical in ensuring fair and equitable treatment in healthcare. Serving on an ethics committee allows me to contribute to important discussions and decisions that can profoundly impact patients’ lives, ensuring that ethical principles guide clinical practice and resource allocation. 

 

References 

Morrison, E. E., & Furlong, E. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.). Jones & Bartlett Learning. 

 

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