Introduction
“Awakenings,” Penny Marshall’s directorial debut (1990), narrates the true story of Dr. Malcolm Sayer’s work in the late 1960s. This was a time when the doctor was known for his breakthrough treatment with catatonic patients. The movie painstakingly follows the legal and ethical labyrinth of the famous tragic case of encephalitis lethargica that resulted in a number of patients in incurable and deliberate comatose conditions due to the neglect of the healthcare system, and especially focuses on the administration of the then-novel drug L-Dopa to those patients (Marshall, 1990). This paper will critically analyze the ethical problem confronted in the movie, addressing this in the main body using scholarly resources, including the medical ethics paper by Pozgar as the reference source.
Ethical Challenges summary
The protagonist of “Awakenings” undergoes experimental therapy, which poses the ethical dilemma of whether autonomy and the essence of being are important. This moral problem centres on the freedom of choice, what a good and bad life is, and the Hippocratic oath that doctors do not cause harm to people while seeking good things. The profound ethical issues that intertwine with such actions are among the most fundamental in any such project (Lipinsky, 2021). One major issue is the protection of patient rights and dignity, which a doctor should always defend. The challenge is to find the delicate balance between satisfying the innovations of new treatments and safeguarding the freedom and well-being of patients. This tricky interplay between high medical ambition and ethical care in medicine requires thoughtful reflection and a patient-centred approach (Pozgar). In conclusion, the ultimate thing to consider is putting the patient’s interests at the centre while exploring groundbreaking medical science discoveries.
Legal and Ethical Considerations
In medical treatment, informed consent is an essential factor used in ethical care to ensure that the patient understands and agrees to the suggested treatment. But, in the movie “Awakenings”, patients are catatonic, and this makes it very difficult for them to give their consent in this way, and so raises legal and ethical challenges (Lamont et al., 2019). This case scenario begs many questions, such as the patient’s autonomy and the healthcare providers’ duties. Traditionally, medical care providers are guided by the principle of “first, not harm”, but the patients’ inability to convey their wishes further complicates the physician’s attempt to be the patient’s voice.
Moreover, we see how the movie deals with the ethical dilemma between beneficence and nonmaleficence. The cure for Parkinson’s disease is a harsh reality that Dr Sayer is deeply aware of, and the reason why he decided to administer L-Dopa to his patients is to make their lives better. Nevertheless, this decision prompts an ethical dilemma: Is it right to apply highly risky treatments on patients who are not even ready to give their consent for the therapy when the benefits are tremendous? This question stimulates contemplation of the previously unknown balance that healthcare providers should perform between actions that they feel are in patients’ best interests and those promoting their autonomy (Lamont et al., 2019).
The hallucinatory awake condition of the patients reveals problems centred on patients’ autonomies. The first problem for them is to choose the options when they wake up suddenly after a long period of being in a vegetative state. Their condition is unpredictable, so it gets more complex, and the drug can also cause side effects. Medical providers must grapple with the intricacies of respecting the patient’s autonomy while guaranteeing their well-being and safety. The principles of beneficence and nonmaleficence are the two major pillars of medical ethics, which guide practice by advocating the need to perform actions that are in the best interest of the patient and to avoid causing harm. The initial improvement of the patients under the influence of L-Dopa might be considered beneficial, but the gradual decline into their original impaired state may be problematic (Lamont et al., 2019). This amazing condition that we call the balance between the doing of good and the avoidance of harm confronts the doctor with the question of what is ethically right. The film shows the movie depicts the conflict between these two principles and the hard choices physicians must make to meet ethical standards in medical practice(Marshall, 1990).
Examination Through Legal Concepts
In the movie “Awakenings,” the use of L-Dopa leads to the ethical and legal dilemma related to the inability of patients to consent for themselves while not being able to fend for themselves as well. In the US, it is mandated that patients or their legal representatives be fully informed of the risks involved in medical procedures. It becomes more complicated when patients are unconscious or the other way around since this is the case in the movie. Here, the surrogate decision-making concept plays, where the surrogate, as designated, makes medical choices rather than the patient.
Nevertheless, it is filled with obstacles. Surrogates could be unaware of the details of medical risks that might not be disclosed by the patient’s doctor, or the patient may have yet to share their wishes and values with the doctor. The scene illustrates this in “Awakenings”, where the surrogates, through no fault of their own, have to take a position and guess the patient’s will (Rosenthal, 2018). This ethical issue is further aggravated by the problem of the balance between the surrogate’s point of view and considering what may be in the patient’s best interest so that the care provided should be in line with what the patient would likely expect and what is best for them.
The film illustrates the intricate intertwining of medical ethics, legal rights, and personal decision-making in health care very well. It brings the fact that patient autonomy is one of the critical aspects of the healthcare process and the importance of patient consent to the forefront. Thus, it pinpoints the ultimate responsibilities accompanying decision-making from the surrogate decision-making side. At the end of the day, “Awakenings” can be said to be a moving study that actively sheds light on the ethical issues at the core of medical ethics, emphasizing the rights of those who cannot have a voice for themselves.
Cultural Values Impact
Abroad, some communities highly value life, leading to making certain decisions, especially regarding medical cases. The healthcare system commonly upholds life protection principles through medical interventions intended to treat different diseases, including mental ones. This is often represented in motion pictures, TV and other media, where medical staff and family members are usually seen to be driven by public perceptions towards mental health while making critical decisions. They show the common idea that science is a powerful tool to be used not only to cure old diseases but also to create new advanced treatments, even if one can target diseases that have never existed before.
On the other hand, this heavy dependence on the medical approach initiates a hot discussion of ethical questions (Appelbaum & Grisso 2019). The moral problem arises when we discuss the degree to which patients are to be involved in decision-making regarding their treatment. In the modern world, people are gaining more and more knowledge about their right to decide for themself and not to have procedures that would be imposed without the patient’s detailed understanding or consent, which in some cases can be accompanied by feelings of violation and loss of agency. Using a method like this results in ethical issues and the provision of a balanced approach that shows respect for both the medical aspects and the rights and voices of patients. The healthcare system must maintain this balance while working on medical discoveries and saving lives. At the same time, the dignity and independence of the patients it seeks to heal should remain unharmed.
Proposed Course of Action
Having the ethical burdens brought out by “Awakenings” in mind, it is vital to develop a program that considers the well-being of patients and the whole family. It is inevitable that before administering experimental therapies, it is necessary to do an in-depth analysis of the patient’s values, preferences, and quality of life they want to preserve (Elder, 2023). This approach adheres to the ethical principle of respect for persons, which means that treatment commitment is made after considering the person’s viewpoint. The other issue is creating more transparency and dialogue between medical specialists, patients and their families. Such a step will promote a more ethical way of handling novel treatments. Thus, aside from getting the patient to agree, respect for their autonomy and dignity–the backbone of ethical healthcare–is also preserved, which is highly significant.
Conclusion
“Awakenings” is a reflective study of the trials of the new medical technology and the ethical problems it accommodates. The movie shows that the medical concept is an edge between the latest technology and ethical fundamental principles. As such, it requires an enlightened comprehension of patients’ rights, informed consent, and the moral obligations of healthcare personnel. The questions are not only relevant to neurology as a speciality area but are also significant in the sphere of medical ethics in general. Such analysis highlights the role of ethical standards and legal norms as relevant irrespective of the moral situation.
This paper will provide a critical analysis of the interactions of ethical and legal norms with medical innovation. The main argument will be that a balanced approach that takes into account the importance of patients’ autonomy and informed decision-making should be given priority in medical practice.
References
Lamont, S., Stewart, C., & Chiarella, M. (2019). Capacity and consent: Knowledge and practice of legal and healthcare standards. Nursing ethics, 26(1), 71-83.
Lipinsky, Y. T. (2021). Clash of Titans: An ethical framework towards limitations in religious accommodation within healthcare (Doctoral dissertation, Duquesne University).
Rosenthal, M. S. (2018). Clinical Ethics on Film: A Guide for Medical Educators. Springer.
Appelbaum, P. S., & Grisso, T. (2019). The MacArthur Treatment Competence Study. I: Mental Illness and Competence to Consent to Treatment1. Clinical Forensic Psychology and Law, 129-156.
Elder, A. (2023). What can Confucian ethics teach us about designing caregiving robots for geriatric patients? Digital Society, 2(1), 7.
Marshall, P. (Director). (1990). Awakenings [Film]. Columbia Pictures.
Pozgar, G. D. (Latest Edition). *Legal Aspects of Health Care
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