Distributor:  The Fanlight Collection
Length:  45 minutes
Date:  2001
Genre:  Expository
Language:  English
Grade level: College/Adult/Professional
Color/BW:  Color
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Caring at the End of Life

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The challenges patients, families and health care providers face when addressing end-of-life care and decision-making.

Caring at the End of Life

Central to this provocative documentary is the case of a comatose patient, whose family and healthcare team are in conflict over how long to continue with the treatments which are keeping him alive. In making decisions about his care, they confront disturbing ethical questions about patient autonomy vs. the needs of the family, about who is in a position to judge what another person would want, about the role and impact of faith, and about the certainty or fallibility of medical judgement. This moving film focuses on the key roles of nursing staff in patient care and communication. It profiles six severely ill patients who agreed to be a part of the Robert Wood Johnson Foundation's SUPPORT Study on end-of-life care and decision making.

Their stories offer no easy answers, but raise many of the key issues faced by patients and those who care for them, including the role of technology, deciding when to use or withdraw life-sustaining treatments, the importance of effective pain management, and the impact of patients' culture and community on care decisions. This film was partially supported by the Robert Wood Johnson Foundation.

'A thought-provoking, controversial video that really makes the healthcare provider sit up and take notice. Real-life patients were filmed with staff and family members to illustrate the complex realities of end-of-life care and decision making. Should be required viewing by healthcare workers, administrators, and students.' American Journal of Hospice and Palliative Medicine

'Sensitive and provocative. Does something that no other video on the subject has done: rather than blanket the presentation with reassurance that may falsely lead viewers to believe that there are easy answers to concerns at the end of life, this video lays out the message that uncertainty is part of the experience. Sometimes pain can be relieved, sometimes not. Sometimes medical personnel are right that a coma is irreversible, sometimes not. Caring at the End of Life has a place in medical ethics and nursing curricula, but the most important venue for this video is as part of a carefully facilitated conversation in the community at large.' Deni Elliott, University Professor of Ethics, University of Montana

'Highly recommended. This is another quality Fanlight Productions item and is appropriate for any collection with this topic focus.' MC Journal

'Looks respectfully at the roles of nursing staff and others as they help people who are dying. A good resource for college students and others who are working with dying patients.' Science, Books and Films

'Recommended for medical libraries and medical training collections. Video Librarian

'Demonstrates the importance of collaborative practice in advance care planning and superbly highlights the critical role nurses can play in achieving better end-of-life outcomes. Offers the opportunity to eavesdrop on skilled communication (verbal and nonverbal) between caregivers, patients, and families when tough end-of-life decisions are being made.' Carol Taylor, CSFN, RN, PhD, Georgetown University Center for Clinical Bioethics

'Achtenberg and Mitchell have captured the complexity of end-of-life decision making. Their documentary footage of real cases illustrates the importance of patient and family involvement and suggests key questions to ask of one's clinicians. Health care professionals may see themselves and their colleagues in new ways that will, hopefully, encourage self-scrutiny and behavior change.' Mildred Z. Solomon, EdD, Center for Applied Ethics and Professional Practice

'Focuses on the importance of emotional caring in the complex and increasingly technological care of seriously ill patients. Many of the situations illustrate the effects of changing situations and medical uncertainties, the burden of making care decisions for both the family and the caregivers, and the importance of communication. These situations will ring true to practicing clinicians and offer an opportunity for stimulating discussions among students, clinicians, and all involved in health care. Elizabeth F. Hiltunen, MS, RN, CS


Awards

CINE Golden Eagle
Silver Award, Houston International Film Festival
Honorable Mention, American Academy of Nursing
Excellence, American Medical Writers Association
Columbus International Film and Video Festival
American Society on Aging

Citation

Main credits

Achtenberg, Ben (screenwriter)
Achtenberg, Ben (film director)
Achtenberg, Ben (film producer)
Mitchell, Christine (film producer)
Loeb, Jeff (narrator)

Other credits

Written & directed by Ben Achtenberg; produced by Ben Achtenberg, Christine Mitchell.


Distributor credits

with Christine Mitchell, RN, FAAN

By Ben Achtenberg

with Christine Mitchell, RN, FAAN
By Ben Achtenberg

Docuseek2 subjects

Death and Dying
Longterm Care
Nursing Education

Distributor subjects

Death and Dying
Ethical Dilemmas
Healthcare
Issues and Ethics
Nursing

Keywords

film; captioned video; documentary; robert wood johnson foundation; SUPPORT project; SUPPORT study; critical care; life-support; life-sustaining treatment; futility; patient autonomy; faith; religion; medical judgement; patient communication; medical technology; pain management; culture and communication; doctor patient communication; physician nurse communication; advance directive; death; dying; end-of-life care; end of life; terminal illness; caregiver; caregiving; health care; healthcare; illness; disease; patient; nurse; nursing; doctor; medicine; physician; hospital; ; "Caring at the End of Life"; The Fanlight Collection

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