Final Evaluation Assignment: Ethics and Caregiver Stress in Healthcare

This assignment analyzes the ethical dilemmas presented in the movie "Still Alice," focusing on the conflict between autonomy and beneficence in healthcare. The assignment explores a scene where Alice's children, Tom and Ana, struggle with allowing her to make her own decisions due to her Alzheimer's diagnosis, while her daughter Lydia supports her independence. The assignment discusses the representation of autonomy, caregiver stress, and the challenges faced by Personal Support Workers (PSWs) in balancing client well-being and autonomy. It also examines how caregiver stress is depicted in the movie, particularly through the experiences of Alice's husband and daughter Lydia, who sacrifices her career to care for her mother. The assignment references the principles of healthcare ethics and provides techniques for PSWs to ensure client safety and well-being while respecting their autonomy.

Running head: ETHICS AND PROFESSIONAL PRACTICE 1
Ethics and Professional Practice
Name
Institutional Affiliation

ETHICS AND PROFESSIONAL PRACTICE 2
Ethical dilemma in the film
In the movie, an ethical dilemma arises when two of the principles of healthcare, autonomy,
and beneficence conflicted. Autonomy refers to giving the patient the freedom to make
decisions while beneficence doing and promoting good. This conflict is shown in the scene
when the family is in their beach house for dinner. Alice’s son Tom, a medicine student,
enquires about all of her mother’s prognosis and diagnostic tests that she has undergone. On
the other hand, Ana (her daughter), wants to make all the decisions for her mother like a
child. While their intentions are pure in doing good for their mother (beneficence), they take
away their mother’s freedom to make her own decisions (autonomy). At this stage, her
condition had not severely progressed. Her other daughter Lydia, however, who abandons her
life to take care of her does her best to maximize her independence and decision-making. We
can argue that Tom and Ana were right in the later stages of the movie when Alice had her
personality robbed off by the diagnosis. After visiting a caregiving facility for people with
her condition, the vision that this might be her future prompts her to seek a prescription for
heavy pills and make a video on instructions on how to take them to commit suicide. Her
phone had become an essential tool helping her maintain the person she used to be before
Alzheimer’s. At this point autonomy is not an option because she has become a danger to
herself. Striking a balance between her well-being and safety and her freedom was extremely
difficult at this point (Genova, 2009). This gave rise to ethical dilemma.
Principle of Health Care Ethics presented in the film – Autonomy
In the scene at the beach house, Alice’s two children Tom and Ana are skeptical about letting
her make her own decisions due to her diagnosis. However, her daughter Lydia (a struggling
actress) abandons her life to stand by her mother tries to promote Alice’s independence. Later
on, Alice visits a care-giving facility for people with her condition while she is struggling to
maintain her identity before Alzheimer’s. The facility maximizes autonomy for the patients

ETHICS AND PROFESSIONAL PRACTICE 3
as the patients can move freely within the facility, they can be visited anytime, there are
personalized interactions between staff and patients and the patients are not confined
wheelchairs. Towards the end of the movie, it is debatable whether, Alice should be given the
freedom (autonomy) to carry out the wishes of the Alice of the past as now she has become a
different person, a shadow of her former self, or not. This is evident when she makes a video
instructing herself to commit suicide in the future. Alzheimer’s had robbed Alice of her
autonomy. She could no longer carry out the decisions she had made for herself before the
illness took over.
Balancing client well-being and autonomy
In caring for their clients, PSW must be able to strike a balance between the safety and well-
being of their clients and the freedom to make their own decisions. A PSW working from the
client’s own home can employ several techniques to enable the safety and well-being of the
clients while still allowing the clients to participate in daily activities. These techniques
include: having alarms that go off when the client leaves the bed or the chair (just like the
facility Alice visited), having electric cookers that automatically switch off, safety proofing
the house and most importantly joining them in doing these activities. Joining them that
requires full commitment from the PSW. The most effective is utilization of alarms and
automatic switches since they are not prone to attention lapse.
Caregiver stress in the movie
In the movie, Alice’s husband (John) hires a caregiver for his wife while they were living
together. Alice is unable to recognize her hired caregiver and feelings of frustration begin
rising. Later on, John receives a job offer from Mayo Clinic in Minnesota. As a result, Lydia
has to come back home to take care of her mother for her father to leave for Minnesota. Lydia
sacrifices her acting career to devote her life to taking care of her mother. Caring for an
Alzheimer’s patient requires full attention and exhaustion for Lydia was inevitable. She was

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able to do so as a result of a wonderful relationship she had with her mother. As a result, she
experienced caregiver stress. She was able to do so while the rest of her family continued
with their lives as usual.
References
Falcus, S. (2014). Storying Alzheimer's Disease in Lisa Genova's Still Alice.
Genova, L. (2009). Still alice. Simon and Schuster.