Stories Matter: The Role of Narrative in Medical Ethics

By Rita Charon; Martha Montello | Go to book overview

CHAPTER 2

THE ETHICS OF MEDICINE, AS REVEALED IN LITERATURE

WAYNE BOOTH

The drama Wit, by Margaret Edson, mostly located in a hospital ward, has I become one of the most celebrated plays of this decade. The heroine, a middle-aged woman dying of ovarian cancer, reports to the audience both how she is feeling, as she endures each miserable step of her decline and treatment, and how her miseries relate to her professional life as a teacher of literature. She discovers only slowly that the treatment she has been receiving from top doctors is part of the drug research experiment they are aggressively pursuing. The play provides mounting evidence that the doctors care far more about their research results than about her pain and death; it is possible that they have even violated the standard rules about patient consent. As the heroine, Vivian, dies, she leaves her bed, takes off her garments, and appears before us beautifully nude. She has escaped, by dying, from the inhumane treatment of those doctors and various assistants. Only one nurse has exercised genuine “kindness,” teaching the teacher that she should have shown more kindness to her own literature students.

We are thus left with a powerful but complex response: grief at Vivian’s suffering, relief over her escape, and fury at the cruel behavior of the doctors, who have in scores of ways revealed that they are more interested in pursuing research results than in what she feels or whether she survives.

The play is not just about the ethical issues of medical treatment. It is aggressively “literary”; Vivian constantly celebrates the beauty of John Donne’s Holy Sonnets,1 remembering her skillful—and excessively bossy—teaching of students to understand how Donne probes the meaning of death. But though the play never abandons her interest in literature, and in how Donne’s work faces the problems of death, its plot depends on our taking an aggressive ethical stance that relates only obliquely to the study of literature. The power of the ending requires us to share, without question, the author’s implied judgment that humane, honest, compassionate treatment of patients is ethically far more important than the pursuit of research results. Thus it can be said to impose on us—some serious researchers might say “dogmatically” or “unfairly”—a decisive ethical conclusion about issues that have plagued philosophers forever: When “truth” and “goodness” clash, which should win? Is it immoral to use a patient’s life in the pursuit of

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