Channel 4 Learning


Channel 4 Programme Notes
PSHE - Up Close and Personal
Decisions
Programme 1
Ben's patient

Aims:

To raise awareness of:



Synopsis:

Ben opts out of education for a year to care for his mother who is terminally ill, and has to make a decision he hadn’t planned on. A realistic and sensitive docudrama tackling issues that frequently make newspaper headlines.

00.00-05.11
Ben’s mother diagnosed with Motor Neuron disease. Falls down stairs - alerts everyone to reality. Ben wants to be carer; parents want him to go to university. Ben wins.

05.12-08.53
Mother falls again strikes out at Ben. Hostile to wheelchair. Father away on business. Ben establishes routine. Father returns. Finds mother attempting stairs alone. Blames Ben, who argues parents not accepting reality. Reflects on role of carer.

08.54-15.09
Family’s aging dog has stroke. Ben and mother become closer. She asks him to promise he’ll make something of his life. Father appears as outsider. Dog put down - mother asks vet if there is any lethal injection for her?

15.10-21.31
Mother contemplates suicide. Husband horrified - legalities etc. Ben uncertain, confides in friend. Would be relief, but she’d need help. Friend shocked, warns of legalities.

21.32-24.10
Ben reflects on mother’s illness and right time to die. Before unable to, she attempts suicide. Ben finds her, hesitates, then calls ambulance.


Curriculum Relevance:

Major PSHE and Citizenship focus. Cross-curricular: English and drama, media, biology, psychology, religious and moral education.

England & Wales Key Stage 4

PSHE

Citizenship

Northern Ireland

Learning for Life and Work Area (14-18):

Personal Development Strand (Including PSHE and Home Economics):

Scotland

Scottish Executive: Guidance on PSD, Citizenship - middle to upper secondary stages.

Background Information:

Motor Neuron Disease (MND - the issues)
Although relatively rare, Motor Neuron Disease is a distressing terminal disease which often makes the headlines because people want help to die before the disease takes its natural course. Some forms of cancer, and full blown AIDS, place people in a similar position. Coping with such conditions, and requesting the help to die, can be very stressful for carers and others.

The Law
Currently in England and Wales any assistance in a suicide carries a prison sentence in years. In Scotland prosecution comes under 'recklessly endangering life' or 'culpable homicide'.

Young carers and MND
Relatively little is known about MND and although rare, the fact that a small percentage of cases are familial may cause further anxiety for young people coping with a parent with the disease. While risks may be small statistically, most people are frequently unclear about how to interpret statistical risk, and may make emotional and personal interpretations which can be detrimental to their mental and physical health. To try and keep anxieties to a minimum, at what is already an anxious and frightening time, it is important to try to have some kind of perspective on the relative rarity of the disease, the average age at onset (55) and possible developments in science and medicine in the future.

The nature of the disease
Motor Neuron Disease (MND) is neurodegenerative disease which occurs in adults. The exact cause is unknown. At present there is no treatment that substantially slows the progression of the disease and the average time of survival from the start of symptoms is only about three years. It can begin in either the lower limbs or upper body but eventually spreads to the entire body. People with MND eventually die from asphyxiation as the motor neurons controlling breathing become affected by the disease and gradually cease to function. Those with the disease remain mentally alert throughout the entire course of the disease.

Incidence
The incidence of the disease in the UK is currently one or two per hundred thousand of the population. A GP practice with 10,000 patients on their list is likely to encounter a case every two to three years. MND predominantly affects middle aged and elderly people with mean age of onset being 55 years, although younger adults are occasionally affected. The disease is sporadic in about 90% of cases, but about 10% are familial.

How's it diagnosed?
There is no specific test for MND at present. Tests are usually carried out to confirm the diagnosis by eliminating other possible conditions. Diagnosis may be difficult because the pattern of symptoms varies between individuals and may be similar to those seen in other conditions.

The future
New understanding of the development of the disease is suggesting the way towards more effective treatment to try and slow or stop injury to motor neurons. As scientific developments prolong survival, attention will become increasingly focused on quality of life.



Activities:

Teachers and lecturers should be aware there may be students who have had to cope with a parent or close relative dying from a terminal illness (see background).

Before viewing

Depending on context teachers may wish to use the following questions for brief discussion before viewing, or after.

  1. What would make a teenager want to be the carer for a parent with a terminal illness?
  2. Would some people find this easier than others? What might influence this?
  3. Should people be allowed to control when they die?

Teachers may wish to alert students to the themes below, or use them to frame discussion after viewing.

Three themes (see outline for related timings).

  1. Deciding to become a carer for a family member with a terminal illness.
  2. Coping with the illness’s progress and the responses to this by all involved.
  3. Thinking about suicide, assisted suicide, rights and the law within this context.

After Viewing

  1. Identify the stages by which the illness progresses, and the reactions of those involved. What would be most difficult challenges for Ben? The family are well off. Does this help? How would you sum up the way Ben and his father handle the situation? What do you feel about this?
  2. Identify the different reactions to the idea of suicide, and assisted suicide, in the film and the current legal position in UK. What are students’ reactions to this? Is there disagreement or consensus? Discuss the way in which the dog is treated compared to the mother. Are any conclusions reached about this?

Key questions

  1. Did Ben make the right decision to call the ambulance?
  2. What will be the future impact of his action on his mother, his father, himself?
  3. Reflect on the three questions in section A (above). Have opinions changed? If so, why?



Links:

This web page contains links to other websites that are not under the control of and are not maintained by Channel 4 Television. Channel 4 Television is not responsible for the content of these sites and does not necessarily endorse the material on them.

The Motor Neuron Disease Association provides information on MND, current research, and care services. Has helpline and branch websites.
http://www.mnda.org

Europe’s leading cancer information service: cancers and their treatment, organisations and support for suffers and carers, free phone helpline.
http://www.cancerbacup.org.uk

Supports people who provide unpaid care for family, partners and friends who are ill, frail or have a disability. Sections for the four countries in the UK and under 16s.
http://www.carersonline.org.uk

Voluntary Euthanasia Society (UK) campaigns within current legal framework for those terminally ill to be able to ask for medical help to die, at time of choosing, with proper legal safeguards. Good clear information on the issues involved.
http://www.ves.org.uk

Credits:

Series
Camera: PAUL OTTER
Sound Recording: CHRIS GIBBIONS
Producer: GARRY LYONS
Executive Producer: ALLEN JEWHURST
Webnotes: IAIN RAMSAY

Ben's Patient
Music: JOHN MILES
Editor: BARRY REYNOLDS
Director: JO SHOOP

Steve's Heartache
Written by GARRY LYONS
Music: W. INDIAN CO.
Editor: TIM RITSON
Director: GERRY TROYNA

Leah's Trial
Music: EDWIN PRESTON, JASON WILLIAMS
Editor: BARRY REYNOLDS
Director: JO SHOOP

CHAMELEON TV 4