Educational Media Reviews Online

This isn't Thursday night and this isn't ER.

Hard Choices is a film about the events at Westinde, an inner city hospital that borders The Hague, Netherlands. The film is done in 3 parts and is well organized and compelling. It examines the lives of doctors, nurses and patients over the course of a few days. Viewers are exposed to the real life situations experienced by our cast of characters. While the focus of the film centers on the choices the hospital staff make in the course of treatment, we the viewer can't help but be affected by the patients. We feel their pain, their joy and their hope.

Hard Choices presents a balanced view of life and sometimes death in the hospital setting. You get to experience the view of the patient as well as the medical professional. You are exposed to situations that do not always have a clear-cut solution or a happy ending. The realness of the film is a credit to the director. The viewer is exposed to a variety of situations in the form of 6 cases. Each case is specific about its point. The first case raises the question of "to treat or not to treat" and if so how much or how little. The second case confronts a situation where the patient does not wish treatment. The third case deals with not being able to make a definite diagnosis even after all tests have been run. The fourth case explores dealing with an aggressive patient and how best to offer treatment while maintaining a level of safety for other patients and hospital staff. The fifth case examines how cultural and language differences play a role in diagnosis and treatment. The final case looks at when what the patient wants is against medical creed.

Hard Choices should not be approached as a teaching video in the traditional sense. It presents situations where the decisions can be as varied as the staff or patients. A definitive solution or "right answer" is not presented - real life is often not tidy or explicit. Complex cases offer the viewer a wide range of options on the course of treatment allowing for interpretation.

The film is spoken entirely in Dutch with English subtitles. This should not dissuade the viewer for the film is not as much about words as it is actions. The film provides the viewer an opportunity to observe real time medicine in another country. Different in pace and technique but still familiar. Viewing the film in the context of the study of international medicine is beneficial.

Hard Choices is recommended for hospital and academic health sciences libraries. The film presents topics for students of medical ethics, medicine and nursing as well as practicing healthcare professionals.