Documentaries often deal in sadness and Netflix’s new short Extremis is no exception. A film on end-of-life care that is shot entirely in an Intensive Care Unit at Highland Hospital in Oakland, California, the piece centers on Dr. Jessica Zitter, a palliative care specialist who leads a team in helping terminal patients prepare to die. Zitter treats or oversees patients who have no hope of recovery—for example there’s Selena, who stopped breathing on the way to the ER and suffered severe brain damage, and Donna, a woman with severe myotonic muscular dystrophy that has severely compromised her existence. Her family is tormented with the knowledge that the breathing tube is likely all that’s keeping her alive. A third patient is a woman on a respirator who is unsuccessfully trying to write her intentions on paper. Many of these patients are chained to supportive equipment with no hope to ever get off.

The main tension in the film is Zitter’s efforts to help guide her patients and their families toward the ultimate realization that there is often no realistic chance of recovery. She comes across as compassionate and supportive if rational to the point of dogma. There are disturbing points in the film where families such as Selena’s try to resist, clinging to a sliver of hope, which Zitter cuts through with reasoning and calm resolve. In this way, the documentary highlights the main tension of end-of-life care: Doctors often have different priorities than the patients and family members they’re treating. That’s because doctors are often able to see the stark reality of a situation before the patients and family can. “I’m always looking for another miracle,” Selena’s daughter Tama says, adding that pulling her mother’s tube “feels like murder.”

Extremis runs just 24 minutes, but the film still manages to address several difficult questions about who ought to make the decisions of when it’s time to stop treatment: Can a patient who is severely ill make a clear decision about when and if to withdraw care? At what point should family members (or surrogates) take over decision-making from a patient? What is the role of a person’s faith even when the science seems irrefutable? (…) Read Full Publication Here

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