A couple of years ago, Jennifer Rubin wrote in Commentary magazine about the phenomenal impact of John Grisham’s legal novels and movies such as The Rainmaker. Juries have ramped up their expectations about the amount of damages that should be awarded to underdog plaintiffs. Fiction is remaking not only law, but medicine as well. The Fox network recently announced plans to develop a medical drama focused exclusively on medical ethics.[1] You may already be familiar with medical dramas such as House, M.D. or Grey’s Anatomy. For some viewers, including medical students, this is their primary window into understanding medical ethics.
We know these shows present stylized depictions of hospital life and their story lines are fictional, but we do expect the medical facts to be accurate. After all, medical dramas routinely hire medical advisors for just that purpose. Do we have similar confidence when it comes to ethical scenarios? These shows may influence what behavior we think is ethical, what to expect and what not to question if we encounter our own ethical dilemma.
When it comes to demonstrating ethical behavior and offering positive examples of medical professionalism, many medical dramas fail miserably. A recent study found that “exemplary” informed consent discussions were depicted only 43% of the time on Grey’s Anatomy and House, M.D. The remainder featured “hurried and one-sided discussions,” and doctors refusing to answer patient questions.[2] In most cases of serious unethical conduct, such as patient endangerment, the implicated physician is not penalized or held accountable by their fictional supervisors. This is unlikely in real life.[3]
These negative depictions of medical professionalism are of particular concern to those involved in training the next generation of nurses and doctors. More than 80% of medical and nursing students watch medical dramas and are likely to be informally educated through these programs.[4] I’ve heard this confirmed in discussions with fourth-year medical students.
Even so, medical dramas have an educational purpose. They are certainly engaging, and evoke more emotional involvement by the viewer than reading a case study. Different scenarios addressed on these shows may be useful in highlighting examples of professional misconduct and encouraging meaningful discussion on ethical issues.
We too can use scenarios featured on medical dramas as a springboard for discussion with our family and friends. Given the poor examples of ethical behavior, however, we should ensure that medical dramas only supplement and not provide the core of our education on medical ethics.
We can’t help but be affected by the television shows we watch. But the lordship of Jesus Christ should affect every inch of our lives as Abraham Kuyper famously said. Christians should not merely be shaped by television. We should use our minds and interpret what we see through the redemptive lens of the Gospel. That’s why understanding how we are affected by the medical dramas we watch is “everyday bioethics.” Whether it’s medicine or law, our ethics should be about what’s right, not about the underdog or an emotional hook. Let’s make sure that we know how to separate fact from fiction.
[1] Nellie Andreeva, “Fox Developing Medical Drama From Writer Warren Leight and Chernin Entertainment,” Deadline, January 3, 2011 http://www.deadline.com/2011/01/fox-developing-medical-drama-from-writer-warren-leight-and-the-chernin-co/ (accessed January 31, 2011).
[2] “Spoiler Alert: TV Medical Dramas ‘Rife’ With Bioethical Issues and Breaches of Professional Conduct,” PhysOrg, March 26, 2010, http://www.physorg.com/news188816826.html (accessed January 31, 2011).
[3] Ibid.
[4]Matthew J. Czarny, et al. “Medical and Nursing Students’ Television Viewing Habits: Potential Implications for Bioethics,” The American Journal of Bioethics 12 (2008): 1-8.