Grey's Anatomy, House present skewed ethics
March 31, 2010
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Nancy J. White
LIVING REPORTER
An intern, in love with her patient, makes him sicker so he’ll go to the top of the waiting list for a donor heart.
The hospital chief orders an intern to make up a diagnosis so a patient can be discharged.
Interns and doctors sneak into the on-call room, or any available broom closet, for hot and heavy sex.
While these television plot lines make for lively entertainment, their portrayal of medical professionalism barely has a pulse.
A new study, available in the April issue of the Journal of Medical Ethics, analyzed season two of the popular medical dramas Grey’s Anatomy and House M.D. to see what is being depicted to the public.
Conducted by the Johns Hopkins Berman Institute of Bioethics, the study found the shows rife with powerful examples of bioethical dilemmas but the doctors’ professional behaviour was more often egregious than exemplary.
“This is part of a wider initiative at the Berman Institute to look at the relationship between bioethics and popular culture,” says a study author, Ruth Faden, director of the Institute. “We are very committed to help expand the public conversation about ethics in medicine, science and public health.”
Even if it means using the antics of Gregory House, the rude, arrogant but brilliant physician on House, and the escapades of Meredith Grey and her fellow interns on Grey’s Anatomy.
“I’m intrigued by these shows,” says Faden, who won’t quite admit to being a fan. “They are an important force in the cultural mix.”
The Institute is creating an online library of clips from medical dramas categorized by ethical issues, says the director. The clips will be available to medical school professors, high school teachers and community groups to spur discussions.
While these shows may well influence people’s ideas about medicine, this study addresses just content, not the impact on viewers. Faden hopes a future study will evaluate that.
It fell to Johns Hopkins University medical student Matthew Czarny to watch the full seasons on DVD — 26 episodes of Grey’s and 24 of House — and code each event.
Fun job? “It was enjoyable at the beginning,” says Czarny, “but tedious by the end.”
Out of the combined 50 episodes, bioethical situations arose 179 times, dealing with such matters as confidentiality, right to refuse treatment, and human experimentation.
The characters debated: Should a doctor tell the potential liver donor that her lover, the one who needs the liver, intends to dump her after the transplant? Should a brain-dead pregnant woman be kept on life support so the fetus might survive?
“Many of the ethical issues were difficult ones with different characters presenting different positions, showing there was not one right way to go,” says Faden.
The worst ethical breach? Czarny doesn’t hesitate. The multi-episode plot on Grey’s about intern Izzie Stevens falling in love with heart patient Denny Duquette. To move him up on the transplant list, she cuts the wire to the device supporting his heart, worsening his condition. (No happy ending: He gets a new heart, but dies. Stevens confesses and quits.)
Czarny also coded 396 incidents of professionalism in the two series. Only 5 per cent of those between medical professionals and 28 per cent of those between doctor and patient were shining examples. The rest would have made Hippocrates cringe.
One of the worst was a doctor on House stealing another doctor’s work and submitting it to a medical journal. And, of course, the sexual flings of the hospital staff on Grey’s, a main plot of the show.
Only under the category of caring and compassion did the authors find more examples of good behaviour than bad. Doctors fought for patients’ rights and exposed themselves to danger to save lives. When a man is admitted to hospital with live ammunition in his chest, who you gonna call? Intern Grey to the rescue.
Czarny says a previous study showed that the hospital dramas are popular with medical students.
“The first- and second-year students remembered the shows more positively than the third and fourth year students,” says Czarny, a fourth-year student himself. “Possibly more exposure in the hospital colours their interpretations.”
That’s comforting.
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