Hi, dear doctor. Everytime I check your post, I get inspired and I sincerely appreciate reading high quality medicine-related fun stuff from your post. I’ve enjoyed so much since I began to follow your post. Never disappointed, I’d like to thank you for sharing those. For your question, I’m wondering how you as a doctor view these hot medical dramas, especially like Dr. House, my big time favorite! I’d like to know how you think about the ethical issue on the show.
(Egads, 2 Cranquis Mail replies within 2 days? What, is Cranquis on vacation or something?)
Hello, Viv! Thanks for your question. I don’t really watch much TV of any sort (for a number of factors: no TV + 2 young children who suck up all hypothetical TV-watching time), and the last medical show I watched was House MD (and HEY SPOILER ALERT: I had quit watching during the whole Season 7 “Huddy” nonsense, and then the internet informed me that Season 8 was actually quite good, and then the internet proceeded to totally spoil the ending of the show for me, so… *bitter*).
As you can guess from this blog’s House/Hugh Laurie motif, I certainly did enjoy certain aspects of the House MD show (particularly the outpatient clinic scenes, where Dr. House got away with all the things I wish I could do in my Urgent Care). I never got into the shlock-fests like Grey’s Anatomy or E.R., either — but I loved the original Scrubs series (and actually felt it did the best job out of ANY medical TV show in realistically portraying the ethical and medical issues that doctors deal with every day! How ironic, eh?).
So let’s just focus on the ethics within the world of House MD, shall we?
- I don’t care how awesome Dr. House is: in the real world, he would’ve been fired/suspended/lost his medical license/murdered by an offended patient or family member MULTIPLE TIMES. And rightly so (except for the whole “murdered” part) — the show likes to pretend that the end justifies the means 100% of the time, but medicine (like all high-stakes careers) is a political minefield, and House’s actions would’ve resulted in costly lawsuits against the hospital (and against him and his staff, if the all-too-often Breaking and Entering crimes had come to light) and bad publicity which would’ve forced the state medical board to yank his license to practice medicine.
- The show does a better job, IMO, of painting out the tangled issues regarding substance use/abuse among medical professionals. I won’t attempt to gainsay the overall presentation of Dr. House’s opiate addiction/dependence, except to point out that any doctor who is caught breaking into a pharmacy or forging prescriptions for Vicodin is, again, going to be facing the state licensing board right quick — regardless of what levers he/she tries to pull with the ridiculously sexy/manipulate-able medical director of the hospital, or how many children he cures of combination Hansen’s/Chagas/Parkinson’s Disease.
- Not directly an “ethical” issue, but: no medical specialist has the training/time/hospital clearance/inclination to do ALL OF THE THINGS which House’s team-members do in almost every episode — draw blood, run the lab tests on the blood, perform surgery on ANY part of the body (including brain, eye, and other highly-specialized surgical areas) or fill in for the scrub nurse, do biopsies of all sorts of tissue and run the pathology on those samples, operate the radiology machines and personally read all the radiology films, administer the patient’s medications, take extra shifts in the ER, work in an outpatient clinic seeing random patients, and break into patients’ homes. Hospitals have a PAID STAFF of trained individuals (phlebotomists, nurses, radiologist, surgeons, rad techs, scrub nurses, hospitalists, pathologists, ICU specialists, primary care doctors, cat burglars) who would get rather pissed if their skills (or at the very least, their fair usage-time of the lab, O.R., radiology suite, lockpicks, and all other medical equipment) were not valued and utilized.
- But hey, what about all the breaking into people’s homes to look for clues because the patients are assumed to be either too dishonest or too stupid to do anything except get sick? Yeah - not ethical, let alone legal. End of story.
- Don’t get me started on the ethical intricacies of romantic relationships between supervisors and employees. I’m sure the show found a convenient way to explain that away, but I stopped watching right around that whole mess, so I’m just gonna call it like it would be in real life: it’s not ethical to be bangin’ your current boss.
- One specific ethical complaint which I’ve mentioned before about a specific incident on the show: in Season 7 Episode 7, a patient with smallpox goes into cardiac arrest. There was NO cure for the stage of his condition, and the cardiac arrest is the logical conclusion to the progression of the disease — but in a fit of "I can save him"-itis, House violates the isolation chamber (potentially exposing not only himself but the rest of the team to an incurable disease) and proceeds to do full CPR (including defibrillations) on the dead patient. That was just grossly unethical — the patient was (essentially) tortured. I’m not saying every event of CPR with defib is torture (although it certainly isn’t as painless as TV shows make it appear to be!) — but even if the CPR had revived the patient temporarily, there was no hope of cure/recovery from the underlying disease which had already killed him, so House would’ve just condemned him to live for a little while longer in additional pain from the defib-induced burns, before dying again.
Do all these complaints mean that I think the show was a failure at depicting life in the medical profession? No, not entirely. Trust me, I understand that TV shows have to play things to the lowest common denominator — there’s gotta be simplistic plot twists, illogical relationships, and shocking behavior to keep the attention of the slack-jawed masses. But I see enough wacky things in my daily job that I feel medical TV shows could be more life-like without losing their entertainment value. For yes, truth is stranger than fiction.
Thanks for your question!