Published October 24, 2006
The ABC medical drama Grey's Anatomy has become television's top show by transferring the "all for one, one for all" mentality of the now-departed mega-hit Friends to a hospital setting.
The problem is that in real life, friends don't usually look the other way when crimes are committed and rules are broken -- nor should they.
And, the show's message that it is perfectly normal, and to some degree acceptable, for people in the position to decide who lives and who dies to give preference to their personal emotions over the law and medical ethics is profoundly disturbing.
Of course it is only TV. But given the medium's power and the topic's seriousness, I for one am offended by a major story line of the hit show, which by the way, is terrifically entertaining.
One of the show's main characters, Dr. Isobel Stevens, a lingerie model turned medical intern, breaks the law and medical canon to manipulate the way heart transplants are allocated to save her fiance, Denny.
The show's failing is that it gives the inaccurate impression that the transplant process is capricious, can be easily manipulated, and if so, what's the harm, since it's to help a friend.
I am not a doctor, but I was fortunate enough in 2002 to receive a liver transplant. I became acquainted with the arduous process by which organs are allocated.
Organ transplants are the ultimate zero-sum game. For every patient saved, someone else is not. There are many more people needing hearts, livers, lungs and kidneys than there are available organs. Thousands of Americans die each year waiting for a transplant.
Everyone connected with the transplant process -- doctors, nurses, donor families, or recipients and their families -- understands this.
The United Network For Organ Sharing supervises U.S. transplants. It has set criteria for evaluating patients' needs, primarily based on a recipients' closeness to death, overall health and ability to thrive afterwards. It decides who gets a transplant and who doesn't.
In Grey's Anatomy, the Dr. Stevens makes her fiance sicker in order to move him up the list when a heart becomes available. Several fellow interns, instead of stopping her, aid in her efforts.
The patient dies after the transplant and the other interns don't report what happened. Later, they refuse to finger the culprit in some kind of celebration of friendship. If coming attractions are to be believed, the hospital lets Dr. Stevens back on staff.
Arthur Caplan, the Emmanuel and Robert Hart Professor of Bioethics at the University of Pennsylvania, says what would then happen in the real world is this:
--Dr. Stevens would probably face murder or manslaughter charges, since she began a process that resulted in the patient's death. She would face criminal charges for falsifying medical records. She would be dismissed from the intern program and almost certainly never get a medical license.
--The hospital, aware it could lose its accreditation to do transplants and have to pay a huge damage settlement (not just to this patient's family, but to the family of the one who didn't get the heart due to the fraud), would report what happened to the state medical board, UNOS and the police.
--The other interns could also face criminal charges. Their medical futures would be in doubt since they could be considered accessories to the crime.
In the show, no one calls the cops or the state medical authorities. Nothing happens to the other interns.
Now, television is, of course, entertainment. It is invested in hooking viewers on Dr. Stevens' character. But it is also a business, hence their reluctance to write a popular character off the show.
You got the feeling when the tough resident doctor who supervises the interns began lobbying the big boss to take Dr. Stevens back that she is going to somehow return to the hospital and all her friends.
That is a shame. Television doesn't have to replicate real life. But when a drama, not an obvious farce like the NBC comedy Scrubs, suggests crime can be without consequences, it is as dangerous to the public good as when it glorifies sex and violence.