Bioethics on TV: What is being portrayed?

(Image credit: ABC/Eric McCandless)

It is likely no surprise to regular viewers of the television medical dramas “Grey’s Anatomy” and “House, M.D.” that bioethical issues and the conflict they create are frequent components of the storylines. These programs aim to entertain, and the drama inherent in contentious bioethical issues seems a natural fit. Furthermore, these programs aim for realism, frequently employing physicians as consultants to check their medical facts. This combination of realism and frequency raises concern that these medical dramas have the potential to affect viewers’ beliefs and perceptions of bioethics. In fact, previous studies have demonstrated this phenomenon in other areas, including organ transplantation and obesity.

With that background, I, along with Dr. Ruth Faden and Dr. Jeremy Sugarman at the Johns Hopkins Berman Institute of Bioethics, aimed to systematically describe the bioethical and professionalism content of one season each of the widely watched medical dramas. While we would have liked to include “E.R.,” it wasn’t available on DVD for the same time frame. In addition, “Nip/Tuck” and “Scrubs” were excluded because of their dissimilarity to the shows analyzed. Our goal was simply to document the bioethical and professionalism content of these two programs as a starting point for a discussion about their possible impact on the perceptions and beliefs of the general public, as well as their utility as a tool in the education of medical and nursing students.

Perhaps unsurprisingly, we found that both “Grey’s Anatomy” and “House, M.D.” are rife with depictions of bioethical issues and egregious deviations from the norms of professionalism. We identified 179 depictions of bioethical issues, which we separated into 11 categories, of which the top three were consent, ethically questionable departures from standard practice, and death and dying. We also identified a total of 396 deviations from normal professional interactions, classifying those into categories of “respect,” “sexual misconduct,” “integrity and responsibility,” and “caring and compassion.” Most of the professionalism incidents were negative, which is less striking when one considers the fact that these programs are more akin to soap operas than documentaries. Importantly, we did not try to evaluate the possible impact, whether positive, negative, or neither, on viewers of these programs. Rather, we hope that our study will provide the groundwork for other studies assessing exactly that.

I’d personally like to encourage any interested readers to take a look at the full text of our article, “Bioethics and professionalism in popular television medical dramas,” which is available in the April issue of the Journal of Medical Ethics. In addition, more information about the wide variety of ethical issues investigated by the Johns Hopkins Berman Institute of Bioethics can be found at our website, http://www.bioethicsinstitute.org. Finally, more information about media and health can be found at the Kaiser Family Foundation website.

Thanks for letting us share our work with the thoughtful readers of the Women’s Bioethics Blog!

-Matt Czarny

Avatar: The Future of Bioethics is Now

Avatar, the recently released big budget movie by James Cameron, has taken the entertainment industry by storm. Normally “not to be pleased” film critics cannot find enough complimentary words to print. With a $300 million price tag to produce, Avatar has become an instant “cult hit”. Audiences leave theaters in awe of the computer generated special effects that reportedly have transformed the movie viewing experience to a state of virtual reality. In addition to achieving ultimate moviemaking technology, the story line is a compelling account of a science fiction that may be less fiction than it is real science.

The story of Avatar explores the ability of a human to inhabit the mind and control the body of a lesser being created by science to accomplish tasks considered too dangerous for the human to engage in. The manufactured humanoids are sent to an inhospitable planet where war is being waged for control of the universe. Sound like a better way to wage war? Sound far-fetched? Perhaps science is far more capable of creating this fantastic world than most moviegoers would expect.

The word “avatar” derives from a Hindu word representing the embodiment of the god Vishnu in typically lesser forms of being some of which are god-like and others much less so, including turtles, fish, boars or lions. Vishnu was embodied in countless life forms all created for specific purposes to achieve the intent of the god who engendered them. 

The word came into popular American culture through the language of Internet gaming in which players created virtual selves to live, play and potentially die to live again in the game “Habitat” first created in 1986.  As players created their “online persona” they lived vicariously through their surrogate in playing the game by engaging in virtual activities which hopefully they would never choose to participate in “the real world”. Their avatars could murder, maim, deceive and steal with impunity.

How could this fiction possibly be realized through science? It is much closer to reality than we might wish to admit. The science of transgenics has accomplished amazing feats in the laboratory which movie makers could only wish to recreate for the big screen. Truth in fact is stranger than fiction.

Would you like to manufacture a natural fiber much stronger than steel? How about combining the genetic code of a spider with that of a goat to create goat’s milk with the strength characteristics of a spider’s web? Outlandish, you say! Done. BioSteel® is the product of a Canadian company which comes from its “spidergoat” created by combining the genomes of spiders with those of goats.

Barnyard experimentation is one thing, but human experimentation is something entirely different. Right? Wrong. In Amherst, Massachusetts genetic engineering company Advanced Cell Technology created hybrid embryos resulting from the injection of human cells into cows eggs. South Korean research company Maria Bio-Tech created a “hu-mouse” by injecting human stem cells into mouse embryos The living altered embryos were implanted into to a mouse womb with a litter of healthy “hu-mice” delivered thereafter. And just for the fun of it, Cambridge University researchers created “she-male” hermaphrodite human embryos by implanting male genes into female embryos. These chimeras (part one life form and part another) are scientifically capable of creation in infinite varieties.

Make no mistake about it, as a human born with a bi-cuspid aortic heart valve, I am very interested in creating a pig which would carry my own genetic code so if the time arrives that a valve replacement is medically necessary, I can harvest a perfect body part for the task. But because I can, should I?

More critically, because we might be able to create human-like forms in the lab for the purpose of conducting warfare, scientific experimentation or medical therapy should we?

At present, no federal laws in the US prevent these outcomes. Only human restraint does so (if in fact such experimentation is being restrained rather than simply not reported).

All significant human scientific advances raise ethical concerns. The time has long passed for us to seriously consider and engineer the ethical limits, conditions and consequences of genetic experimentation. Only a multi-disciplinary dialogue will provide the breadth and depth of discourse necessary for this critical conversation. Scientists, ethicists, lawyers, physicians, policy makers and the public must be invited into this discourse lest one segment of society hijacks the possibility of a reasoned outcome.

In all the debate and diatribe surrounding health care reform, dialogue concerning bioethics has been noticeably absent. For the sake of humans, avatars, chimera and other life forms capable of being “born” in our laboratories, the time to convene this dialogue is now.

[Larry Bridgesmith is a guest blogger for the Womens Bioethics Blog; you can see more about his background here. ]

Donate $50 - Get Progress in Bioethics

Please consider making a tax-deductible donation to the Women’s Bioethics Project so we may distribute as many copies as possible of the soon to be released book "Progress in Bioethics: Science, Policy, and Politics" (MIT Press 2010) to policy makers, science writers and bloggers around the world. This important book will help ensure progressive values of social justice, critical optimism, practical problem solving inform bioethical debate on issues such as stem cell research, genetic modification, therapeutic cloning and end-of-life issues. I wrote chapter 4 on "Bioethics: The New Conservative Crusade." Don’t let the debate be defined by narrowly driven ideological interests.

Help us reach our goal of one hundred books distributed by January 2010. A $50 donation will get a copy of the book into the hands of a key policy maker and we’ll send you a copy too. Find our online donation page here.

Thanks for helping build the kind of world we all want to live in.

Panayiotis Zavos: I've Cloned a Human!

Whether the news stories on Panayiotis Zavos’ latest efforts to clone a human embryo are a hoax or not, there is no doubt that a tremendous amount of scientific progress has been made since the 1997 announcement that a sheep had been successfully cloned; cloned primates and pets and the creation of induced pluripotent stem cells and human-nonhuman chimeras are just a few of the scientific discoveries that get us closer everyday to the prospect of a cloned human being. The ability to radically alter human reproduction raises fundamental questions regarding the nature of our humanity and the character of our society.

Thousands of scientists, scholars, journalists, religious leaders, and policy makers have debated and discussed the ethical implications of a wide range of reproductive technologies, citing ethical concerns from safety, kinship disruption, and the commoditization of reproduction to concern for genetic diversity and the threat of eugenic application. While the benefits of many reproductive technologies – genetic testing, therapeutic cloning, genetic germline modification, and chimeric modeling, to name a few – are still being debated, reproductive cloning is nearly universally opposed. Most believe it currently poses unacceptable safety risks.

The opposition to reproductive cloning has led to a growing effort to ban the practice at a state, national, and international level. All this activity led us to consider the question: Is there a consistent theme in the ethical language used to justify banning reproductive cloning? Does the language reflect the moral values and common goals of the world community or does it unwittingly set the stage to undermine procreative liberty and scientific progress by appealing to vague ethical principles that serve a broader political agenda?

Before we support a worldwide ban on cloning, we need to carefully examine the ethical language used and be sure it reflects the common good. We must watch carefully as human dignity is employed to ban human reproductive cloning, for it can set the stage for banning other reproductive technologies such as IVF, genetic testing and genetic modification as well as therapeutic cloning.

You can read our full analysis here.

WBP Advisory Member R. Alta Charo Joins Transition Team of President-elect Obama

*****Congratulations and Hooray! ***** for R. Alta Charo, one of the WBP's Advisory Board members, who has been named by President-elect Barack Obama to his Transition Team. A prominent nationally known bioethicist, she is also the Warren P. Knowles Professor of Law and Bioethics at the University of Wisconsin at Madison. Well known for her brilliance, insightful lectures, keen wit, and scholarly publications, Charo is working on the team reviewing the Department of Health and Human Services, taking advantage of her familiarity with a number of issues related to bioethics, health policy, and science policy.

The full press release from the University of Wisconsin can be found here.

Top 10 Hot Careers for 2012

I'm often asked by my students "what kind of job can I get with a master's degree in bioethics?" -- the short answer is that one needs to look at the master's degree as a supplemental degree -- that is, it is beneficial in terms of analysis, problem-solving, and critical thinking in your basic field. Last month, Daily Galaxy published a Future 'Top 10' Hot Careers in 2012, and all ten arguably have aspects that could benefit from an bioethics (that is the broadest spectrum definition of bioethics -- from food ethics to neuroethics to healthcare ethics to computer ethics and beyond) perspective:

1) Organic food Industry

2) Computational Biology

3) Parallel Programming

4) Data Technology

5) Simulation Engineering

6) Boomer Caregiving

7) Genetic Counseling

8) Brain Analysts

9) Space Tourism

10) Roboticists

Some wag wrote in a cheerful comment to the original article "I'd also add 'AI wrangler' (for when the Singularity happens)" -- but that's more likely in 2025, at according to Ray Kurzweil and the experts at TechCast.

Full article can be accessed here.