Doctor House’s Bioethical Philosophy

Is American Media so drama centric that we can just dismiss any hopes that we’re consuming something genuine? House M.D. is a medical Drama/Mystery that debuted on first in the USA on the 16th of November 2004(“House M.D.”). It had a run time from 2004-2012 with 176 episodes and was created by David Shore (“House M.D.”). House has won a staggering 56 awards and has had 131 nominations, which includes a notable, 2 Golden Globes and 5 Primetime Emmy Awards (“House M.

D.”). How authentic is House M.D. as a show presenting itself as a telling of a lead diagnostician and his team? I will evaluate the approach of House M.D. to its medical practice surrounding Gregory House by discussing three main facets; the authenticity of the medical deliberations during diagnostics, the show’s execution of Doctor House’s bioethical philosophy, and the potential for the show to be used as an educational device.

The pilot episode begins much the same as the rest of them, a cold open that will showcase the patient suffering from their complicated set of issues and then assumed to be brought to the Princeton Plainsboro Teaching Hospital that is set in New Jersey.

The Medical Doctor (MD) Gregory House (Hugh Laurie) and his team of diagnosticians then tackle the puzzle-like cases that often involve new complications as the symptoms are tackled throughout the show. The show’s supporting cast mostly consists of Doctor Eric Foreman (Omar Epps), Doctor James Wilson (Robert Sean Leonard), Doctor Robert Chase (Jesse Spencer), and Doctor Lisa Cuddy (Lisa Edelstein) that are often the moral, bioethical, and political compass that restrains the maverick genius Doctor House from going too far in his methods, but the cast also acts as the ‘Watson’ to Dr.

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House’s ‘Holmes’(Koch) (House M.D.). The deliberations of the diagnostic team, guided by Doctor House, are often a central point to moving along the episodes, they discuss the symptoms of the patient using the differential diagnosis and the Socratic method to deduce what the patient is suffering from. It is generally followed that after the episodes progress a new problem arises that ranges from political, bioethical, or personal issues or another whole new symptom that complicates the diagnosis or treatment.

As the series progresses you can see each of the supporting cast members personalities emerge as they clash with main character House and the way he treats the medicinal practice and his personal life. The pilot episode captures a central theme of the show very well between Dr. Foreman and Dr. House, where Dr. Forman questions an analysis of Dr. House on the patient has Dr. House’s response is, “Everybody lies.” Even when not state, this thought process is assumed with all House’s diagnoses and decisions. The shows depictions of medical conundrums are a big draw for those into the mystery facet of the show, if not the authenticity, as the puzzling symptoms and drama unfolds.

Typically, television dramas are known to put their theatrics first, and the truth of the subject matter second, so I will discuss the accuracy of the writing of the show’s portrayal of handling medical cases. The first episode opens with a teacher going through a seizure while at work, and reviewer and authentic physician, Doctor Mike is able to accurately discern that the teacher displayed what is called a generalized tonic-clonic seizure (Doctor Mike). Since a big part of the show are the medical puzzles, being able to accurately act out the symptoms of the mysterious illness is important for authenticity. Further into the episode, the same patient experiences uncomfort at being in the MRI machine is showing signs of claustrophobia. It is described that since MRIs sometimes require an extended period of time of laying down in a closed space with very loud noise, you have to occasionally pre-medicate your patients with something such as benzodiazepines for treating anxiety(Doctor Mike). In the same MRI scene, the reviewer was able to discern that the patient was having an anaphylactic attack due to the CGI and acting of the patient. Before the Doctor Mike could see how the doctors could respond to the new symptom he was able to deduce the appropriate response was to inject the patient with an EpiPen (a medical device for injecting a measured dose of epinephrine (adrenaline).) into the upper thigh, which the doctors proceeded to do. The scene also progresses with the patient needing a tracheostomy (a surgically created hole in your windpipe that provides an alternative airway for breathing) due to an edema (abnormal accumulation of fluid) (Doctor Mike).

The two complaints about the realism of the events in MRI scene was that the incision of the tracheostomy was too large, which could be attributed to creative license of the director and that if the patient was experiencing the symptoms she exhibited it would be considered a “code blue”, which would entail, “an emergency team of nurses, doctors, respiratory therapists.” Doctor Mike details, “You also gotta get IVs said, you gotta figure out why the patient’s heart stopped, or stopped breathing, there is a lot more that has to happen. You don’t just automatically assume it has something to do with the contrast you gave,” (Doctor Mike). The show seems to have this tendency of treading towards realism, and a firm grasp on the medical details but then tends to have a clear, understandable creative directing flair that takes away from a completely true feel. A similar critique of the show existing in this real, but exaggerated depiction of reality is surrounding House and the politics and ethics of operating in an American Hospital.

Dr. House is a man that is described as both a genius and reckless, but his methods are consistent throughout the show and are depicted as overall good as he puts saving a life over seemingly arbitrary rules. Hospitals have a large philosophical contrast in operation to the 19th century and modern models that Dr. House encapsulates (The Afterbirth of the Clinic). Dr. Foreman questions House’s perspective of not wanting to speak with the patient, and his reply is that he is more concerned about the disease because people lie. A central theme is that House tries to get his team to think on his unorthodox terms as he gets his team to break laws, such as breaking into a patient’s home. Although the diagnostic team under Dr. House is tentative about his methods, ultimately, it’s to save a life. Even breaking into a home is to investigate things like potential chemical reactions that are causing symptoms to occur. Rules and ethics of the hospital as well as the normal law seems to be irrelevant in House’s pursuit of diagnosing and treating his patient.

House is described as capable, although this is a fantastic tool to depict drama and ultimately the goal of the show, the maverick methods of Dr. House double as an artful way to showcase the many inconsistencies with the political and ethical rules of American Hospitals. In one episode, Doctor James Wilson announces that the patient doesn’t want any more treatment, she wants to, “go home and die.” Due to the real concept of principle of respect for autonomy, which states; if competent, patients have the right to refuse or choose their treatment, the patient’s decision must be respected. Dr. House proceeds to describe the patient as an idiot, and goes to talk to the patient, being harsh and straightforward in the fact that she could die that weekend if not treated soon. Ultimately, Dr. House found a way to convince the patient to hang to life and pursue treatment, even though the respect for autonomy described the situation as a something that was out of the doctor’s hands. There are many situations where the political and bioethical current understanding are odds through the show, and officially House was in the wrong but because it ultimately saved a life, it makes people question the current circumstances and conditions of the methods today. This same problem also comes up in classrooms for medical students, potentially and likely one of the reasons why the student became interested in the school of medicine the first place is because of doctor heroes like House who do many things against what is being taught.

House MD and other such medical-based TV series, are well received by medical students, but how good are they at actually educating after considering the details of the show. One attractive feature of the medical TV series is that it creates an interest into the medical field and rare diseases. A large study by the Advances in Health Sciences Education concludes, “This systematic review suggests that fictional medical television programs may represent an untapped resource that can serve as teaching tools for students and medical professionals. Because existing studies have been limited in terms of sample size, scope, and study quality, it will be valuable for future research to utilize more rigorous study designs and to more directly assess the impact of these experiences on clinical practice instead of focusing on feasibility and acceptability.” (Advances in Health Sciences Education). 213 students were surveyed about their experiences in learning which included, 76.6% of students reported watching medical dramas on a regular basis. The Dr. House seminar was compared to traditional seminars and our students reported an improved learning effect (69.9%), better concentration (89.7%), higher motivation to participate (88.7%), and more fun (86.7%) (Teaching medicine with the help of Dr. House). This study shows an unarguable perspective into how interested students are towards the medical dramas and the thus the use of these shouldn’t be underrepresented.

Dr. House’s behavior is seen critically by students. Likert assessment (which is a detailed assessment on the ethics of the physicians.) on a scale of 5 points, identified strong disagreement with Dr. House´s interpersonal skills in dealing with his patients and colleagues (Teaching medicine with the help of Dr. House). Although students disagree with his interpersonal skills they agreed with his therapeutic and diagnostic capabilities. When Dr. House is represented in seminars, students are shown to have an interest in rare diseases. They were shown to have a positive influence by medical TV series like Dr. House to improve their clinical and diagnostic skills. At the same time, they are critical enough not to see Dr. House as a role model for their own personality (Teaching medicine with the help of “Dr. House”). The article; “Afterbirth of a Clinic”, shows the similarities between the 19th and 20th century transition between medical philosophical medical practices. They provide a parable about the state of biomedicine, still within in modern scope but forced into a postmodern, managed care world. House M.D., however, is more than a mere depiction of the modern-postmodern tension that exists in today’s exam rooms (The Afterbirth of a Clinic). Medical TV shows such as House M.D. can successfully be used in an educational setting to motivate medical students to come into seminars to learn more about rare diseases.

Overall, House is delivers on the accuracy of the diagnostic medicine even if it’s loose at times, the bioethics of House plays an intriguing yet extreme performance of a doctor’s capabilities, and with the modern age and well put together writing, House can work as an education tool with context. However, House M.D. holds not just the medical realm up for inspection but also medical philosophy. House’s personification of le regard remains untouched by his personal and professional strengths and shortcomings. He regularly ignores comments by patients and colleagues about his rough demeanor, his lack of humility, and even his success in diagnosing disease. Whether House succeeds or fails, the audience never doubts the efficacy of his method. House is brilliant, of course, but it is the way he thinks and the way he thinks about thinking that make him singular in his ability to find the root of the patient’s maladies that no one else can find. He has no interest in the patients themselves, and only takes on cases that he finds intellectually interesting or challenging. (House rarely even sees the patient he is diagnosing until the end of the episode, believing that since emotions distract the intellect and “everybody lies” anyway, he is more effective when unencumbered by actual contact with the patient.) House does a fantastic job portraying diagnostic medicine and this show will do a great job of portraying the history of medicine for the future to come.

Works Cited

1. Czarny, Matthew et all. “Bioethics and Professionalism in Popular Television Medical Dramas.” Journal of Medical Ethics, vol.36(4), April 2010, pp.203-206, www.jstor.org.db06.linccweb.org. Accessed 2 May 2018
2. Doctor Mike. “Real Doctor Reacts to HOUSE M.D. | Medical Drama Review | Doctor Mike” YouTube, commentary by Doctor Mike Varshavski, Apr 22, 2018, youtu.be/RFRN1WY98Ik. Accessed 1 May 2018.
3. Hoffman, B.L. et all. “Use of fictional medical television in health sciences education: a systematic review.” Advanced in Health Sciences Education, vol. 23(1), pp. 201-216, https://doi-org.db06.linccweb.org/10.1007/s10459-017-9754-5. Accessed 3 May 2018.
4. “House M.D. (2004-2012).” IMDb,
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6. Jerrentrup, Andreas et all. “Teaching Medicine with the Help of “Dr. House”.” PloS one, vol. 13(3): e0193972, 13 May 2018, www.ncbi.nlm.nih.gov/pmc/. Accessed 1 May 2018
7. Rich, Leigh et all. “The Afterbirth of the Clinic: a Foucauldian perspective on ‘House M.D.’ and American medicine in the 21st century.” Perspectives in Biology and Medicine, vol.51(2), pp.220-237, https://www.gale.com/databases. Accessed 4 May 2018.
8. “New Data from Swansea University Illuminate Findings in Health and Medicine (Hospital doctors’ Opinions regarding educational Utility, public Sentiment and career Effects of Medical Television Dramas: the HOUSE MD study).” Clinical Trials Week, 9 May 2016, pp.99, https://www.gale.com/databases. Accessed 2 May 2016.