I watch Grey’s Anatomy for the fast-paced gore and the overblown personal dramas. I watch its spin-off, Private Practice, for all that along with its thoughtful treatment of bioethical dramas – the same dramas we’re seeing in real-life hospitals and public debate.
The bioethics debate isn’t just a clinical and scientific debate or an abstract and philosophical one. It’s a debate about how to best fulfill the human longings for long life, good life, health and family. There’s all sorts of humanity mixed up in it – competing human longings and fallible human judgment deciding human life’s creation and existence. While philosophers and politicians squabble, doctors practice bioethics every day; and they don’t always have the time for debate when human life is at stake and the ethical choice isn’t clear.
In Private Practice, Kate Walsh plays Addison Montgomery, a neonatal surgeon working at a wellness clinic with her friend Naomi (Audra McDonald). The second season premiered on October 1, and the show’s writer Shonda Rhimes says that this season will raise more medical and ethical dilemmas.
The first episode launches into an ethical dilemma when a woman six months pregnant comes to the clinic, desperately demanding that Addison deliver their baby immediately. Their seven-year-old son has leukemia and his donor has fallen through. Their son will die in a week, and their unborn baby’s cord blood is the only thing that will save him. Their baby’s cord blood matches their son’s because they screened their embryo to create a match. They created a baby to save their son, and now Addison and her coworkers face a painful choice: save the son’s life and endanger the daughter’s, or protect the daughter and let the son die?
Bioethics deals with questions where the best and strongest human longings compete. Doctors and ethicists and patients have the same good end: to enhance the quality of life and protect it. But are all means ethical to accomplish that end, and what happens when one human life becomes the means to protecting another? People begin to make dubious ethical decisions – often out of pure respect for human life – and they eventually have to decide whose life comes first: The premature baby, or the seven-year old with leukemia? To the mother, the seven year old comes first because she knows him. She says she can’t love her unborn baby in the way that she loves her son.
Private Practice is interesting in that unborn humanity is assumed. There’s a legitimate debate – the life of the unborn child, or the life of the seven-year-old – and it’s clear that Addison’s outrage is righteous when she faults the parents for sacrificing an unborn life for the life of their son. “The problem is that she is carrying a child, except to her it’s not a child,” she confronts Naomi. “It’s organs for her dying son.”
The desires for a long, healthy life and a family are strong – so strong that they sometimes blind people and create a passion so consuming it becomes dangerous and skewed. The mother ends up forcing Addison to delivery her baby when she induces her own labor, pleading that she’s only doing the best she can to save her family. In another episode, a man whose wife underwent fertility treatments switched his sick baby with a healthy baby. When confronted, he’s livid with the clinicians for taking “three years and 250,000 dollars and all my wife’s hopes and dreams” and giving him a faulty product. They spent their future so they could have a child and if his child is sick, he wants his money back.
Naomi’s response is, “I never promised you perfection. I promised you a child.” But the idea of customer satisfaction is almost implicit in what Naomi does since she can manipulate the product to fill the parent’s wishes, just like she did for the couple who needed a genetic match for their son. When Addison interrupts Naomi as she fertilizes an embryo in her lab, Naomi casually drops a thought-provoking line: “I’m creating human life here.” If you can create a human life, why not make her grow up to be 5’10” with blue eyes, athletic ability and a high I.Q.?
The first episode highlights another human motivation influencing the bioethics debate: greed, which always capitalizes off of the strongest human needs and wants. The couple offered Naomi $80,000 to implant an embryo that could provide a match for their son. The practice was in financial trouble, so Naomi fudged the ethical boundaries to save it. There’s money in baby-making and in life-saving, and sometimes the desire for money trumps the ethical considerations.
Private Practice shows why the bioethics debate gets so heated. These are issues in which one decision – sometimes one that seems ethical – can create a situation where it’s less easy to differentiate between black and white. It is easy for each side to believe that it is the side protecting human life, and the other side is destroying it.
Playing God can be exhausting. Dr. Charlotte King (KaDee Strickland) shows a rare vulnerability when she says, “I miss the good old days, when life and death was decided by God instead of doctors. It would be good to just not be in control, to just let go, let God.” Letting go is impossible, though. They have the medical ability to give life, and now they have the ethical responsibility to use their ability well.
Private Practice airs on ABC on Wednesday nights at 9:00pm EST.
