BioethicsTV: Mistaken diagnosis, patient battery, “work-arounds,” and trans-gender patient health

by Craig Klugman, Ph.D.

A look at the ethical and professionals issues raised in medical dramas this week: Chicago Med and Heartbeat.

Chicago Med

This new show is always good for presenting challenges in professionalism and bioethics. This week (season 1; episode 16) is no exception as the fictional hospital finds itself in the middle of a surprise Joint Commission visit (though they often refer to the organization as “jay-koh” it’s previous abbreviation). One of the storyline this week deals with a retired neurologist and her husband with Lewy Body syndrome. She diagnosed him originally and took him to see two specialists who confirmed her diagnosis. But the staff at the hospital is confused because he has moments of extreme lucidity and has not declined as much as he should have with this disease. Dr. Charles, the resident font of wisdom and psychiatrist, orders an MRI for the patient. The scan shows not Lewy body but rather a small tumor that is responsible for his observed behaviors.

This storyline demonstrates two professional issue and two ethical ones. The first professional concern is a boundary issue: Don’t treat your own family. As we learn, the neurologist made the diagnosis based on the symptoms she saw and her experience of seeing many patients with that disease. What she didn’t do was order brain scans to support her differential diagnosis. One also wonders if the two specialists actually bothered to examine the patient independently, or did they start the examination with the bias of what their esteemed colleague found?

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.