My favorite TV show of all time is Grey’s Anatomy and I have watched it way too many times. Some of the most thought provoking episodes are the ones that include the role of spiritual and religious beliefs in patient decisions about their health care. Some examples include:
1. Season 1 Episode 8: Save Me
An Orthodox Jew named Devo comes into the hospital with mitral valve regurgitation (the valve between the left heart chambers does not close entirely) with the recommended treatment being a porcine valve. She refuses that treatment due to its un-kosherness. She tells them: “If you give me a pig part, I might as well be dead.” Dr. Karev manages to come up with an alternative treatment of a bovine xenograft (a cow valve). She has a rabbi bless her before surgery and receives the operation.
2. Season 2 Episode 5: Bring the Pain
A Hmong woman named Anna has a myxopapillary ependymoma, which is a tumor located in her spinal canal that requires surgery to prevent paralysis. Her father refuses the surgery, which Anna follows because he is the “elder.” She tells the doctor: “Our religion has got rules that are way old and way set in stone and way spiritual, and you don’t mess with them. You don’t anger the ancestors.”
Anna informs Dr. Grey that she is missing a soul that she needs for surgery. The doctors bring the family’s shaman to the hospital so she can be healed with a ritual and get her missing soul back.
3. Season 9 Episode 13: Bad Blood
A patient named Rich comes into the hospital with severe injuries. During his treatment it is discovered that he is a Jehovah’s Witness, which means he cannot receive any blood transfusions. When the doctors tell his parents that he is at risk of dying without blood, the parents tell the doctors: “We believe that life is a gift from God and we don’t try to sustain it by taking in blood… your blood wouldn’t save his life. It would condemn him. Living with it would be so much worse for him than dying without it.”
The patient ends up dying without ever receiving blood.
4. Season 13 Episode 22: Leave it Inside
A child named Liam has a pituitary adenoma (a tumor on the pituitary gland), but his parents refuse treatment based on their religious belief that the tumor is God’s will. Dr. Minnick approves the parents’ demand to take him home saying, “We can’t keep a minor for treatment against his parents’ will, especially when that treatment goes against their religious beliefs.”
When the boy makes his way back to the hospital again, he tells the doctors “I promise I tried, I did what they said, and I prayed and I prayed, but it didn’t work. God didn’t help me. Can you help me, Dr. Karev?” Dr. Karev operates on him, which angers the parents.
Dr. Edwards lectures the father: “We did your job. Your job is to protect your child. Your job is to keep him safe and healthy… That’s your job and you couldn’t do that.”
The father responds: “That is not my job. That is up to God.”
It is later revealed that the mother had brought him to the hospital the second time because she wanted Liam to get treatment.
One thing all of these episodes have in common is the doctors’ disregard or disdain for the patients’ or patients’ families beliefs. Doctors want to treat people the way textbooks, science, and their own beliefs say to treat them. When this contradicts what the patients want, conflict arises between the doctor and the patient. The doctor gets angry and tries to ignore or work around the patient’s wishes, regardless of the rules that protect patient beliefs.
This begs the questions: Is the patient wrong for standing firm in their beliefs even if those beliefs could or will kill them? Is the doctor wrong for wanting to break the law and ignore the patient’s wishes when it will or could save their life (at least medically speaking)? What is right and what is wrong?
Personally, I believe every human being has the right to accept, refuse, and dictate their own treatment. It is up to them to refuse, accept, or change the doctors’ recommended treatment. It is the doctors’ responsibility to respect those wishes and do everything in their power to work with patients to treat them the way they wish to be treated.
I also think this applies to children. In the case of the last patient, he wanted treatment and the parents were against it. Regardless of if the mother ended up approving of the treatment, I think the boy had every right to seek and accept treatment on his own volition and I think the doctors did the right thing by operating on him. This case toes a careful line between children’s rights, religious rights, and parental rights to which I’m not sure there could ever be a “right” solution.