The Good Doctor has me thinking…
Recently I have begun watching ABC’s The Good Doctor, which is a medical drama based in the fictional, yet prestigious, San Jose St Bonaventure Hospital and follows the professional and personal journeys of a number of characters. The show is based on a South Korean tv medical drama called Good Doctor and is produced by Daniel Dae Kim and developed by David Shore (creator of House). The main character is Dr Shaun Murphy who has Autism. He is a surgical resident in the early seasons and the show focuses on how Dr Murphy navigates his professional and personal life, as well as how the hospital and other doctors, surgeons, nurses and patients navigate Dr Murphy’s style of communication and respond to him. As a medical drama, in my humble opinion, it is highly entertaining with the usual mix of interesting medical cases and personal drama required. The characters are also relatable in a number of different areas. As a springboard for a platform to talk about equality, equity and fairness, it is accessible and thought-provoking.
A key focus of the programme is the difficulty Dr Murphy has with communication. Well, I say difficulty in communicating, but in actuality I would say he communicates differently to what is recognised as an ‘accepted’ or ‘normal’ form of communication. Dr Murphy struggles to express emotions and becomes overwhelmed when things change and are not within his controlled environment. A number of his colleagues adapt their responses and ways of interacting with him in order to support and include him, whereas others do not and argue that despite his medical brilliance, and first-rate surgical skills, he should not be treated differently to the other surgical residents, as this is deemed unfair.
Whilst watching, the claims of treating all surgical residents equally, and ensuring the hospital higher-ups are being fair; notions of John Rawls’ writing scream out at me. Students who have studied Crime and Justice should be familiar with Rawls’ veil of ignorance, liberty principles and difference principle, in particular with its reference to ‘justice’. But the difference principle weighs heavily when looking at how Dr Murphy functions within the hospital institution with its rules, procedures and power dynamics which clearly benefit and align with some people more so than others. Under the veil of ignorance, maybe an empathetic doctor or surgeon is not required, but a competent and successful one is? Maybe being empathetic is a personal circumstance rather than an objective trait? For Rawls, it is important that the opportunity to prosper is equal for all: and this might mean the way this opportunity is presented is different for different individuals. Rawls asks us to consider a parallel universe and what could be (a popular stance to take within the philosophical realm): why can’t people with autism be given the chance to save lives and perform surgeries just because they cannot communicate in a way deemed ‘the norm’ when dealing with patients.
It is possible that I am over-thinking this. And when I ask my partner about it, they raise questions about why Dr Murphy should be given different opportunities to the other residents and the harm Dr Murphy’s communication barriers could and do cause within the series. But I feel they are missing the point: it is not about different opportunities, its about different methods to ensure they all have the same opportunity to succeed as surgeons. It is not about treating everyone the same, which might on the surface appear to be fair, it is about recognising that equal treatment involves taking account for the differences. Why should Dr Murphy be measured against norms and values from an institution which is historically white, non-disabled, male, and cis-gendered? This might appear to be a lot of thought for a fictional medical drama, but to reiterate it’s an excellent programme with plenty to think about…
Bibliography:
Rawls, J. (1971) A Theory of Justice. Oxford: Oxford University Press.
Ryan, A. (1993) Justice. Oxford: Oxford University Press.
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Food Banks: The Deserving vs Undeserving
A term that has been grating on me recently is ‘hard work’. I have had a recent bout of watching lots of television. From my observations it appears that more commentators within the media have grasped the idea that the continued need for Food Banks in the United Kingdom is awful. Yet commentators still continue with the same old deserving/undeserving tripe which has existed for centuries (which CRI2002 students are well-aware of). That being, that we should be concerned about food banks… ‘because now even hard-working people are using them!’, aka those within formal (preferably full-time) employment.
What is it that is not being said by such a statement? That being unable to survive off benefits is perfectly fine for people who are unemployed as they do not deserve to eat? If that is the case perhaps a reconsideration of the life experiences of many unemployed people is needed.
To provide some examples, a person might claim unemployment benefits because they are feeling mentally unwell or harmful to themselves but a variety of concerns have prevented them from seeking additional support and claiming sickness benefits, in this situation working hard on survival might be prioritised over formal employment. Another person might sacrifice their work life to work hard to unofficially care for relatives who have slipped through cracks and are unknown to social services, whilst not reaching out for support due to fear/a lack of trust social services – they have good reasons to be concerned. Some people might have dropped out of formal employment due to experiencing a traumatic life event(/s) which means that they now need to work hard on their own well-being. Or, shock-horror, people may be claiming unemployment benefits because they are working hard post-pandemic to find a job which pays enough for them to survive.
Let’s not forget that many of those who access Food Banks are on sickness benefits because they cannot work due to experiencing a physical and/or mental health disability. The underserving/deserving divide appears to be further blurred these days as those who claim sickness benefits are frequently accused of being benefits cheats and therefore undeserving of benefits and Food Bank usage. Even so, the acknowledgement of disability and Food Bank usage within the media is rare.
Is it really ok to perceive that the quality of a person’s life and deserved access to necessities should depend on their formal employment status?
There is twisted logic in the recent conservative government discourse about hard work. There is the claim that if we all work hard we will reap the rewards, yet in the same breath ‘deserving hard workers’ are living from payslip to payslip due to the cost of living crisis, poor quality pay and employment. Hence the need to use Food Banks.
The conservatives hard working mantra that all people can easily gain employment is certainly a prejudiced assumption. With oppressive, profit seeking, exploitative and poor quality employment there is little room allowed for humans to deal with their personal, family life pains and struggles which makes job retention very difficult. Perhaps the media commentators need a re-phrase: It is awful that any person needs to use a Food Bank!
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Stop strip searching children!
The Metropolitan Police are under constant criticism, more than any other police force, for at least as long as I have been a criminologist. Their latest scandal began with the case of Child Q, a 15 year old girl who was strip searched in school while she was menstruating after being suspected of carrying cannabis. No drugs were found and Child Q was extremely traumatised, resulting in self-harm and a suicide attempt. Tré Ventour recently wrote a blog about Child Q, race and policing in education here but following this week’s Children’s Commissioner report, there’s so much more to discuss.
The report focussed on the Metropolitan Police who strip searched 650 children in 2 years, many (23%) of whom were searched without the presence of an appropriate adult and as we criminologists would expect, the children were disproportionately Black boys. These findings were not surprising or shocking to me, and I also know that the Metropolitan Police force are not just one bad apple in this respect. The brutal search of Child Q occurred in 2020 but incidences such as these have been happening for years.
A teenage boy aged 17 was subject to an intimate search in 2019 where the police breached a number of clauses of PACE, ultimately resulting in the boy receiving an apology and £10,000 damages for the distress caused by the unlawful actions. These actions started with basic information being withheld such as the police officer failing to identify himself and informing the boy of his rights and ended with the strip search being undertaken without an appropriate adult present, in the presence of multiple officers, without authorisation from a senior officer and with no justification for the search recorded in the officer’s pocket book. Now I understand that things may be forgotten in the moment when a police officer is dealing with a suspect but the accumulation of breaches indicates a more serious problem and a disregard to the rights of suspects in general but children more specifically.
These two cases are the cases of children who were suspected of carrying cannabis, an offence likely to be dealt with via a warning or on the spot fine. Hardly the crime of the century warranting the traumatising strip searching of children. And besides, we criminologists know that the war on drugs is a failed project. Is it about time we submit and decriminalise cannabis, save police time and suspect trauma?
What happens next is a slightly different story. Strip searching in custody is different because as well as searching for contraband, it can also be justified as a protective measure where there is a risk of self-harm or suicide. Strip searching of children by the police has risen in a climate of fear surrounding deaths in custody, and it has been reported that there could be an overuse of the practice as a result of this. When I read the report, I recalled the many conversations I have had over the years with my friend Rosie Flatman who is a practitioner who specialises in working with victims of Child Sexual Exploitation (CSE) and other forms of abuse. Rosie has worked with many girls who have been subject to strip searches when in custody. She told me how girls would often perceive the search as punishment for being what the police believed was disruptive. That is not to say that the police were using strip searches as punishment, but that is how girls would experience it.
Girls in custody are often particularly vulnerable. Like Rosie’s clients, many are victims and have a number of compounding vulnerabilities such as mental ill health or they may be looked after children. Perhaps then, we need to look at alternatives to strip searching but also custody for children, particularly for those who have suffered trauma. Rosie, who has delivered training to various agencies, suggests only undertaking strip searches where absolutely necessary and even then, using a trauma informed approach. She argues that even the way the procedure and justification is explained can make a big difference to the amount of harm caused to vulnerable children in police custody.
Thoughts from the criminology team 