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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…
Rawls, J. (1971) A Theory of Justice. Oxford: Oxford University Press.
Ryan, A. (1993) Justice. Oxford: Oxford University Press.
No April Fools
The first of April has consisted of a steep 54% rise in what energy company’s can charge customers for using energy, with further rises set to occur in October. This coincides with rises to other bills such as council tax, national insurance and water within a climate of inflation. Previous to this many were struggling to make ends meet…what are these people supposed to do now?
Russia’s atrocities and Covid-19 have been blamed for the steep price increases and inflation. I suspect that employers will be using this as a reason to not increase the persistent low rises in wages that workers are receiving, all whilst their bosses are becoming richer and richer. Of course, both Russia and Covid will have a significant impact on the economy, however, it does not take a genius to be aware that people have been struggling to survive well before this, hence terms like, food poverty, period poverty and fuel poverty predate these issues. Also, so do the persistent low rises in wages for workers.
Apparently, MPs are due a £2,200 pay rise which whilst it seems low (2.7%) compared to inflation, a few MPs themselves (such as Zarah Sultana) have stated that they do not need this pay rise as they already receive a high paying wage.
Oh, and let us not forget that the increasing energy prices will ensure that privatised fuel companies such as Shell and BP continue to profit, with a predicted profit of £40 BILLION for this year.
Meanwhile benefits for those who are not formally employed and spend a higher proportion of money on household bills and rent are set to increase by 3.1% – a rise which will not cover these price increases.
How is it that employers and the State cannot afford to pay people more – but can ensure high wages for the already rich, privileged and powerful?
It is not surprising that the government’s measures to deal with the problem, such as one-off payments and energy loans, have been heavily criticised as inadequate and significantly failing to support the lowest income homes. The government employs a group of elites and many are completely out of touch with reality. Apparently the man presiding over these measures, millionaire Rishi Sunak and his billionaire wife, often donate to charitable causes, such as donating £100,000 to Rishi’s former elitist private school. Because a private school in need is a pressing cause…yeah right!
The opposition parties have rightly criticised the Conservatives take on this but listening to Keir Starmer’s bumbling take on what Labour would do to solve these issues is also worrying. During an interview he stated that windfall tax could be a solution ‘for right now’ with no feasible long term plan. My usual vote for Labour in May will be damage control against more Tory time in power.
A long term TAX on THE RICH to use this money to support those that need it is not even that simple, given that the government accepts donations from the super-rich it is unlikely that decisions would be made to genuinely reduce inequality between the rich and poor. The world will never be a better place if those in power continue to focus on their own interests and huge profits in place of looking after people. The rise in energy prices on the first of this month was no April Fools’ joke…I really wish that it was.
Rule makers, rule breakers and the rest of us
There are plenty of theories about why rules are broken, arguments about who make the rules and about how we deal with rule breakers. We can discuss victimology and penology, navigating our way around these, decrying how victims and offenders are poorly treated within our criminal justice systems. We think about social justice, but it seems ignore the injustice perpetrated by some because we can somehow find an excuse for their rule breaking or point out some good deed somewhere along the line. And we lament at how some get away with rule breaking because of their status or power. But what is to be done about people that break the rules and in doing so cause or may cause considerable harm to others; to the rest of us?
Recently, Greece imposed a new penalty system upon those over 60 that are not vaccinated against Covid. Pensioners who have had real reductions in their pensions are now to be hit with a fine, a rolling fine at that, if they do not get vaccinated. This is against a backdrop of poor vaccination rates which seem to have improved significantly since the announcement of what many see as draconian measures by a right-wing government. There are those that argue that vaccination ought to be a choice, and this has been brought into focus by the requirements for health workers and those in the care profession to be vaccinated in this country. And we’ve heard arguments from industry against vaccination passports which would allow people to get into large venues and a consistent drip-drip effect of how damaging the covid rules are to the leisure industry and aviation, as well as the young people in society.
So, would it have been far more acceptable to have no rules at all around Covid? Should we have simply carried on and hoped that eventually herd immunity would kick in? Let’s not forget of course that the health service would have been so overwhelmed that many people will have died from illnesses other than Covid (they undoubtedly have to some extent anyway). The fittest will have survived and of course, the richest or most resourceful. Businesses will have been on their knees as workers failed to turn up for work, either because they were too ill or have moved on from this life and few customers will have thought about quaffing pints, clubbing, or venturing off to some faraway sunny place (not that they’d be particularly welcome there coming from plague island). It would have felt more like some Darwinian evolutionary experiment than civilised society.
It seems that making some rules for the good of society is necessary. Of course, there will be those that break the rules and as a society, we struggle to determine what is to be done with them. Fines are too harsh, inappropriate, draconian. Being caring, educating, works for some but let’s be honest, there are those that will break the rules regardless. Whilst we can argue about what should be done with those that break the rules, about the impact they have on society, about victims and crimes, perhaps the most pressing argument is about equality of justice. The rest of us, those that didn’t break the rules, might question how draconian the rules were (are) and we might question the punishments meted out to those that broke the rules. But what really hurts, where we really feel hard done by, let down, angry is to see that those that made the rules, broke the rules and for them we don’t get to consider whether the punishment is draconian or too soft. There are no consequences for the rule makers even when they are rule breakers. It seems a lamentable fact that we have a system of governance, be that situated in politics or business, that advocates a ‘do as I say’ rather than ‘do as I do’ mentality. The moral compass of those in power seems to be seriously misaligned. As the MP David Davis calls for the resignation of Boris Johnson and says that he has to go, he should look around and he might realise, they all need to go. This is not a case of one rotten apple, the whole crop is off, and it stinks to high heaven.