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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.