ABC’s “Private Practice” and the Vaccination Debate

Two different factors brought me to this post: firstly my potentially obsessive fascination with the ethical issues surrounding vaccination, and secondly my unhealthy and frequent tendency to avoid my problems by binge-watching TV shows on Netflix.

I was enjoying one of my aforementioned Netflix binges, pretending that graduation wasn’t looming and that my life was totally on track, when I stumbled upon an interesting representation of the vaccine issue. I was watching a Grey’s Anatomy spinoff entitled Private Practice (try graduating with no life plan before you judge my TV habits). In the episode, a pediatrician named Dr. Freedman is treating a child presenting with symptoms of the common cold. In a stereotypically melodramatic fashion, Dr. Freedman eventually discovers that the kid has the measles. The child has two younger brothers, the older of whom has severe autism that his mother blames on immunization. As such, she is forcefully opposed to vaccination, to the point where she refuses to vaccinate her youngest son for fear of losing him to the same fate as his middle brother.

The oldest brother must be quarantined in a hospital, and his health rapidly deteriorates. Dr. Freedman continues urging the mother to vaccinate her youngest son, who stands to catch the measles from his oldest brother. Dr. Freedman’s genuine and intense concern for the youngest son goes unappreciated as the mother continues to refuse, getting more and more adamant as the episode continues.

Finally, moments after the oldest child has passed away in the quarantine ICU, Dr. Freedman gives the mother a look, turns away, and, in what I like to call “The True Shonda Rhimes Drama Strut”, marches over to the youngest child, vaccine in hand. The mother, initially confused and eventually horrified, runs screaming after Dr. Freedman, begging him to stop. In the pinnacle of dramatic tension, Dr. Freedman pokes the youngest child with the needle, and the camera pans to the mother, whose face falls tragically before she runs to kneel before her child and check him for any potential signs of autism (take a moment to appreciate how ridiculous that looks).

In a very clear lesson in the morality of vaccination administration, this episode shows Dr. Freedman’s overflowing concern for his patients, and his willingness to break CLEARLY DEFINED laws for the sake of his patients’ health.

I found this episode especially interesting because, unlike much of our focus on vaccination in class, Dr. Freedman is not concerned with the pubic health repercussions of leaving the potentially infected child unvaccinated (sidenote: if the child may be infected, administering a vaccine is the BEST way to take care of it. (Sarcasm.)).  He is, instead, solely focused on the well-being of the child. This different perspective marks other vaccination motivations for doctors: preventative medicine on a case-by-case basis and the right of the child to safety from infectious disease.

There also exists here an angle on paternalism. Dr. Freedman overrides the mother’s right to make health decisions on behalf of her child, having clearly stated that there exists no medical connection between vaccination and autism. This overstepping of boundaries, while hugely illegal, is an interesting decision on behalf of the doctor. Dr. Freedman, ignoring all opinions and decisions made by the mother, barges through and vaccinates the child because he knows it is the right thing to do, parental consent be damned.

Overall, I felt this episode raised some very important and difficult questions about vaccination and parental control over a child’s medical decisions. The focus on individuals rather than public health in the debate about vaccination was also a nice shift. The show may be hyper-dramatized to the point of ridiculousness, but they definitely got their point across, loud and clear.

Works Cited:

Childress, James F, Faden, R.R., Gaare, R.D., Gostin, L.O., Kahn, J., Bonnie, R.J., Kass, N.E., Mastroianni, A.C., Moreno, J.D. and Nieburg, P. “Public Health Ethics: Mapping the Terrain.” Arguing About Bioethics. By Stephen Holland. London: Routledge, 2012. 10075-0461. Kindle.

“Contamination.” Private Practice. American Broadcasting Company. Netflix. Web. 8 Jan. 2009.

Isaacs, D., H. A. Kilham, and H. Marshall. “Should Routine Childhood Immunizations Be Compulsory?” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 398-406. Kindle.

36 thoughts on “ABC’s “Private Practice” and the Vaccination Debate

  1. First of all, you are a hilarious writer so huge props on this blog post because it was very entertaining.

    The individual part of the vaccination debate it extremely interesting, but it still all comes back to the broader scheme. Should we be mandating vaccinations? YES. That is my take. While hearing the story of an individual mom, who clearly has the best interest of a child at heart while making such a decision – it is hard to find the fault. Is the fault in the education – is health literacy generally low, are we explaining vaccination potential and harms properly, what can be done to better help parents make an informed decision.

    Ultimately, I think most of us would agree that vaccinations are beneficial. While it is highly unrealistic to believe that forcing mandates on all children is feasible (in the near future) I still think it should be mandated for public schools. Barriers, big barriers, need to be created to push mom’s like this mother, to have their child vaccinated at as young an age as possible. Of course, the very dramatic choice to stick the child is wrong – there are so many instances before this moment where the child should be been vaccinated. If social pressure is the best way to do that, I still think it is a valuable start.

  2. I find your post very entertaining and very interesting. However, I want to point out a few aspects that you didn’t mention. One aspect is that at the end of the day, the doctor has to live with his/her decisions. This means that the doctor will have to either live with not vaccinating the youngest child and potentially watching the child meet the same fate as his brother, OR he can vaccinate the child and hope that he has saved the child’s life at the end of the day. While he may have broken the law and went against the mother’s wishes, he will probably always be happy that he did potentially save the child’s life, even if he loses his job/is sued.
    Another aspect that you did not mention is if the doctor tried to educate the mother about vaccinations. If he just tried to persuade her that vaccinating her child was in his best interest, then this would not be a very solid argument. However, if he tried to educate her, but she still ignored him, that is a different story. In this case, there probably is no right thing to do.

  3. Your argument was intriguing for two reasons: 1) this was an amazing story that made me laugh and 2) it brings up the moral question of whether the physician has a right to do what’s best for his patient or worry about legal repercussions for himself. Even though it seems heroic that he was willing to forgo losing his medical license and to be sued for malpractice, this would seem irrational in the scope of a real-life situation. There still is a chance that the child may not ever get measles in his life due to herd immunity, and having a license is important so that he can continue to care for more patients. Therefore, it would be more rational if he didn’t override the mother’s decision. That being said, I can understand his reasoning behind his decision: he did not want the child to suffer the same fate as his older brother. Unfortunately, the media propagated the link that was erroneously made between autism and vaccines. Some people fall prey to the media as the only credible source of information. However, he did the best that he could do by adamantly trying to convince the mother to get her youngest child vaccinated. Hence, I would say that he would have followed through on his commitment to both seeking the best interest of the patient while respecting the mother’s decision.

  4. I think you can also draw in Pellegrino’s arguments about physicians being in a moral community. Despite the youngest son not being the primary patient of the doctor, he still has an obligation to do what is right for people in his direct contact and in his community. By vaccinating the child he protects them from the detrimental disease and in a way even protects the mother form emotional distress that could occur if the youngest child had acquired measles.

    I also find the portrayal of the characters and their thoughts about vaccinations to be particularly important because a larger audience could very well be influenced by what they see on television. While I personally agree with the doctors actions, a person watching the episode on TV could completely disagree with the illegal action and question the autism vaccination link even further. This may have a detrimental effect on the population’s trust in doctors and vaccinations themselves.

  5. i loved your blog post especially that you brought in Grey Anatomy and Private Practice. I remember this episode vividly and my thought on it initially and how my views have changed since taking this course. Essentially, I thought both the mom and Dr. Freedman were acting irrationally. The mom for not vaccinating her youngest child despite the obvious risk of contracting the measles and even dying and then Dr. Freedman for breaking the law.

    However, I now see how both parties were acting in their believed moral and ethical values. The mother was trying to protect her son because of an unfortunate circumstance with her older child. However, it is now known that despite the medical and public belief, scientists have proven that the paper correlating vaccinations and autism was fraudulent. The medical community is now working hard to dispel the notions associated with this paper. Dr Freedman was acting on the moral principles of non-maleficence because he believed that by not giving the child the vaccination would be harming the child.

  6. I think one of the most interesting aspects of this story is how Dr. Freedman was acting in the manner he thought was best for the individual. One of the things which I think we have talked about a lot in class is how doctors often do not create a strong emotional relationship with their patients unlike the one Dr. Freedman has with this family. In this case while I believe that the child should have been vaccinated, I think it is clear that he is overstepping in some fashion and should have been a case potentially where child services or other lawyers should have been brought in to deal with the case. While it is important for doctors to develop relationships with their patients, perhaps there is a line which the doctor-patient relationship should not cross so they can maintain a professional relationship and the doctor is able to make rational choices without emotions taking over.

  7. This story provides an interesting reflection of the current state of affairs in context to vaccinations. Yes, the paternalism is seemingly justified by strong caring of the MD for the outcome of the patient’s sibling. Is this an image of mandated vaccines? While this comes from a television show, there is an eerie reality to the situation. Mandated vaccines do seem like the MD is aggressively jabbing needles without permission, but the reality of the consequences to refusing such vaccination is quite evident: death by disease. This television show does both a dramatic depiction of both sides of the argument, and it is comforting to see that bioethical issues are being contemplated on mainstream television. Bioethical debates are personal for everyone so it is important that people are informed of the decisions they are making and understanding the reasoning for their side. Thus, I thought this episode could powerfully challenge the viewpoints of the viewers and hopefully spark conversation. The dramatic effect could have tainted the realities of each side, but drama is needed to draw attention to the current issue at hand.

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  21. The child has two younger brothers, the older of whom has severe autism that his mother blames on immunization. As such, she is forcefully opposed to vaccination, to the point where she refuses to vaccinate her youngest son for fear of losing him to the same fate as his middle brother. Really?

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