The Moralities of House (3×21, "Family")

“Nothing like a dead patient to send you back to your choir boy roots.” – House to Foreman

A few days late with this week’s House M.D. review. Sorry, some other topics crowded this one out!

As I explained a couple weeks ago, I intend to write a short summary of the moral issues in House, M.D. for the remaining episodes in the season. Last week I did 3×20 “House Training” and the week before that, 3×19 “Act Your Age.”

First things first – *spoiler warning*. I’m writing with the presumption that readers are either familiar with the show, have seen the episode in question, or are not worried about having plot arc points given away. Also, House treats of fairly explicit themes often (“viewer discretion advised”), so be warned. Enough said …

3×21, “Family”

Here’s the TV preview spot for this episode:

PoliteDissent provides a weekly plot recap of each episode, and then (helpfully) evaluates the medical claims made by the show.

The Moralities:

This week’s episode was, as PoliteDissent notes, much more an episode about ethical dilemmas rather than interesting medicine, playing upon the fact that House’s team is trying to save a boy by operating and experimenting on his brother (and vice versa).

House: Is back to his regular abuse of patients and especially their parents, who he tries to browbeat into giving him the permission slips he needs. Again, �giving parents the option of making a bad choice is a bad choice.� House believes its better to circumvent their consent and go for what he sees as objectively the best medical course of action. His blowup with Wilson in the hallway is uncalled for, and completely typical. He does apologize, but in his own way. He also orchestrates a one-on-one conversation with a the leukemia brother, in order to convince him to give up his life for his brother.

Chase: �And it�s Tuesday. It�s the day I remind you I like you and I want us to be together.�

Cameron: *sputter*

Foreman: Is having a tough time getting over the patient he lost in last week�s episode. The main thing that irks him is how he lost the patient by, in his mind, acting like House would have, coldly calculating the odds. His worry about the possibility of losing another patient prompts him to go behind everyone�s back and talk to the parents about the option � a very irresponsible action. And of course, the most shocking moment of the episode, where Foreman plunges a needle into the healthier brother�s bone marrow without anesthesia, is a show-stopper. But morally? I guess you can weigh on the one hand the incredible pain of being stabbed against saving the life of that person�s brother. But what is most troubling is that as Foreman is doing this the boy is screaming for him to stop! I can�t help but think this is poor writing and that in real life such an action would result in the immediate suspension and criminal prosecution of Foreman. At any rate, the way the episode treats it is that Foreman is becoming more and more like House, and is so scared of becoming him that he�d rather submit his resignation. We�ll see if he goes through with it by season end, but of course, it�s very doubtful.

Wilson: I think House�s withering criticism of Wilson has some foundation, namely, that Wilson believes so much in patient autonomy because he�s unwilling to live with the guilt of advising someone wrongly. He councils the family to �protect themselves as a whole� and choose a surgery that hurts one brother but saves the other simultaneously. Wilson continues to demonstrate his effective way of dealing with House�s pathological social problems. �You�re Pathetic, I didn�t mean that.� �Yes you did.� �Times infinity.� �Yes you did� you�re pathetic.�

The Parents: Come across very well in this episode. They do defer very often to Wilson when the situation quickly becomes tangled. The hardest choice they face is whether to intentionally infect one son with a disease in order to discover how to heal the other before he dies of it. House puts it this way: �you either leave with one dead son or two.� The parents simply refuse this option. They won�t give up on either son, especially if saving one means intentionally destroying the (admittedly slim) chances of one.

The Patients: The brothers are good figures, who, at 10 and 14, are willing to sacrifice their lives for one another, with the stated reason that �you�d do the same for me.� I appreciate that leukemia brother reaches a point where he starts talking about �it�s my time to go�, and then has his life saved at the 11th hour. It�s not over till it�s over, especially for a fourteen-year-old.

The Big Morality: The main question in this episode is to what degree you can intentionally sicken one patient in order to derive benefits for another person. It starts with intentionally weakening the immune system of one brother to more quickly ferret-out his illness (with the intention of curing it). The second major stage comes when they consider open heart surgery on the healthier brother to (it gets complicated) provide healthy bone marrow to the one with leukemia. �Either we cripple one son or kill the other.� Matters reach a fever pitch when House suggests transplanting the sickness from the healthier brother to the sick one, effectively using him as a live Petri dish to quickly discover what is killing the healthier brother. The moral question becomes to what degree, and for what foreseeable benefits, one can intentionally sicken someone for another person�s benefit? Clearly the brother with leukemia was not �doomed� to dying, because he in fact survives, and therefore the argument for making him worse (that he could not get better anyway) evaporates. There�s much to consider here.

Oh, and � the dog?!

Next Week:

Here’s the TV preview spot for next week’s episode:

More House resources:

Legalize: All pictures copyright FOX and found here.

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