Another TV Doctor, Another Breach: Dr. Sanjay Gupta’s Heroic And Self-serving Ethics Blindness

Are TV doctors entertainers, journalists or doctors? In a way the question doesn’t matter: if they are doctors, then they are obligated to follow medical ethics and the standards of their profession at all times, no matter what else they may be taking compensation for. This is why “Dr. Oz” is ducking the issue when he tries to avoid accountability for pushing quack remedies on his TV show (if it ducks like a quack…) by arguing that he isn’t practicing medicine, but engaging in entertainment. He’s still a doctor, every second of his life, once he takes that oath.

CNN’s Dr. Sanjay Gupta has largely steered clear of ethical issues in his tenure as the network’s medical expert. Not entirely, however; for example, in 2009, he was prominently mentioned as a possible Surgeon General, and was in discussions with the White House while continuing his reporting on the air, raising real and potential conflict of interest concerns. The most recent controversy is more serious.

Following the  devastating earthquake in Nepal, CNN crew filmed Gupta, on-site in his role as chief medical correspondent, as he performed emergency brain surgery on an eight-year-old girl and resuscitated another victim of the quake on a helicopter using a cardiac thump. This was not the first time Gupta practiced medicine on a patient in front of the camera. He treated a two-year-old boy on assignment in the Middle East, and examined patients on camera after the 2010 Haiti earthquake.

In doing so, Gupta violates both medical and journalism ethics. As a doctor, he is obligated to protect client confidentiality. He may not show the procedures being performed on them without their informed consent, and in a foreign setting under emergency conditions, informed consent by patients is impossible. In the U.S., doing what Gupta did in Nepal on camera would be against the law. That means it is unethical…anywhere. American doctors do not escape the obligation to practice medicine ethically as defined by American ethics rules, regulations and laws simply by escaping U.S. jurisdiction and enforcement. [ NOTE: This last statement has been added as clarification to the original post. I should also note that this is my position. There is no formal positions on whether American doctors can ethically engage in practices abroad that would be illegal in the U.S., nor would I expect there to be.] As a journalist, meanwhile, he is required not to interfere with the story he is covering. Performing medical procedures on camera is becoming the story. Worse, it exploits injured victim for drama, sensationalism and ratings.

Tom Linden, a professor of medical journalism at the University of North Carolina, has proposed that new ethics guidelines should be drawn up for reporter-doctors. He has argued in the journal Electronic News that while physician-journalists like Gupta should not shirk their medical duty to save lives,  a doctor-reporter should also never feature his patient in a television report, or even ask  permission to do so. That’s exactly right, but a rule shouldn’t be necessary. Current medical and journalistic ethics standards already make that the ethical course.

Dr. Sanjay Gupta has just chosen to ignore those standards, that’s all.

__________________________

Facts: The Guardian

 

25 thoughts on “Another TV Doctor, Another Breach: Dr. Sanjay Gupta’s Heroic And Self-serving Ethics Blindness

  1. He was already a squish for caving on marijuana. And this isn’t the first time he’s joined n the story, remember him stepping in to perform head surgery on an injured US Marine in Iraq?

  2. Worse, journalists apparently no longer have any ethics, so when the two are combined, you get a net negative. Is that possible?

  3. I don’t think you could even obtain proper consent in this situation.. the child and the CPR recipient surely couldn’t have given theirs. Others maybe but they likely felt they had no other options and would’ve felt enormous pressure to allow their treatment to be filmed even if they were uncomfortable with it – so not valid consent. I’ve given permission to have one of my operations recorded/photographed for education purposes though the paperwork I signed was rather vague and could have been misunderstood by some. There was a lady is the UK who agreed to have the birth of her child filmed for the benefit of medical students and years later it was sold and she saw the footage broadcast on television! There was no recourse as far as I remember so it must have been at least alluded to in the contract and she just didn’t understand, or perhaps selling it to a TV network for a documentary technically falls within the definition of educational use, idk.

    • Filming it is one thing, showing it is another. I would think they had time to get permission before they aired the footage, and should have.

      The version I saw of the “cardiac thump” didn’t show the actual thump. He did a sternal rub to see if she was unconscious, then there was an edit in the video. I think they at least had the sense to not show how a potentially dangerous procedure is performed.

  4. Does this not actually raise the question of can you even be a Journalist and a Doctor at the same time?

    I’d submit (without further exposition) that the answer is no.

    In such emergencies, the two professions call the professionals in different directions. We can’t have schizophrenics trying to handle both.

    • Schizophrenia is not so much multiple personalities, which I think you meant, as it is a break (Schism) from reality. Trying to do two different jobs which are mutually exclusive would be multiple personalities. Thinking you could do either or both adequately is schizophrenic.

  5. Beep. Wrong.

    You have just stated, as a general principle, that if something is against U.S. law, it is universally unethical. That does not follow, and in fact it would be easy to find many past and present counter-examples, e.g. driving on the left side of the road. The fact that the current case is not one is irrelevant, and my refutation of the general principle should not be read as asserting that.

  6. Drat – the blockquote got dropped:-

    In the U.S., doing what Gupta did in Nepal on camera would be against the law. That means it is unethical…anywhere.

    Beep. Wrong.

    You have just stated, as a general principle, that if something is against U.S. law, it is universally unethical. That does not follow, and in fact it would be easy to find many past and present counter-examples, e.g. driving on the left side of the road. The fact that the current case is not one is irrelevant, and my refutation of the general principle should not be read as asserting that.

    • No, I didn’t state it as a general principle. If I had meant that, I would have said that it was a general principle.

      Gupta is an American doctor, and his ethical obligations are described here, are binding on doctors who practice here, and are what he pledged would guide his medical conduct, regardless of whether he is engaged in medicine elsewhere. (Whether those ethics requirements could be enforced is s different issue.) The ethics rules do not exclude other nations where the doctors may practice: an American doctor is still an American doctor. Similarly, the laws that relate to ethical obligations, like HIPPA, simply legally enforce what are already established ethics requirements for for American doctors. In thus case, it’s privacy and confidentiality. Do you think an American doctor could ignore “do no harm” because a particular country’s laws told doctors to “do whatever the hell you like to people, we have too many of them anyway,” with the defense that “it’s legal”? US law defines the ethical boundaries of medical practice as much as the formal ethics rules and regulations do.

      My position is that an American doctor does not free himself of the ethical obligation to practice medicine in the fashion American doctors are required to practice here by simply escaping US enforcement.

      I didn’t say, nor do I believe, that “as a general principle, that if something is against U.S. law, it is universally unethical.”

      I’ll grant you this: the statement should have been more precise. What I should have written to preclude a plausible misreading like yours was: “American doctors do not escape the obligation to practice medicine ethically as defined by American ethics rules, regulations and laws simply by escaping U.S. jurisdiction and enforcement.” I’m going to add that as clarification. Right now.

      • No, I didn’t state it as a general principle … I didn’t say, nor do I believe, that “as a general principle, that if something is against U.S. law, it is universally unethical.”

        I don’t for one moment suppose that you believe that – though certain U.S. exceptionalists might indeed go that far, if I have been correctly informed about them. However, as a matter of the words you used, you most definitely did state that “as a general principle, that if something is against U.S. law, it is universally unethical”. If you did not mean or intend that yourself, your communications skills have let you down – because you followed that unexceptionable first sentence, setting the facts out, with “That means it is …”, i.e. a claim that there was a causal link from that to the following words: “… unethical…anywhere”; that is a claim which is general as it stands. And that is neither more nor less than stating that “as a general principle, that if something is against U.S. law, it is universally unethical”.

        I fully appreciated that you never intended that (though only because I have the context of seeing other of your work over time). But I also appreciated that you had conveyed that, and that others might take that as its plain meaning – particularly if it accorded with their preconceptions. I felt, and still feel, that it was incumbent on me, as someone on the spot, to try to halt that runaway.

          • Yet it isn’t precise. He had a beef with a “general” principle in his own words. Yet, as a “general” principle there ISN’T anything wrong with the assertion he gripes about.

            Had he asserted that you made an “absolute” or a “universally affirmative” principle, then he might have room to quibble. But here, he’s hung himself with his own rope. As a “general” principle, which therefore may contain reasonable exceptions, such as *driving laws*, it is still useful in weightier matters, such as *medical ethics*…

            And to clarify, I believe the onomatopoeic term he’s looking for is “bzzzt” not “beep”.

            • Bluntly, no.

              Exceptions may be added to qualify a generality, but without them a general principle stands or falls by fitting every case within its universe of discourse. For instance, it is not true that every fourth year is a leap year; but if you qualify it appropriately, it becomes true – but not by becoming different, by working on a smaller set of cases delivered by the further qualifications.

              So, I was objecting to the general principle that was (inadvertently, we now know) asserted – that behaviour is unethical anywhere because it would be illegal in the U.S.A.

              • Exceptions need be added to *clarify* a generality, not to *change* the generality.

                You are still conflating “General” with “Universal Affirmative” or “All S are P” syllogisms. General statements, though bearing no logical defined equivalent are best viewed as “Some S are P” syllogisms, where “some” in this case means a overwhelming majority, but not all. This in an error on your part and undoes the rest of your bit.

          • When he was leader of the U.K.’s Liberal Party, the late Jo Grimond is alleged to have said of his colleagues, “they don’t appreciate my views, and even if they did, they wouldn’t like them”.

            Also, you may be familiar with the story of the man who was seen hitting a mule over the head with a hammer. When asked why he was doing it, he said he was educating the mule. When asked to clarify how hitting helped, he replied, “well, first I have to get its attention”. (You may or may not appreciate this.)

            Perhaps it would help if I gave a part for part translation of what you even now have up there (remember, all of that is free standing, and not in any way qualified or altered by your clarification of your underlying thinking):-

            – “In the U.S., doing what Gupta did in Nepal on camera would be against the law” = “actions such as Gupta’s are illegal when done in the U.S.A.”

            – “That means” = “which leads to or causes to obtain that”.

            – “it is unethical…anywhere” = “such actions are universally unethical, without any qualification”.

            Now, it would have been perfectly safe, though wordy, to state something as general as “actions such as Gupta’s are illegal when done in the U.S.A. because such actions are universally unethical, without any qualification; their being illegal there is a particular instance that illustrates the generality of their being unethical”. That does not draw a cause and effect chain from a U.S. legal barrier to a universal ethical truth. But what you have there, even now, does draw such a chain; all your clarification does is bring out an irrelevance, since it does not cure the assertion that a generality derives from a U.S. particular (as opposed to being illustrated by it). Yet all you would have to do to cure your statement is to take out its generality, e.g.:-

            In the U.S., doing what Gupta did in Nepal on camera would be against the law. That means it is unethical for a U.S. accredited doctor like Gupta …anywhere.

            Of course, that is inadequate as it leaves open the possibility that it might be ethical for others, and so it might not be what you wanted to state either. It is not ethical for others to do as Gupta did, where he did it; but that can only be derived from U.S. particulars for U.S. particulars, and not in general, so it would have to be established separately.

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