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House M.D. is a widely acclaimed and very successful television series about medicine, produced in the USA and broadcast in the UK and 10 additional countries i . The series features a physician, Dr Gregory House, who heads a "Department of Medical Diagnostics", and each episode features a challenging search for the diagnosis of a patient's symptoms. Accordingly, the series might be characterised as a "medical mystery". Indeed, in an interview, the producers stated that the choice of the name House was a pun on Holmes (homes); and the name of House's physician friend Wilson was chosen because of its similarity to Watson . 1
In the final scene of "Honeymoon", the last episode of the first season of House M.D. , Dr House listens to a Rolling Stones song, and we hear Mick Jagger sing, "You can't always get what you want, but if you try sometimes, you might find, you get what you need ..." These words express a recurrent paternalistic theme of the series: patients don't always get what they want (that is, their preferences and choices are disregarded), but they get what House ii believes they need (that is, tests, medical procedures and medications that enable him to successfully diagnose and treat their medical conditions).
House is a paradigm of a paternalistic physician iii . He believes that he knows what is best for his patients, and he repeatedly flouts their wishes in order to diagnose and treat their illnesses. For him, informed consent is a meaningless ritual and, worse yet, a potential obstacle to providing patients the tests, medical procedures and medications that he believes they need. Accordingly, House M.D. is an excellent vehicle for an analysis of medical paternalism.
INSTANCES OF MEDICAL PATERNALISM IN HOUSE M.D.
One of the most extreme and dramatic examples of medical paternalism in the series occurs in "Honeymoon". In that episode, a patient named Mark refuses to allow House to perform a diagnostic test. Mark, the husband of Stacy, House's former fiancée, is completely paralysed. House believes he knows the cause of Mark's symptoms: acute intermittent porphyria. To confirm the diagnosis, House proposes to trigger a seizure with an injection and then perform a test on a urine sample. Triggering seizures is risky, and...