Medical Drama Causes Moral Drama: Holby City and Alcohol Misuse?

by Dr. Nileema Conlon Vaswani in

The media is known to influence all of us. Psychological studies have shown links between violence in the media and aggressive behaviour in children, cigarette companies are disallowed from advertising cigarettes because it is believed that doing so will encourage smoking, junk food advertisements are often under scrutiny, and so on. This week, however, Holby City, a British Medical Drama broadcast on BBC television, is in the spotlight because of an episode that is claimed to show alcohol misuse without showing the consequences of that misuse. The complaint has been put forward by the Portman Group, the body deals with social responsibility issues that surround alcohol.

The episode, broadcast on 11 September 2007, showed a short scene between two colleagues where the character Maddy, a doctor on the show, is at the bar with her male colleague, Sam, who is also a doctor. They "down" five tequila shots each and then Maddy suggests that Sam and she go back to her place. Nothing further is shown and the episode ends at this point. Concerns raised by the Portman Group include the suggestion that the consumption of alcohol was connected to sexual behaviour between the two characters but the main complaint was that although excessive alcohol consumption was shown, its consequences were not. This claim is debatable but apart from this, one ought to ask whether drama shown on television ought always to point in a socially acceptable moral direction?

Although the Portman Group has argued that the misuse of alcohol was shown without its consequences, the strong suggestion that the two characters were to go on to engage in a sexual encounter, one of the Group's complaints, is a consequence in itself. If we must look for moral messages in this scene, then they were present and so were the messages surrounding excessive and rapid alcohol consumption. The alcohol might have been a reason for two people who were not in a traditional relationship to engage in a one-night stand if, indeed that is what happened. This in itself might send out messages of how people might be carried away by the effects of alcohol and engage in behaviours that they might not otherwise engage in. To argue that the consequences of alcohol misuse were not shown is technically correct because they were not visually shown as part of the episode but the consequences were suggested and certainly left the viewer with a clear indication of what might have happened between the pair that night. To that extent, the misuse of alcohol did not stand independent of the consequences.

One can see the value of disallowing tobacco or junk food advertising but whether a medical drama ought to be held to the same standards is an entirely different matter. If, for example, Holby City had shown Maddy and Sam returning to work after consuming their tequila shots and had shown the alcohol to have no negative impact on their work or their interaction with patients, that would have been irresponsible because it would have been inaccurate and misleading. But the fact that the consequences entailed their going home and perhaps having sexual intercourse, is well indicated as a consequence of the alcohol. Holby City is a medical drama and not an alcohol education programme but even if it were meant to convey a message regarding the effects of alcohol, it did that.

Aside from the issues of alcohol that have come to light, there are numerous controversial issues that are routinely dealt with in this medical drama. These include people cheating on their spouses and partners, taking drugs, stealing, and even assisted suicide. These issues exist in addition to the medical and ethical problems surrounding the treatment of the patients. The treatment of these issues is often interesting and thought provoking even if the conclusions or "solutions" offered are sometimes ones that people would find unacceptable in real life. For example, in an older story line, one consultant helps the wife of another consultant to arrange for her own death at an organisation in Switzerland. The pain and turmoil of the decision was effectively revealed both by the lady who wanted to end her life and by the consultant who helped her go to Switzerland. If we were to apply the same model of social responsibility suggested by the Portman Group, i.e., of how behaviours on television can be imitated in the context of alcohol, one could make the same argument in the context of assisted suicide. In the case of alcohol, excessive drinking is dangerous and usually socially unacceptable; in the case of assisted suicide, whatever the views of individual people, in the UK it is legally and socially unacceptable. Still, there was nothing morally wrong in bringing those issues to light. If anything, the drama highlighted the suffering of people with serious and debilitating medical conditions. Drama is different from education and documentary, and hence also has its own creative licence.

Despite creative licence, drama that does replicate real life, such as Holby City, is helpful. The current controversy ought to placed in the context of the story line. Maddy had just lost her young niece to methadone poisoning. If the programme had suggested that she ought to have dealt with her problems through drinking, that would have been wrong. But for the programme to show that sometimes when people are going through a hard time, they turn to alcohol for the evening (Maddy is not generally an alcoholic), only portrays a realistic picture of how many people cope; it does not suggest how one ought to cope. It also shows that doctors have their share of problems and deal with them as well or as badly as does anyone else.

If alcohol were a problem on Holby City or any other show, then so ought various other issues that are shown on medical drama. If drama can't include theft, infidelity, death, addiction and other problems that affect the lives of many people, one would have to ask why we have drama at all. As long as the issues in Holby City or in any other medical drama, exist as issues and are not prescriptive with regard to how we ought to behave or lead our lives, we can treat drama for what it is and not pretend that it exists for our moral and social education.