Tension or pressure because you feel you cannot provide the care you would like. Or not knowing what the right thing is and feeling forced to choose between two evils. These are issues facing fictional characters in drama series, but also a daily reality for healthcare professionals. ‘The interesting thing about the drama series I studied is that they do not offer an unambiguous moral framework. They disrupt your moral compass and challenge you to relate to your own views anew,’ Van Ommen explains. Her PhD research focused on the question: how do people come to a moral judgment when the story does not unambiguously tell them what to think? ‘These are complex situations that healthcare professionals also have to deal with. The advantage of drama series over films is that they are longer, making it possible to explore dilemmas endlessly and from the perspective of many characters and situations. This connects them more closely to unruly reality.’
Difference in experience
For her PhD research, Van Ommen watched several drama series, such as the medical series House M.D. and the psychological thriller series Dexter, together with doctors, psychologists, and law enforcement officers. What did she observe? That healthcare professionals at the beginning of their careers make different judgments from their more experienced peers. ‘For example, when watching Dexter, Psychology students were mostly focused on diagnostics,’ Van Ommen reflects. ‘Their judgment was relatively black and white, as in: Dexter has these characteristics, therefore he is a psychopath. While psychologists with more practical experience, when watching this series, also distinguished between their opinions as individuals and as professionals. This led to them more often delaying judgment. Or even refraining from judgment because they indicated that they still had too little information.’
Van Ommen also observed other differences. ‘After watching drama series, Medicine and Psychology students indicated that when faced with moral dilemmas, they relied heavily on existing guidelines and protocols, while experienced professionals recognised that these were not always adequate. As a result, just like fictional characters, they often had to figure out on the spot what “the right thing” to do was. Furthermore, when watching House M.D, a difference emerged around the question of whether a doctor is a physician or a coach, and whether diagnosis should be an end or a means. Doctor House is more interested in diagnosing people than in curing them. Young physicians perceived his behaviour as fiction, while experienced doctors acknowledged that, although the series is exaggerated, it contains a kernel of truth. So as you get more experience, you become more aware of complexity and these kinds of series become more realistic in a moral sense.’
Help with moral choices
Van Ommen's research shows that drama series can help healthcare professionals become more aware of moral choices. ‘They act as a whetstone for the moral compass because they constantly present complex situations that do not fit into existing guidelines and protocols. Drama series say something about current moral fault lines in society, about questions to which we do not yet have unambiguous answers. The beauty of quality drama is that it works as a moral laboratory: viewers can find answers to abstract questions, such as what they believe constitutes good care, by experimenting with moral positions in fictional situations and from different roles. They are not given guidelines, but perspectives that require them to think for themselves. The urgent choice situations that emerge as a result can feel just as in real life. They evoke reactions such as increased heart rate, hope, and fear. As a result, stories enrich ethics education: whereas philosophical texts speak to the rational mind, drama series also address feeling.’
Van Ommen therefore developed the training course ‘Dealing with moral complexity for healthcare professionals’, together with Radboud philosopher and spiritual counsellor Rob van Grinsven-Peters. In this course, healthcare professionals watch a number of drama series together, including the acclaimed series Adolescence. ‘In the training course, participants experience and unravel morally complex situations,’ Van Ommen explains. ‘They then use practical tools from philosophy to systematically arrive at moral decisions, formulating in their own words the basic principles of their profession. Finally, they process their insights into a strategic plan for sustainably shaping their moral ambition.’ Van Ommen stresses the added value of drama series in this regard, as a kind of learning simulation for healthcare professionals. ‘We often think moral choices are rational, but we often make these choices unconsciously, intuitively, and emotionally. By pausing fictional choice situations and then thinking, feeling and acting together, you increase moral awareness and develop strong character. That is the strength of drama series: they are true to life.’
Read more about the training course ‘Dealing with moral complexity for healthcare professionals’. The Radboud Centre for Social Sciences also offers two courses with content related to this training: ‘Self-care’ and ‘Pigeonholing, stereotyping and prejudice’.