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When I watch Mad Men I am constantly reminded of the stark contrast between the world we live in today and the world that existed in the 1960s. Although the stories of Don Draper and the Madison Avenue advertising agency are certainly fictional and highly exaggerated, there are aspects present in the show which constantly remind me how different modern day society is when compared to that of the 1960s. Some of the most obvious differences lie in the change of fashion over time and how much less people smoke and drink in social situations today. But something I noticed which truly shocked me was the lack of respect men had for women at the time. This lack of respect spread so deep that not only would women be treated as second class citizens but were not even granted their basic ethical rights when visiting a medical doctor! Mad Men portrays Betty’s psychiatrist Dr. Wayne as breaking his Hippocratic oath and disclosing Betty’s confidential medical information with her husband Don. Seeing this kind of complete disregard for Betty’s confidentiality – a basic ethical right which should be granted to all patients, truly enraged me as a viewer.
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The concept of “doctor-patient confidentiality” derives from English Common Law – something conceptualized around the 12th or 13th century. Although it is technically based on ethics and not law, this concept can be traced as far back as the Roman Hippocratic Oath! What is even more interesting is that the Hippocratic Oath is still taken by all physicians out of medical school to this day. An important part of the oath is:
“Whatever in connection with my profession [as a doctor]...I will not divulge as reckoning that all such should be kept a secret...and that those things which are sacred, are to be imparted only to [other doctors]; it is not lawful to impart them to [non-doctors].”
After reviewing this Oath, I could not simply dismiss Dr. Wayne’s lack of ethics as a result of the fact that “things were different in the ‘60s”. I could not believe that the lack of respect for women had infiltrated so far into society that even doctors did not hold their confidential information as sacred. I figured that there had to be some law somewhere which made this violation in ethical behavior illegal.
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After some research, I was surprised to find out that there hadn’t been a law in the 1960s that made the doctor-patient relationship a legally binding concept. In fact, it wasn’t until 1996 that Senator Kennedy sponsored HIPAA in congress, which was a bill which basically said that unless a patient signed a waiver saying otherwise, a doctor couldn’t mention anything you say to a parent, friend or spouse unless it had to to with personal safety or someone else’s safety. Although the bill was passed in 1996, it took until April 14th 2003 for the “Privacy Rule” amendment to pass which said that “an individual who believes that the doctor-patient confidentiality rule is not being upheld, can file a complaint with the Department of Health and Human Services Office for Civil Rights”.
It is certainly common knowledge that the doctor-patient relationship is central to the foundations of contemporary medical practice. Especially to a viewer who has grown up in the age of this rule being enforced, it is understandable that Dr. Wayne’s actions were disturbing to modern day viewers. But even though there was no law at the time which deemed Dr. Wayne and Don’s conversations illegal, they were still unethical, and I feel that Betty deserved better. Medicine is and has always been a sacred profession, and Dr. Wayne and Don’s lack of respect for Betty doesn’t only bring shame on the medical field but brings shame on the male gender as well.
It is interesting that there wasn't any legislation put in place to protect patients rights until 2003-common knowledge would lead you to believe that this would have happened years before. I bet that actions likes Dr. Wayne's were not uncommon at the time, even though they were unethical. It is also interesting to note the lack of participation in the sessions with Betty and Dr. Wayne; he says nothing to Betty but then goes back and repeats everything to Don.
ReplyDeleteWhile I agree that Dr. Wayne's actions are despicable and would certainly not be tolerated today, did you find any evidence that this sort of thing took place in the 60s? Perhaps it was added to the plot solely to develop Don's character by showing his paranoid nature. If this is the case, then it may not really say anything about how the medical field or gender relations were different back then.
ReplyDeleteI agree. He really wanted to know what was wrong with Betty. He even brought it up to Midge. I don't think he did it out of disrespect to her, I think he was just worried about her.
DeleteI really enjoyed the blog post because it raises a lot of good points. The history of the concept of “doctor-patient confidentiality” was very well done. I had no idea how far back it dated. However, as it relates to the show and the time period, the fact that Dr. Wayne tells Don everything is not surprising or viewed ethically wrong. Psychiatry today when compared to back then is very different. While by today's standards Dr. Wayne would lose his practicing rights back then husbands acted more like fathers. Don pays for the visits, he doesn't agree with them, and he wants to make sure that he is getting what he pays for. Should Dr. Wayne encourage this? Maybe not, but he does because as I see it he is satisfying his customer and giving a husband insight on his wife. Where else would Don learn about Betty? If he asked her what was wrong he wouldn't get a straight answer, just the one he wants to hear. So does Betty deserve better? I don;t think so. If you act like a child you are going to be treated like one.
ReplyDeleteI recognize that Dr. Wayne's methods were pretty unethical and that this show and our mindset portrays him in a bad light. But I have to say, these practices were extremely common during the 60's and other chauvinist sort of eras. This could have been perfectly normal, I'm not saying right but normal, for Dr. Wayne to have conversations with Don about his wife. In fact, he could be doing it for the best, however convoluted it may seem. He could genuinely have Betty's best interests at heart also, and be coaching and using Don to do what is best for her, it doesn't seem malicious in intent at all. Don and Dr. Wayne seem realistically concerned for her wellbeing and mental health getting better. Although this is a high encroachment of privacy for the patient, I don't think it was meant to be damaging in anyway although embarrassing for Betty, an d as educated viewers take that into account.
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