Is gallows humor in medicine wrong?
Doctors and other medical professionals occasionally joke about their patients' problems. Some of these jokes are clearly wrong, but some joking between medical professionals is not only ethical, it can actually be beneficial, concludes an article in the Hastings Center Report.
The author, Katie Watson, bridges the worlds of medical ethics and comedy: she is an assistant professor in the Medical Humanities and Bioethics Program at the Feinberg School of Medicine at Northwestern University and she teaches improvisation and writing at The Second City Training Center in Chicago. What prompted her to explore the ethics of gallows humor in medicine was the story a doctor friend told her in which, years earlier, he and other residents tried unsuccessfully to save a teenage pizza delivery boy who had been shot while delivering their dinner.
After finding the pizza box where the boy dropped it before running from his attackers, one of the residents made a joke: "How much you think we ought to tip him?" The residents laughed, and then ate the pizza.
"Was it wrong to make a joke?" the doctor asked.
This question intrigued Watson as a bioethicist, she says, "because it is about moral distress, power imbalances between doctors and patients, and good people making surprising choices."
While there is a lot of literature on humor in medicine generally, particularly about clinician-patient interactions and the health benefits of laughter, she says there is relatively little that addresses gallows humor in medicine, which usually occurs between health care providers, and treats serious, frightening, or painful subject matter in a light or satirical way.
"The claim that being a physician is so difficult that 'anything goes' backstage misuses the concept of coping as cover for cruelty, or as an excuse for not addressing maladaptive responses to pain," Watson writes. "However, blanket dismissals of gallows humor as unprofessional misunderstand or undervalue the psychological, social, cognitive, and linguistic ways that joking and laughing work. Physicians deserve a more nuanced analysis of intent and impact in discussions of when gallows humor should be discouraged or condemned in the medical workplace."
Watson's analysis draws on literature from the humanities and social sciences on why we joke and on various uses of humor, including "backstage" humor that serves as a bonding and coping mechanism among insiders and "bullying jokes." She also observes changing standards in the backstage humor of doctors and medical students whereas "cadaver antics," in which medical students clowned around with body parts, were once a rite of passage, today they are "rarely tolerated, and the modern approach frames cadavers as former people."
Deciding when gallows humor is okay, Watson says, turns on the ethical question, When is joking a form of abuse of a patient, of trust, or of power? A joke about a patient's condition told in front of the patient or the patient's family is unethical because it has the potential to harm them. But she concludes that the tip joke was not wrong. "To me, the butt of the doctors' tip joke is not the patient. It's death," she writes.
Not only did the joke not harm anyone, she adds, it may have helped the residents "integrate this terrible event and get through the shift." In so doing, the joke may also have helped the next patient get the best possible care. After all, she writes, the residents "needed to laugh before they could eat, and they needed to eat to be at their
Provided by The Hastings Center
- Researchers find older folks don't get the joke Jul 31, 2007 | not rated yet | 0
- Computer program understands the 'that’s what she said' joke May 02, 2011 | not rated yet | 0
- Study: hospital staff joke about patients Apr 26, 2006 | not rated yet | 0
- To scientists, laughter is no joke -- it's serious Mar 31, 2010 | not rated yet | 0
- Psychologists find that jokes help us cope with horrifying images Aug 02, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
High blood glucose is associated with poor outcomes in hospitalized patients, and use of intensive insulin therapy (IIT) to control hyperglycemia is a common practice in hospitals. But the recent evidence does not show a ...
Other May 24, 2013 | 4 / 5 (1) | 0
Two out of five medical students have an unconscious bias against obese people, according to a new study by researchers at Wake Forest Baptist Medical Center. The study is published online ahead of print in the Journal of ...
Other May 23, 2013 | not rated yet | 0
Nanyang Technological University's (NTU) new medical school will be pioneering the use of plastinated bodies for medical education in Singapore.
Other May 23, 2013 | not rated yet | 0
A 2012 survey of internal medicine residents at Massachusetts General Hospital (MGH) – one of the nation's leading teaching hospitals – found that more than half rated the training they had received in addiction and other ...
Other May 22, 2013 | 5 / 5 (1) | 0
Early use of tracheostomy for mechanically ventilated patients not associated with improved survival
For critically ill patients receiving mechanical ventilation, early tracheostomy (within the first 4 days after admission) was not associated with an improvement in the risk of death within 30 days compared to patients who ...
Other May 21, 2013 | not rated yet | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
16 hours ago | 5 / 5 (3) | 0 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
11 hours ago | 3 / 5 (2) | 0 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
13 hours ago | 3.7 / 5 (3) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
14 hours ago | 5 / 5 (4) | 0 |
How can healthy people who hear voices help schizophrenics? Finding the answer for this is at the centre of research conducted at the University of Bergen.
16 hours ago | 4 / 5 (2) | 2
(Medical Xpress)—The way Alzheimer's disease is portrayed by advocacy groups and the media is having undue influence on the euthanasia debate, according to a Deakin University nursing ethics professor.
17 hours ago | not rated yet | 2