Should Abusive Husbands Get to Make Medical Decisions for their Wives?
By Noah Evslin, Director of Medical Research

If you watch our show closely, you'll realize it's not the medical treatments that make Private Practice different than other shows on television; rather, it's the ethical debates surrounding the myriad decisions our doctors need to make every week.

In the twelfth episode of the season, "Losing Battles," we're re-introduced to JOANNA GIBSON (episode 501), a patient Violet counseled to leave her husband DAVID after finding out she was a victim of domestic abuse. Unfortunately, Joanna didn't heed Violet's advice, so when we see her again in this episode, she's just been beaten within an inch of her life. Worse, she's pregnant and the traumatic blows to her head and abdomen have not only caused her to miscarry, but they've also caused a life-threatening tear to her uterine wall.

The dilemma arises when Addison discovers that Joanna's best chance at survival is if she removes her uterus (which will also make her sterile). Unfortunately, Joanna's unconscious and therefore can't make any decisions regarding her care. In normal circumstances, you'd ask the patient's next of kin, which in this case is Joanna's husband, but Violet doesn't want to heed David's advice because she suspects, but can't prove, that he's the person behind Joanna's injuries. This brings us to this week's ethical debate:

Do you allow a suspected abuser to make medical decisions for their disabled spouse?

According to the National Coalition Against Domestic Violence, one in every four women will experience domestic abuse in their lifetime, and an estimated 1.3 million women are victims of physical assault by an intimate partner each year. Worse, many of those women don't leave their abusers, because they fear some aspect of being alone.

The same is true for Joanna who, earlier in the season, decided not to walk away from her marriage, as there was only incidence of domestic abuse. Unfortunately, one act of aggression often leads to more and in Joanna's case, her decision to stay with her husband had tragic consequences: she lost her baby. But it could have been worse. Luckily, Addison was able to perform a life-saving surgery that managed to stem Joanna's internal bleeding AND save her uterus.

This should have been a somewhat happy ending, but if you watched the entire episode you'll know that the ending was anything but happy. After David learns that Addison defied his wishes by saving his wife's uterus, he goes on a rampage against both the hospital and his still-recovering wife. This leads us to our most traumatic ending of the season (SPOILER ALERT) -- Joanna stabs her husband to death with one of Violet's kitchen knives.

Do you think Addison did the right thing by going against the abusive husband's wishes?