Don't Stop 'Till You Get Enough

How Can You Possibly Choose Who Lives and Who Dies?
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 seventh episode of the season, "Don't Stop 'Til You Get Enough," Addison, Jake and Pete treat SHANNON IVERSON, the unconscious, brain dead victim of a bad car accident – who happens to also be carrying a sixteen-week-old fetus.

Under normal circumstances, our doctors would help the family decide between unplugging the patient or keeping her alive long enough that the still-developing fetus becomes viable. In this situation, however, things become even more complicated by the realization that not only is Shannon brain dead and pregnant, but she's also an organ donor, and Sam's very sick patient LEANNE is a perfect match for Shannon's still-beating heart. This brings us to our first ethical debate:

Do you attempt to save an unborn fetus or the mother of children who are already living?

As our doctors try to make this difficult decision, we learn there's a law stating that a person's desire to be an organ donor (made evident by the check mark on her license) comes before any other consideration. This is the type of situation that hospital administrators dread, as although the law requires them to unplug the patient and harvest the organs, this decision will most likely go against the still-living husband's desire to keep his baby alive.

During the course of this episode, Jake fights to keep Shannon's child alive until her estranged husband DOUG is able to come to decide what to do. On the flip side, Sam is adamant that Leanne gets the heart, because he know she'll die soon without it. Poor Addison is stuck in the middle. There's a part of her that wants the baby to survive, yet another part of her knows that the chances are extremely low that this baby will make it to twenty-four weeks, which is the cusp of viability for a fetus.

In the end, it's Jake who tells Doug that premature babies often develop chronic lung problems, developmental issues and blindness, amongst many other things. He also tells Doug that the chance's he'll have a happy, healthy baby are very slim. Doug then makes the agonizing decision to pull the plug on both his wife and his unborn child, allowing Sam to save Leanne's life.

Do you think Jake gave Doug the right advice?