ABC's 'Private Practice' explores bioethics

Date: 9/30/2008 10:26 AM

By SANDY COHEN
AP Entertainment Writer

LOS ANGELES (AP) _ On a massive sound stage at Hollywood's Raleigh Studios, a woman is dying of ovarian cancer. One doctor wants to treat her traditionally, by removing her uterus and ovaries. Another wants the patient to participate in a clinical trail that might preserve her ability to have children, but could have serious side effects.

On a different day, an obstetrician is conflicted about whether to deliver a premature baby she believes was conceived solely because the umbilical-cord blood could save the family's older, dying child. Another doctor struggles to do what's right when his teenage patient — who has HIV but doesn't know it — confides that he plans to have sex for the first time.

Bioethical questions like these come up weekly on ABC's "Private Practice," the "Grey's Anatomy" spin-off that begins its second season Wednesday.

"We're telling stories ... that will provide a lot of moral debate among our doctors and maybe debate at home when you watch," said series creator Shonda Rhimes.

The issues they face cause plenty of drama for the doctors at the Oceanside Wellness Group, where Kate Walsh's character, Addison Montgomery, came to work after leaving "Grey's" Seattle Grace Hospital.

"They're all viable conflicts ... grounded in these medical stories," Walsh said. "It's topical but not so procedural that it's not a Shonda Rhimes show. You still have all the great dialogue and characters and stories and romance."

Like "Grey's Anatomy," ''Private Practice" features an ensemble cast of doctors whose personal lives are often far messier than their professional ones. They have affairs with one another and struggle with love as they overcome tough medical challenges and the financial realities of keeping their medical co-op alive.

The bioethical issues raised are based on real medical cases and community concerns, said researcher and writer Elizabeth Klaviter.

"We look at the things that have ourselves and our family members and friends buzzing — the issues that people are talking about in terms of right or wrong and the laws, ethics and social morays that are put on us in terms of how we conduct ourselves," said Klaviter, who also researches cases for "Grey's Anatomy."

"Doctors disagree," she said. "We're looking for cases where there are different courses of action or treatment."

This season, the doctors at Oceanside Wellness will have to decide what rights prostitutes have to medical care and whether to treat a sex offender at their child-friendly practice. They also engage in an abortion debate that surprised actor Tim Daly, who plays Dr. Pete Wilder.

"I never thought we'd be doing something like that on Disney," which owns ABC, he said. "It was just these characters discussing their opinions and they didn't agree and they were passionate about it, just like in the real world."

Daly and his castmates credit Rhimes and the show's writers for using the forum of a prime-time drama to inspire viewers to consider current bioethical issues.

"If you can make anybody think in this day and age, and entertain them at the same time, that's a dream come true," said KaDee Strickland, who plays Dr. Charlotte King, a physician at a rival hospital.

Making bioethics a theme of the show is "seductive," Walsh said, because it deepens the characters while raising important issues for viewers to ponder. Though she said it was a risk for her to leave "Grey's," she feels she landed in a good place.

"It was a risk but it wasn't like sex-without-a-condom risk. It was an offer I couldn't refuse," she said. "I'm hugely grateful that it did really well last fall... It's really a testament to Shonda and her gift for being able to tap into the culture and the big collective consciousness of what people really relate to."

History proves that viewers respond to medical shows: "We may never end up in a courtroom or never end up arrested, but sooner or later everybody's going to come through the doors of a doctor's office," Rhimes said. Exploring bioethics adds a new dimension to the already-beloved genre.

"It's something more and more doctors are facing these days," Rhimes said. "It's just a very different way of looking at medicine that I don't think we normally think about — the ethics of what you're doing."

ABC is owned by The Walt Disney Co.

Copyright 2008 The Associated Press.

Baby deaths shock Turkey

Date: 9/26/2008 8:01 AM

By SUZAN FRASER
Associated Press Writer

ANKARA, Turkey (AP) _ Outside the Zekai Tahir Burak maternity hospital stands a bronze statue of a mother nursing a baby with an inscription from the Prophet Mohammed: "Paradise lies at the feet of the mother."

In July, the Ankara facility became the scene of any parent's hell: A total of 27 newborns died here within two weeks, most of them from infection.

Now Turkey is reeling from a similar tragedy at another hospital, this time in the western city of Izmir, where 13 premature babies died last weekend within 24 hours, apparently from tainted IV treatment.

The deaths at two of the nation's most modern maternity hospitals go to the heart of Turkey's uncertain status as a country energetically seeking to modernize in its bid to join the European Union — but held back by problems associated with the developing world.

The scandals have exposed a shortfall in the number of specialized neonatal units dealing with premature and high-risk babies as well as a shortage of qualified staff in a country of 70 million.

Most hospitals lack specialized premature birth units, and high-risk or premature babies are often transferred to larger hospitals in cities such Istanbul, Ankara or Izmir. The transfer and high concentration of newborns in the same place increases the risk of infections, experts say.

"There just isn't the facility that allows a premature baby to survive in the hospital that it was born in," said Bedriye Yorgun, who heads the Ankara-based Health and Social Services Workers' Union, which advocates improved health services. "When the babies are transferred, there is a higher chance of exposure to infection and of spreading an infection."

The government has acknowledged a shortage and has said it plans to increase the number of neonatal wards nationwide from the current 156 to 200 by 2010. It has also admitted to a shortage of more than 400 specialized doctors and thousands of nurses.

After the first deaths at the capital's Zekai Tahir Burak maternity hospital, a team of government-appointed doctors said a staff shortage had increased the risk of infection.

Dr. Fahri Ovali, one of the doctors, told reporters: "There were four high-risk babies for every nurse."

The Izmir tragedy caused a renewed explosion of outrage in this country where children are cherished and people will often stop to show affection to other people's kids.

"Such shame does not exist elsewhere in the world," read a headline in Bugun newspaper. "13 mothers' arms left empty," said Aksam newspaper.

A preliminary investigation concluded that the infants died of a bacterial infection spread by IV treatment. Further investigation is under way to see how the bacteria got mixed with the intravenous solution used to treat the infants at Izmir's Tepecik hospital. The bodies of three of the babies, who were buried immediately after their deaths, were exhumed to help with the investigation.

Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted.

Some of the families have filed complaints against the hospital accusing its directors of negligence. A local prosecutor has also launched a criminal investigation into the deaths, while the main opposition party has called for a parliamentary debate on the deaths.

A chief obstetrician at Etlik Zubeyde Hanim hospital said a government decree forcing hospitals not to turn away any patients was to blame.

"If there are no spare incubators and you are forced to admit more and more babies, what do you do? You have to put two babies into the same incubator, which increases the possibility of infections," he said. He spoke on condition of anonymity because of the sensitivity of the issue and because as a state-employee, he is not authorized to speak to journalists.

Yorgun, who heads the health workers' union agreed.

"The government is telling the people that no one will be turned away from hospitals, but it is not creating the conditions to allow doctors to treat everyone," she said.

Copyright 2008 The Associated Press.