- Lisa Cuddy: "You induced a migraine headache in a coma patient?"
- House: "Gave him a little headache, similar to the one you're giving me now"
- Lisa Cuddy: "Have you even read an ethical guideline?"
- — Dr. Cuddy to Dr. House as he induces a migraine headache in a coma patient. (Distractions)
The field of Medical Ethics dates back to Roman times and the development of the Hippocratic Oath, which despite being somewhat out of date, is still routinely taken by medical students throughout the world. However, modern medical ethics is now governed by uniform codes which bind practicing physicians in just about ever place in the world.
That being said, House and the other doctors at Princeton-Plainsboro are constantly faced with difficult ethical problems. These problems stem directly from the knowledge and power of the physicians themselves, together with the type of trust they must develop and foster in patients. However, despite the existence of clear rules, doctors often find themselves unable to deal with their ethical obligations.
House is generally seen as a doctor without ethics. While there is some truth in this, it's also correct to say that House has a deeper understanding of ethics than most doctors. In the case of the coma patient, House noted very correctly that what would be more unethical was to run his experiment on a conscious patient who could feel pain. When he needed a conscious patient, he chose to experiment on himself.
However, all the doctors have had serious ethical lapses. Cuddy perjured herself to keep House out of jail. Wilson lied about prescriptions he knew House had forged. Cameron assisted a patient with suicide. Foreman once went against the direction of his superior to treat a patient when the patient would have died if he hadn't been right.
That being said, in all those cases, the doctors were trying to serve a higher purpose. Cuddy wanted House to stay at the hospital, as did Wilson. Cameron wanted to take the patient out of his suffering. Foreman acted as House would have, risking his professional life in order to save a patient when not taking any action may have resulted in the patient's death.
In the long run, House's so called ethical lapses are always related to his willingness not to let a patient die without knowing what is wrong. House can't always treat a patient he diagnoses, but unlike other doctors, he is not satisfied with finding out what was wrong at the autopsy.
- "The last stage is... death. Just in case you missed that day in medical school, that one's not treatable."
- ―Dr. House - All In
Interests of the patient[]
House also has no compunctions about putting a patient's interests above those of society as a whole:
- In Control, he lied to a transplant board by not disclosing his patient's bulimia, which was the direct cause of her congestive heart failure.
- In Sex Kills, House hunts down a dead body that is otherwise unsuitable for transplant in order to find a new heart for his patient.
- In Euphoria (Part 2), House attempts (but fails) to do an autopsy on a quarantined body that will give the answer to Foreman's illness despite the risk that, if the disease is contagious, the whole community may be at risk.
Do No Harm[]
Medical professionals are trained to avoid treatments that may worsen the patient's condition. As a result, when any treatment is effectively irreversible (such as irradiating the thyroid gland), the physician is expected to confirm the diagnosis before proceeding.
However, House has often said "confirmation is for wimps" and often will proceed with dangerous treatment before confirming the diagnosis. Although he is often right, he is occasionally wrong as well, which often has had adverse effects on his patients. House usually recovers, but this is not always the case.
However, House does have a point. When a patient is on the verge of death, a delay in treatment can often be fatal. House and Foreman have both learned that you have to go with your judgment at times. It has resulted in damage to both of their careers, but also a long string of successful treatments.
Informed Consent[]
Current ethical guidelines require that all risks of a procedure be explained to the patient and that they be given the right to refuse treatment that they feel is too dangerous. However, House rarely observes this protocol, and is not above tricking, threatening and berating patients into agreeing to procedures, or even on occasion proceeding without any consent whatsoever.
House does have a point. Patients are often ill o make informed decisions about complicated medical procedures. Foreman once gave the informed consent speech, "It's dangerous. He may die. You should do it."
However, this does not mean that House always ignores the patient's wishes. If he believes a patient truly understands the situation, he will comply with their wishes, even if it will most likely result in their death. This often astounds Cameron, who's most likely to proceed with treatments that she knows will work despite the wishes of the patient.