Medical dramas and documentaries are enduringly popular, understandably given the practice of medicine involves problem solving in high stakes circumstances. They often include characters that viewers can relate to as ordinary people who are suddenly thrust into life or death situations. It can be hard (and entertaining) to watch them without questioning the realism of such programmes. 

Whether you are a doctor who avoids watching medical dramas or one who partakes while muttering things like, "that would never happen" and "you’d get struck off for that in real life," believe it or not, they can be a source of potential professional development.

Below we’ll take a light-hearted look at some fictional doctors and the medico-legal lessons their stories offer. May contain spoilers – you've been warned!

Dr Nick Riviera in The Simpsons

Dr Nick from The Simpsons is a physician with questionable qualifications, competence and ethics. There are many lessons that could be learned from him but perhaps the most notable come from the time he is performing coronary bypass surgery on Homer. He begins sweating and the scrub nurse asks him if he doesn’t know where to make the incision. He tells himself not to panic and casts his mind back to his medical school days where we see him telling an attractive girl, "Seriously baby, I can prescribe anything I want!"

In the end, Lisa Simpson talks him through how to perform the surgery, but there are two major issues in the section of the scene described above.

Firstly, Dr Nick is clearly undertaking a procedure he is not competent to perform. While undertaking cardiac surgery with no idea how to, is an extreme example for entertainment value, but it raises a point about competence. The GMC says 'you must recognise and work within the limits of your competence'.

Secondly, his assertion in the flashback that he can prescribe anything he wants, to a fellow party goer. It’s not clear what his meaning is, or what his relationship to this girl is, but he may be suggesting that he can supply her with medication.

Obviously doctors cannot prescribe any drugs they want and there are very few situations when doing so for someone you know socially would be appropriate.

Doctors are responsible for all prescriptions they sign. The GMC is also clear that ‘you should prescribe medicines only if you have adequate knowledge of the patient’s health and you are satisfied that they serve the patient’s needs.’

The full GMC guidance on prescribing can be found in Good practice in prescribing and managing medicines and devices.

Sarah Sawyer in Skyscraper

In the opening sequences of this 2018 film, Dwayne Johnson’s character William Sawyer, an FBI hostage rescue team leader, loses his left leg below the knee when he and his team encounter a hostage taker with a suicide bomb. The last thing he sees prior to his emergency surgery is the face of Neve Campbell’s character, Sarah, the surgeon who will be treating him.

Fast forward 10 years to the present day and we see Will and his now wife Sarah in Hong Kong with their two children. While this film is not set in the UK it raises an interesting question that we occasionally get asked – is it ok to date a patient?

The GMC makes it clear in its guidance it is never appropriate for a doctor to pursue a sexual or improper emotional relationship with a current patient or someone close to them. It is also inappropriate to end a professional relationship with a patient in order to then pursue a personal relationship.

In terms of former patients, the situation is more nuanced. You will need to consider how long ago and for how long you were involved in their care, and whether they were vulnerable at the time, or now. If your professional interaction was a long time ago, and short-lived, then it would be easier to justify a later relationship.

It also depends on the nature of your work. If they were a paediatric or psychiatric patient, any relationship is more likely to be seen as an abuse of your position. It would also be seen as inappropriate if you still provide care for members of their family.

It makes no difference if the patient approaches you. The GMC says that you should politely decline their offer and try to re-establish a professional boundary.

If you are considering embarking on a personal relationship with a former patient, ensure you have considered the factors above, and are satisfied that there could be no perception that you are taking advantage of your position, or of a vulnerable person.

Do not contact them using information obtained from their records. This would be an unlawful use of their data, and doctors have been criticised by the GMC for doing this. You also should not use social media to contact them. Even if their profile is public, it would not be appropriate to use this to contact them, when the reason you had met was professional. Similarly, if a patient contacts you through social media, the GMC makes it clear that you should decline their offer and maintain a professional boundary.

It is also worth considering the possible impact on your career, should the relationship fail. There have been cases of doctors referred to the GMC by disgruntled ex-partners who later claim the doctor abused their position of trust to start the relationship. If any concern were raised to the medical school about you, this could result in a fitness to practise investigation, and this could cause problems when applying for registration with the GMC.

All things considered, relationships with former patients come with an added risk of criticism, and you would be wise to protect your position by documenting any approach by a patient within the record, and seeking advice about dating a current or former patient from a trusted senior colleague before making a decision.

While the movie does not give details of how Will and Sarah’s relationship developed it does all seem to end well (spoiler alert) as he manages to rescue her and both their children from the flaming skyscraper.

Dr Doolittle

This character first appeared in Hugh Lofting’s book of 1920 and he has been through various on-screen incarnations ever since. The original literary character was a physician who opted to stop treating humans in favour of treating animals as he could communicate with them.

In the UK, Dr Doolittle would fall foul of legislation that prevents doctors from routinely treating animals.

The GMC does not give specific advice on doctors treating animals. For that, you have to look to the Veterinary Surgeons Act 1966.

The Act only allows qualified and registered vets to carry out veterinary surgery, but there are certain exemptions. In carefully defined circumstances, the Act allows non-vets to treat animals. For example, doctors may carry out treatment at the request of a registered vet. This has been arranged for exotic creatures at the zoo, but is extremely unlikely in the case of regular family pets.

In addition, the GMC’s Good medical practice is clear that:

14. You must recognise and work within the limits of your competence.

It is also likely that Dr Doolittle was not indemnified to treat animals.

Victor Frankenstein

In the 2015 film adaptation of Mary Shelley’s novel, Victor is a medical student rather than a scientist. He and Igor carry out reanimation experiments on dead human tissue.

We won’t go into all the ways that his experiments would be illegal and unethical however it does lead us onto the interesting subject of the Human Tissue Authority. We occasionally get queries from doctors when they are asked to take samples from deceased patients.

The 1999 discovery that Bristol and Alder Hey hospitals had retained organs of deceased patients without valid consent brought about a definitive change in the law.

This culminated in the Human Tissue Act 2004 (the Act) and the establishment of the Human Tissue Authority (HTA). Today, the Act provides a consistent legislative framework for issues relating to body donation and the taking, storage and use of human organs and tissue. 

Activities regulated by the Act include:

a) post-mortem examination

b) anatomical examination

c) public display of tissue from the deceased

d) the removal and storage of human tissue for a range of purposes, including research, medical treatment, education and training.

Consent is considered to be the underpinning principle of the legislation. Appropriate consent must be obtained to undertake regulated activities. Appropriate consent is defined by reference to who may give it, such as a 'nominated representative', who becomes a decision maker after a person's death. There are penalties for carrying out regulated activities without appropriate consent.

It is also unlawful to obtain any bodily material with the intention of analysing its DNA without qualifying consent, subject to certain exceptions. This offence applies to the whole of the UK.

The HTA is the regulatory body set up in 2005 which licenses organisations that store and use human tissue for purposes such as research, patient treatment, post-mortem examination, teaching and public exhibitions. The HTA codes of practice set out expected standards for each of the sectors regulated and provide guidance to support professionals.

The law in this area can be complex. Therefore seeking advice from your trust legal team and medical defence organisation would be advisable when faced with requests to take samples from deceased patients.