The Doctor Will Be You Now: A Case Study on Medical Ethics and Role-Play

The Doctor Will Be You Now: A Case Study on Medical Ethics and Role-Play

Nahil Sharkasi (University of Southern California, USA)
Copyright: © 2011 |Pages: 16
DOI: 10.4018/978-1-60960-120-1.ch017
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Abstract

In the field of fertility medicine, technology has vastly outpaced our ethical, legal, and social frameworks leaving us in a quagmire of gray morality. Seeds is a role-playing game and ethics simulation about Assisted Reproductive Technology and its effect on 21st century medical decisions. Players play the role of a fertility doctor and must make difficult ethical decisions through courses of treatment while balancing economic, emotional, and scientific concerns. With Seeds, the goal is to foster meaningful decision-making that may transfer from the game world into the real world through stimulating role-play and by creating a safe space for exploration of ethical issues. This chapter offers critical reflection on the design choices made in the process of creating this ethical exploration space on the subject of Assisted Reproductive Technology.
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Introduction

Babies are in. Between the Octomom, Jon and Kate, and the Jolie-Pitt brood, baby stories are leading media sales (Washington, 2009). Often missing from these stories, however, is the ever-increasing use of Assisted Reproductive Technologies (ART) and the ethical complexities that come with it. With new technological approaches to reproduction, such as in-vitro fertilization, pre-implantation genetic diagnosis, and the use of sperm donors, egg donors, surrogates and gestational carriers, come emergent ethical situations. Ethics, as a socially accepted notion of right and wrong, have not yet been defined in the United States as it pertains to ART. The field of fertility medicine is one area among many in the modern world where technology has vastly outpaced our ethical, legal, and social systems leaving us in a snarl of gray morality. We are becoming increasingly aware of the physical risks that come with the luxury to control the specific circumstances of the process of birth— chief among them multiple births and pre-maturity (Mundy, 2007). The rapidly growing population of parents and caretakers of premature children, and children conceived using ART, face unique challenges and may benefit from a game experience that allows them to explore these ethical issues.

At the core of each ethical conflict surrounding ART is the essential question of life and death that resonates intimately with each individual. Regardless of whether players have specifically considered this topic before, everyone has an opinion. The conflicts that arise from the availability of new reproductive technologies are receiving more and more coverage in popular media. While the drama unfolds—how many embryos to implant, or which donor to choose, this project, Seeds, specifically explores what it would mean to more actively engage with these ethical situations.

Ethics simulations are a niche in the field of interactive media, and are becoming an increasingly necessary tool to navigate the murky waters left in the wake of speeding technological advancement. Ethics simulation software is currently available for training in corporate ethics, financial ethics, biomedical ethics, and many other fields. Last year, the United States Office of Government Ethics developed their own ethical training software CD-Rom based on their established ethical training protocol (USOGE, 2009).. Laws often represent a society’s commonly agreed upon ethical standards, though legal codes cannot always be equated to ethical codes. Like most ethics simulation software, this CD-Rom uses some multimedia and limited interactivity to teach users a pre-determined code of ethical behavior, which is already established by law. For example, in a sexual harassment training simulation, the goal of the experience is to clarify the established right and wrong codes of behavior, even within socially ambiguous situations.

In areas of emerging technology, however, there are many ethical questions to which a right or wrong has not yet been commonly agreed upon and codified by law. Whereas the goal of many current ethics simulations for established fields is to direct audiences to a so-called correct answer, role-playing games can provide alternative ways of understanding and evaluating ethics (Simkins, 2010). There is an increasing need for a virtual space for ethical exploration that lets the user understand their own ethical decision-making process and the implications of the choices they make to help navigate areas like ART where new technology yields emergent ethical conflict. Further, the model for ethical exploration outlined in this chapter may also be useful in revisiting areas of established ethical codes, as well as with emergent ethical codes.

In the next section, I will discuss my approach to creating a virtual space for ethical exploration in a role-playing game about fertility medicine called Seeds. I will describe the game and my design process, as well as my results and observations. Finally, I will discuss challenges I faced and outline directions for future research.

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