Dr. James Wilson on Raising Ethical Questions in SURGEON X

While crafting Surgeon X, Sara Kenney’s Image comic about an apocalyptic future where antibiotics have lost their effectiveness and the resulting chaos that ensues, the writer consulted a variety of scientific experts to make her tale as true-to-life as possible. One such expert is ethicist and philosopher Dr. James Wilson of University College London, who collaborated with Ms. Kenney on how the ethical dilemmas that characters in Surgeon X might face.

Dr. Wilson spoke with me recently about how he became involved with Surgeon X, what ethical topics he felt the team behind the series should address, and what fiction can teach us about real life.

FreakSugar: How did you become involved with Surgeon X?

Dr. James Wilson: Sara Kenny approached me as a potential biomedical ethics advisory to the project in 2015. I was very intrigued by the proposal: I have a long standing interest in ethical issues raised by infectious disease, and I liked the idea of bringing the question of drug resistant infections to popular attention through a comic.

FS: You are an ethicist and philosopher with University College London. What kind of philosophical and/or ethical questions do you consider important when discussing the sciences?

JW: The most difficult thing to do when analysing emerging technologies is to avoid saying something seems naive or superficial in ten or fifteen years’ time. If you look back at the history of debates about the ethics of new technologies over the past fifty years, you see three big failures. First, failure to grasp that the technology is similar in important ways to technologies already existing, leading either to an over-excited boosterism or fear-laden doom-mongering. Second, imagining that the ethical considerations that seem most salient about a technology when it is being used on a small-scale and experimental basis will be the same as the ethical considerations that seem most salient about that technology when it has come to be used much more widely. Third, failure to anticipate the ways in which social attitudes co-evolve with new technologies.

There isn’t an easy way of avoiding these difficulties — in particular given that it may be unclear which way social attitudes are likely to evolve in this case. But perhaps the most important thing to take into account is to provide an ethical analysis that will be able to guide the further development of these technologies not just in their very earliest and experimental stages, but also remain relevant as they move towards becoming part of the taken for granted background of day to day life.

FS: Following up on that, what kind of concerns or issues did you feel were pertinent for the creators to address in Surgeon X?

JW: I was most keen for the creators of Surgeon X to explore a world that was a realistic possibility for our own, and then to have the ethical issues arise naturally out of the features of this world. I was keen for them to address the ways in which existing power inequalities in society tend to be magnified by increases of scarcity, and the ways in which inequalities outside of the domain of health have devastating impacts within the sphere of health and health care.

FS: While it is a work of fiction, Sara Kenney has made a concerted effort to make the scientific concerns of Surgeon X feel as rooted in reality as possible. What was the collaboration like with Ms. Kenney?

JW: I found Sara’s rigour and attention to realism in all aspects of the comic refreshing. She always had a clear sense of what she was trying to achieve. It was fascinating to be contacted with an off-the wall question every now and then, such as whether there are any circumstances in which it could be ethical for doctors to kill their patient, or about Martha’s taste in philosophy.

FS: Fiction is often used to teach us lessons about real life. What kind of lessons do you feel we can learn from a book like Surgeon X?

JW: I think Rudolph Virchow put it well: “Medicine is a social science, and politics is nothing else but medicine on a large scale.”

Surgeon X: The Path of Most Resistance, brought to you by Sara Kenney, John Watkiss, and Jared K. Fletcher, is on sale now from Image Comics.

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