Age, gender, race and culture in the "ER": A content analysis of end-of-life issues in the television drama
Within one of the most popular television dramas on American television, hundreds of depictions of end-of-life (EOL) care and decision-making conveyed impressions of how death and dying occurred in a hospital. This content analysis of EOL incidents that appeared in every episode of the television drama ER indicated that viewers got powerful messages about EOL. The long-playing, popular television drama exaggerated the role of physician within the EOL scenes and minimized the roles of women, racial minorities and ethnic groups. Notably lacking from the EOL content were accurate or positive representations of racial, ethnic or cultural differences in death and dying practices. The absence of these important distinctions in EOL effectively marginalized groups that have been at risk, historically, for receiving less or substandard health care services. The American health care system as it exists, fit the definition of an Althusserian Ideological State Apparatus. The potential, therefore, exists for this newly-identified ISA to disseminate an EOL ideology calling for limits on care to the dying, through the mass communication structure. This study, however, did not reveal any substantial indication that fictionalized content about EOL fulfills that expectation. This study revealed previously-unidentified themes that recurred in the majority of the 222 end-of-life-incidents (EOLIs), most of which were about organ donation. Each of these three areas--new themes, population differences in approaching EOL, and organ donation--bear additional scrutiny to develop insight into how mass media portray them in dramatic television content.