What “The Golden Girls” Taught Me About Bioethics

The Golden Girls was ahead of its time. The show, which ran from 1985-1992, is best remembered as a chatty sitcom where four friends in their golden years—Blanche, Rose, Sophia, and Dorothy—discuss their personal lives. But it included a surprising number of plotlines about significant scientific and medical issues that other TV shows seldom discussed, including conceiving a child via in vitro fertilization, the HIV/AIDS epidemic and stigmatization, organ donation, sexual health, body modification, end-of-life care, and cryopreservation. For many people who grew up watching the show either during its original run or in syndication, The Golden Girls was their first exposure to these complex issues. More than just a handful of token Very Special Episodes, The Golden Girls made difficult ethical issues a staple of the show. 

The Golden Girls started just before my second birthday—today is the 30th anniversary of the show’s very first episode. Between watching the original run with my parents and its years of syndication with my roommates in college and beyond, these four women have always been in my life. The Golden Girls became my security blanket when I was feeling particularly anxious, which, admittedly, occurred frequently while I was completing my Ph.D. in bioethics. The more time I spent studying bioethics—a discipline that examines the ethics of the practice of, research on, and policy regulating medicine and science—the more I realized that The Golden Girls incorporated many important questions that we’re still dealing with today. 

The Golden Girls read the results of a blood test that says Rose may have HIV

Often when TV shows address bioethical issues, it can come off as either pedantic or skirt the emotional issues involved.  The reason it worked for The Golden Girls to grapple with bioethics is because all four of the main characters are sincere in their discussions of these topics. It helps immensely that the women are solidly developed to the point where the audience understands their behavior and motives—how and why they would react in various situations. Like ethics itself, the characters are each nuanced and multifaceted, which allows for the characters to evolve as they have new experiences. Each character is an effective lens for considering different aspects of complicated issues. For instance, in the 1990 episode “72 Hours,” Rose becomes worried that a blood transfusion she had years ago may have contained HIV-infected blood. As she waits for her results, Sophia refuses to drink out of Rose’s mug. The audience can recognize how Sophia’s behavior is stigmatizing, but we can also understand her actions as coming from a character who is in her eighties in the height of the AIDS epidemic. There were certainly viewers who would have reacted the way Sophia did—and they can learn along with her. 

The fact that the four protagonists are all mature women living in an unconventional household allowed the show to take on topics that would have been off-limits to most other sitcoms of the time. It portrayed Rose, Blanche, Dorothy and Sophia as attractive and sexually active—a far cry from the typical sitcom trope of the kooky, unkempt, out-of-touch little-old-ladies. It wasn’t just the double entendres and sexual innuendo that made The Golden Girls envelope-pushing; the show also served as a platform to expose the systemic, ingrained paternalism in medicine.  For instance, in a 1989 two-part episode “Sick and Tired,” Dorothy grapples with an unidentifiable illness and is told by multiple doctors that nothing is wrong with her (including a pre-Arrested Development and Transparent Jeffrey Tambor who tells her that it is probably mental and that she should try dating). Of course, Dorothy knows something was wrong with her own body and is eventually diagnosed with chronic fatigue syndrome.

In another episode (1990’s “Feelings”), Rose describes how her dentist groped her breasts during an appointment. She tells the ladies that she doesn’t think “wowee-wow-wow-wow” is a medical term. Dorothy reminds the women that “just because men in the medical profession wear white, does not mean that they're angels.” Rather than remaining silent—presumably like the rest of the patients he has violated—Rose confronts her dentist about his inappropriate behavior, perhaps sparing other patients from his roaming hands. Too often, doctors are seen as virtually infallible, so scenes like these illustrate that regardless of your age or gender, you have the right to be included in your medical treatment and treated with the same respect and care as any other patient. 

Rather than waiting until it established a solid fan base that would sit through episodes addressing uncomfortable issues, The Golden Girls came out swinging in the first season with an episode that deals with the complicated decision-making process surrounding organ donation. In a 1985 episode, Blanche’s sister Virginia has renal failure and asks Blanche for a kidney. Blanche, never afraid to articulate her own interests, discusses her dilemma with the other women; she either loses a sister, or a kidney. Most TV shows would probably have a protagonist like Blanche jump at the opportunity to help her sister. But like anyone facing an ethical medical dilemma in real life, Blanche weighs the risks and benefits of the procedure. She and her sister have had a strained relationship for a long time. Plus, something could go wrong with the surgery and there’s a chance that she will lose function in a kidney later in life and end up needing both. Blanche also understands that without a kidney, her sister will die. Ultimately, Blanche decides to go through with the procedure and donation, but after initial tests at the hospital, she finds out that she is not a viable match for Virginia. Better yet, the hospital was able to find a kidney that was a match, so in Blanche’s words, she got to keep her sister and her kidney. Everyone wins, including the audience, who benefits from watching Blanche’s decision-making process. 

In another challenging episode (1989’s “Not Another Monday”), Sophia’s friend Martha determines that she no longer wants to live, and asks Sophia to be there with her when she kills herself. Sophia is no stranger to the aches and pains of aging, but she also knows how hard she has fought to make it to 80-something years of age. Martha makes it clear that she is going to end her own life whether or not Sophia is present, but would prefer Sophia to be there so she doesn’t die alone. Knowing Martha’s mind is made up and not wanting her to spend her final moments alone, Sophia—against the advice of the other women—decides to be there for Martha. Sophia’s decision requires her to weigh the ethical principles of autonomy, beneficence, and non-maleficence.  Martha appears to be a mentally competent individual with the capacity to make her own medical decisions, but does this autonomy include ending her life? Sophia certainly does not want her friend to die—taking into consideration the principle of non-maleficence, or doing no harm. But she also recognizes that by being present, she is a performing a beneficent act for her friend. In the end, Sophia gives one of her trademark persuasive speeches, convincing Martha that she does have a reason to life.

These are only a few of the many examples of how The Golden Girls utilized a 22-minute sitcom format to raise issues typically left to dramas, or left off television entirely. The fact that we’re still watching and discussing the show 30 years later is testament to the show’s smart, timeless writing, and innovative ways of addressing the tough topics. Also, it’s really funny to boot.

by Elizabeth Yuko
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Dr. Elizabeth Yuko is a bioethicist and writer. 

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