Medical comic books may be an acceptable form of patient education material, but clinicians should assess and honor patient preferences before providing these materials. A commentary published in the AMA Journal of Ethics explored the idea of comic books as a form of pictorial medical education.

Gary Ashwal, MA, and Alex Thomas, MD, the co-founders of Booster Shot Media in Santa Monica, California, examined a case in which a psychiatrist offered a comic book to a patient who he suspected had post-traumatic stress disorder (PTSD). The patient, not believing that a comic book was an appropriate way for a physician to provide health information, rejected the comic book and did not return to the psychiatrist for further care. Using the AMA Code of Medical Ethics as their basis, the Mr Ashwal and Dr Thomas discussed the issue of comics as an appropriate communication format in terms of relevancy, accuracy, and patient opinion and preferences.

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Physicians often use physical materials to supplement verbal information given to patients, including handouts, videos, and other media. Comics fall into this category of supplemental materials as a way to present information differently. As with any other format, comics can be out-of-date or inaccurate, but they can also provide a relevant way for patients to learn more about a given topic.

Comics can be humorous, but they can also deal with serious topics such as terminal illness or mental health. The combination of text and explanatory images may resonate better with some patients than all-text or verbal resources alone. However, because of the general opinion of that comic books are entertainment for young people, a physician choosing to use comics should be prepared to explain why they think this format will be helpful to the patient.

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In the case presented in the Journal of Ethics article, the physician did not take the patient’s opinion or preference concerning comics into account, leading to the patient’s negative reaction and dismissal of the material. Another consideration for physicians who use comics is the choice between personal memoir comics — which include titles like Mom’s Cancer and Spot 12: Five Months in the Neonatal ICU — and health education comics, the 2 main types of graphic health-focused literature. While the latter are more straightforward, some patients may find it easier to relate to the former. However, personal memoir comics are records of individual experiences, and it should be noted that not every patient will experience an illness or disorder in the same way.

“When determining the appropriateness of a health-focused comic for adult patients, clinicians may need to invest more time than they do with other formats,” concluded Mr Ashwal and Dr Thomas. “Clinicians need to be prepared to present this less-common format in a sensitive manner by explaining its potential educational advantages and particular usefulness.



Ashwal G, Thomas A. Are comic books appropriate health education formats to offer adult patients? AMA J Ethics. 2018;20(2):134-140.