April 2021

Bioethics on Film: The Moral Dilemmas That Make Movies Worth Watching

“Hollywood,” Marilyn Monroe famously said, “is a place where they’ll pay you a thousand dollars for a kiss and fifty cents for your soul.” The entertainment industry, like any other, is not always squeaky clean when it comes to moral scruples. And, as the saying goes, life imitates art: It’s hard to think of a film that doesn’t touch on the universal theme of what is right and what is wrong. From sci-fi to thrillers, rom coms to mysteries, films portray, in often brilliant and nuanced ways, ethical challenges that are at the heart of what makes humans human. 

Taking a closer look at cinema, it’s not much of a stretch to spot bioethics topics as drivers or themes in contemporary and classic feature films and documentaries. Health and wellness issues, for example, are nearly universal. “I’m going to go out on a limb and hypothesize that almost every movie with a health/medicine related plot has a bioethics theme or subtheme. It’s the moral tension that makes them so compelling,” said Greenwall Faculty Scholar Alum Steven Joffe, MD

To celebrate the Oscars, The Greenwall Foundation queried Twitter and asked, what is your favorite film with a bioethics storyline? Here are some favorites, including suggestions from Greenwall Faculty Scholar Natalie Ram, JD, and Greenwall Faculty Scholar Alums Dr. Joffe, Aaron Kesselheim, MD, JDPeter Reese, MD, and Alex Smith, MD. (Spoiler alert: in describing the bioethics angles, we’ve revealed some crucial plot points): 

  • Amour (2012) – Anne and George, now in their eighties, are still deeply in love. However, when Anne has a stroke, their lives quickly change. The story shows Anne’s steep physical and mental decline and George’s struggle to care for her and maintain her dignity—and their bond. The film poses the difficult personal question, is there a point at which life is no longer worth living?  
  • Gattaca (2004) – In a world where genetic testing determines everything—from where you work to who you can marry—Vincent, conceived without genetic selection and considered inferior, takes over his brother’s genetically superior identity in order to pursue his dream of being an astronaut in the Gattaca space program. The deck is stacked against “in-valids” like Vincent in a society where gene manipulation is used to ensure children are born with genetically superior traits. The film shows the potential risk of widespread genetic testing as a barrier to relationships in society, essentially creating a caste system based on genetic predispositions. 
  • Million Dollar Baby (2004) – Maggie, a young boxer from the Ozarks, persuades Frankie, a stubborn, old-school coach, to train her. They form a close bond, and Maggie does extremely well, moving up to compete in Europe and getting a reputation for swift knockouts. Things take a turn when Maggie is hit after the referee ends a match. The hit causes her to fall and break her neck, leaving her paralyzed for life. Suffering from bed sores, she loses her leg to an amputation. Maggie asks her coach if he will help her die with dignity. When he refuses, she tries to take her own life. This film examines many moral and ethical dimensions of disability, autonomy, pain, and end-of-life decisions. It swept the 77th Academy Awards, winning four Oscars. 
  • The Constant Gardener (2005) – British diplomat Justin is determined to find out what happened to his wife, Tessa, who was murdered in a remote area of Kenya. Justin discovers that Tessa had been investigating a suspicious drug trial: A powerful and influential pharmaceutical company was conducting research on poor and desperate Kenyans without their knowledge—and covering up deadly side effects. The company reasoned that if they never received an official report on side effects of the drug, they could not be held liable for any resulting deaths. To prevent those reports from getting out, the drug company contracted kills on anyone investigating them. 
  • Kids in the Hall: Brain Candy (1996) – When a pharmaceutical company finds itself in trouble, they rush a new drug into production without doing adequate testing. The drug is marketed as an antidepressant and allows those taking it to relive their happiest memory, but some users start slipping into comas. The scientist who created the drug wants to tell the world the truth, but the company wants to keep silent and protect their profits.  
  • Safe (1995) – Carol, a suburban housewife, develops a mysterious illness that cannot be explained by doctors. Either she is allergic to chemical substances in her environment, or it is all in her head. The movie starts out tackling environmental destruction, questioning the health impacts of human activity, truck exhaust, and pesticides, but shifts when the main character enters a remote, new-age treatment facility where she pays an exorbitant amount of money only to be told that her illness is psychosomatic. As she continues to get worse, the question arises: is she being helped, or is she being conned? is she being helped, or is she being conned? 
  • Groundhog Day (1993) – In this iconic film, Bill Murray plays Phil, a man trapped in living the same day over and over: His alarm goes off to the pop strains of “I Got You Babe,” and the unspools in exactly the same sequence. His initial reaction is to act without consequence, stealing money, seducing women, and baiting the police. Phil grows tired of the repetition and tries to kill himself in increasingly outlandish ways. He then decides to spend his looped days getting to know Rita, a news producer, but no matter what he does, the day always ends with her slapping him. Eventually he decides to confide in her, and she suggests altruism as a means of ending his loop. He goes around the town helping everyone, with one exception. There is a homeless man who dies, and no matter what Phil does, no amount of intervention can save the man’s life.

Two films nominees for Best Picture at the 93rd Academy Awards include characters, situations, and themes that are well-known to bioethics scholars as well:  

  • Sound of Metal (2019) – When Ruben, a heavy metal drummer, starts losing his hearing, a doctor suggests cochlear implants, but the implants are expensive and are not covered by insurance. Ruben’s friends help him find a spot in a rural recovery house for deaf addicts. He makes friends there but ultimately decides to sell his possessions so he can afford the cochlear implants. This decision offends his housemates, who view deafness not as a disability that needs to be fixed, but an inherent part of who someone is. Ruben wrestles with this idea and with the implants, which distort sounds in ways that make it impossible to take part in the things he once enjoyed. The Sound of Metal received Oscars for sound and editing at the 93rd Academy Awards. 
  • The Father (2020) – Anthony, played by Oscar winner Anthony Hopkins, refuses assistance from his adult daughter as his Alzheimer’s progresses. Through his eyes, the film jumps back and forth, traversing time as he begins to doubt his own mind, his loved one’s identity, and reality itself. The movie brilliantly imagines what consciousness and memory might look like from Anthony’s perspective and shows the toll dementia takes on both the patient and caregiver. Anthony Hopkins won best actor for his performance in “The Father” at the 93rd Academy Awards.

For more films with bioethics themes, check out recommendations from the the Kennedy Institute of Ethics’s Bioethics Film Collection and the 2019 University of Pennsylvania Bioethics Film Festival.