The Picture of Health: Medical Ethics and the Movies

The Picture of Health: Medical Ethics and the Movies
Edited by Henri Colt, Silvia Quadrelli and Friedman Lester
Oxford University Press;  2011
ISBN 9780199735365
527 pages (pb)

German film director Werner Herzog once commented that, “Academia is the death of cinema. It is the very opposite of passion. Film is not the art of scholars, but of illiterates.” Given these comments you could be mistaken for thinking that film is the antithesis of academia but this would be to overlook the complimentary nature of the two. Very often abstract ideas and concepts can be extracted from film for discussion and debate.  With very little knowledge or experience, viewers of a film can offer their opinions, ideas, reflections, argue contradictory positions and display emotions in direct relation to a narrative played out in a movie. It is with this thinking in mind that has helped shaped the idea behind a recent release from OUP, “The Picture of Health: Medical Ethics and the Movies”.

An edited volume of some 84 essays subdivided into nine sections, the book acts as a one stop source for a rich variety of films and specific clips from those films, all of which help to tackle questions as well as teach various aspects of medical ethics.  The essays are short (3–4 pages on average) but most are well written, concise and informative. Some tend to provide a general overview of a particular ethical issue and how it relates to the film whilst others drill down deeper, tackling a particular issue in more precise detail and present a more nuanced discussion and analysis. Consequently the essays provide an excellent insight for a teacher or group leader to read prior to showing the film to a group or as a short discussion article for a group to read in order to kick start discussion, prior to or after watching the film clip. What is more, for those wishing to use a short specific clip from the film as opposed to watching the film in its entirety, relevant DVD chapters and timings are given at the beginning of each chapter to help with cueing up DVDs. Each chapter has end notes and references providing an ample spring board for further study.  Furthermore, a filmography is also given at the end of the book of a further 140 films not covered in the book. This in itself helps to point to the immense breadth of material in within cinematography, making it rich pickings in assisting with the educating and discussion of medical ethics.

In terms of target audience, the book has probably been prepared with an ‘A’ level audience in mind. However, as is the case with many films the depth of discussion and analysis is largely determined by the group you are working with. Comparing a group of ‘A’ level students and a group of undergraduate medics, similar themes will emerge from discussions but the depth and nuance of the conversation will undoubtedly vary. Therefore, in my opinion The Picture of Health is not and cannot be limited by a particular age range.

The book is fairly multidisciplinary in terms of the contributors. Whilst many hail from a medical background, there is representation from the fields of law, bioethics, philosophy and various areas of the arts and humanities. More disappointing is the fact that the contributors tend largely to be from the USA, with the odd one or two from other countries (such as Brazil, Argentina and Europe). I think the book’s value would have been further enhanced by broadening the variety of opinions, ideas and reflections presented as a result of including more contributors from across the globe.

Structure

Part one of the book is entitled ‘Personal reflections about film and ethics’ where four contributors offer their thoughts and insights into the use of film in teaching medical ethics and how it has shaped and enhanced their teaching of it. Certainly Albert R. Jonsen’s opening essay on Frankenstein and the birth of medical ethics helps to frame the discussion well and demonstrates persuasively how the medium of film can exemplify the many pertinent aspects of medical ethics including pursuit of perfection, the duty to heal, disease, the power of science, human rights and human dignity. It is therefore no surprise that Jonsen brands Frankenstein as the “modern Prometheus”.

To highlight some other essays of note, Michael D. Dahnke’s essay “The challenge of personhood” which addresses the film Lorenzo’s Oil tackles the ethical differences and problems encountered with the concept of personhood. Dahnke presents a balanced summary of the main issues whilst weaving in the aspects of the film which help to exemplify the key difficulties. In many respects this is a perfect exemplar of the focus of the essays presented in the book. Lois L. Nixon’s essay of ‘Speaking truth to power’ draws upon the poignancy of the film Pan’s Labyrinth in order to cover the important themes of patient–professional and professional–professional relationships within the field of medicine.  Her essay also helps to highlight the significant cross cutting themes which transcend disciplinary lines, reaching not only medical ethics but also lessons in business and leadership.

Marcia Santana’s Fernandes focus on Artificial Intelligence sets the scene for a discussion on emerging technologies, picking up on the slippery slope principle as well as the challenge to humanity and how we treat one another. As someone with a particular interest in new emerging technologies, this seemed like a good but basic discussion of the issues and yet the actual movie boasting so much more material to fuel discussion and debate. At this point I think it is useful to recall the main purpose of the essays and their purpose to initiate a conversation but by no means provide a comprehensive analysis and development of the main themes. Other books and articles can do that and may well help to contribute to the discussions which ensue from watching the movie.

Probably one of the most quintessential bioethics movies there is, Gatacca is not overlooked and is the focus of Alexander M. Capron’s essay. A film which is rich in some many different ways, Capron’s discussion provides a clear overview of some of the main themes of utilitarianism, genetics discrimination, human worth, the artificial versus the natural and offers some good sign posts for further reflection.

The avid film buff may well wish to sit down and read the book from cover to cover, but A Picture of Health will probably be used by the majority of readers as a reference volume, to be thumbed through and referred to when in need of a relevant film to show. In this regard, the book is an excellent resource, bringing together a rich variety of films and themes in one book. Without doubt, it is not a new idea to use film to illustrate a particular point, to help bring context to abstract concepts or to kick start discussion. However, what is new is to have a book which has been edited with this use in mind and offers a good ‘one–stop–shop’ to help you in this. This is where A Picture of Health shines.    

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