HUGO: Bioethics and Technology

Technology includes all applied knowledge, including science in the service of art. Film, has an impact on people and so other aspects of the biosphere. The first public screening of a film was in 1895, a century old it is a relatively new technology. Martin Scorsese's film, Hugo, eases the task of exploring historical relevance of screen grammar and technique. The story is adapted by screenwriter John Logan from Brian Selznick's fantasy novel. A children's film, it is all the better for this target audience. Adults are delicately guided to consider pitfalls of infatuation with applied science through a child’s innocent eyes. We are reminded that often scientists, physicians, engineers, film directors and others cursed with knowledge and creativity, are often found teetering between genius and ruin.

Hugo, also the name of the film’s main character, is trapped living between the walls of the Gare Montparnasse in Paris during the 1930s. He is surrounded by period appropriate icons of technology, clockworks and trains. The setting is not the Gare Montparnasse of today, rebuilt in the 1960s and where the TGV shoots off to Bordeaux. It is more the site of the 1895 spectacular train derailment, reported in all the world's newspapers and in Hugo's nightmares. The steam engine was the technological revolution of the 19th century, as the large screen and rocket were of the twentieth, and the small screen is of the twenty-first. A reclusive pre-teen orphan, Hugo maintains the train station's clock works, and studies mechanics. He spends his free time repairing an automaton; the broken mechanical robot left by his now dead father. In his pursuit of technological reward, Hugo is driven to immoral acts of lying, cheating and stealing.

People perceive the world first from real direct contact; primary socialization. Film works through depicted contact; secondary socialization. Film memory seems indistinguishable from dreams and primary memories in our brain’s catalog. The rub is, we are not sure what is learned primarily, secondarily or whether it matters. Audience capacity to host psyche altering screen depictions appears infinite. Predictable responses are invoked by repeated film viewings. 

Bioethics is branch of philosophy that explores what we ought to be doing with science and its applied technology. No longer is bioethics only applied to medical science but to all aspects of science and technology affecting the biological world. Scientist and technologist are increasingly charged with being moral custodians of beneficence. Beneficence is the bioethical principle supporting the obligation to rail against ignorance and simultaneously do good with what we know. Knowledge, like Eve's apple, causes conflicts particularly between beneficence, autonomy and justice. What new technology breeds down the time line is often difficult to anticipate. Who could have guessed the Lumiere Brothers home movies would yield Clockwork Orange or soldiers trained by video games? Uncertainty is rampant in the case of screen technology. Bioethics is a system of reasoning seeking to clarify ambiguity and facilitate action.

In a recent New Yorker cartoon, Dr. Frankenstein types on a computer while explaining to Igor, "I've given up trying to create life and instead create online personas." Frankenstein's Monster is an icon being replaced by screen technology. Distributive computing, reflected on beloved smart phone screens, singles out disease causing genes but also pinpoints a dissident for apprehension who is texting news of revolution. Hugo shows the challenges inherent in the evolution of screen technology while encouraging continued foray into the breech. Bioethics enhances moral reasoning regarding technology. Any technology created will be used; the bridle being considerate ethical analysis.

Hugo. (35mm) directed by Martin Scorcese. 2011. USA. Paramount Pictures. 128 mins.

Frankenstein. (35 mm) directed by James Whale. 1931. USA. Universal.

Clockwork Orange (35 mm) directed by Stanley Kubrick. 1971.  USA.Warner. 137 min.

Perils of Pauline (16mm) directed by Louis J. Gasnier Donald MacKenzie  1914.  USA. General Film Company & Eclectic Film Company. 

Le Voyage Dans La Lune (Trip To The Moon) (16mm) Georges Melies. 1902.  France. Gaston Melies Films.  14 min.

Metropolis. (16mm) directed by Fritz Lang. 1927.   Germany UFA. 153 mins (at 24 frames/min)

Safety at Last.  Fred C. Newmeyer and  Sam Taylor. 1923.  USA.  Hal Roach Studios.  73 min.

Williams, S.  Justice Autonomy and Transhumanism: YESTERDAY.  in The Picture of Health.:  eds. H. Colt, S. Quadrelli, L. Friedman   Oxford University Press . New York. 2010

see Inception: transhumanist dreams resolve grief ( 7/17/10 Bioethicsscreenreflections)


FREEDOM WRITERS, meet TO SIR WITH LOVE: Bioethics, Film and Understanding

FREEDOM WRITERS is another in the genre that started with the movie TO SIR WITH LOVE. It tells the story of a desperate inner city high school English teacher (Hilary Swank) forced to get creative. She discovers that every kid in her class, but one, knows first-hand what a Holocaust is. However, every kid in her class but the same one, does not actually know what "The Holocaust” was. 

This is the story of how a single teacher can change lives.  In films about the transformative power of education, the children are at risks in most ways defined by the Declaration of Human Rights; food, housing, education, safety.  The learning gap between the rich and the poor screams for the principle of justice. However, conflict in the principle of beneficence is more accurate.  Ignorance is the disease to be fixed.  Beneficence is ethical use of knowledge. Beneficence directs what we ought to be doing with the knowledge we have. 

In principle based ethical decision making, we look for tensions between beneficence, autonomy and justice.  Clarifying the tensions supports the "hunch" that there is an ethical conflict.    In the medical context, beneficence is an obligation to transfer medical information. Information communication requires understanding. How do you make a person understand?

In FREEDOM WRITERS, the teacher physically walls her students off from the chaos of the contextual, geopolitical features which bear on justice.  She closes the door to her class room with the kids inside of it. A safe haven is created out of the storm. This is a smart approach when faced with a bioethical dilemma.  You can't control the geopolitical matters that create social injustice so you do what you can. Conflicts are best resolved resulting in suitable action if the order of considerations is weighted; starting with beneficence, then autonomy and finally justice. Our creative teacher takes her students out of the fray. She weights beneficence, or conveying knowledge, as the first priority. 

In FREEDOM WRITERS, the hook is introducing a group of adolescents to the Holocaust memoir, The Diary of Anne Frank.  Anne's story "de-alienates" the contemporary children. It makes them a part of a broader historical context. The students are freed from the narrow confines of a culture of underdevelopment by exposure to Anne Frank's life and death. 

It is not necessary to grasps every single aspect of a complex field but a clear conceptual understanding of the trends resultant from key information is important.  If knowledge is not relevant to groups of people themselves, it may not be absorbed.  How groups define themselves is called culture. Cultural relevance gaps frequently limit appropriate distribution of benefits and burdens (Justice) as regards information exchange.    

The basis of using film to enhance ethical analysis results from the interchangeable energies associated with narrative forms. Narrative forms include the Aristotelian six arts: dance, music, painting, literature, drama and poetry. Film is referred to as a synergy of all of the arts; becoming Andre Bazin's "seventh art".  What all the arts have in common is narrative.  Narrative forms have historically conveyed morality, through myths, jokes, fables, or religious books.  A specific case is outlined or seen.  The telling case has a theme which guides the observer to a planned engagement, a final conclusion and a resolution as the process finishes.  Using stories or cases to convey morality, is called Casuistry. It seems to work because it connects our common morality, leaving us to feel less alone.  This is how the teacher in FREEDOM WRITERS enhances understanding. 

The classic format of teacher "rescuing" the under developed children in films, is not always about white folks going to the black ghetto. The genre was initiated by the legendary Sydney Poitier, a black man, cast in TO SIR WITH LOVE.  This teacher changed the lives of working class white English teens.  Class, in the Euro-American context, has become synonymous with race. The most compelling films deal with those who return or stay in their communities to provide change. Examples of this version of the genre include STAND AND DELIVER (Menendez, 1988) and COACH CARTER (Carter, 2005).

Freedom Writers. dir. (35mm) directed by Richard LaGraveness.  USA. 2007. Paramount. 122 min. 
To Sir with Love (35 mm) directed by James Clavell. UK. 1967. Columbia. 105 min.

Also read:
Frank, Anneles Marie. The Diary of a Young Girl. (The Diary of Anne Frank) 1947. Bergen Belsen Concentration Camp 1947

For more information on bioethics film and understanding: see
this blog site section on  Film/Bioethics Literacy - Lighten Up: Dying on Screen Slides  .030 and  .018 ( Narrative and Casuistry)  and slides 019 and 0.20 (Informed Consent)


During a recent California governor’s election race, ethical tensions surrounding "the American knowledge gaps" were voiced. Most party candidates endorsed the film WAITING FOR SUPERMAN.  WAITING FOR SUPERMAN is a documentary about young American teachers striving to change the broken public education system. This, like other documentaries, tells the story by following individuals who are, in this case, striving for better education. The story also tracks the careers of a number of graduates, trained in Teach for America, as they struggle to build more equitable models of education for American Children. These teacher's gains are modest overall, but large in the communities where they have served. 

WAITING FOR SUPERMAN argues that communities have not let down the schools so much as schools have let down communities. Accompanying the analysis are truly shocking facts about the ways in which American public school districts are operated. Administrative rigidity appears to be to a detriment to education of the poorest students in the country. In contrast, educators are left to do one of the hardest jobs with limited resources. 

WAITING FOR SUPERMAN falls short in its analysis of the education gap because it never quite explains the value of education. Many of the kids depicted believe education will get them a good job. The film never corrects this misconception. Though better educated people are shown to have better jobs, all better educated people don't.  Getting a job through education is certainly a passé expectation in the current era.  FREEDOM WRITERS(LaGraveness, 2007), on the other hand, suggests that education enhances human consciousness.  Enhanced human consciousness changes the quality of individual lives; a more reliable outcome than guaranteed employment for most under-resourced communities. 

Looking at the educational gap more globally provides a better context than race alone. It also leads to more allied existences. TO EDUCATE A GIRL squarely anchors itself in expanding human consciousness. It, like WAITING FOR SUPERMAN, is a documentary. TO EDUCATE A GIRL best addresses all of the dimensions  of ethical  conflicts in education;  beneficence, autonomy and justice issues.  I screened this film at the Mill Valley Film Festival this past October. It is directed by Frederick Rendina and Oren Rudavsky.  It was made primarily with United Nations funds and was undistributed at the time of my viewing. It is, to my mind, the best of the type. TO EDUCATE A GIRL offers a thoroughly modern handling of how to fix significant aspects of the education gap between subsets of classes and universalizes the context. 

In a paradigm flip, TO EDUCATE A GIRL suggest that the true underclass of concern are the 110 million school aged children, not in school or under-schooled; two thirds of whom are girls. The narrative places the lower status of women squarely in the center of the major conflicts of human development. It weaves the geopolitical contextual features of the two nations of Nepal and Uganda. Both of these nations are fresh out of civil war. 

TO EDUCATE A GIRL gets high points for demonstrating how people can explore their own cultural attitudes, legacies of religion, colonialism and neocolonialism. It illustrates which attitudes cripple and underdevelop a generation's knowledge. It also highlights those practices which support beneficence, autonomy and justice.
Use of modern techniques of radio, television and the public health model of outreach are promoted in TO EDUCATE A GIRL. Equal weight is given to technical and more traditional models of singing and performing stories to guide better understanding. 

The fierce competition to get into "the best school" as in WAITING FOR SUPERMAN does not exist in TO EDUCATE A GIRL.  The goal instead is getting into school at all. Like the barefoot doctors movement, the film demonstrates a barefoot teacher’s movement. Teachers recruit children from villages by convincing their families to send their children to school. These teachers educate families first. The film also documents boys and men supporting themselves through supporting their sisters and wives aspirations.  It is the enlightened mother's, who wish to protect their girls from the perils of underdeveloped womanhood, who ultimately facilitate the most attitudinal change regarding education.  

TO EDUCATE A GIRL provides an honest assessment of real obstacles in girl’s lives. Girls in most cultures, including the developed world, often do domestic work and toil in actual or metaphorical fields. Girls are sent out to work at an early age in under-resourced families. They are reliable as are usually their mothers.  If not working outside of the home, girls are often responsible for raising their siblings and caring for the elderly while the adults are working, dead or incarcerated. In many instances, forced or arranged marriages are required to support a girl’s family. Finally, female child genocide is a feature where agriculture and resources are limited. Girls create more mouths to feed. 

During war and the aftermath there is cultural destruction. Girls and women are often victimized by sexual assault. This occurs to a greater extent when women and girls are also political prisoners. Here victims of rape in the developed world meet their international sister in post-traumatic stress.  We find a similar circumstance in natural disasters and wherever people are refugeed or decimated en masse. Walking to school can mean losing a girl’s life in many contexts.  All of these are shown in TO EDUCATE A GIRL.  All of these frequently preclude the educational aspirations of girls. 

Fancy uncrowded classrooms may be ideal; however, they are not sufficient.  A good teacher, on the other hand, can transform even the worst classroom into a learning environment. The best and most creative teachers are needed in the most difficult circumstances.  A good teacher engages the learner. This is not to say they must be touchy feely. Teachers as shown in these films must have an organized program for engagement applicable to the community they teach.  Without engagement there can be no understanding and beneficence becomes a theoretical construct.  Without understanding there can be no autonomy and all the clinical medical ethical devices like informed consent and advance directives become useless.  Without autonomy there can be no transformation of individuals to form just societies. 

Waiting for Superman (DVD) directed by Davis Guggenheim. USA. 2010. Paramount Vantage. 112 min. 
-->To Educate a Girl. (DVD) directed by Frederick Rendina and Oren Rudavsky. 2010 USA/Uganda/Nepal Talking Drum Pictures. 2010.  70 min.

For more information on understanding, education and bioethics: see
this blog site  section on  Film/Bioethics Literacy - Lighten Up: Dying on Screen Slide 25, ( Spiritual Assessment & Cultural Relevance)


THE KIDS ARE ALL RIGHT meets KRAMER VS KRAMER: Cell, Reproductive Science and Bioethics

I saw THE KIDS ARE ALL RIGHT in July of 2010.  Annette Bening was a highlighted guest at the Mill Valley Film Festival the following October. I suspected it would be an Oscar contender and so might not need the support of this blog to get into the teaching dialog in bioethics.  I couldn’t help noticing that as a bioethicist my take was different from the reviewers I read.

THE KIDS ARE ALL RIGHT is a movie beautifully acted by leads Annette Bening and Julianne Moore. They are two women married to each other who co-parent two children (Mia Wasikowska and Josh Hutcherson). The children seek out their biological father (Mark Ruffalo). The father is a womanizing habitually single man who gets his come uppings from the mothers, the children and his current bed partner and longtime friend (Yaya DaCosta).  THE KIDS ARE ALL RIGHT is about an average, upper middle class, American, nuclear family undergoing changes.  

There is no progressive politic in this film; neither feminist, racial, gender or even sexual, no call to action other than to hold onto your family tight and ride the roller coaster. It is a statement of facts of this family, presented as blithely as the reality that the sun rises in the east.  Writer-director Lisa Cholodenko shows craftsmanship in not cluttering the presentation with exposition. What buys our attention is the bioethical-cultural C change inherent in this narrative. 

Forty years ago, the characters and premise of the KIDS ARE ALL RIGHT would have given worldwide viewers whip lash.  Of the Mom’s in this film, one is a woman gynecologist.  Back in the day gynecology was considered a surgical subspecialty solidly dominated by men.  Informed consent only really hit real world medicine about thirty years ago. In THE KIDS ARE ALL RIGHT even the anonymous sperm donor has the opportunity to give informed consent before being contacted by his genetic daughter. Adopted children only recently have hope of routinely identifying their biological parents, it makes sense that this right should extend to genetic parents as well.  

Sperm banks differ in how they select donors.  One cryo-bank accepts only donors who attend or have graduated from a four year university, are tall, trim, heterosexual and between 19 and 34. Another bank only takes sperm from Nobel Prize winners. Newer sperm banks seek more eclectic gene pools. We like to think this diversity is an effort to avoid any appearance of supporting eugenics.  The genetic Papa in the KIDS ARE ALL RIGHT is a college drop-out and cook with a preference for meaningless sex. He is flawed like most people.  We gather from his comments that he may have fathered more than ten children by sperm donation for money.  Currently there are restrictions for number of children a sperm donor may parent. Fathering less than 10 children by sperm donation seems to statistically limit accidental marriage possibilities between siblings. Payment for sperm donation still occurs. You can’t buy babies but you can buy the stuff they are made of.   

Sperm donors and client parent rights are usually established via written informed consent that is signed by the client and surrogate. The informed consent is verified by the client's doctor. The principle of informed consent is a device of the medical ethical principle of autonomy.  It was the 1974 Belmont Report on the Protection of Human Research Subjects, the federal government's procedural response to the US Public Health Service Syphilis Study at Tuskegee, that established informed consent as a norm in both research and clinical patient interaction. 

Deep in the narrative of THE KIDS ARE ALL RIGHT lays the story of Baby M. In 1988, the New Jersey Superior Court awarded custody of “Baby M” to a couple named Stern under a “best interest of the child analysis”.  This analysis attempts to circumvent the commodification of children whilst recognizing the contractual relationship between clients who employ surrogates and their gene donors. This court’s analysis validated the surrogacy contract between Mary Beth Whitehead, the genetic mother of “Baby M,” and the Sterns, the client parents. However, buried in the best interest of the child decision, there may be a bias against Ms. Whitehead’s potential of being disabled by Multiple Sclerosis and her circumstantial psychological unbalance.  Informed consent is used as evidence of a fiscal contract in surrogacy.  It is a twist in clinical ethics that a device to insure autonomy can inadvertently lead to human commodification.   Commodification of human beings is of particular concern to groups of people, and their offspring, who have historically or currently been bought and sold. 

In THE KIDS ARE ALL RIGHT, two children result from cell science. Cell Science has led to extraordinary technological advances including fertility surrogacy, vaccines, and most prominently the human genome project.   Completed in 2003, the Human Genome Project (HGP) was a 13-year project coordinated by the U.S. Department of Energy and the National Institutes of Health. Its goals were to identify the 20-25,000 genes in the human DNA, determine the sequence of billions of base pairs, store the information in databases, improve data analysis, transfer technologies to the private sector, and address the ethical, legal and social issues that arise from genetic  technologies.

Not the least of ethical concerns related to cell science and its offsprings, reproductive technology and the Human Genome Project,  is the origins of the cells used to develop them.  Much of what we know of cell science derives from cells taken from an African American woman named Henrietta Lacks. In the 1950s, Mrs. Lacks resided in Baltimore. She was born from tobacco sharecropper slave roots in Clover, Virginia.  Her cells were taken from her during a biopsy for cancer. They were used for research purposes without her permission.   Her cells were named HeLa. HeLa became the first human cell line to grow in-vitro. HeLa is the origin of billions of dollars reaped by  private technology companies.  Neither Mrs. Lacks and her family, nor anyone else who has their tissue taken in medical procedures, has the legal right to consent or veto how their tissue is used once extracted.  

Generally there is no legal support for extending personal or family autonomy to the tissue of a person, unless it is to be implanted in a living recipient. Tissue routinely excised in medical procedures provides its source no legal assurance to partake in revenue that is generated by the use of their body part.  If there is no informed consent, there is no contract to be legally upheld. Like Mrs. Lacks, anyone's human body parts can be scattered across the world. This lack of wholeness, particularly at the point of death, is more than fiscally important in many cultures.  

THE KIDS ARE ALL RIGHT signifies an advance in human consciousness as regards same sex relationships and marriages.  KRAMER VS KRAMER premiered in 1979, creating a shock wave in its conclusion.  Mrs. Kramer (Meryl Streep) is a Lesbian.  Mr. Kramer (Dustin Hoffman) is inconsolable. The two enter a bitter divorce and custody battle underpinned by the emergence of their gender preferences.  The battle outed the gay parent on screen for the first time in history. However, Kramer vs. Kramer also highlighted the capacity for parents to show love for their children despite personal issues between themselves. They do the right thing; Mr. Kramer, Mrs. Kramer and her lesbian partner find a way to raise the child.  In THE KIDS ARE ALL RIGHT, the gender preferences of the moms are hardly a question in contrast to KRAMER VS KRAMER.  Ethical conflicts of reproductive technology and challenges of honesty between family members are correctly more important in THE KIDS ARE ALL RIGHT.

The Kids Are All Right.  35 mm. Directed by Lisa Cholodenko. USA. 2010. Focus Films. (106 min)

Kramer vs. Kramer.  35 mm. Directed by Robert Benton. USA. 1979. Columbia Pictures. (105 min) 

For further information:

http://www.kylewood.com/familylaw/babym.htm. In the Matter of Baby M., 109 N.J. 396. 1988.

Skoot, R. The Immortal Life of Henrietta Lacks. Random House Inc.., New York.  2010, 2011