UNDER THE SAME SUN: Peace and Bioethics

In the Indian state of Rajasthan, near the Pakistani border, three orphaned children take in an injured adolescent boy, securing his humanity. “It’s a little film,” said writer-director Mitra Sen about Under the Same Sun, waiting in the Filmmakers Lounge at the 2015 Mill Valley Film Festival. Her modesty is genuine but the characterization of the works significance is inaccurate.  

This ‘little film’ tackles enormous questions, using an equally large intelligence. Despite Sen’s earlier film, Peace Tree (2005), winning some 12 international awards, the director is oblivious to the power of Under the Same Sun. In this film, children are depicted exercising their moral capacity through their daily interactions with one another. 

Sen’s film craft honors the legacy of Mira Nair, with its complex screenplay, and converging political and emotional plot lines. Perhaps, the greatest surprise is Sen’s facility with suspense. It rivals Alfred Hitchcock’s on his best day.  Think of the corn field scene in North by Northwest, or racing through the Marrakesh market in The Man Who Knew Too Much. A ‘tell’ forewarns Sen’s mastery. Seeing her diligence when ordering a sandwich in a deli is to see the artist at work. When she sorts out what she wants, Mitra can teach others how to help create it.

The geography of the film is significant. The region has a cross cultural population, split between Hindu, Christian, Muslim and Sikh people, who interact with one another routinely. The balance between these religions derives from a long complicated past. Mitra Sen’s contemporary handling of the cross cultural issues is masterful. She pushes the viewer to see so many colors in motion at once that the differences between them blend into a white light. Through a single example of emerging conflict, we are forced to consider the universal human rights violations when using children as weapons of war. 

Bioethics pays special attention to the moral protection of innocent third parties. Justice requires an equal distribution of burdens and benefits. Children are disproportionately burdened and reap the least benefit in conflict zones. A middle school teacher, Mitra Sen’s primary aim is promoting childrens’ understanding of the mechanisms of peace.  

Under the Same Sun was not an easy film for which to find resources, as if any ever are. Beyond financial issues was the reality of the nation of principal production. Sen arrived from her Canadian home to commence casting and production within hours of the 2008 Mumbai terrorist bombings. Neither India nor Mitra Sen are unfamiliar with difficult chaotic circumstances. Yet, it is remarkable that amid unprecedented horror, Mitra traveled from across the country to the border between Pakistan and India and began to make her Peace Genre movie. 

One bioethical definition of peace is that it is a ‘good’.  Such ‘goods,’ in this context, cannot be held by the individual but only by humanity as a whole. However, we recognize peace when we catch glimpses. Otherwise, it eludes clarity.  In the same way that individuals may derail peace, a collective can keep it on track. Under the Same Sun turns the violence of war inside out, in search of the elusive peace. 

Under the Same Sun, directed by Mitra Sen ( 2015) Canada, Sandalwood Productions, 93 min.

Under the same Sun Trailer https://www.youtube.com/watch?v=vOHl7CKz4vs Accessed October 17, 2015


Williams, S. LA MISSION : Prototype for the Peace Genre http://www.bioethicsscreenreflections.com/2010/05/la-mission-prototype-for-peace-genre.html?spref=tw Accessed October 17, 2015

Director Mitra Sen (Under the Same Sun), 
September Williams,MD (Bioethicsscreenreflections.com


A LIGHT BENEATH THEIR FEET Bridges Between Mental Health, Home Health Workers and Bioethics

A Light Beneath Their Feet is a coming of age story for both a daughter and a mother. Valerie Weiss’s directorial skill is remarkable. She uses a spotlight halo soft focus to keep the viewer tied to the amazing performances of Tayrn Manning (Gloria, the mother)  and Madison Davenport (Beth, the daughter). It is fortunate for the viewer that the director is able to keep up with the sophistication of the script and actors she has chosen to direct. Writer Moira McMahon Leeper has brilliantly clarified an inverted mother and daughter  relationship, occurring against the backdrop of mental illness. This film makes stressed family, clinicians, home care workers, and those with labile mental illness, feel less alone.

This film premiered at the 38th Mill Valley Film Festival, October 10, 2015. This is an intimate film about the continuum between mental illness and mental health. The bridge between these two entities is always in sway for everyone, the issue is extent.  Director Valerie Weiss came to her full film career after completing her doctorate in biophysics at Harvard. As such, she well understands the concept of elementary forced resonance, and that understanding has transferred to the subtleties of  her movie. It’s the subtleties that make this film great for  expanding bioethics consciousness. 

Every science student learns about the Tacoma Washington Narrows Bridge collapse in 1940. It is a bedrock tale in physics. Aeroelastic flutter, caused by high wind, unable to pass through the construction’s unbending side walls, caused the bridge to “catch the breeze.”  The arc of the bridges sway increased in magnitude,  eventually over taxing the elastic capacity of the materials used to build the structure. The initial signs of the rigid architecture’s collapse were barely perceptible. In A Light Beneath Their Feet Beth is able to recognize tiny shifts in the mental health of her mother, Gloria. Beth knows the bridge between her mother’s decompensated bipolar disease, and her functional capacity to be delicate, vulnerable to a cascade, gaining resonance, yielding ever widening arcs of suffering.

A Light Beneath Their Feet represents  the 38th MVFF programming as both Active Cinema and the theme Mind the Gap.  Mind the Gap  is about disparity between talent of women, and availability of sustainable work for them in the film industry. The film brings honor to both these categories of the MVFF interest.

Through this film, we experience life with one of the 40 million (1:5)  people in the United States, with decompensated mental health. The mechanism of the film's narrative outlines that though  this is the story of a mother and a daughter, there are two caregivers. Family and professional caregiver’s narratives should star women. They are the people who usually do that work. Women do this work for less than a man would, poor acknowledgement, income and generally unacceptable working conditions. A Light Beneath Their Feet may be a work of fiction, but there is a whole lot of truth in it. 

Family caregivers and home health workers, like Beth, struggle to cobble together a life for themselves as well as that for their loved ones who may be ill. The movement for home health care workers to  unionize, and  be recognized, is well underway.  Beth is younger than most of the children caring for their mothers in the USA.  At college age, Beth is  forced to consider her educational options in the context of her mothers needs. The more accepted situation sees a middle aged child caring for an elderly parent. However, it is mental illness which usually prompts that inverted relationship as well. 

Dementia occurs disproportionately in the elderly, those with cardiovascular disease, traumatic brain injury and liver disease. Common fellow travelers of dementia are: depression, anxiety and psychosis. In the hands of an activated society, managing the abundant  dementia  diagnoses could be a back door to improving the home support for others with mental illness.

Those of any age or cause for decompensated mental health, share legal concerns regarding competency and bioethical assessment of capacity. Competency is an assumed legal construct  until proven absent. Capacity is innate. It allows individuals to establish and maintain a functional system of reasoning, protecting their own personhood. It is loss of capacity which results in judges declaring people ‘incompetent’ to manage their affairs. Incompetency is legally decided between matters of person and those of estate or finance. Fiscal conservators manage financial matters, writing checks, paying bills.  A guardian of person is assigned in circumstances where a person not voluntarily taking medications, or relinquishing weapons, may pose danger. All conservators are appointed by the court and serve as agents of that court. Being a danger to oneself or others is the sine qua non of incompetency. 

The chronic pain community teaches us that most intractable suffering, from pain, is either initiated or worsened by adverse emotion.  In the current century science has realized, when the mind is unsettled by anger, sadness or fear, the brain becomes a petri dish for neuro-psychologic and physiologic decompensation. This was beautifully shown in the drug store where Beth was lucent enough to recognize the psychosis another customer was similar to her own mania, which frightened her. It frightened her so much that she could not rationally respond by getting and taking her psychotropic medicines. The concept of emotional stress resulting in imbalanced health has recently been distilled, for children, in the animated film Inside Out. 

Gloria’s relationship with her psychiatrist has them both walking a clinical tight rope throughout the film. Her ability to maintain guardianship, not only of herself but her daughter is dependent on a consistent internal system of reasoning. True to reality, Gloria’s mental compensation is maintained through the love she shares with her daughter, but also by the essential use of appropriate psychotropic medications. Often with humor, A Light Beneath Their Feet captures the sense of wonder, and fear, for those sharing a life straddling the border of sanity. 

Photo Director Valerie Weiss PhD,  Actor Jena Malone, writer September Williams, MD
After Give Us A Break!  Mind The Gap panel Mill Valley Film Festival 2015

Photo: Director Valerie Weiss PhD,  with Stacey L. Smith, PhD Director Media, Diversity and Social Change Initiative, USC Annenberg School for Communication and Journalism lunch after Mind The Gap panel Give Us A Break!


A Light Between Their Feet (2015) directed by Valerie Weiss, USA PhD productions (90 min)

Inside Out (2015)directed by Pete Docter,Ronnie del Carmen USA Walt Disney Studios (94 Min) 


National Alliance on Mental Illness https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers


INTERWOVEN: Listening, Hearing and Bioethics

Director, Writer, Cinematographer and some Cast of INTERWOVEN

The film Interwoven had its world premiere at the 38th Mill Valley Film Festival,  October  9, 2015. It recalls the best of ensemble film traditions. There is a touch of John Cassavetes improvisational script development, a whisper of Pasolini’s version of Giovanni Boccaccio’s Decameron, and the texture of films like Grand Canyon and Traffic. This film is a part of the Peace Film genre (c.f. La Mission)

Unique to Interwoven, each character is initially stereotypical. Then, just as the viewer raises their palms to yawn, the inner-lives of the characters explode, or implode, on the screen in a web of inter-related complexity. Does the homeless sage deserve what he’s not got? Is a suicide prevention worker past giving a damn?  Can a violinist’s shrill racket be a prelude to virtuosity? This is not a preachy movie, though it does not shy away from message.  Everything doesn’t work out for this band of some sixteen Interwoven people, but everything does indeed work.

Directed by VW Scheich, and co-written with Uyen K (who is incidentally the director’s entertainment attorney-wife). Interwoven is an ambitious first feature for this team. Scheich breaks many novice rules.  A new director should use a small cast, few locations, and focus on dialog over geography. — These were not Scheich’s choices. Scheich confounds matters more by moving boldly across culture, race and class, over wide swaths of Los Angeles, creating a kaleidoscope of hope.  

The ensemble of Interwoven includes award winning star Mo’Nique (Precious). However, the majority of the players are solid ‘work a day actors.’ In casting, the writer-director team operated as though documentarians, searching for the story, not beginning with a theme but instead a process. When the casting call went out, some two hundred actors responded. “That was just the first day, ” Scheich says. Actors were asked to share poignant stories about their lives during their auditions. Some of the actors describe being confused at having neither lines to read nor monologs to recite.

Interwoven highlights the power of listening in both its production style and themes. In this way the film gains its bioethical influence. Listening is an acquired skill, requisite for ‘hearing’, but not sufficient.  Hearing it is key to bioethics. Informed consent is a process which requires listening and hearing, not just signing a piece of paper.  

The elements of informed consent require that a person is able to reflect back information delivered during disclosure of expectations if particular course of action is taken, it’s risks, benefits, and alternatives. Informed consent also demands that permissions are given for the course without coercion. The rules of informed consent  are are associated with  articles 6 and 12 of the Universal Declaration of Human Rights, which relate to personhood.  Matters of  family, spirituality, past struggles and personal cultural icons influence an individual’s capacity to give informed consent. Policy and procedures related to informed consent in medicine and human research are further operationalized in the Helsinki Declaration of the World Medical Association and its revisions. 

Without heavy handedness, the stories of Interwoven relate to death and loss. The film evolves, perching solidly, on what the late bioethicist Paul Ramsey described as “the edges of life.”  The team creating Interwoven has an intelligence which allowed them to find the truth they were meant to interpret from the narratives heard. Many of the characters were cast with actors from whom the original stories derived. Interwoven adds value to those watching from a clinical medical ethics vantage. How do you give bad news? Where does drinking alcohol cross the line into alcoholism? What is anticipatory versus prolonged grief, and how do we deal with it best?


Interwoven (2015) directed by VW Scheich (USA) 87 mins

Interwoven Trailer https://vimeo.com/109253941



THE ASSASSIN AND BIOETHICS: Death and Destruction vs. Peonies and Silk

The Assassin was one of  the three opening night films at the 2015 Mill Valley Film Festival. Taiwanese filmmaker Hou Hsiao Hsien is no stranger to the Cannes festival awards. This film won him the Cannes 2015 Best Director. Attraction to the screen narratives of ‘assassins’ raises clear bioethical concern during pervasive aggression at home and abroad. The Assassin differs from others in its genre. It does not titillate with the brutality of cold blooded murder. Instead, The Assassin may demonstrate a filmic antidote for the desensitization of screen violence.

The original assassins are thought, by some, to have been mercenaries, in Persia, from the sect of Shia Islam, in the period between the 9th and 10th century. This sect worked against the Sunni Islam who controlled that empire. Assassins were tools of barons who held no independent army.

Though set in the Chinese context, and created by a man, The Assassin has a profoundly feminist sensibility. The assassin of this film’s interest is a woman born in a ninth century imperial court. It is a profoundly feminist approach to story telling. Her mother rejects imperial control and escapes, knowing the action will likely cost her life and that of her daughter. Before her death, the fleeing mother arranges her daughter’s care by an aunt and uncle. The imperial powers eventually wish to conquer the geographical region where the child has been fostered, again risking her death. For the child’s protection her surrogate parents place her in the care of a ‘nun.’ The Nun’s machinations train the child as an assassin. We meet the girl in young adulthood, were she is driven by her filial longings to break away from her heinous training.

The ‘Assassin Genre’ usually depicts an innocent, extracted from their family’s stability and values, being co-opted by an evil power. The plethora of large and small screen versions of this theme includes screen works ranging from The Borne Identity to more recent television shows like Complications and Blindspot. Malleability of unformed systematic reasoning, when faced with moral conflict, is often essential to training in the Assassin Genre, as in life. —Think child soldiers, street gang members, late adolescents in the military,  and fascists masquerading as religious extremist.

Bioethics is an applied ethics concerned with science and technology affecting the biosphere and it is inclusive of medical ethics. The underpinning principles of bioethics  are beneficence, autonomy and justice. Ethical sense generally comes from two separate mechanisms. The first is through principles, drilled into a person as in religion, academia and professions. The second approach to enhancing morality is ‘casuistry.’   Casuistry imparts moral understanding through cases or stories. However, it is not just the Aristotelian narrative plot curve that generates the organized portrayal of ethical dilemmas. Particularly in the case of film, the way in which stories are told influences meaning.

Greek drama analysis might argue that depicting an assassin's journey allows viewers to work through feelings of loss of connectedness. But screen science is a technology, incidentally facilitating art, and can be held to the standard bioethical scrutiny as are other technologies. Does the technology do good?  Does it interfere with the viewers autonomy or enlightened self interest? Are the burdens and benefits of this technology equitably distributed between the most and least vulnerable persons?

Clinically, film can be used to  intentionally manipulate emotion and physiology. Think Clock Work Orange. Other examples include use of film to desensitize persons with, say, arachnophobia. The retina can’t tell the difference between a real spider unless the mind clarifies the matter.  Our movie memory is stored  in the same places as our real experiences. ‘Suspension of disbelief’ is required to watch a film.

If the arachnophobe believes a film spider is real, then the clinical matter is training them to sublimate the emotional and physiologic response during repeated exposures. Eventually, the sublimation becomes automatic. If a viewer suspends believes the screen violence is real, there should be a mechanism to train them to abhor that violence.

Among the tenants of bioethics, and especially clinical medical ethics, is that those who know a field best have increased ethical obligation within that field. Film master Hou Hsiao Hsien’s gives a new twist to reversing the desensitization to violence.That’s a good thing since drilling principles into young minds doesn’t seem to be working.  He uses the juxtaposition of heinous acts with extraordinary beauty. He directs  viewers’ minds to be afraid of violence, initially because it waste time better used for more intimacy with the pleasing aesthetic of this filmmakers’ world. We beg, “Let her walk through that field just one more time!”

Though presaged by the elegance portrayed in many martial arts films, Hou Hsiao Hsien's film Assassin has left the ‘kick’ genre in the dust. The Assassin is not about killing, but demonstrates escape from horrid depictions by pushing prayers for peonies and silk.

Reference for Assassin

The Assassin (2015) directed by Hou Hsiao Hsien (China, Hong Kong, Tiawan) Well Go (2015) 105 mins

The Assassin Trailer https://www.youtube.com/watch?v=YSoXoOAY1zU


2015 Mill Valley Film Festival

Bioethics and the Mill Valley Film Festival

Bioethics Screen Reflections Supports the California Film Institute 38th Mill Valley Film Festival (www.cafilm.org) From October 8, 2015 to October 18, 2015 we will screen/review the following films:

The Assassin 
A Light Beneath Their Feet
Son of Saul (Saul Fia)
Here Is Harold (Her er Harold)
Love Between the Covers
Beasts of No Nation
Creative Control
A Perfect Day
Paper Tigers
In Defense of Food

A special focus will follow bioethical issues reflected in the 38th Mill Valley Film Festival category of “Mind the Gap”  which considers the relatively small number of women able to earn a living in the film industry, despite the large percentage of talent and skill women represent in the field.  

Follow along with us over the month of October. Mill Valley Film Festival programmers have proven to be among the most savvy in the field. Their online film notes can guide direct viewing for the year even, if you are not able to attend. But, do try to join us. Often the world, continental and USA premieres  offered become the most highly awarded films of their release years. 

We will keep you posted 

@Bioethicsscreen  and @MVFilmfest