Antonio Blanco Mercadé
Servicio de Otorrinolaringología del Complejo Asistencial de León. Comité de Ética Asistencial del Área de Salud de León (Spain).
Correspondence: Antonio Blanco Mercadé. Hospital de León. 24071 - León (Spain).
Scientific and biotechnological advances always go hand in hand with ethical problems, some of which can be identified in The Island. An ecological disaster threatens the survival of humankind and individuals are no longer allowed to take decisions freely and voluntarily, deprived of their moral condition so that they can be used as a means. The goal that is pursued in the film (organ transplant to save lives) does not justify the means employed (the cloning of donors who are unaware of their condition and are thus sacrificed). Living donations must always be voluntary and free, carried out after an appropriate information process. Reproductive human cloning is unanimously rejected, but even if it is developed for therapeutic or research purposes, and even though it is legally allowed, it remains a matter of great ethical controversy.
Keywords: Bioethics, Ethics, Cloning, Transplant.
Title: The Island
Original title: The Island
Country: United States
Director: Michael Bay
Photography: Mauro Fiore
Music: Steve Jablonsky
Film editor: Paul Rubell and Christian Wagner
Screenplay: Caspian Tredwell-Owen, Alex Kurtzman and Roberto Orci based on a plot by Caspian Tredwell-Owen
Cast: Ewan McGregor, Scartett Johansson, Djimon Hounsou, Sean Bea, Steve Buscem, Michael Clarke Duncan, Ethan Phillips, Brian Stepanek, Noa Tishby, Siobhan Flynn, Troy Blendell, Jamie McBride, Kevin McCorkle, Gary Nickens and Kathleen Rose Perkins.
Runtime: 136 minutes
Genre: Action, Science fiction, Thriller
Production companies: DreamWorks SKG (accredited as DreamWorks Pictures), Warner Bros. Pictures and Parkes/MacDonald Productions
Synopsis: In the year 2019, when the world is polluted by an ecological disaster, a group of people, among whom are Lincoln Seis-Eco (Ewan McGregor) and Jordan Dos-Delta (Scarlett Johansson), live in a withdrawn community in which all aspects of their lives are controlled, apparently for their own good. The only escape is to be chosen by a draw to go to “the island”, a heavenly place, the last retreat in the world that is free from pollution. Lincoln has inexplicable nightmares and wonders about the restraints that have been put on his life, finding out that it is all a lie and that “the island” is a sham. He and the rest of the community are really clones produced from rich individuals who need transplants; those who are “lucky” do not travel to “the island”, but die in an operating theatre when their vital organs are extracted for transplantation. Lincoln and Jordan discover the sham and manage to escape from the community, having to find their clones in order to expose the lie underlying the mask of a supposedly benefactor organization.
Film is a particularly adequate form of narrative for bioethical reflection, since it as able to relate the biological knowledge of living systems to ethical values1. The neologism “bioethics” is attributed to Van Renssealer Potter (Figure 1) - a researcher at Wisconsin University - and first appeared in a 1970 article and again in 1971, in the book called Bioethics: Bridge to the future2. Within a broad context, the author is concerned with the survival of humankind and warns of the dangers to the life of the plant of technological advances, which is why it is necessary to build a bridge between two cultures: the sciences and the arts. Bioethics currently addresses very diverse areas, from “macro bioethics”, related to globalization and the environment, to “micro bioethics”, which can be subdivided into ethics specific to biotechnology and ethics characteristic of medicine, applied to research or health care. The Island tackles all these fields. In the film we are told that pollution has caused the destruction of most of the world, an ecological disaster related to the bioethics proposed by Van Potter. Biotechnology bioethics (with reproductive human cloning) and clinical bioethics (with organ transplants from a living donor) are also present.
Scientific progress always goes hand in hand with new ethical problems. The Island is a very credible science fiction film, in line with recent scientific advances, particularly in issues of reproductive and genetic interventions, but also in regenerative medicine and transplant techniques. The film reveals and clearly illustrates several ethical conflicts related to cloning and organ transplantation, as well as other more general issues, such as the ones analyzed below.
The Island reminds us of important science fiction works such as 1984 (Nineteen Eighty Four)3, a novel written in 1948 by George Orwell (a pseudonym for Eric Arthur Blair), which tells the story of a future world whose inhabitants have lost their identity, thought and feelings and are dominated and controlled by the omnipresent Big Brother. The main character tries to rebel against the established government. The film version, Nineteen Eighty-Four (1984) (Figure 2), was directed by Michael Radford and features John Hurt and Richard Burton (in his last appearance on screen). In The Island there is also domination and control over the individual, leading to annulment as a moral being. This attempt to annul the moral quality of the human being, by means of manipulation, prevents the inhabitants of the community from taking decisions freely and voluntarily. The truth is concealed and lies are told with false promises of happiness, later even resorting to coercion and violence to try to avoid the collapse of the whole network of deception.
Human beings are used as a means and are not considered ends, thus violating the moral canon formulated by Kant4, according to which the individual as such is an end and not only a means, which is why he/she has dignity and not a price. The end that is pursued in the film (to heal by means of organ transplant) does not justify the means used (the unwilling donors are sacrificed). The power over life and death, leading to the creation of human beings that are later killed with the aim of saving the lives of others, proves, once again, that the end does not justify the means. Not everything that is possible (from a technical point of view) is good (from an ethical point of view). The spectator is reminded, by this film, of the experiments with human beings carried out by Nazi doctors in extermination camps.
Coma5, published in 1977, is a novel by Robin Cook, a doctor and writer of medical thrillers, which also has its corresponding film, Coma (1978), directed by Michael Crichton and starring Genevière Bujold and Michael Douglas (Figure 3). The topic of organ trafficking is addressed (common to The Island), in this case based on patients who suffer brain death apparently as a consequence of surgical accidents. The transplants carried out in The Island are isografts since the donors are alive and are clones of their future receivers, and, deceived, they are unaware of their condition. There is also illegal trafficking and trading with organs and with the human beings themselves. Live donations must always be voluntary and free, following an adequate information process. Moreover, both in the process of generation and development of the donating clones, and in the removal of their vital organs and subsequent death, there is a constant display of extreme technical correctness; it could be said that “medically assisted homicides” are committed.
In the novel Brave New World6, written by Aldous Huxley in 1932, there is absolute control over a class system to maintain order and happiness. Within that charitable tyranny that is Utopia, universal contraception and a process of eugenic selection are the order of the day, among other things, based on a kind of high-technology assisted in vitro reproduction whose purpose is to obtain genetically manipulated test-tube babies so that they can belong to one of the five population categories designed according to their intelligence. The main character, as is also the case in Nineteen Eighty-Four and in The Island, attempts to prove that it is possible to live outside the prevailing system. The film adaptation of this work was carried out by Burt Brinckerhoff in 1980 (Brave New World) and by Leslie Libman and Larry Williams in 1998 (Wi) (Figue 4), in both cases for TV. In 1962 Aldous Huxley himself happened to write a novel called The Island7, but it contents are different to those of its homonymous film.
As the focus of its argument, The Island tackles the topic of human cloning. Currently, it is technically possible to clone a human being by means of nuclear transfer, which consists of replacing the nucleus of an ovum with the nucleus of an adult cell (say, from the skin) from the individual who is to be cloned. The cells of the blastocyst or embryo thus obtained (embryonic stem cells) can be used for research and in regenerative therapy (the so-called therapeutic cloning) (Figure 5). In the Spanish legal system the activation of ovocytes through nuclear transfer for research or therapeutic purposes has been approved8.
It is common knowledge that the use of embryos, even for research or therapeutic purposes, is the origin of strong ethical controversy. The problem lies in believing or not that the pre-implantation embryo, whose destruction is ensured, is alive as a human being or not, and if so, whether or not it is a full human being; that is to say, a person. The question is whether all biologically human lives should be equally respected. It is not, therefore, a biological problem but essentially a philosophical one, because biology cannot provide the answers to the questions “what is a person?” and “who is a person?”. The discussion about research using human embryos could proceed from a strictly biological approach to ethical-philosophical or theological-religious approaches, which is when it almost always falls on deaf ears, because the interlocutors take up a priori stances as to whether they see the embryo as an object or as something sacred. From both these extreme attitudes, pressure groups trying to persuade society of the truth of their respective criteria arise. Preconceived ideas (prejudices) are claimed to be indisputable.
If a cloned embryo were allowed to develop, this would be human cloning for reproductive purposes, which is not allowed by any legal system. This is precisely the case in The Island. The ethical rejection of reproductive cloning to obtain developed organs, which would be totally compatible with the recipient but which would mean the death of the donor, is unanimous. In the film reproductive human cloning is carried out and it affords human beings that are not only genotypically but also phenotypically identical and of the same age, as if they were identical twins (Figure 6). So we are seeing not only the generation of perfectly compatible organs, but also of identical organisms. This is obviously science fiction, but it does give raise to another ethical conflict: that of personal identity crisis, which is made clear in the film when Lincoln Seis-Eco meets his alter ego. Both are genetically and phenotypically alike, but their biographies are different and hence their ethical quality is also different.
Translation by the team of the Languages Service of the University of Salamanca.
Figure 1: Van Renssealer Potter (1911-2001)
Figure 2: Nineteen Eighty-Four (1984) by Michael Radford (American poster)
Figure 3: Coma (1978) by Michael Crichton (American poster)
Figure 4: Brave New World (1998) by Leslie Libman and Larry Williams (American poster)
© JJ Arce, 2009
Figure 5: Therapeutic human cloning
1.- Patient's somatic cell. 2.- Enucleated donor oocyte. 3.- Nuclear transfer. 4.- Embryonic stem cells. 5.- Different cell types. 6.- Immunologically compatible transplant
Figure 6: Complete human beings originated from human cloning