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March 04, 2005

Million Dollar Baby

Elizabeth Anderson: March 4, 2005

Warning: This post reveals the ending to the Academy Award winning film Million Dollar Baby below the fold.  If you have not seen the movie and plan to do so, do not read further, as knowing the ending might spoil the experience of viewing it for the first time.

So, the Academy Awards ceremony has once again piled top honors (best picture, best director, best actress, best supporting actor) on a sentimental favorite, Million Dollar Baby, slighting the far superior Aviator, which only managed to bag awards for technical merit.  Million Dollar Baby did have one great merit: its exploration of a father-surrogate daughter love relationship, an unusual focus that thankfully avoided the trite alternative of turning the boxer/trainer relationship into a romantic one.  But other aspects of the film are a mess.  Clint Eastwood, playing boxing trainer Frankie Dunn, resists putting his successful boxers in the ring for championship fights, out of gnawing guilt over the fact that the last time he had a contender, his boxer was blinded in one eye and reduced to working as a janitor in Frankie's gym.  Never mind that his janitor has no regrets and was glad to have had the chance to contend for the championship, which makes Frankie's guilt seem out of place.  What is Frankie doing training boxers if he thinks the risks are not worth it?   Why put one's boxers in pre-championship fights, where they also risk grave injury without even the chance of winning the championship?  Frankie is a troubled soul who attends Catholic mass nearly every day, apparantly to contend with his guilty estrangement from his daughter, who has refused to see him for years, and who returns all his letters unopened.  (One wonders what awful thing he did to prompt such an extreme, unforgiving reaction from her.  The film can't say, because it would either have to reveal Frankie as an unsympathetic ogre, or the daughter as grossly overreacting, which would make Frankie's guilt less compelling.) Yet, instead of coming clean with his priest over his past, he spends his time debating theology with him, baiting him over apparant metaphysical contradictions in orthodoxy.  Catholics may well be offended by the film's flip treatment of some fundamental questions in Catholic theology. I worry more about the moral incoherence of Frankie's behavior.  Engaging in abstruse metaphysical debates is no way to deal with profound estrangement from one's daughter.  And if one is so obsessed with logical incoherence at the core of Catholic theology, why trust the church to offer sound moral guidance?  Moral incoherence pervades this film, not least in the ending, which flatters liberal sentiments on a critical issue that deserves a more searching and serious treatment.

The end of Million Dollar Baby amounts to a brief for the cause of euthanasia.  Frankie's boxer and surrogate daughter Maggie becames quadriplegic after being sucker punched in her championship fight.  Hopelessly confined to bed, Maggie wants to die before memories of her glory days fade.  Distraught over the prospect of losing her, but determined to respect her wishes, notwithstanding his priest's warning that his soul will be lost if he does so, Frankie does the "right" thing by killing her with an injection of adrenaline.

The film indulges a prejudice: that the lives of quadriplegics are so hopeless that one needn't expend much effort inspiring them to want to continue living.  (Frankie's weak efforts to persuade Maggie to take college classes collapse immediately upon confronting her resistance to the idea.)  The disabled members of Not Dead Yet beg to disagree.

Too see what's wrong with the film's treatment of euthanasia, it helps to consider a real story.  My husband is a physician who once treated a quadriplegic patient.  After the accident that caused his paralysis, this patient wanted to die, very badly.  But he was physically incapable of doing so, and no one would assist him in committing suicide.  He was in rehabilitation for a very long time, working doggedly to restore movement to a single finger.  After an extraordinary struggle extended over many months, he succeeded.  He told my husband that the only thing that kept him going during this time was the thought that, if he could just move his trigger finger, he would be able to shoot himself.  Only a funny thing happened once he got this minute bit of movement back:  he didn't want to kill himself anymore.  He saw hope in his life, a different point to all that struggle.

I'm not claiming that every quadriplegic would feel this way.  But this patient's story repeats a common pattern among people who have suddenly lost major physical capacities in an accident, but still retain enough mental functioning to reflect on their lives:  after a period of despair, they eventually return to their prior level of happiness, notwithstanding their disability.  There is also a common pattern among suicidal people in general, that the wish to die is temporary.  One follow-up study of suicidal people rescued from the Golden Gate Bridge moments before they took the plunge found nearly all of them alive and wanting to continue living.

I'm not claiming that euthanasia is categorically wrong in all cases.  In this, I differ from Not Dead Yet.  I would want to be unhooked from a respirator and thereby allowed to die if I were in a permanent coma.  Being stuck in a coma is no way to live.

I am saying this:  respect for the gravely disabled requires that we not accept their immediate post-accident state of mind as final.  Respect requires that we give their lives a chance, that we work hard to inspire them to want to keep living, that we give them reasons for living.  Respecting a person's wishes at a time is not always the same as respecting the person, who is a being with a life extended over time.  It can take a very long time to find the person behind the despair.


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Posted by: Stephen M (Ethesis)

There is also a common pattern among suicidal people in general, that the wish to die is temporary.

That is the core fact that has always given me a great deal of pause over suicide support. Combined with the "help" that many get in Europe (I put help in quotes since many of those being helped resist the aid), I'm bothered.

This is an excellent post.

Posted by: Stephen M (Ethesis) | Mar 4, 2005 8:17:01 AM

Posted by: D.A. Ridgely

Or one might reasonably conclude the film just tells a story in which, rather like real life, people make decisions which are neither clearly right or wrong, or at least we can't be sure from the information available.

In any case, assisted-suicide was clearly the theme this year in La-La-Land. Speaking of which, Best Oscars Wrap-up Comment of 2005 goes to Jesse Walker at ReasonOnline for the following:

"Best Picture went to Million Dollar Baby, an assisted-suicide movie. Best Foreign Film went to The Sea Inside, an assisted-suicide movie. Conservatives are upset that there were no awards for The Passion of the Christ, their own assisted-suicide movie."

Posted by: D.A. Ridgely | Mar 4, 2005 8:39:38 AM

Posted by: Bill Gardner

Thanks for the thoughtful post.

I responded differently to the film. I did not understand the end of the movie as a brief for euthanasia. I didn't think the movie was a brief for anything. The priest's views were, I thought, presented just as sympathetically as Frankie's eventual choice. Frankie was an intelligent, ordinary, and unlearned character faced with bad options defined by inadequate institutions and circumstances created by his prior bad choices. That texture of real life -- that one can be required to make a moral choice even when one sees no satisfactory option and the choice's consequences will be destructive to self and others -- is what I thought the film captured beautifully. In the end, like William Munny, Frankie has to vanish. (Was _Unforgiven_ a brief for revenge killing?) Frankie is morally incoherent. I am too -- and sometimes practical bioethical choices can end in these terrible corners, despite the best intentions of all parties.

Viewing your post as a brief for a particular view on euthanasia, I was impressed with your statement of the meaning of respect for persons and your observation that the wish to die may be inconstant. There is a great deal of psychological evidence for your point that, over time, people adapt to circumstances and recover their sense of well-being. Therefore, I would bet that you and I would agree about euthanasia -- I hope that in the future you spell our your views further.

I just disagree about the movie. Even the best bioethical policy is going to work out badly sometimes. The will to die is inconstant -- Yes, and so is the will to live. Consider the harrowing climax of _Outerbridge_Reach_, in which the protagonist finds that both his wish to die and his epiphany that he wants to live are inauthentic.

Posted by: Bill Gardner | Mar 4, 2005 8:57:26 AM

Posted by: john t

Frankie apparently doesn't have the internal wherewithall to reconcile the perceived wrongs in his life with his own better angels,a failure to understand himself,as is said in other circumstances,for better or for worse,as such he is immobilized. "What is Frankie doing training boxers"etc. Because he loves the game. Having worked in a professional boxing gym I understand the feeling. Climbing into the ring is the ultimate challenge,not like waiting under the basket for a teammate to throw you a pass. There's just you and the other guy. I don't have time,and nobody has the interest,to describe the rest of it but it sticks with you for life. As to his relationship with his daughter,a smart dramitic move,not revealing the causes. Oscar Wilde did just that in The Picture of Dorian Gray. You are left to wonder at the sins or perversions of the protagonist and are therfore hooked so to speak. As to assisted suicide,in the age BK,before Kervorkian, I wonder what anguished love ones,or doctors for that matter,did in hopeless situations,there being such as part of our human condition thru the ages. The age of media has shined it's too bright light of ignorance and shallowness on a act that perhaps would have been better left alone. That probably explains part of the reaction to the movie. Can hope see us thru,a terrible and heart rendering question and one I can only answer for myself.

Posted by: john t | Mar 4, 2005 9:21:28 AM

Posted by: No Labels Please

It wouldn't be much of a movie just to show her day-to-day struggles after being hurt, would it? Or at least it wouldn't be the same movie.

I don't really see how the movie is taking a position on euthanasia at all - it's telling a story.

Should people have a right to end their own lives - obviously yes. Others have the right to try to dissuade them and not to help, but that's it. The state has no role interfering here.

Quite interesting that the argument given here to support state [i assume?] intervention...

"Respecting a person's wishes at a time is not always the same as respecting the person, who is a being with a life extended over time."

...sounds familiar to a similar case that could be made *against* abortion rights, no?

Posted by: No Labels Please | Mar 4, 2005 10:34:05 AM

Posted by: LPFabulous

I had no idea you were a movie person. I want to hear more about The Aviator!

Posted by: LPFabulous | Mar 4, 2005 11:14:59 AM

Posted by: Robert Gressis

I agree with Anderson about Million Dollar Baby. I felt morally outraged by the film, because the film advances the view that "the lives of quadriplegics are so hopeless that one needn't expend much effort inspiring them to want to continue living." This is clearly the movie's view. For one thing, near the beginning of the movie, when Maggie is trying to convince Frankie to train her, she points out that if she can't box, she has nothing else in her life (because she's thirty-one, still a waitress, has little income, and has a crappy family). Her family--for a movie that's supposedly so sensitive to moral complexity--is a ridiculous caricature of real human beings, and when they show up later in the movie, they cement in the viewer's mind that Maggie really has very little to live for. Moreover, Maggie tells the story of her crippled dog, which her family laughed at (as they later laughed at her), and which, because its life was so hard, her father put down. Furthermore, and frighteningly, there's a speech by Morgan Freeman's character to the effect that, "Maggie got to do what she loved; how many people who are janitors or cleaning ladies get to say that?"; in the context of the movie, "Maggie got to do something wonderfully well, she can't do it anymore, so it's okay that she die." Finally, there is Maggie's preternatural prowess at boxing. Let me just say, as someone who is a boxing fan, that nobody I've ever seen--not Prince Naseem Hamed, not Mike Tyson--knocks out people as quickly and reliably as Maggie. The movie presented Maggie's boxing skill in this tremendously unrealistic way because it wanted to highlight just how much had been lost when Maggie became a quadriplegic. To sum up: the movie, without question, presents the view that boxing (and Frankie) are the only good things in Maggie's life, and that without boxing, she has nothing to live for. More starkly: the worth of a person's life depends on how good they are at what they most enjoy. If they're no longer good at what they most enjoy, then their lives have no worth anymore.

This is not to say that I disagree with Maggie's decision. I have no idea what I would want if I were a quadriplegic, and I can imagine wanting to die. But I strongly disagree with the reasons for Maggie's decision, and I was repulsed by the movie's unquestioning endorsement of those reasons.

Posted by: Robert Gressis | Mar 4, 2005 11:50:21 AM

Posted by: Tad Brennan

"Should people have a right to end their own lives - obviously yes. Others have the right to try to dissuade them and not to help, but that's it. The state has no role interfering here."

Can it be this simple, even for a libertarian? The state surely has a role in preventing murders, and so it has a role in making sure that murders do not happen under cover of assisted suicide. Maybe that means that after a variety of vetting processes--waiting periods, multiple witnesses, etc. as in Oregon--the state should then back out. But I don't see how the state can avoid *all* involvement and still uphold even its minimal duties to protect the weak from predation.

(To clarify: I'm not taking a stance pro or con assisted suicide, or pro or con this movie. I'm just suggesting that the anti-state formulation I quote looks too simplistic.)

Posted by: Tad Brennan | Mar 4, 2005 1:39:26 PM

Posted by: David

I am saying this:  respect for the gravely disabled requires that we not accept their immediate post-accident state of mind as final.  Respect requires that we give their lives a chance, that we work hard to inspire them to want to keep living, that we give them reasons for living.  Respecting a person's wishes at a time is not always the same as respecting the person, who is a being with a life extended over time.  It can take a very long time to find the person behind the despair.

However, in the film she did have a lot of time to reconsider her view. The Clint Eastwood character did try to change her outlook and had a substantial amount of time to do so.

The patient is a former athlete who is not only a quadriplegic, but on a permanent respirator and without her two legs, thanks to gangrene. The doctors also have to force-feed her, because of her preference to starve to death.

Don't you think that by the time she bit her tongue in an attempt at suicide, she had made her wish clear and final, after a sufficient amount of time to think about it? The only way she was prevented from committing suicide was by being doped up (which practically put her in a comatose state).

Although I agree with some of your criticisms of the Eastwood character and the place of Catholicism in the film, I found the ending quite reasonable. Whatever one's opinion of euthanasia, I found it appropriate to the story in light of what we know about the characters.

Posted by: David | Mar 4, 2005 2:44:45 PM

Posted by: Chris Dodsworth

Liz points out that "Catholics may well be offended by the film's flip treatment of some fundamental questions in Catholic theology." The "fundamental questions" she has in mind here are metaphysical ones, such as the nature of the Trinity. This would be worrisome, if the on-screen discussion of the issues actually rose to the level of treating them, but it doesn't even do that. When Frankie voices confusion about the Trinity - how can there be three persons in one God - the priest's response is pathetic, to be sure, but not horrible. In the end, the priest effectively tells Frankie to stop asking such questions. Since, as Liz accurately points out, Frankie is just avoiding his moral issues altogether, the response the priest gives is the right one. The priest could have been a more caring figure, but if we imagine that Frankie has been pulling such stunts for a long time, it's understandable that the priest would have little patience for such questions.

Much more troubling is the film's treatment of Catholic *moral* theology - specifically, the fact that it simply gets it wrong. The priest warns Frankie that his "soul will be lost" (here I'm just quoting Liz) if he kills Maggie. If the priest means that Frankie will go to hell (that's the only thing that I think he can mean), then he's just wrong; the Catholic Church has never affirmed that anyone has gone to hell - not even Judas. It has, instead, constantly affirmed that we cannot fathom God's mercy and love for us. The film also severely misrepresents the Catholic Church's position on end-of-life issues. It is true that the Church categorically opposes euthanasia; however, it does not teach that extraordinary means must be taken to keep someone alive. (Those of you who are squeemish about too many moral distinctions, stop reading here.) This means that while it's not moral to kill Maggie, it isn't immoral to disconnect her from the respirator and let her die naturally, if that's what she wants. (There are some other caveats which I'm ignoring here.) Furthermore, theologians argue that injecting her with, e.g, morphine, to ease the dying process is also acceptable, so long as the purpose of the morphine is to ease pain and not directly to kill her. (This is the principle of "double-effect".) As I understand the film, Frankie injects Maggie with adrenaline in order to kill her directly, so he does run afoul of this last principle. To that extent, the priest is right in telling Frankie that what he will do is wrong. My point, however, is that there is an important distinction in play here, one that the film ignores. In so doing, it misrepresents Church teaching.

All that said, I agree with Liz's central point. It might be morally licit to disconnect Maggie from the respirator, but any such action should surely be proceeded by some serious reflection. Liz is exactly right when she says that "respecting a person's wishes at a time is not always the same as respecting the person, who is a being with a life extended over time."

Posted by: Chris Dodsworth | Mar 4, 2005 3:16:01 PM

Posted by: Alan Hoch

I think you are making a mistake by jumping to the shaky conclusion that the movie is promoting euthanasia. Doing so recasts the film as a piece of propaganda, but clearly that is not the case -- if MDB wanted to be a true "brief for the cause of euthanasia" then it could have done a much better job. It could, for example, have made both Frankie and Maggie fierce opponents of euthanasia who when faced with the latter's sudden disability switch gears and admit they were wrong. Now, that would have been propaganda.

Instead, we see a movie that just states that >in this case< for >this person< she chose euthanasia. This plot point flows naturally from what we know of the characters. It doesn't suggest she made the right choice, just that she made >a< choice.

When we automatically impose our own personal morality on a film all we do is remove its power to help us better understand who and what we are. In fact, such an imposition suggests a psychological defensive reaction. Instead of dealing with the questions the movie raises we just casually dismiss it as being either for or against our own beliefs. Such black and white thinking is a dangerous trap for it suggests that anything we disagree with is automatically immoral and evil.

One of the ways that a movie touches us is by >frustrating< our expectations. By attempting to recast MDB as little more than a piece of propaganda you are in effect suggesting that a movie should never offer up a version of reality you dislike. Yet, if we are never willing to have our assumptions questioned let alone challenged how can we ever hope to grow or to know when our own beliefs are lacking?

To my mind a better response would be to respect the movie's power and use it as a launching point to make the case that Maggie's decision was the wrong one. Instead of seeing MDB as part of the problem see it as a convenient means toward greater understanding.

Posted by: Alan Hoch | Mar 4, 2005 4:01:04 PM

Posted by: No Labels Please

This is an instructive real-world example of why the interventionist thinking in this post [however well intentioned], is counter-productive:


Posted by: No Labels Please | Mar 4, 2005 4:06:28 PM

Posted by: mpowell

Just a small note: When I watched the film, it seemed to me that a significant amount of time passed w/ Maggie as a parapalegic. Some people seem to have a different take. Those people who think the argument that the desire to die is inconstant is relevant here: do you feel that not very much time passed in the film, or that a few months of time would not be enough?

Posted by: mpowell | Mar 4, 2005 4:36:37 PM

Posted by: freelunch

The film indulges a prejudice: that the lives of quadriplegics are so hopeless that one needn't expend much effort inspiring them to want to continue living. (Frankie's weak efforts to persuade Maggie to take college classes collapse immediately upon confronting her resistance to the idea.)

Sorry, I didn't take that away from the movie at all. Maggie wanted to die. After an apparently long battle in his soul, Frankie finally breaks down and does what he is asked to do, just as she has managed to get him to do every other thing that he didn't think was right to do. This isn't about a moral coherence. Frankie is not a deep thinker and his morality is a bunch of unexamined prejudices cobbled together. He's not a nice guy, but he's not an evil guy, either.

Unlike Maggie's family, Frankie actually cares about her. Yes, he may have made a decision that he will regret or that Maggie might have changed her mind on later, but he did it because he cared about her in his own imperfect way. While I cannot imagine the circumstances under which I would commit suicide, I understand that I have that capability and, in a very free will sense, the right to do so. Maggie had no such capability. Does that mean that the least among us must be made to suffer further than those who are well?

I do not support euthanasia laws. I cannot imagine assisting at a suicide, but I do not think that my opinion about how I should live my life automatically makes it possible for me to impose it on others. I didn't see such an attitude in the movie, either.

Posted by: freelunch | Mar 4, 2005 4:55:22 PM

Posted by: Dennis Whitcomb

Nice post.

...Respecting a person's wishes at a time is not always the same as respecting the person, who is a being with a life extended over time.

This position may get into trouble in cases where injured people do not immediately want to be killed but in which we know that later in life they will want to be killed. Suppose that

1. Someone gets injured at time t, and is in a small amount of pain,

2. At t we know that this pain will get worse over the next few weeks and then kill the person,

3. At t the person does not want to be killed, and

4. At t we know that if we do not kill the person at t, then at t + 1 week, she will wish that we had killed her at t.

If future wishes to not have now been killed count, then future wishes to have now been killed should count as well. Thus the "respect requires respect for a life extended over time" principle entails that in the foregoing case we are permitted to perform an active involuntary euthanasia (or maybe an active euthanasia that is "involuntary-at-t", or something like that). This seems problematic. No?

Posted by: Dennis Whitcomb | Mar 4, 2005 8:02:06 PM

Posted by: Heidi


Not really. Killing is irreversible in a way that letting them live isn't.

Posted by: Heidi | Mar 4, 2005 10:53:31 PM

Posted by: Aaron S.

1. why assume that there is a moral lesson to be had? Perhaps the film was merely showing that these sorts of situations are difficult, and, therefore, should all the more be considered on a case by case basis.

2. and if one insists on drawing a moral lesson from the film, why generalize the story of Maggie-the-boxer to the lives of other quadriplegics?

Posted by: Aaron S. | Mar 5, 2005 1:13:34 AM

Posted by: David

First, about the "killing is irriversible", so is eating an icecream. Any action is irriversible, since we can't go back to a world in which we have not committed such action. Second, I entirely disagree with the take of the post, although I have not watched the film.
I don't think that tetraplegic people can't have fulfilled lives, but neither do I think that all of them do. Personally, if I want to kill myself, and I am sound of mind (there's a lot of misinformation about suicidal people being insane or otherwise unsound of mind) it is entirely my prerrogative. If I can't, for reasons of logistics (such as having no ability to move) I would expect a good friend of mine to help me. Yes, I would understand my friend arguing the issue with me, and making sure that my decision is firm and properly thought through, but at some point it comes the time to make a decision, and that decision is either to respect the will of the person in question as a free agent, or to instead consider that one knows better, and they'll be happy in due course...

Contrast with The Sea Inside, which is in my view a much stronger apology of Euthanasia, with which I fully agree.

Posted by: David | Mar 5, 2005 2:47:31 AM

Posted by: john t

If suicide is permissible,and to the actor it is,then it is a small step to assisted suicide. I've always been sympathetic to the stoic view of suicide,that it is an act of freedom,certainly the last and ultimate act of freedom. But I'm not planning anything right now.

Posted by: john t | Mar 5, 2005 9:09:33 AM

Posted by: D.A. Ridgely

Sung to the tune of... oh, hell, you know ...

I am just a poor girl though my story’s often filmed
I have squandered my resilience
For a bag of bigger purses, such are movie tropes,
The same old lies, still with Clint behind the camera
I might get that Oscar prize... La, La, La, La, La-La Land...

When I left my white trash family I was pushing thirty-two
In the company of agents,
On location and in back-lot stages, training hard,
Punching through, working with the grizzled cowboy,
And his old Malpaso crew,
Still I’m wondering what Sly Stallone would do.

Asking only for ten million, I come looking for a for a part
But I get no offers
Until “Rocky” crossed with “Love Story” hits my desk
Don’t ask me why when I finally get my title shot,
In the last scene I must die...
(“Cause the grosses go up when the viewers cry.”)

Now I’m lying in a hospital and wishing I was gone,
Checking out... where my Jerry Springer family isn’t robbing me
Sobbing, “Gee, Boss, help me die!”

In the hospice lies a boxer and a fighter in her role
And she carries the reminders
Of ever doc who cut her up or drugged her till she mumbled
In her stupor and her pain, “Help me leave here, help me leave here,
Cause this flick has got to end...”

Posted by: D.A. Ridgely | Mar 5, 2005 10:09:28 AM

Posted by: john t

D A Ridgely There is this thing called meter,you should try it sometime. Then again given the impoverished state of poetry today you may have just printed a masterpiece. If so will you autograph your first volume for me?

Posted by: john t | Mar 5, 2005 10:42:01 AM

Posted by: D.A. Ridgely

John T, you'll have to take that up with Paul Simon. I may not know anapestic tetrameter from a garden hose, but I know when lyrics fit the original melody, my obvious status as a poetaster, aside.

Posted by: D.A. Ridgely | Mar 5, 2005 11:02:36 AM

Posted by: john t

DAR,my mistake, oh hell I didn't know.

Posted by: john t | Mar 5, 2005 11:43:41 AM

Posted by: Dennis Whitcomb


I'm with David in failing to see what is irreversible about killing but not irreversible about letting live.

Suppose I say "A week ago you knew how much pain I'd be in now, and still you let me live. You bastard!" You can no better remove my grounds for making that complaint (= the fact that you let me live), than you could remove the grounds of posthumous complaints about having killed me (= the fact that you killed me). Neither act can be reversed.

Posted by: Dennis Whitcomb | Mar 5, 2005 12:47:22 PM

Posted by: Alyssa P

I just saw the movie last night. I have to disagree with Rob Gressis about at least one thing: I don't think that the message of the film is that if you're not good at what you love, life isn't worth living. Maggie was clearly enjoying life even before she got good at boxing, and the pity-object character whom Morgan Freeman finally picks up as a trainee at the end is also clearly enjoying life even though he stinks at boxing. (We are invited to see him as misguided during most of the film, but by the end his eternal optimism is supposed to be hopeful-seeming).

I did find myself terribly distracted from the gut-wrenching narrative by my (as it turns out, only partly founded) belief that because she is a mentally sound adult, Maggie ought to have the right to terminate her treatment, including the ventilator, as she so chooses. There was a part of me crying out for some filmic explanation for why Clint Eastwood had to do the assisting when this was so. My ethicist friend Dave explained to me afterwards that it is not always quite so easy (though, he thinks, moving more in the direction of respecting the autonomy of mentally sound adults who have this desire).

The film left out a lot of things I'd like to see happen in real life: not just her opportunity to refuse treatment, but the presence of some kind of mental health counseling and occupational therapy that might have given her some more reasonable expectations about what she could do next. In real life, if an adult has gotten access to those resources and still prefers to refuse treatment (and thereby die), I think she's entitled. (Just to be clear: I don't think adults are NOT entitled if they don't have access to those resources, but I do feel a lot more squeamish about it under those circumstances.)

(I think the film also highlighted, perhaps inadvertently, exactly how much someone in Maggie's situation is dependent on family labor to keep life going. If you're Christopher Reeve, and your wife is world-renowned for her patient and supportive nature, you can keep working and being productive. If your mother is a selfish welfare cheat, you're pretty much out of luck. In real life, as opposed to film life, this strikes me as an inequity that could be addressed, if not resolved, with better social policy.)

I also have to disagree with Chris Dodsworth about how clear or reasonable the doctrine of "double effect" actually is, as played out in real life. Five years ago, my grandfather, who was incapacitated by a combination of Parkinson's and macular degeneration, developed pneumonia while in a nursing home. His physicians felt that his chances of a good quality of life if treatment for the pneumonia were successful were low. They recommended putting him into hospice. The entire time he was in hospice, he was unconscious. The hospice physicians, together with my family, regarded any expression (facial, vocal, etc.) he made while in hospice as evidence of suffering, and treated him with morphine. Eventually he stopped breathing and died.

You could say that the morphine had a "double effect"--it relieved his pain, but it had the subsidiary impact of causing his death. But the interpretation of signs of pain in someone who is nearly comatose is not nearly as strightforward as we'd like it to be. Is making noise itself a sign of pain? Does it depend on the quality of the noise? Should the health care provider be recording the noise in order to produce it as evidence when some right-to-life fanatic steps in and tries to argue that the health care being provided is tantamount to murder?

Certainly, there was never an explicit conversation in which my grandfather's health care providers and my family members said: "We're going to kill him by administering morphine whenever he makes noise." But in essence, that is what happened (and frankly, given how miserable an unmedicated death from pneumonia might have been, I think they were right to do it). Is this "double effect"? I think it's in a big gray area between double effect and actual euthanasia. I think that gray area is a lot bigger than the Church's teachings about "double effect" admit of it being.

Posted by: Alyssa P | Mar 5, 2005 2:56:22 PM

Posted by: Abe Delnore

Liz, unfortunately you've put words into the mouth of the priest character.

After Frankie has told the priest that he is thinking about, in effect, killing Maggie as she has been begging him to do, the priest says to Frankie to forget heaven and hell, if he does this thing, he will be lost. He can't be talking about anyone's soul being damned, since he's already disclaimed that. Rather, he seems to mean that if Frankie does this, he will turn into a very different person and not be able to continue his life as it was. This turns out to be absolutely correct: Frankie never goes back to his gym, never sees his friends again, and apparently gives up trying to contact his daughter.

So I don't think this film is nearly as anti-clerical as you imply, or that it is some sort of liberal tract on euthanasia. Frankie does a terrible thing that alters him completely. The priest warns him of the cost, but acknowledges that he cannot control Frankie's actions. Indeed I think the priest is portrayed as a good pastor. He doesn't let Frankie's theological jabs rile him up, but does recognize Frankie's spiritual crisis and provides sensible advice when called upon.

I think the film leaves it an open question whether Frankie should have taken that advice.

--Abe Delnore

Posted by: Abe Delnore | Mar 7, 2005 3:26:32 PM

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