国产传媒

Written by Acting Director of the Bioethics Certificate Program, Wanda Teays

What are the limits of individual liberty? The answer to that question has significant consequences when it comes to healthcare and is a major concern in Bioethics. The movie Million Dollar Baby¹ shows us just how powerful the issue can be.

After considerable reluctance and discouraging words to aspiring boxer Maggie Fitzgerald, Frankie Dunn agreed to be her trainer. It’s not going to be easy, given her age and greenhorn demeanor. But there’s something about her determination and her drive that pulls him in.

At the heart of personal autonomy is self-determination. Maggie demonstrates it in spades: She has made any number of sacrifices to train to be a boxer. Had she known what lay in store for her, perhaps she would have been deterred, but that seems unlikely.

We watch Maggie give it her best. She’s good, very good really and her determination underscores how serious she is about being a boxer. Slowly but surely she progresses and, finally, makes it to the championship fight. Her opponent is the best of the best, Billie the Bear. Unfortunately, the Bear fights dirty. When the umpire’s back is turned, she socks it to Maggie, causing her to fall and break her neck. Maggie is paralyzed, her spinal cord broken.

Like a hawk with broken wings, Maggie could not easily adapt to being a quadriplegic. Things go from bad to worse. She can’t eat, gets a feeding tube, and a respirator. In time come bedsores and blood clots in her legs. Getting her leg amputated came next: “They took my leg boss.” Maggie never once loses her dignity, never asks for pity, never ceases to be anything less than impressive in handling the adversity that shattered her boxing career and her life.

Both Frankie and Maggie grapple with what “quality of life” means when you no longer have the ability to act on your own free will. How far should individual autonomy extend? It’s not a simple question— but lies at the heart of Bioethics. Maggie’s sense of self is that of an athlete and what she now has is tragic beyond words. Frankie sees that and Maggie shows it. She’s had enough and wants Frankie to help end it all.

I can’t be like this, Frankie. Not after what I done. I’ve seen the world. People chanted my name. Well, not my name, some damn name you gave me, but they were chanting for me. I was in magazines. You think I ever dreamed that’d happen?…. Don’t let me lie here till I can’t hear those people chanting no more.

Frankie can’t do it. “Please don’t ask.” “I’m asking,” she replies. He can’t, he just can’t take her life. It’s as if a ton of bricks just landed on his shoulders. Sometimes people want something so bad they go to extremes, terrible, heart-breaking extremes. Her mind is made up—this is not the life she wants to lead.

Assisted suicide wasn’t on his list, but Frankie is moved by the situation. He understands that, but his integrity runs deep. As many would do if they were in his shoes, he seeks advice. Father Horvak tells him, “You step aside, Frankie. You leave her with God. … If you do this thing, you'll be lost. Somewhere so deep … you'll never find yourself again.“ The priest has good intentions. These intentions are widely supported by Deontological ethicists, including Catholic moral theologians, but they don’t negate the visceral impact of Maggie’s plight.

Frankie is mortified by what he sees. “Mercy killing” has credence in some quarters. Others would walk away, leaving Maggie to God’s hands, her life too sacred for any mortal to terminate. Others still would leave God out of the equation but feel a line would be crossed for assisting a suicide, however dreadful the circumstances. These are wrenching life and death issues. They lie at the core of moral reasoning.

Whatever Frankie does there are repercussions.The movie raises important questions. “What do I need in order to live my life as I see fit? How can I keep the flame alive? What would I do if I saw it flickering out? Is suicide ever okay? Do I have the right to ask someone else to help me die?”

The concepts of patient autonomy and self-determination are at the heart of this debate. Utilitarian John Stuart Mill is one with strong views on individual rights to liberty. He contends that not doing harm to others is the only justifiable restriction that should be placed on individual liberty. However, Mill does not think individual liberty should be without bounds. Certainly we can’t act freely if we are dead. And there’s another issue— namely, the moral permissibility of taking another person’s life or enabling a mercy killing.

Maggie faced choices. Frankie faced choices. And we are left to contemplate where the lines should be drawn.

¹ © 2023 Wanda Teays. Published in Seeing the Light: Exploring Ethics Through Movies by Wanda Teays.