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Health, debt and death

Vivian David Jacob

DOI: https://doi.org/10.20529/IJME.2012.044


Repo Men. Producer: Scott Stuber. Director: Miguel Sapochnik. English, 111 minutes 2010.

A plethora of criticisms are frequently made of the commercialisation of healthcare and how it delivers people into debt due to high costs. A future where the healthcare industry is entirely commercialised is a dreaded situation. Repo Men is a movie themed to a similar future and is based on the novel "Repossession Mambo” by Eric Garcia.

The plot is set in the future (2025) where a private corporation named "The Union” provides artificial organs on credit. The artificial organs are marketed aggressively to people who require an organ transplant. However, prices are high, and interest rates on loans even higher, which makes it impossible for most customers to repay their dues. Once a borrower has defaulted on the monthly payment for a few months, "The Union” sends people called "repo men” to mercilessly cut open the defaulter and reclaim the organ, often resulting in the borrower’s death. These deaths do not lead to any legal issues whatsoever.

Remy and Jake are the lead characters in the movie. Both former soldiers, they are now best friends. They have joined "The Union” as "Repo men” and are the best in the business, callously cutting people open without the slightest emotion, except joy. Due to Remy’s wife’s disapproval of his job, he tries to switch his job profile which makes Jake jealous. Jake then sets up Remy with a faulty defibrillator which destroys Remy’s heart, and leaves him requiring an artificial heart from "The Union”. Remy soon realises that he is, now, one among the ‘the others’ who are unable to repay their debt to "The Union”. This makes him unable to perform his brutal repossession jobs. A battle ensues between him and Jake, delivering Remy into a coma after being knocked out with a hook and chain.

The final part of the movie shows Remy enjoying his time on a tropical beach, happy he has published his life-narrative, after destroying "The Union’s” headquarters with the help of Jake who has now switched sides. However, in reality, destroying "The Union’s” headquarters, publishing his life-narrative and the tropical island have all been fantasies induced by a neural-network-machine (artificial brain) on which Remy is sustained after Jake had knocked him out with the hook and chain, leading to brain damage. Jake had paid off Remy’s account and sponsored the neural-network-machine for the rest of his life, maintaining Remy in a ‘happy world’. The film ends with Frank (a top business official at " The Union”) pitching to sell artificial organs on a commercial, and Remy in his fantasy world of ‘living his dream’.

In the first part of the movie, the director has rendered an excellent interpretation of the ruthlessness of the corporate healthcare industry and the bargaining power it has in manipulating the regulatory bodies of healthcare. A futuristic portrayal of the corporate healthcare sector is vividly showcased throughout the movie. The second part of the movie speaks about how money, health and associations affect human behaviour and the way we perceive life and other people around us. The director makes a subtle attempt to capture how humans become empathetic and more ‘humane’ in weakness, and less so when in good health and power. This also contains an appeal to the audience to put ourselves ‘in the other’s’ shoes” which I believe is a fundamental way of conceptualising ethical practice. The final segment tries to visualise future developments in the neurosciences. However, the movie fails to bring out the ethical implications of neurological interventions and advancements while exploring other problematic areas of the future healthcare industry.

Finally, rather than speaking the dry and philosophical language of ethics, the director has done an excellent job of portraying various ethical issues arising in commercialised healthcare through the universal language of emotions. This makes the movie more appealing to a larger audience and not just to individuals interested in healthcare ethics, while still portraying the deeper issues involved.

About the Authors

Vivian Daivd Jacob ([email protected])

Junior Programme Officer

Centre for Studies in Ethics and Research, Dalkhania House, B-Wing, Vakola, Santacruz East, Mumbai 400 055

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