Medical ethics is the involvement andconcern of medical practitioners in all aspects and fields of medicine, particularly doctors, hospital, and health care providers of whom are compelled to give the best service to theirpatients and quality treatment surrounding the patients' personal feelings and concerns.[1] Upholding the dignity, honor and integrity of the profession , in providing a humanitarian service, financial gain being inferior to that of the service being provided.[1] Inclusive of medical ethics, is the upholding of good medical practice, the maintenance of medical records ,exposure of unethical conduct and evasion of legal restrictions  to name a few.  Medical ethics or the term medical ethics wasset up in 1803 by Thomas Percival [2]. Before then historians had noted that in ancient Egypt there was already a code to go buy for then healers to go by, and without a doubt this was expressed similarly in everyand each society then and there after. Despite varying beliefs, practices and common knowledge from different culture, the international medical society collectively decided on four major “pillars” of medical ethics. Those four being beneficence, non maleficence, autonomy, and justice.[3] 

　　Beneficence is the principle based on a doctoracting for the benefit of a patient, not simply avoiding harm but giving them the best feasible options, to leave the patient at some type of advantage whilst adhering to moral rules. Non maleficence a simple rule to not cause harm to the patient, not give unnecessary pain nor suffering allowing for the physician to scale the benefits and burdens of any treatment. Autonomy is based on a person's intrinsic worth, how they view themselves and their right to make their own choices about their health, body, and life without infringing on another person's autonomy or life and health. Justice regards the appropriate, equal, and fair treatment for persons of any social class and is multifaceted into many types of justice. Apart from the four major pillars there are also principles such as confidentiality, informed consent and truth telling.[3] With those principles and general background of medical ethics in mind, it navigated my choice in expressing my opinions about the 2023 Netflix movie” Paradise” introduced to my class, here at E-Da Medical University by our Life Sciences professor.

　　Paradise is a futuristic film where personshave found the ingenious yes scientifically plausible way of transferring one patient's life span or youth over to another. This is through means like blood transfusions where they need to be of similar blood group and HLA antigens. The movie revolves around a husband attempting to reclaim his wife’s years that they had put up for mortgage and she has lost forty years of her life leaving her unable to conceive, forcing a miscarriage and overall a drastic change in lifestyle and mental health creating a rift between the couple. The ploy behind the scenes is that rich persons are able to buy life spans from more impoverished classes, powerful persons create schemes in order to force persons to mortgage their life span and create a scenario In which the debt needs to be repaid as with the co stars. The owner of the company who created this procedure is of a specific blood type than only 1% of the world has, and the wife is the only match she has found in years. Due to this coincidence she creates an elaborate plan, having the family put her years up as collateral in the event they are unable to pay rent, burning down the building that they live in forcing them into a situation of debt , pulling strings to have the husband be able to attain that very same house which he in actuality cannot afford , all in order to “legally” get the years of life she so desperately needs to continue running her business and empire. In this brief synopsis alone many medical ethic principles can begin to be put on the forefront of students, physicians, and movie enthusiasts' alike opinions.

　　The theme of autonomy sparks questions aboutindividuals making decisions about their lives when put in dire circumstances such as financial debt and bankruptcy. Is it really autonomy if the persons only choice to continue living or serving in means selling part of their life? Is there really a choice to be made with them being forced in a corner with only one option or way out. Knowing the rules and loops of this created a visible gap in the medical ethic principle in the movie. Where despite wanting a longer, happier, or healthier life, persons without options must now put their life on sale to continue to live with what is left of it. Can a monetary value really be placed on someone’s life, and what would be the parameters for pricing if this theory were a reality in our day and age which leads into the second theme of justice.

　　Is it truly just for persons with more moneyto be allowed the privilege of buying more life while those with less do not have this advantage and are left with options of living a life of suffering or selling their own life span to achieve temporary riches as they are to be short lived. It also creates a cycle of rich buying from poor, the poor getting rich

at the cost of their life and then trying to by life back from someone less fortunate than them. This touches on the themes of social justice and inequality, recognition justice, interactional justice, and economic justice. When signing these contracts, for collateral or to simply sell your life span to make money to begin to live, makes someone question, does the donor really know what they are signing up for?

 　　Are donors really aware enough to beconsidered to have informed consent over signing over their lives to the company and does the company allow for full transparency to the donors giving them complete details as of to how this will affect their lives. Does it educate, and counsel them on both the benefits and disadvantages of it. Similar to life one can never tell what age and time will bring , and this donating of life means the speeding up of life on a singular individual , one cannot fully assess and analyze nor predict exactly the full extent to the age related impacts that would take place on a specific individuals body nor their mind. As seen in the movie losing her youth, forty years at once makes the co star spiral into a state of depression and reduced health with such an abrupt and intense manner.

　　The duality of the principles ofnon-maleficence, doing no harm along with beneficence, are the benefits of extending someone’s life at the extent of another worth it, and can it be justified if whether or not it is for the greater good. By reducing someone’s life span you put their life in direct jeopardy despite aging being a normal aspect of life, aging abruptly as with rusting quickly can be detrimental to human life as it is to steel or iron forcing both to the breaking point.  

　　In conclusion the movie “Paradise “ Boris Kunzand Peter Kocyla and directed by Boris Kunz is a beautiful display of the duality of medical ethics , that allows physicians and students like myself to really meditate deeply upon the repercussions of treating patients at the cost of another, the vast inequities that we must be aware of and multiple loops in the system of medical ethics that we must be able to navigate through to remain dignified and honorable physicians with all of our patients best practices at hand and heart. The movie highlights the possibilities of future advances in medicine and the fine print associated with growth and the principles of medical ethics.

*References

1. Markose, A., Krishnan, R., & Ramesh, M.(2016). Medical ethics. Journalof Pharmacy And Bioallied Sciences, 8(5),1. https://doi.org/10.4103/0975-7406.191934 

2. Baker R, McCullough L.What is the History of Medical Ethics? In: Baker RB, McCullough LB, eds. The Cambridge World History ofMedical Ethics. Cambridge University Press; 2008:1-15.

3. Varkey B. Principles ofClinical Ethics and Their Application to Practice. Med Princ Pract.2021;30(1):17-28. doi: 10.1159/000509119. Epub 2020 Jun 4. PMID: 32498071; PMCID: PMC7923912.

4. Kunz, B. (2023, July27). Paradise. IMDb.https://www.imdb.com/title/tt21308888/