Urban Bioethics: A Call for the Prestige

In the Christopher Nolan film, The Prestige, the opening monologue elaborates on the three elements of a successful magic trick—the pledge, the turn, and the prestige. The pledge is when the magician shows the audience something ordinary like a deck of card or an object. The turn is when the magician changes the object or makes it do something out of character, for example—disappear. The prestige is the last and most important element of the trick—making whatever disappeared, reappear. I will to use this format to illustrate the course that urban bioethics has taken in teaching hospitals and their respective medical schools, because the paths are very similar.

When we consider the format of The Prestige, the pledge was philanthropy. It was an ordinary and noble goal for hospitals when they were established. The turn is a change in purpose. Though the hospitals mentioned had a very clear and ordinary purpose, their purpose was altered through the avenues of disenfranchisement, accolades, and changes in healthcare. The prestige, however, is not here. The most important element—the element of reappearance—has not shown itself yet. To quote the film directly, “...But you wouldn’t clap yet. Because making something disappear isn’t enough; you have to bring it back.”2 Urban Bioethics is not a magic trick, but the sentiment seems to be similar. This is a call for the prestige.