as always, the below contains spoilers…
Bioshock provides an environment built around an objectivist society. The game explores how the high, well-organized ideas, presented so well by Andrew Ryan, fall apart. One of Ryan’s main concepts is that there should be no moral oversight on the works of great men. This starts to tear apart aspects of life that are generally considered highly ethical. Early in the game, the Medical Pavilion shows the player how far Rapture, Ryan’s city, has delved into depravity.
As you explore the area, you find three dental clinics, an insurance agency, a crematorium, and a cosmetic surgeons. No where is there a general practitioner’s, an emergency room, or the type of clinic you would expect to see. There is not a lot of effort made to heal people in Rapture. First Aid stations exist throughout the city, but these can be corrupted on an individual level. The player can hack the stations so that if anyone else tries to use them, they are poisoned, adding to the theme of corrupted medicine.
Rapture’s main medical area contains no emergency services. There is a banner stating “Altruism is the Source of All Wickedness” in this area:
This explains the lack of any sort of service for those in need of dire treatment. Helping someone, just for the sake of it, without them requesting it or offering compensation, is an act of evil by the morality present in Rapture. It would be wrong, in this place, to just help someone. A diary from Ryan states “People who want free healthcare or food are perverts in search of victims.” Traditional medicine, which contains an element of assisting those who need it for its own sake, no longer exists.
Part of this is due to ADAM, the substance developed to allow genetic modification throughout the city. ADAM replaces existing cells in a host with unstable stem cells. This can be used to grant some of the psychic powers throughout the game, and there is also some indication that it contains healing properties. The Little Sisters are nearly invulnerable to harm based on the ADAM injected into them, with the exception of the harvesting process, for example. Medicine was not needed in the same way, due to ADAM. In spite of the side effects, making splicers who used the substance mentally unstable and cosmetically deteriorating them, people chose this over traditional healthcare throughout the city. It should be noted that the main researchers behind ADAM were a Nazi collaborator and an opium dealer, providing insight into the ethics involved in even the most upstanding uses of ADAM.
Doctor Steinman is the driving force behind what was left of the Medical Pavillion. He felt that on the surface, he was held back by morality. He became obsessed with human ascetics, and is the main reason the majority of the Pavillion the player explores are for more cosmetic procedures. With ADAM’s ability to reshape people in his hands, Steinman’s obsession with beauty becomes extreme. He has the ability to change people entirely, and begins to experiment with non human appearances.
This obsession has literally driven Steinman mad, and left its dark mark throughout the area. He has written on the wall in blood “Adam denies us any excuse for not being beautiful”. He also writes “Aesthetics are a moral imperative.” This man is in charge of the medical section of the city, but he has no concern for healing. His only concern is curing what he perceives as imperfections. An audio journal in his surgery theatre records his work on one of his patients, where he decides that while she came in for a nose job, he feels a face lift is also necessary. His nurse is confused, and tries to stop Steinman, but the doctor continues to work, in spite of her screaming protests.
Steinman has lost his way as a doctor. He has also written on the walls, in blood “Above all, do no harm.” This is perhaps the most twisted perversion of the Hippocratic Oath, which all doctors swear. He has caused harm to create this message, but to his mind, only a lack of aesthetics is harmful. He cares about nothing but making people fit his version of beauty, which now allows for more than mere symmetry, as he looks at adding extra pieces, or removing them from people, using the power of ADAM.
The institution of medicine is completely destroyed in Rapture. Doctors who should be concerned with healing their fellow man are now injuring them under a misguided sense of beauty. Healing is no longer a human endeavour, as it is all done by ADAM and first aid stations that inject it. Medicine has no more place in Rapture.
Next time we’ll take a look at smugglers and relgion