Review
Assisted dying
Death & life
Film & TV
5 min read

The dying decision: choice, coercion and community

A Japanese drama about medical assistance in dying, Plan 75, reveals a lot about our relationlessness.

Sian Brookes is studying for a Doctorate at Aberdeen University. Her research focuses on developing a theological understanding of old age. She studied English and Theology at Cambridge University.

In a retirement home, a older person sings karaoke while the person behind waves a hand.
Chieko Baishô plays Michi.
Happinet.

“Being able to choose when my life will end provided me with peace of mind. With no feelings of doubt. She led a good life on her terms, people will say”.  

In Chie Hayakawa’s 2023 dystopian drama Plan 75, these are the words of a silver-haired, wrinkled woman in a promotional video for the eponymous plan – a government scheme which offers all over 75-year-olds the option of a pain-free death at the time of their choosing.  

And yet for Michi, an older lady toying with the decisions around Plan 75 it doesn’t really feel like it is her choice which matters at all. Whether it is the $1,000 grant offered as an incentive to die, the luxury amenities on offer at the Plan 75 facility promoted in leaflets and magazines, or the young person employed to gently guide the candidates towards their death (but whose real job it is to make sure they follow through with it), this is a world which has a clear agenda – to rid society of older people. Indeed, it is clear that this is a vision of a world which believes it is better for old people to die than to put financial burdens on the economy or their families, and this is a culture willing to subtly coerce individuals to accept and act on that belief.  

Plan 75 reveals an interesting point at the heart of the MAID (Medical Assistance in Dying) debate. One of the primary reasons that MAID is so attractive is the ability to take back control of one’s life and death, yet what happens when that seeming control isn’t really within the individual’s own control at all? For Plan 75, what is marketed as giving control back to older people, is really just a twist on a more sinister political policy to pressure individuals to sacrifice their “burdensome” lives for the greater good. Of course, this is a common argument for rejection of assisted suicide. This is the dangerous ‘slippery slope’, where MAID begins as an option only for those who desperately need it to relieve intense physical suffering. Yet it quickly becomes a tool to remove people whose lives no longer seem worth living due to societal expectations and opinions, rather than any objective reality.  

Do we ever truly choose to die totally independent of the expectations of those around us? 

For many, this problem can be appeased through strict legal controls over MAID – as long as the powers that be are regulated, MAID is still OK. As long as it is the individual who maintains control over their own death (and not the state), the goal of personal autonomy is maintained and all is well. And yet this perspective fails to ask the question - is such control over our own death ever actually possible? Do we ever truly choose to die totally independent of the expectations of those around us? In a world which places so little value on old age, can older people really make choices unaffected by that (deeply flawed and inhumane) logic? And, indeed - the elephant in the room – no matter how much we try to control death, in the end is it not death that ultimately controls us? As fundamentally finite beings we can never escape it completely – it will always find us one way or another. Ultimately, we will all have to face the reality of death when it comes to us. Complete control and autonomy are never truly possible. 

In light of this unveiling, the possibility that complete choice and autonomy around death isn’t really an attainable goal, what better options might we pursue? 

Where previously we would find comfort and hope in being loved, known and held by others in our death, now all too often this isn’t the case. 

One thing is clear in Plan 75, the isolation and loneliness of older people in a society that has rejected them is deeply problematic. The movie primarily follows the stories of Michi, who lives alone with no family and Yukio Okabe, an older man totally estranged from his remaining family. Both face life, and are facing death, alone. We live in a world where increasingly we are forced to face death alone. When our final days and hours rarely happen in the family home, surrounded by our loved ones, but in faceless institutions devoid of lifelong meaningful relationship the sense that we are no longer doing death together as a society is acute. Where previously we would find comfort and hope in being loved, known and held by others in our death, now all too often this isn’t the case.  

At the same time, there is no doubt that our modern world is unceasingly committed to the ideal of individual personal agency and autonomy – “She led a good life on her terms”. As a myriad of philosophers and theologians have commented, belief in human autonomy has come to replace belief in God. And MAID is one area which reveals this to be the case most acutely. Where previously we would turn to God to find comfort in the face of our finitude, instead now we turn to ourselves – the last hope we find in the face of death is our individual ability to control it.   

Death and health should be a corporate phenomenon – when one person is ill, all of society is ill. 

The German theologian Eberhard Jüngel described death in this broken world as “the occurrence of complete relationlessness”. In fact, Jüngel suggests that as human beings we are first and foremost made up of our relationships – we are truly human not by how we self-define in isolation but how we relate – how we relate to the God who made us, and how we relate to other people. This need for relationship is found most acutely in the face of death. As Ashley Moyse points out in his book, Resourcing Hope for Ageing & Dying in a Broken World, death and health should be a corporate phenomenon – when one person is ill, all of society is ill. And so, as death increasingly becomes the journey of the individual – when we face death in isolation from others and in isolation from God no wonder we feel such a strong desire towards control, towards ending our lives prematurely, towards science to help us avoid any more pain than we can bear alone. 

In Plan 75 we see glimmers of hope in the possibility of relationship. As Michi and Yukio find rare moments of human connection with a long-lost nephew, with a young person working for Plan 75, with another older person going through the same questions around mortality you can’t help but feel deeply uncomfortable with their choice to apply for the scheme. It is in the hints of love, physical touch, smiles exchanged, even a simple conversation shared between two people that suddenly MAID seems so disconnected with the hope that life still has to offer through relationship. Perhaps if we could imagine a world where death became no longer an occurrence of complete relationlessness, but a locus for relational dependence, for familial connection, for leaning on God and not ourselves, the need for MAID would feel a little less necessary. It would be a world with a little more hope. 

Review
Culture
Film & TV
Mental Health
Trauma
5 min read

The battle between seen and unseen pain

Jesse Eisenberg explores how the generations cope with pain.

Krish is a social entrepreneur partnering across civil society, faith communities, government and philanthropy. He founded The Sanctuary Foundation.

Two male cousins converse across the aisle of a train.
Kieran Culkin and Jesse Eisenberg.

In today’s ultra-developed world, where technological and medical advances have reached unprecedented heights, suffering remains an unsolved problem. While the World Health Organization claims the successful prevention, elimination, or treatment of more diseases than ever before, it also highlights significant increases in anxiety, depression, and stress-related disorders worldwide. This paradox raises questions not only about the root causes of mental health suffering but also about the way we understand its current prevalence and impact. Are today’s struggles any different to those others have experienced before us? Is the pain equally real? As we approach the eightieth anniversary of Holocaust Memorial Day, can we truly equate the silent struggles of contemporary emotional health challenges with the unimaginably harrowing experiences of those who endured the worst horrors of war, violence, and genocide?  

Jesse Eisenberg dares to tackle these complex questions with his directorial debut, A Real Pain, a masterful exploration of trauma, resilience, and the search for meaning. Co-starring Kieran Culkin in a career-defining performance, the film takes viewers on a journey that is part road trip, part comedy-drama, part historical reflection, and wholly compelling. I believe it offers a timely and deeply thought-provoking challenge to consider how we recognise and process pain across generations as well as understand the way pain shapes – and reshapes – our lives.  

In the film, Eisenberg and Culkin portray two estranged Jewish-American cousins, David and Benji, who embark on a shared mission to retrace the steps of their grandmother, a Holocaust survivor. What begins as a simple road trip to Poland quickly transforms into something much more as the brutal reality of intergenerational trauma and mental health struggles rise to the surface.  The film’s themes can be explored through three key lenses: the passing on of pain, the proximity of pain, and the problem of pain. 

The passing on of pain 

At its heart, A Real Pain is a story about legacy—the burdens and blessings passed down through generations. Though their shared grandmother is no longer alive, her story of survival, resilience, and eventual flourishing has left a profound impact on her descendants. Her story draws the cousins in, but it also draws them together and apart in different ways over the course of the trip. There is tragedy and comedy, and poignant moments of connection as well as frustration as Eisenberg explores how trauma echoes through generations, affecting different people in different ways, weighing heavily on those who did not live through the original events. This theme is handled with nuance showing both the strength and fragility that come from confronting a painful past. Ultimately it brings us to a new question – how do we honour the suffering of those who came before us while also finding our own path, or paths, to healing? 

The proximity of pain 

As the cousins delve deeper into their family’s history, the film juxtaposes the grandmother’s resilience in the face of antisemitism, war, and Holocaust with Benji’s struggles. Despite severe loss, grief and trauma, the grandmother went on to live a meaningful life. Benji on the other hand struggles to keep on top of his daily responsibilities, hold down a job, and maintain relationships. He struggles to find any meaning in his life and reveals he has attempted suicide. How, he wonders, did his grandmother find the strength to fight for her life against the backdrop of the Holocaust when he can’t even navigate the relative peace of middle-class America? This question seems to add to his despair. He seems thoroughly beaten.  

Eisenberg does not provide easy answers but instead invites viewers to wrestle with these complexities of life and death, resilience, and vulnerability. He forces us to confront our assumptions about suffering and strength. By making us reflect on which pain is more real, he seems to have found a way to challenge us both to honour the reality of past trauma and recognise the reality of the struggles faced by those around us.  He has certainly found a way to help us empathise both with the millions of people who are currently displaced and traumatised by violence, conflict, and displacement, and, equally, with the millions whose mental health is in tatters.   

The problem of pain 

At its core, A Real Pain tackles the universal question: what do we do with suffering? Do we bury it in the past? Do we pretend it does not exist? Do we insulate ourselves from the pain of others? Do we respond with frustration and anger or with patience and empathy? Do we accept pain as a tragic by-product of existence? Do we struggle under the burden of it? Do we let it defeat us? Do we find ways to learn from it? Can pain make us stronger? Can it make us better people? Does it point to something deeper within us or, indeed, something beyond us? 

Right in the middle of the film, David and Benji meet a survivor of the Rwandan genocide. who provides a stark reminder that the horrors of the Holocaust are not just consigned to history, that even today there are places where entire people groups are being targeted, destroyed, and displaced. This character has clearly found solace and meaning through his faith, in contrast to the cousins’ secular Jewish identities. The tension between belief and unbelief runs through the film and reflects the wider experience of many for whom pain has been a critical factor in their journey either to faith or away from it.  

For C.S. Lewis, the author of the Narnia chronicles who offered spiritual solace to the nation during the Second World War and who was personally familiar with suffering writes: “God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is His megaphone to rouse a deaf world.” Pain, for many Christians like Lewis is supposed to draw us towards faith – it is an urgent invitation to seek meaning and connection in a fractured world. Pain reminds us of our mortality and vulnerability, and our dependence not just on others, but perhaps too on an Almighty being who offers hope, healing and the promise of a life beyond this in a world where there is no more death, no more tears, no more pain.  

With A Real Pain, Jesse Eisenberg has crafted a film that will make you laugh and cry and think and discuss and reach out to others, or even to God.  This film invites you to reflect on the past, present and future, to wrestle with the pain we carry and to seek meaning beyond it. It’s a must-watch for anyone who dares to reflect on life’s most profound questions.  

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