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
Books
Culture
Film & TV
Purpose
8 min read

You may never take the Salt Path but here's why the tale makes sense

Kindness runs deep in the architecture of reality.

Roger is a Baptist minister, author and Senior Research Fellow at Spurgeon’s College in London. 

A hiking couple sit on the grass next to a pack.
Gillian Anderson and Jason Isaacs.
BBC Films.

The Salt Path is a phenomenon.  

An internationally best-selling book and now a movie starring Gillian Anderson and Jason Isaacs. How is it that a memoir of a middle-aged couple walking the South West Coast Path from Somerset to Dorset, via Land’s End, has had such an impact? 

Well, it’s because it resonates. It rings true. It’s about life as we know it, even if we haven’t hiked the 630 miles of the path from start to finish. A journey that is also, incidentally, the equivalent of climbing Mt Everest four times over. 

In the events leading up to their walk Raynor (Ray) and Moth Winn are dealt a series of body blows. They’re left bankrupt and homeless empty-nesters, struggling to come to terms with Moth’s deteriorating health.  

It was just as the bailiffs were seeking to gain access to their farm and take possession of it that Ray spotted an old book, 500 Hundred Mile Walkies, and took inspiration. 

‘We could just walk.’ 

And that’s what they did. 

So, what are the truths about life and our human experience that this story opens up for us? 

Life is precarious  

Bad stuff happens. Sometimes we bring it on ourselves, the consequence of wrong or ill-judged decisions. Other times it is thoroughly undeserved. Life turns around and bites us, hard. We’re left with our heads numb and spinning round with the persistent but unanswered question, ‘why me?’ 

For the Winns, an investment in the business of a trusted, life-long friend failed. The deal he structured left them responsible for the debts of his company. The end of a prolonged legal battle meant they lost everything, their farm, their home, their business, and the life-long friend. 

The same week also found them in a hospital in Liverpool getting the diagnosis for Moth’s chronic shoulder pain. It was not the suspected nerve damage, but rather the fatal neurological condition corticobasal degeneration. CBD. A diagnosis that was untreatable and only finally confirmed postmortem. 

Whether it’s the South West Coast Path or the familiar details of our own life, we can never fully anticipate tomorrow. We do not know what lies behind the next headland or what unwelcome surprises life may spring on us. No, we need to live in the moment. It’s pointless worrying about tomorrow and we ought to let it worry about itself. We can only live in today. As Ray reflected towards the end of their time on the path: 

“This second in the millions of seconds was the only one, the only one that we could live in.” 

Who am I, really? 

Early in the book Ray recalls: 

“I once heard a lecture by Stephen Hawking, when he said, ‘It’s the past that tells us who we are. Without it we lose our identity.’ Perhaps I was trying to lose my identity, so I could invent a new one.” 

Who are we when everything is stripped away? What defines us? Homeless and jobless, questions about where we’re from and what we do are not only awkward, they also create an existential void.  

Often mistaken for tramps, Ray and Moth noticed people treating them differently. Some quietly moved away, others were more forthright, “disgusting!” But the judgement of others does not define who we are. Yet, who actually were they in this new world of theirs?  

And then there’s the impact of failing health. Each stage of deterioration promising to erode what can be physically done and requiring a redefinition until there is nothing left at all.  

Yet identity is deeper than that. It is at the core of who we are, at the very heart of us. It is the sum of our experiences and choices, our successes and failures, of what we have gladly embraced and that which life has unexpectedly thrown at us. We are unique individuals with intrinsic value, worth and dignity. People who love and are loved. 

At the end of the path Ray muses: 

“Most people go through their whole lives without answering their own questions: What am I, who do I have within me? The big stuff. What a waste.” 

I guess that’s one of the attractions of making space to walk. To lose the distractions and busyness of our over-complicated lives for self-discovery to break in. 

One step at a time 

How do you get your head around walking 630 miles? How can you appreciate the demands of climbing unknown hills and cliffs and navigating their gullies and ravines.  

On top of the terrain there’s the notorious English weather to negotiate. With little money and only a tent for respite: when it rains you get wet and stay wet, when it’s cold, you shiver and put on as many layers as you can. Even in August it can be challenging. 

Walk, eat, sleep, repeat. 

Sometimes the only thing to do is put one foot in front of the other.  

“Each step had its own resonance, its moment of power or failure. That step, and the next and the next and the next, was the reason and the future. … each day survived a reason to live through the next.” 

There is always agency. There is always the opportunity to choose today which path to travel and which attitude to serve. To give in or go on, to be a defeatist or hopeful, complaining or generous, those choices are always there, even when they’re limited. Even in the wake of unfair decisions and unexpected tragedy, we choose today the way we take. And sometimes that’s all we can muster. 

The kindness of strangers 

Ray and Moth’s story is littered with moments of kindness and warmth. From the lovelorn waitress who sneaks them the day’s leftover pasties to the generosity of a hippie commune there is a recurring theme that echoes an underlying goodness in the nature of people. And often it is those with the least who prove to be the most open-handed and thoughtful. 

On more than one occasion the Winn’s themselves share from their own meagre supply of food, especially their precious fudge bars, with those in a more uncertain state than their own. On another occasion they step into a tense and potentially violent situation with a young woman, Sealy, the subject of an abusive relationship. They offer her company and a way out, ultimately paying for her £5 bus journey to get away to family. 

There is something heartwarming about kindness, something elevating. Both the giver and the receiver feel encouraged, lighter, happier. The abiding truth continues to stand the test of time that it is ‘better to give than to receive’.  

Strangely, watching these scenes play out in my local Showcase Cinema was an uplifting and inspiring experience. You can never predict or properly anticipate when a tear will unexpectedly present itself to the corner of your eye. I suspect that kindness runs more deeply in the nature of things than we comprehend. It is part of the deep architecture of reality.

Love and relationship in tough times 

When it comes down to it, The Salt Path is about Ray’s relationship with Moth. How they face an unimaginably difficult set of circumstances and find a way through together. This is a profoundly hopeful story. And from it we can draw hope too. 

There was nothing religious about what they were doing, “It’s not a pilgrimage. Is it?”  

At one level it is purely a response to desperation. But in the midst of it all they have each other. Thirty-two years together, having begun their relationship when Ray was 18, they are still deeply in love. They epitomise the values enshrined in the marriage vows. 

“… to have and to hold from this day forward, for better for worse, for richer for poorer, in sickness and in health, to love and to cherish, till death us do part …” 

This is not slushy sentimentality but rather love that proves itself in the face of the onslaught of ‘worse … poorer … sickness … death’. 

The conclusion of their journey led Ray to a realisation: “I was home, there was nothing left to search for, he was my home.” As the ancient poet wrote: 

“Set me as a seal upon your heart,  

as a seal upon your arm; 

for love is strong as death, 

passion fierce as the grave. 

Its flashes are flashes of fire, 

a raging flame. 

 

Many waters cannot quench love, 

neither can floods drown it. 

If one offered for love 

all the wealth of one's house, 

it would be utterly scorned.” 

(Song of Solomon) 

That’s it then. The book and the movie work because they reflect back to us the life we know, the lives we live. Yes, they’re in high relief in the choices that Ray and Moth take, but that clarifies things for us. Most of us won’t ever find ourselves in the position they were in, but we can empathise. Most of us would never think to do what they did even if we were. But for all that, we see, we understand and it makes sense. 

If you get a chance to see the film, then do. Gillian Anderson and Jeremy Isaacs are exceptionally good in their understated performances. The visual experience of the South West coast is everything you would expect it to be, sounding as majestic and immersive as if you were there. A real treat. 

For me, the most poignant and telling moment of the story happens at Lyme Regis. Moth says: 

“When it does come, the end, I want you to have me cremated. …keep me in a box somewhere, then when you die the kids can put you in, give us a shake and send us on our way … They can let us go on the coast, in the wind, and we’ll find the horizon together.” 

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