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

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.

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Conspiracy theory

Death & life

29 August 2024

4 min read

A Bayesian theory of death

The sinking of the superyacht displays the probability, and banality, of death.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

Rescue workers look at the plan of a yacht.

The search for the Bayesian.

Vigili del Fuoco.

On any statistical calculation, the probability of dying by drowning when your luxury yacht suddenly and inexplicably sinks at anchor in the Mediterranean has to be extremely low.

So it’s the cruellest of ironies that tech tycoon Mike Lynch should so die, along with his daughter and five others, having devoted his commercial life to the application of such statistical probabilities. He had named his yacht Bayesian after the 18th-century theorem that introduced the idea that probability expresses a degree of belief in an event.

That doesn’t expressly mean religious belief. But, intriguingly, it doesn’t exclude it either. According to Thomas Bayes, who published his theorem in 1763, the calculable degree of belief may be based on prior knowledge about an event, such as the results of previous experiments, or on personal beliefs about it.

In essence, you don’t believe your yacht will capsize in the night and sink in seconds, because your experience tells you so. That belief can mathematically be included in the probability of it happening.

We can transfer the method into religious praxis. Christian belief in the event of resurrection, for instance, can be calculated in the probability that the deaths of the Lynches and others aboard the Bayesian are not the end of their existence.

It’s an intriguing legacy of Lynch’s work for theologians. But it’s the sheer lack of probability of the lethal event occurring at all that lends it its random banality. It’s that death visited those asleep on a yacht in the small hours that lends this news story such tireless legs, not just that these were super-rich masters and mistresses of the universe.

There have been bitter observations on social media that the Bayesian’s victims have commanded limitlessly greater attention than the many thousands of refugees who die in small-boat crossings of the Mediterranean every year.

This is a category mistake. And again, Bayesian theory can be deployed. Experience supports our belief that crossing the sea in overcrowded and unseaworthy vessels can all too often lead to tragically terminal events. The probability of death is plain. Again, it’s the sheer randomness of the Bayesian yacht event that sets it apart.

If death can visit at any time, there can be no difference in the valuation of long or short lives.

That randomness brings us back to the banality of sudden death among us, almost its ordinariness, something that just happens, often entirely out of the blue. The prayer book has the funeral words “in the midst of life we are in death”, meaning that death is our constant living companion. But that doesn’t quite cut it for me, because it tells us it’s there, but nothing of its true significance.

The tenets of Christian faith are regularly said to be those of a death cult; that it’s a deep-seated fear of death that leads us to avoid it with assurances of eternal life. But it’s the sheer banality of death, as displayed in the randomness of the Bayesian event, that seems to knock down that idea. In its randomness, death looks ridiculous rather than evil.

Conspiracy theories around the sinking of the Bayesian are a kind of denial of the reality of death too. We want there to be more to it than the utterly banal.

Author Hannah Arendt coined the phrase “the banality of evil” when covering the trial of Nazi holocaust architect Adolf Eichmann in Jerusalem. I’d want to suggest that it’s that same banality, that basic human ordinariness, that is the real nature of the supposed grim reaper, rather than his evil.

None of this can comfort the Lynch family, who mourn the loss of a much-loved father and his young daughter, or the families of the others who lost their lives on the Bayesian. But it is meant to go some way towards an explanation of what we mean in Christian theology when we bandy about phrases such as “the defeat of death”. Because it’s not a wicked serpent that’s been defeated, more of a pointless clown.

There is something especially painful about the death of the young, such as that of 18-year-old Hannah Lynch on the Bayesian that night, a young woman on the threshold of life. And – God knows – the even younger lives we’ve read about being taken lately.

But the concept of banality may lead us to another tenet of faith: The completeness of every life. If death can visit at any time, there can be no difference in the valuation of long or short lives.

A poem, often ascribed to a former dean of St Paul’s cathedral, begins with the line: “Death is nothing at all.” That’s wrong, as an idea. Death is as significant an event as birth. But its defeat is in keeping it in its place.

The dignity in simplicity with which football manager Sven-Göran Eriksson greeted his final illness is a masterclass in this tactic for life. Death isn’t to be negotiated, it’s just there.

In the end, death isn’t a Bayesian probability, it’s a certainty, for all of us. The difference, in Bayesian theory, must be the belief we bring to our personal calculations of the probability of the event.