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.

Review

Culture

Film & TV

Suffering

17 July 2024

5 min read

Eternal Sunshine of the Spotless Mind: 20 years on

Memory and the meaning of suffering.

Beatrice Scudeler

Beatrice writes on literature, religion, the arts, and the family. Her published work can be found here.

A coupe sit on outdoor steps against a blue sky. One holds a plate and the other looks towards them.

Carrey and Winslet as Joel and Clementine.

Michel Gondry’s Eternal Sunshine of the Spotless Mind came out in 2004. Twenty years on, its stubborn insistence that the memory of pain gives meaning to our lives is as relevant as ever.

I first watched Gondry’s cult classic earlier this year, in the midst of recovering from postnatal PTSD. When we are faced with heartbreak, it can be easy to wish that we could retreat from painful memories, hiding them away until the initial pang has seemingly died down. That was my experience, at least. But I quickly learnt that the traumatic memory of my daughter’s birth would continue to resurface until I processed it and accepted it as part of my life. Just so, Eternal Sunshine of the Spotless Mind teaches us that being vulnerable to suffering is a gift, that suffering itself is necessary to our moral growth, and that our ability to remember the past is an invaluable faculty of the human mind.

The film begins simply, with a meeting between its protagonists, Joel Barish and Clementine Kruczynski. As Joel and Clementine start making small talk, they seem immediately comfortable, almost familiar with each other, and yet the atmosphere is eerie. Soon enough, we discover that Clementine was a patient at Lacuna, a clinic which erased every memory of Joel from her mind after their two-year relationship ended in a painful breakup. When Joel finds out, he asks Dr. Howard Mierzwiak, the director of Lacuna, to do the same for him. As viewers, we now start to wonder: was that meeting we witnessed their very first, or have they met again after their memories were erased, unaware that they loved each other in a ‘past’ life?

This tone of disorientation continues throughout the film, and that’s what makes it so special. As Joel’s memories of Clementine are erased one by one, he realises that the removal of one’s painful experiences is in itself a kind of trauma; what promises to be a relief, turns out to be nothing more than loss.

We experience this sense of disorientation and loss alongside Joel as we jump through snippets of his and Clementine’s happiest and saddest moments together, trying to piece together in our minds a linear narrative of their relationship. While this is happening, the film’s subplot focuses on Stan, Patrick, and Mary, three young people working for Lacuna. As Stan and Patrick, the ‘technicians’, work on Joel’s memory removal, Mary, Lacuna’s naive receptionist, muses on the beauty of their mission. She begins quoting aloud the passage of poetry which inspires the film’s very title, taken from Alexander Pope’s verse epistle Eloisa to Abelard (1717):

How happy is the blameless vestal’s lot!

The world forgetting, by the world forgot.

Eternal sunshine of the spotless mind!

Each pray’r accepted, and each wish resign’d.

Mary has an idealistic vision of her work: she believes she is helping suffering people experience the kind of ‘eternal sunshine’ that only a ‘spotless mind’ can achieve. But the human mind is not so simple. Joel’s desire for forgetfulness quickly turns nightmarish. As he realises he has made a mistake, he starts fighting to retain the memory of his love for Clementine, but his is a hopeless quest. Dr. Mierzwiak’s intervention ensures that the procedure is completed.

Left alone without Stan and Patrick, Mary confesses to the married Dr. Mierzwiak that she is in love with him. It is at this point that her idealism crumbles down. He reveals that they’ve already had an affair in the past and that she agreed to let him erase its memory from her mind. Mary is devastated. She decides that what Lacuna is doing is unethical - even if Mierzwiak technically has the patients’ consent to the procedure - and releases the clinic’s files back to the patients. It is this decision which leads Clementine and Joel, just a few days after they ‘meet’ again, to discover that they’ve already loved each other in the past.

Accepting suffering and holding it in our hearts, not with bitterness, but rather with courage, requires endless patience and infinite hope.

Although the script of the film doesn’t spell it out, Mary’s story emphasises that the absence of painful memories is in itself experienced as a painful loss. What’s more, it shows that, without the memory of the suffering which we have inflicted on others, and which others have inflicted on us, we are incapable of moral growth. Thanks to the knowledge of the past, Mary is able, this time around, to resist having an affair with a married man. Just so, the final scene of the film, which sees Joel and Clementine vow to renew their relationship, is hopeful not in spite of the fact that they have regained the memory of the ways in which they hurt each other in the past, but precisely because of it.

Accepting suffering and holding it in our hearts, not with bitterness, but rather with courage, requires endless patience and infinite hope. But that is what we were made for. Each one of us is called to endure pain in imitation of Christ, and, out of that pain, to discover a greater capacity for sacrificial love. We make meaning out of pain: that’s what human beings do.

The very last lines of Eternal Sunshine of the Spotless Mind perfectly express the fruits of this Christ-like acceptance. As Joel reassures Clementine that he can’t see anything he doesn’t like about her, she expresses her doubts and anxieties: ‘But you will! But you will.’, she repeats, ‘You know, you will think of things. And I’ll get bored with you and feel trapped because that’s what happens with me.’ Joel and Clementine look at each other, and, after a pause, they simply say to each other: ‘Okay’. Their ‘okay’ is not an indication that they are doomed to repeat old mistakes. Rather, it signals a new choice: this time, when their relationship becomes difficult, they won’t just run away; this time, they will face discomfort, heartbreak, and disappointment, armed with the knowledge that seeking a sense of permanence by loving another person completely is an inherently valuable pursuit. In accepting the most traumatic parts of our past we grow closer to God; and in bravely deciding to look ahead to the future with hope, we catch a glimpse of the unadulterated joy which we will finally experience in God’s eternity.