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

America

Culture

Film & TV

Race

9 February 2024

4 min read

What do we want from our stories?

New film release American Fiction satirises storytelling and the expectations placed on authors. Jamie Smith records his reactions to watching the movie.

James K.A. Smith

James is a philosopher, cultural critic and author.

A man sitting at a restaurant table turns and looks aside.

Jeffrey Wright as Thelonious "Monk" Ellison aka Stagg R. Leigh.

Orion Productions.

This article was first published on the author’s Substack Quid Amo, December 16 2023.

On a recent visit to Los Angeles, my wife Deanna and I went to see Cord Jefferson’s new satire, American Fiction, playing in only seven theaters nationwide right now. The film is a smart, beguiling adaptation of Percival Everett’s novel, Erasure.

Part of the fun of watching movies in L.A. is being reminded what a company town LA still is. We were slightly puzzled when, as a production company splash screen opened the film, a ripple of hoots and applause bubbled up from the audience. When, at the end of the movie, we saw an entire group video-recording the rolling credits, we realized a production team was in the house, seeing their work on the public screen.

Watching this particular movie in L.A. was especially entertaining because of its meta commentary on our storytelling industries, including film. The winks & nods about screenwriting, adaptation, and philistine studio executives occasioned knowing guffaws in the audience.

The movie asks important, uncomfortable questions about the stories that “we” (scare quotes will become obvious in a second) want to hear today, and why.

What’s supposed to be a farce is embraced by white marketing executives as the latest Black trauma porn for awards season.

The key facet of the plot is relatively simple: a Black novelist (Thelonious “Monk” Ellison, played cagily by Jeffrey Wright) has published several works of deft, critically-celebrated literary fiction. But he can’t sell his latest novel. His agent informs him why: “It’s not Black enough.” The Black novelist is puzzled (“But I’m Black!”) until he wanders into a reading from a new bestseller, the latest by a Black novelist celebrated by some famous white woman’s Book Club. Written in dialect, with flat characters and tired tropes, the novel panders to and perpetrates horrendous stereotypes dusted with a hint of redemption. But it does so with just the right dose of guilt-induction for white readers to feel morally assuaged just by reading the book. The publishing industry has seized upon the mad, pretzeled formula: You can sell a lot of books to white people by offering them the thrill of a little enlightened guilt that actually depends on their continued racist stereotypes.

In a fit of disgust, rage, and desperation, “Monk” begins banging out just such a novel, determined to play a kind of Sokal-hoax on the publishing industry. Just one problem: the market clamors to buy this dreck and even turn it into a movie. What’s supposed to be a farce is embraced by white marketing executives as the latest Black trauma porn for awards season. You can imagine the comedic possibilities here. It’s a funny movie.

As a white viewer of this movie, if I laugh at all the right points and get all the inside jokes, am I being offered a little absolution?

But it is also tender. What’s playing out on screen—the story surrounding the creation of the novel’s story—is a very different kind of Black story. Monk, it turns out, is the black sheep only because he’s a PhD in a family of MDs. Here is a Black family with a massive Victorian home in Boston and a beach house on the Cape—which is just to say, they are a family of accomplished professionals like so many others. Are we surprised? Like any human family, of course, their life is not without pain, loss, heartbreak, and animosity. But like any human family, there is also achievement, pride, joy, connection.

Here’s a Black family. Here’s their story. Is this a “Black story?” Is it “Black enough?” What do we want from our stories?

Jefferson’s endeavor here is fraught, and he knows it. The last part of the movie “goes meta” as a way to concede that there’s no “clean” way to raise these questions without slipping back into being part of the problem. As a white viewer of this movie, if I laugh at all the right points and get all the inside jokes, am I being offered a little absolution? To his credit, Jefferson never quite lets a viewer like me off the hook. Something about this story will, and should, remain unavailable to me.

But also to his credit, Jefferson had me thinking of the Roman poet Terence when we walked out of the cinema. Homo sum: humani nihil a me alienum puto. “I am human: nothing human is alien to me.” Jefferson tells a story that, in this climate, is willing to risk a claim to human solidarity.