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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Film & TV

25 October 2023

4 min read

Why we watch dark drama

Reviewing The Reckoning, and the reviewing cycle, leads George Pitcher to change his mind on whether to watch such darker dramas and documentaries.

George Pitcher

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

A man in a tracksuit sits in an arm chair smoking a cigar while looking towards a curtained window.

BBC.

The BBC’s four-part drama-documentary about the life and crimes of Jimmy Savile, The Reckoning, concluded. And the media caravan moves on.

Its reviews have been mixed, to say the least. You may have got the gist of them: Steve Coogan was brilliant as Savile. But why would he do it? Other actors around him were equally good, if not better. The BBC was either brutally honest or self-exculpatory about its enablement of the monster. I particularly noticed a review line that emerged which hoped the BBC would concentrate on its safeguarding, rather than gather material for its drama department

There’s a case for taking a breath after the television reviewers have completed their work, of asking what we are left with after all this and whether there is a bigger picture than the one our television screens contained.

The first window I want to look through is the church one forever stained by the hideous image of child sexual abuse. Those priests who over recent years have been exposed for these heinous crimes were not, unlike Savile, celebrities. They weren’t as often, like him, committing them in plain sight. But all child abusers, as adults, occupy a position of trust, either as family members, teachers, people of power or as priests, and they abuse that trust as they abuse their victims.

I have had direct experience, as a parish priest, of two instances of child sexual abuse. In both instances, the clergy who abused are long dead. It may go without saying, but in both cases I have witnessed how the victims, now in late middle-age, have had their lives ruined as a consequence, how nothing can really be healed as such, but how we can only help them to manage.

As for the perpetrators, they’re dead. As with Savile, the knowledge of this leaves a feeling that they got away with it and that justice has not been done, nor importantly seen to be done.

The BBC’s depiction of him had him being tortured, to some degree at least, by his Roman Catholic faith, that he faced consignment to hell for his crimes and that his charitable works were an effort to compensate for his moral turpitude and get him to heaven. This was portrayed partly in a tentative fumbling for absolution in the confessional box.

There’s no way to know whether that’s an accurate telling, but it’s not consistent with my memory of the conduct of his final years, nor with that of the period after his death in 2011, as evidence of his crimes emerged. That time was characterised more by intimidation of journalists with lawyers and calling in favours from police. Being in denial seems to have been more likely than being in the confessional space.

That may have been true of abusive priests too. But it’s axiomatic also of a means to evade justice. One can only hope that they have faced divine judgement. But, then, who throws the first stone?

I refused to watch it on the grounds that I feared it fell into a TV category that could bear the file name “true-crime titillation”

I want to turn to another aspect of the reviewing cycle of The Reckoning: Should it have been made at all? This is not the question of whether it should have been made by the BBC, which harboured Savile’s career, but whether drama should be made out of the most atrocious of crimes.

A very little over a year ago, Channel 5 screened Maxine, a three-part drama miniseries based on the murders of 10-year-olds Holly Wells and Jessica Chapman in Soham at the hands of Ian Huntley, ostensibly from the viewpoint of his girlfriend Maxine Carr, unwittingly coerced into his attempted cover-up.

I refused to watch it on the grounds that I feared it fell into a TV category that could bear the file name “true-crime titillation”. I also felt that the twentieth anniversary of the murders was too soon for these events to be revisited for dramatic purposes.

I want to re-visit those opinions now, in light of The Reckoning. Savile was not a murderer, but he destroyed children's lives. It’s important, ultimately, that we know about him and of what he was capable. I have written recently, with regard to a documentary screened on Channel 4 about the Holocaust in Ukraine, that we don’t have the moral option nor the luxury of looking away.

So this: Hats off to broadcast journalists and dramatists who face up to the darkest of crimes and human nature. Journalists show us (or should try to) that it’s really there. And it’s valid territory for drama producers, because it makes us think about it, if not understand it. That’s what drama does, or is supposed to.

Finally, we acknowledge from dramatised events, perhaps, that no one is defined by a single aspect of the lives they lead. From this, we might pray that they (and we) may be forgiven somehow, by someone, simply because we can’t.