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

Hospitality

Migration

29 September 2023

4 min read

The real hearts of oak

The power of the lens, food and hospitality drive the hope in Ken Loach’s last film. Krish Kandiah reviews The Old Oak.

Krish Kandiah

Krish is a social entrepreneur partnering across civil society, faith communities, government and philanthropy. He founded The Sanctuary Foundation.

A man and a woman sit in a cathedral pew and incline their heads towards each other.

Ebla Mari and Dave Turner play Yara and TJ.

BBC Film.

In the dusty back room of the rather rundown Old Oak pub in County Durham, northeast England there is a faded black and white photo. It shows the very same room packed full of hungry families sharing a community meal together. Below it is written a sign:

“When you eat together you stick together.”

Pub Landlord Tommy Joe Ballantyne explains to young Syrian refugee photographer Yara that the picture was taken by his uncle during the miner’s strike when the community made it a priority to feed each other’s children no matter what.

This is the pivotal scene in Ken Loach’s latest, and some suggest, final film: The Old Oak. The multi-award-winning director has produced another masterful piece of cinema which, although set in 2016, provides vivid social commentary on our current cost-of-living crisis and our struggling immigration and asylum system.

By setting the film in an old colliery town facing its own challenges with social deprivation, Loach allows those communities who feel left behind by the rest of the country to raise legitimate concerns about immigration. The film powerfully portrays local people expressing frustration at being used as a dumping ground by government for ex-prisoners while also feeling trapped by unemployment, falling house prices and rising costs. Into this community then arrive refugees fleeing the brutal war in Syria.

The film is not just depicting some sort of Hollywood romantic utopia. It is powerfully celebrating what is happening in communities all around the UK.

Yara arrives camera in hand, snapping photographs of her family’s arrival on a bus. They are met with hostility from the beginning. We see the conflict through the lens of Yara’s camera - black and white photographs that foreshadow the photos of the miner’s struggle she will later discover on the wall of the pub’s back room. We see another photo – the one Yara’s mother displays pride of place in the lounge – of Yara’s father who is lost in the brutal Syrian prison system. These photographs provide beautiful symbolism throughout the movie signalling the themes of solidarity and resistance.

We see in the film the power of the camera to change the way that people see their world and view others in the face of hatred. We see the power of food to unite divided communities. We see the power of hospitality in the face of hostility. We see families from both communities caught in impossible situations.

What this film does most brilliantly, in the rich dialogue which sounds less like a script and more like a fly-on-the-wall documentary, is allow the strongest arguments against refuge and asylum to be raised. Ultimately this dialogue opens the eyes of the two communities, and enables them to discover that they have so much more in common than they might have imagined.

I have witnessed these eye-opening moments connection myself. I have seen Afghans resettled to hotels find a welcome into a village community through integrated cricket matches. I have seen women with no common language forge friendships over a picnic. I have seen children change from sullen and suspicious to animated and inseparable in minutes with the help of an X-box. I have seen the beer and pub industry offer support and help to Ukrainians. I have seen churches open their doors and their hearts to Muslims from Kosovo and Syria. The film is not just depicting some sort of Hollywood romantic utopia. It is powerfully celebrating what is happening in communities all around the UK.

The mining community, that once lost jobs, financial stability and heritage, eats alongside the refugee community – those who have now lost their homes

That dusty pub back room is transformed to the bustling hub of community life once again, as families from different worlds befriend and support each other over shared meals and recognition of their common mortality and humanity. The understanding that both communities have experienced displacement has brought them together. The mining community, that once lost jobs, financial stability and heritage, eats alongside the refugee community – those who have now lost their homes, their country and their heritage.

In a beautiful moment of reconciliation in the film, the Syrian families present their new neighbours with a banner made in the style of the traditional mining banners used on gala days – the ones that took pride of place on marches just behind a brass band. The banner is inscribed in both English and Arabic with the words that have drawn the communities together: Strength, Solidarity, Resistance.

I believe the film, like the banner, offers a rallying cry to those who see it. It helps us understand two of the most marginalised communities in Britain at the moment – the impoverished towns of the North, and the refugees and asylum seekers. It challenges us to find ways to come together with empathy and hospitality. It proffers significant mutually beneficial consequences – love, joy, peace, hope, friendship, forgiveness, reconciliation - when we learn not only to live together, but to share food, time and lives together.