Review
Assisted dying
Death & life
Film & TV
5 min read

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 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. 

Explainer
Change
Development
Film & TV
6 min read

Finding an answer to poverty

A new TV ad challenges stereotypes around how to help the poor. Tarryn Pegna unpacks the impact of one of the most effective ways to eradicate poverty.

Tarryn Pegna is a writer for aid and development charity, Tearfund. She helps to communicate where, why and how the organisation works. 

A woman carries a plastic bucket on her head and held by raised arms and hands.

We’ve all seen them – haunting images of starving children, flies on their faces, begging for help – powerless to change the cruel lot they’ve landed in life… There’s more to the story, though. More to the people in the pictures. 

Extreme poverty is a very real problem. The living conditions faced by many around the world are, indeed, truly devastating, and in hoping to urge a response and to help, we can fall into a clichéd portrayal (and understanding) of need that strips people of a sense of dignity and agency.  

But, the answer to poverty can be uplifting, sustainable, restorative and empowering: the answer can be the Church. 

You may have seen Tearfund’s new TV ad. If not, you can watch it now. With some humour it challenges some of the stereotypes about how those in the developed world go about trying to eradicate poverty elsewhere.  

The ad shows a number of excellent things that a community in Burundi has achieved which have transformed the lives of the people living there. It features them talking about the training that made it possible – but what is this training? And what does it have to do with Tearfund or the church? 

Well, here’s how it works: 

It all starts with Bible studies. These are designed to help people identify the skills and resources that already exist within their community, and to see new ways they can use them to respond to their needs. 

Local church members (or leaders) receive training to facilitate these Bible studies and share the message within their community. 

Each Bible study ends with a call to action. This may be something small to start with – like a change in a harmful way of thinking – but can quickly grow in scale to things like improving or building schools, health centres and roads. 

Tearfund and our local partner organisations help to provide the practical knowledge and skills training needed to make it possible to carry out these plans. 

In this way, churches and communities can find themselves working together to lift themselves out of poverty for good and to realise their God-given potential and thrive. 

I played my part in the construction, even if I was not strong, I worked with others in digging the road and moving rocks.

The ad features Cecile, a young married mum with one daughter. She tells us her experience: 

‘We understood the power of coming together as a church and working together for our own development. A changed church changes the community for the better. Our congregation was able to build a health centre, a road and bring up water. 

‘I am happy to be part of this church as I come to know God and see his hand. I now have a church family, we love and support one another. I played my part in the construction, even if I was not strong, I worked with others in digging the road and moving rocks, and we also contributed some money. 

‘It is like an awakening. People are more engaged, we have been inspired to change and to change our community and we are now active.  

‘Apart from building the health centre, more people are working hard to change their situation. Some have started small businesses, I’ve also been selling vegetables and I hope that once I get enough capital, I’ll be able to start a small business at the market and earn more money to help [me and my husband] improve our lives and build a house.’ 

Every day, thousands of people around the world suffer and die because of poverty. Christians don’t believe that this is God’s plan. At Tearfund we believe that the church is part of his plan to respond – and that we all have a part to play in ending extreme poverty. 

Is the church even still relevant though? 

Here in the UK, it might seem strange to be so focused on faith and the church. The most recent census showed that, as a nation, we have a steadily declining affiliation with Christianity, and the news last year made much of the fact that only around ten per cent of the population regularly attend a church service. It might be worth wondering whether the church has lost some of its ability to influence change.

Almost three million UK adults sought help from churches or faith organisations because of the cost-of-living crisis. 

In England, Anglican bishops are still members of the House of Lords, so they have some voice, but for the rest of us…why the faith? Where does God fit into things and is the church even practical or relevant in society these days? 

It actually works 

In spite of the declining number of worshippers, in 2022 almost 3 million UK adults sought help from churches or faith organisations because of the cost-of-living crisis.  

During the worst of Covid, churches across the country provided a hub for making sure the most vulnerable in their communities were fed and provided for. Many church buildings became food preparation and distribution centres and local church members became temporary delivery drivers. 

The local church around the world 

In the same way, around the world, the church is often first on scene in times of need.  

From its unique position right within a community, the local church knows intimately the needs of the people it serves.  

And in many places where Tearfund works, the church has a significant and trusted influence, giving it a voice for change and for justice in society. 

The church, as a vehicle for transformation, has the capability to work powerfully and effectively in a way that lasts. 

No matter where it is, the Christ-following church has always been about the transformation of lives and about community: called by Jesus to first love God (allowing him to transform Christians’ own lives), and then to love our neighbours as ourselves (bringing transformation to our communities).  

More than could, the church should be the answer to poverty.  

The church is a sustainable, efficient, empowering and highly cost-effective way of helping whole communities lift themselves out of poverty. 

The church (in all its various forms and denominations) is the largest non-governmental, non-profit organisation on the planet. Tearfund itself was born out of the church, and recently an independent study that we commissioned confirmed in numbers what our own experience, stretching back over 50 years, had already shown us: the church is a sustainable, efficient, empowering and highly cost-effective way of helping whole communities lift themselves out of poverty.  

By equipping the local church within a community facing poverty to find solutions to their needs, the people being supported can become agents in their own rescue.  

Like many charities, there are questions about the impact they have. Just how effective is working through the church really? 

In fact, researchers discovered that a social value of £28 was released for every pound invested in community transformation work through the church.  

Practically, that means that when compared to people in communities that had not received training and equipping through the church, those that do are: 

  • 27% more satisfied with their lives in general 
  • 113% more likely to work with others on shared projects 
  • 51% more likely to have maintained or increased their income in the last year 
  • 46% more likely to speak up and raise issues with decision-makers 
  • 62% more likely to have invested in assets, such as property or livestock in the last year 
  • and 26% more likely to feel confident they could cope with unexpected events in the future. 

Working through the local church has the power to bring positive, whole-life transformation which spreads throughout a community – so that even those who aren’t directly involved in the activities still experience some benefits. 

You can read more about the study and its findings here.