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. 

Column
Change
Death & life
6 min read

The really annoying thing about dying

In his first Notes from Solitude, the death of his dad causes Roger Bretherton to reflect on the relationship and the strange emergence of 'father’.
A pocket watch rests next to a black and white photograph of a father lying beside a new born baby.
Photo by Anne Nygård on Unsplash.

The death of my dad was sudden and unexpected. I don’t know why it is that, from the moment he died, I have had to fight the almost irresistible urge to refer to him as father- a term of address I never used about him or to him during his life.  

Perhaps in some psychotherapy session at some point my therapist referred to my ‘father’, and I may have followed suit. And maybe occasionally when socialising with those who seemed a cut above my largely lower-middle class background, I called him father so as to avoid the flat northern vowel sounds that would expose me as an interloper. But that was just to fit in- on all other occasions he was decidedly not father and definitely just good old plain, dad.  

At death he became a classic, a museum piece, a part of history, not the dad who taught me how to ride a bike.

But for some reason the moment he died, it felt like dad wasn’t enough. I now had to call him father - those were the rules. At death he became a classic, a museum piece, a part of history, not the dad who taught me how to ride a bike by panting and sweating my five-year old self round the block, but the father who taught me to be… a man, or something like that.  

The F-word has gravitas, presence, authority. Dads are human, often bewildered, occasionally pissed off, eminently huggable, easily taken for granted - just there. Admittedly, Freud would have lost significant gravitas if oedipal theory had considered common-all-garden dads and not cigar-smoking brandy-swilling fathers. And no doubt the climactic scene of The Empire Strikes Back would have lacked considerable pathos had Darth Vader casually quipped, ‘No Luke, I’m your’re Dad’.  

The curse of the martyr, write Albert Camus, was to have other people tell their story. The principle doesn’t just apply to martyrs, it’s true of all those who die. To be dead is to become a character in other people’s anecdotes. That’s the really annoying thing about dying, we become a topic of gossip, people get to talk about us without the courtesy of ever having to talk to us. We become object, no longer subject. I think that’s why I resist calling my late Dad, Father. It objectifies him, makes of him something that he wasn’t. It, most definitely fails to do justice to all that he meant to me. 

She simply said, ‘It’s your Dad’, and held me tight in a hug that lasted longer than usually permitted in polite company. 

I say he died suddenly. It was a Sunday morning. I was in church at the time. Actually, worse than that, I was on stage speaking to a church. As a psychologist working in academia, I teach and train all kinds of people in every kind of organisation imaginable, but every now and then I get to speak in churches.  

On this occasion I was talking about character, the positive qualities of being – like love, gratitude, hope, wisdom and so on – that make life worth living. When I stepped off the stage my wife was waving to me from the back of the room, which was weird given that we don’t go to that church and she hadn’t come with me. When I wandered to the back of the auditorium wearing my ‘what are you doing here?’ face, she simply said, ‘It’s your Dad’, and held me tight in a hug that lasted longer than usually permitted in polite company. For someone who prides himself on social insight, it shames me to say that it took a while for the penny to drop. We were in the car with the engine running before it finally dawned on me what she meant. 

I try not to make too much of divine timings or fate, but there was something odd in the timing of getting that news. In that month I had addressed church congregations three Sundays in a row- which, as someone who is generally lazy and prefers not to work weekends, is an unusually intense frequency. But over three successive Sundays I had reflected aloud with those congregations that there were prayers that had accompanied the various stages of my life. Prayers that I found myself praying, almost as if they were prayed through me, as if they had chosen me rather than I they.  

In my twenties I had found myself praying as regularly as a heartbeat, ‘God do whatever you need to do with me, to make me into the person you would like me to be.’ It was a radical invitation for God to put me through whatever was needed to become who I was meant to be. But then the prayer faded. Its visit was over, it had done its work and it moved on. But as I addressed the congregations on those three Sundays I mused aloud that while the prayer of my twenties had departed decades before, I found a new prayer stirring in my forties. Now as the father of teenage boys, my new prayer was, ‘God do whatever you need to do with me to make me the father you would like me to be.’  

In the weeks that followed, people asked me whether I had had a good relationship with my dad. The most accurately answer was: we had the best relationship of which we were both capable. We both tried in our own ways to deepen our connection, but we were like the lovers in a romantic comedy; we always managed to miss each other. When he tried with me, I didn’t want to know. For several years, he left a book lying around at home that he wanted me to read. I never saw anyone touch it, but it moved around the house under its own steam. It was by my bedside, in the toilet, on the dining room table…  Macavity the Mystery Cat would have been proud. It was called, Things We Wish We Had Said. We may have wished, but we didn’t say. I never read it. Years later, when I tried with him, he was too flustered to respond. Both of us in our own ways lacked the courage to connect any deeper. But I was never in any doubt that he loved me, and I him. 

When he was alive I was most aware of how different we were. I defined myself in opposition to whatever he was. If he was gentle, I was assertive. If he was indecisive, I was ambitious.

He died of a heart attack on a Sunday morning asleep in bed, while my Mum was at church. Almost immediately his absence prompted a profound change of consciousness in me. When he was alive I was most aware of how different we were. I defined myself in opposition to whatever he was. If he was gentle, I was assertive. If he was indecisive, I was ambitious. If he was inexpressive, I was articulate. If he was like that, I was like this. And yet, almost at the very moment of his death, a reversal of awareness occurred. I started to see just how very much like him I was. His gentleness, his uncertainty, his scepticism, his care, his humour, were all mine. 

There is a rule in family therapy, that adult children relating to their parents should set their expectations to zero. We never truly see our parents until we stop viewing them through the lens of our own desires; what we wanted from them but never got. Until we do that our lives don’t really work, we sit around waiting for an impossible transformation, a payday that never comes, the moment our parents become exactly how we would like them to be, not as they are. For me, that moment of acceptance for dad only came when he was gone, I accepted him as he was when there was nothing left to accept. I don’t write this with any great sense of guilt or regret at opportunities lost, more with a sense of gratitude for what was given but often taken for granted.  

Oddly though, in the shadow of that seismic shift in my interior furniture, I detected the stirrings of an answer to my own prayer to be a better father. No longer compelled to define myself in contrast to what he was, I was freed to be what I was- both like and unlike him, and to be fair, more like him than I cared to admit. At some visceral level I came to appreciate how much of myself originated with him. I came to accept myself as a dad and my dad as a father.