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. 

Review
Addiction
Culture
Film & TV
Monastic life
5 min read

Mother Vera: from heroin addict to heroine helping the recovering

The horse-loving orthodox sister with a liturgy for life, and a dilemma.

Susan is a writer specialising in visual arts and contributes to Art Quarterly, The Tablet, Church Times and Discover Britain.

A nun on a white horse, gallops across a snowy field, in black and white
Equine therapy.
She Makes Productions.

Across the arts, the recovery journeys of people with addiction and mental health issues are being re-narrated, giving voice to the navigators of their own personal transformation. In Mother Vera, the Grierson award winning documentary about a recovery community surrounding the Saint Elizabeth Monastery in Minsk, ritual and nature’s unfolding therapeutic power take centre stage. 

From Sister Act I and II, to The Sound of Music and Black Narcissus, big screen depictions of women’s monastic life tend to be overwrought. But Mother Vera is different. Shot in black and white, Cécile Embleton and Alys Tomlinson’s documentary visually pays subtle homage to Black Narcissus’ bell tower scene, with a nod to Citizen Kane here and a wink to Andrei Tarkovsky there, but the overall tone is sober, in every sense of the word. 

At the heart of the film is charismatic Mother Vera, a horse-loving orthodox nun, whose story of heroin addiction and betrayal by her onetime partner is micro dosed throughout the film. Surrounding Vera are a team of world-weary men, who she organises into readers for the monastery’s liturgies, as well as directing them in caring for the community’s cows and horses. They declare themselves “snowed in” by the monastic routine of “processions and liturgies” and relentless rounds of physical labour: shovelling snow and ice, feeding and grooming the animals. But the recovery community also acknowledges the bounded routines of the monastery keep them alive, able to face down their longing for drugs and drink. The rhythm of the natural world is woven into the liturgical year as Christmas cribs are replaced with Easter celebrations, all linked by scenes of candlelight, prayers and genuflections.

Early on in the film, Vera slips a puffa jacket over her black habit and gallops across the snow on a white horse. Without giving away too many spoilers, Vera’s desire for a life beyond the borders of the monastery grows as her story develops. Visits to her family show adolescent nephews and godsons growing into strapping maturity in her absence. Her mother relates the time Vera overdosed, 20 years ago, and doctors told her “to prepare for every outcome.” Vera reflects on how her charisma influenced “fresh faced girls” to become heroin users. For Vera, heroin went from being a portal of insight and revelation, to “showing its true face” which was diabolic. In monastery community meetings men praise how Mother Vera helped them to “reconstruct”. 

Vera initially joined the monastery for a year, to wait out her partner’s prison sentence. Twenty years on, she has reached a new phase of her own reconstruction. Immersing herself in a river, her parting words are: “Let’s move on. Let’s continue. Amen.” 

The community at Saint Elizabeth Monastery echoes the residents of W-3, the psychiatric ward in the American teaching hospital described in Bette Howland’s memoir W-3 first published in 1974, and republished four years ago. The author is admitted to hospital following an overdose, while she struggles to raise two children alone, on a part time librarian’s wage, while also trying to write. “For a long time it had seemed to me that life was about to begin – real life. But there was always some obstacle in the way. Something to be got through first, some unfinished business; time to be served, a debt to be paid. Then life could begin. At last it had dawned on me these obstacles were my life. I was always rolling these stones from my grave.” 

Howland positions the institutionalised rhythms of the hospital as the supreme life force, and ultimately more curative than talking therapy or medication. “For the sick in their beds were invisible. They were there only by implication. They must have existed, if only for the sake of this other life, full of importance – the bustling arms, starched coats; the carts, mops, ringings, beepings; the brisk comings and goings of white stockinged nurses.” The invisible, timeless guiding spirit of the hospital “as mysterious as a submarine”, would prevail regardless of what the medical staff or patients did, or resisted doing. Realising they were not the ones calling the shots, was the first step for Howland and her fellow patients to returning to life outside the hospital. 

Accepting community and kinship, rather than superiority or aloofness, with others in recovery is also a key feature of Saint Elizabeth Monastery and W-3. “Nothing was original on W-3, that was its truth and beauty,” writes Howland. And continually telling and re-telling her story to fresh batches of medical students, under a psychiatrist’s supervision, eventually allowed it to be transcended. “It is not strictly accurate to say that these interviews were of no use to us. Because you would have to tell your story yet once more, all over again. And each retelling, each repetition, hastened the time when you would get tired of it, bored with it, done with it – let go of it, drop it forever – could float away and be free.”  

In Mother Vera members of the lay community argue about accepting a new member, who may have been raped in prison, and is labelled a “downcast”. But the argument against allowing prison hierarchies to overshadow their new community wins the day, with the new member being integrated, and objectors accepting “you are no better than him.” 

Contemporary approaches to mental health and wellbeing also pivot on an acceptance of shared humanity and imperfect day to day life with its relentless demands, as well as acknowledgement of a power outside human control. In the Netflix documentary Stutz, actor Jonah Hill charts his sessions with Hollywood psychotherapist Phil Stutz. Stutz counsels his clients there is no escape from pain, uncertainty and hard work. To try to avoid these conditions, whether through fantasy or substance or addiction, is to live in the Realm of Illusion. Progress and satisfaction can only be achieved by embracing the here and now, and doing the next necessary thing for life to continue. Stutz calls these actions the String of Pearls, urging his clients to be the one to put the next pearl on the string. The outcome of the action is immaterial, it is the self -belief fostered by taking real world positive action in support of self-flourishing, that is critical. 

Stutz believes in a force for good he calls Higher Forces, and a malign force thwarting human growth he calls Part X. For Mother Vera her latter days at the monastery when she felt she could be of more service in the outside world were “tricking God”.   

From a Minsk monastery to a Hollywood therapist’s office, to a 1970s hospital, an acknowledgement of the divine, together with an embrace of each other and demands of daily life, emerge as key tenets of recovery’s long road. 

 

Mother Vera is released in the UK from 29 August.

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