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. 

Article
Creed
Death & life
Easter
Film & TV
4 min read

Don’t die: the relentless pursuit of life

If there was a way beyond death, shouldn't we give up everything to find it?

Josh is a curate in London, and is completing a PhD in theology.

A man stands in his home wearing a black t-shirt that reads 'DON'T DIE'.
Ryan Johnson at home.
Netflix.

In the days before my daughter's birth, I was reading about the fear of death. Ernest Becker won a Pulitzer Prize in 1974 for his book The Denial of Death. In it, he argues that our lives are structured around the fear of death. In the posthumously published follow-up, Escape from Evil, Becker writes:

"Man wants to persevere as does any animal…but man is cursed with a burden no animal has to bear: he is conscious that his own end is inevitable."  

For Becker, human culture is really a series of attempts to avoid or transcend the reality of death. We follow charismatic leaders in the hope of becoming part of something greater. We have children in the hope that something of us will last beyond the span of one lifetime. We collude to marginalise pensioners and prisoners and any other reminders of our frailty, hiding them away so we can briefly pretend at immortality.  

Last week I thought of Becker when I watched Don’t Die: The Man Who Wants to Live Forever on Netflix. The documentary follows Bryan Johnson, who made his millions in tech and is now going to extremes to undo the impact of ageing on his body. An exacting routine of dieting, sleep, fitness and medication is augmented by riskier interventions, such as experimental gene therapies. 

As Johnson tells it, his past struggles with mental ill health and suicidal ideation led him to pursue a life less reliant on his mind. He seeks instead to listen to what his organs tell him they need via algorithms and diagnostics: fallible humanity corrected by data. 

Johnson is resolute that it is not fear of death that drives the enterprise but a desire to live, particularly to live as long as possible with his son. One of the documentary’s strangest and most touching scenes is an inter-generational plasma transfer. There is evidence that plasma from a younger donor can have a de-ageing effect on a recipients' organs. So, Bryan decides to give his dad some of his plasma and his son gives him some plasma. Each of the three men, we learn, have experienced isolation after leaving Mormonism. The transfer becomes a kind of founding of a family outside the faith they have each rejected and been rejected by. 

Johnson’s pursuit of longevity now plays an equivalent role in his life to that faith– not just as a source of belief and human purpose, but of human connection. The documentary ends with a montage of "Don't Die" communities around the world hiking and dancing and celebrating life together.  

In the months after my daughter's birth, I recognised something of what Becker names. Here is someone who will outlast me, something of me will transcend the limits of my life. And here is someone who reminds me of those limits. Here is this great gift and joy who will sit in the front row at my funeral: the embodiment of life’s goodness a witness to its end.  

Are we wrong to fear death? If there was a way beyond it, shouldn't we give up everything to find it?

There is more going on in Bryan Johnson and the wider de-ageing movement than Becker's analysis would perhaps allow. Fear of death is not the only story here. When is it ever, really? Fear only makes sense alongside—and in light of— goodness, life, gift. To fear loss, you must have something to lose.  

And yet, the story Becker tells about culture does seem to ring truer in the years since his death. As technology improves, death's denial becomes more convenient. As the natural world degrades, it becomes more compelling. And as wealthy men become wealthier still, their denial on behalf of us all becomes ever more creative.  

And who can blame us—any of us? Are we wrong to fear death? If there was a way beyond it, shouldn't we give up everything to find it? 

This Wednesday, Ash Wednesday, marks the beginning of Lent, the Christian season of reflection and self-denial. On Wednesday, I will receive an ash cross, and as I draw that same cross on forehead after forehead, I will repeat these words:  

"Remember you are dust and to dust you shall return,  
turn away from Sin and be faithful to Christ."  

I will hear the invitation, in my voice and not my own, to give up the futile theatrics of a deathless life. I will pray for the strength to live what I have spoken. I will say goodbye to those who I marked, each of us now a signpost to our shared mortality. And then I will go home to yoghurty hands, bathtime songs and giggles at the funny smudge on my face.

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