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

Trauma

Work

4 February 2025

4 min read

Severance: the ins and outs of seeking oblivion

We can't contain trauma to just one sphere of our lives.

Josh Richards

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

In a retro-future styled office, workers stand or sit around a pod of desks.

Apple TV.

How far would you go to stop yourself doing late-night emails? Or what would you be willing to do to escape those painful memories? Severance, returning for its second season on AppleTV+, explores an extreme solution to both.

The show follows a group of office workers at Lumon who have had their memories severed: when outside of work they do not remember what they do at work and when at work they do not know anything about their lives outside. The work-self, referred to as an 'innie', enters the elevator at 5pm and immediately finds themselves back in the elevator at 9am the next day. They feel rested without any memory of the rest. Their "outie" blinks at 9am and then it is 5pm.

Adam Scott's protagonist, Mark, joined Lumon Industries as a severed employee working in "Macrodata Refinement" (MDR) as a result of losing his wife. In an episode early in the second season, one character recounts Mark telling them that he applied for the role because it felt like he was "choking on her ghost." Being severed offers Mark hours each working day where a version of him can work oblivious to this grief.

Of course, Mark's employer is up to something sinister, though exactly what remains unclear even to the innies. Lumon is at times terrifying, at times goofy and always unsettling. Innies are mistreated but cannot communicate with their outie beyond what Lumon allows. Even in these conditions, the small MDR team, each with no more than a couple of years' worth of memories, find purpose in their relationships with one another and in seeking to understand their bosses' designs.

Severance has attracted a lot of attention and reflection. Writing for the Financial Times, Emma Jacobs concludes that the show points us to our impossible longing for a boundaried life. The Northeastern University academic Tomas Elliot proposes that Severance can be read as an inversion of The Matrix: employees knowingly placing themselves in a state of naivety. Jacobs and Elliot both read the show as pointing to the paradoxical nature of modern work as both the cause of discontentment and the place many look to for a sense of purpose and fulfilment.

Instability cannot be contained to one sphere of life. Life is hard and so is work. Neither can offer escape from the other.

At the heart of many of the questions that Severance raises is the relationship between work and identity. Most of us live with a sense that who we are is found in our relationships. Work means something because it is one of the places we are most powerfully shaped by and shape relationships with colleagues, competitors, consumers and everyone else. Work becomes destructive when it cultivates destructive relationships in the workplace or when it displaces other forms of community and sources of identity.

The process of severance protects outies from the formative power of workplace relationships: their strains and their joys. No doubt we could each imagine benefits to this. However, it leaves Mark's outie paralysed by grief because he has denied himself a key source of relationships through which he could begin to heal, integrating that grief into a new sense of self.

Just as Mark's innie is protected by the outie's grief, the outie is protected from discovering who he could be without his wife. As the series progresses, it becomes less clear whether Mark's motivation is the fear of grief's crushing burden or the fear that one day the burden may ease.

In his book Resonance, Hartmut Rosa writes:

Time and again, human beings come to discover that they can become "different people" in different contexts. And under the highly dynamic conditions of late modernity, the task of finding out who we really are collides… with repeatedly having to "reinvent" and creatively redefine ourselves. That said reinvention also should be "completely authentic" is surely one of the more pointed paradoxes of the present age.

As Rosa notes, the dynamism of contemporary market forces produces a dynamism in our sense of identity, which can be experienced as instability. One response to this instability—and all the other humiliations and challenges of living at this time—is to look for ways of separating "work" and "life", to carve out a space where I can be free from constant performance and reinvention. And yet, as Severance shows us, whatever part of ourselves we designate as "life" or "outie", it cannot be free from pain and sometimes we will escape to, rather than from, "work".

Instability cannot be contained to one sphere of life. Life is hard and so is work. Neither can offer escape from the other. Some things must be resisted and some must simply be lived with. Both can only be done together. Ultimately, both can only be done if we are held in and defined by a relationship secure through any failure or loss. Seeking such a relationship is a life's work, for both innies and outies.

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