Review

Culture

Film & TV

Freedom

20 March 2025

6 min read

I’m Still Here is a celebration of Brazilian resilience

The Brazilian Oscar winner is an act of remembrance.

Matt Lewis

Matt is a songwriter and musician, currently completing an MA in theology at Trinity College, Bristol.

A woman, wearing 70s clothing, stands, looking apprehensive.

Fernanda Torres as Eunice Paiva.

The other week in Brazil, crowds were heard jubilantly celebrating: “Brazil! Brazil!” The characteristically enthusiastic nature of their celebration might make you think there had been a football victory. But the victory was in fact the Oscar win for I’m Still Here, the Walter Salles directed movie – a first time win for Brazil in Best International Picture. And Brazil should be proud. As the credits rolled in an independent cinema, I sat in stunned silence. I’m Still Here is a moving and expertly crafted portrayal of family life under tyranny. The film gives a tragic account of the insidious and destructive nature of authoritarian untruth - yet also a celebration of the defiant resistance of unsung heroes in the face of evil.

Set in 1970’s Rio de Janeiro during a military dictatorship that lasted for 21 years, the film centres around the true story of the Paiva family. The father, Rubens Paiva (Selton Mello), a former dissident congressman, is abducted by the military for interrogation and disappears; the mother, Eunice Paiva (Fernanda Torres), who herself is imprisoned and tortured for 12 days, is left to keep the family together and continue the search for her husband.

At this point, I should admit that this review is not unbiased, as I have been to Brazil six times, and have an enthusiastic interest in its history and culture. And despite the sombre tone at the heart of the movie, I’m Still Here felt like a celebration of Brazil. The film opens with an ominous helicopter flying over a Rio beach, which leads us to the Paiva family enjoying the sun with their friends. The fun, vibrancy, and warmth that permeates the family gathering reminded me of much of what I love about Brazilian culture. Even in the midst of a repressive regime, at least for this family, the party goes on.

Unfortunately, the party doesn’t last for long.

Thirty minutes into the film, the relative harmony of the Paiva family’s world is sharply interrupted, when the military police arrive at their home and announce that Rubens is wanted for interrogation. As the intruders close the curtains and doors, the light, warmth and music that permeated the start of the movie are muffled and suffocated. This scene plays like a microcosm for Brazilian society under authoritarian regime.

Historians Lilia M. Schwarcz and Heloisa Starling, in their book Brazil: A Biography document how on 14 December 1968, the Jornal do Brasil, a leading daily newspaper, published a special edition to surprise their readers, including a false weather report: ‘Suffocating temperature. Air unbreathable.’ The previous day, the military dictatorship had announced a law which suspended habeas corpus and freedom of expression, permitted the annulment of citizen’s rights, and determined that political trials would be conducted by military courts, with no right of appeal. This allowed the dictatorship to repress political dissent, and led to the mass disappearances of individuals suspected of anti-government activity.

We see this suffocation slowly take hold of Eunice Paiva. Here Fernanda Torres’ subtle yet arresting performance as the Paiva mother cannot be understated. As she tries to maintain a sense of normalcy in her family, protecting them from the truth, while also quietly and defiantly seeking her husband’s release, we hang on to her every word and nuance of expression.

Every confrontation she makes to the police is met with deflection, lies, and cover-up. We watch as the insidiously persuasive untruth of authoritarianism seems to triumph over integrity. We get this sense from the world around the Paiva family too – the radio only relays state-sanctioned news, and censors music deemed subversive. I’m reminded of George Orwell’s depiction of the Party in 1984, which enforces ‘doublethink’ on the populace: ‘to be conscious of complete truthfulness while telling carefully constructed lies … consciously to induce unconsciousness.’

Eunice can be seen as a counterpart to Orwell’s protagonist, Winston, who claimed ‘There was truth and there was untruth, and if you clung to the truth even against the whole world, you were not mad.’ This refusal to let go of truth carries Eunice Paiva, and us along with her.

While a song won’t take down a dictatorship overnight, it can get into your head, and stick there long enough to inspire some forms of resistance.

The presence of music in the movie likewise represents a significant thread of resistance to the regime’s propaganda and shrouded crimes. This is heard not just in the vibrant soundtrack of resistance music from the period, but also in the dark and hostile prison where Eunice Paiva is held. Amid screams from other inmates, Eunice hears a man sing out from another cell:

Samba:

Black,

strong, fearless,

Was harshly persecuted

On the corner, in the bar, in the yard.

He is quickly silenced by a guard, but the refrain memorialises the cry of the oppressed. While a song won’t take down a dictatorship overnight, it can get into your head, and stick there long enough to inspire some forms of resistance, to combat the ‘official’ narrative of events with a subversive counter-narrative.

Yet in I’m Still Here, the clearest act of resistance comes from the quiet but resolved determination of Eunice Paiva in her refusal to forget her husband, to let the untruth of dictatorship have the final say. I’m reminded of Hannah Arendt’s diagnosis of the ‘banality of evil’ in Nazi Germany. Under dictatorship, with the state’s obfuscatory erasure of its misdeeds, evil becomes normalised, losing its shock, its horror. In this way, atrocities can continue to be committed with impunity.

But Eunice Paiva’s story reminds us, in Schwarz and Starling’s words: ‘nothing can be completely extinguished, and no one disappears completely without someone remembering their name.' As Chico Buarque, a Brazilian musician foresaw:

The banal of today

Will be in journals someday.

One aspect of Eunice’s story the film does not portray is her faith. According to her children, she would attend Catholic Mass every week, partaking of bread and wine to remember Christ’s death. I’m curious what influence this continued reminder of the crucifixion of Jesus had on her.

There are other examples of resistance in Brazil that were explicitly motivated by the image of the cross. Schwarz and Starling recount the opposition of a group of Catholic bishops who used the Church’s communication channels to disclose internationally what was happening in Brazil. One Catholic father, who was personal assistant to the Archbishop of Olinda and Recife, working on international human rights, was kidnapped, tortured and killed.

In 1970 the Saint-Germain-des-Prés Church in Paris displayed a handcuffed Christ on the altar with a tube in his mouth and a magneto (small generator for applying electric shocks) on the top of the Cross. Above the Cross the words from the Brazilian flag ‘Ordem e Progresso’ were inscribed.

While we can see the strong parallels between Jesus’ death at the hands of Roman imperial oppressors and the unjust torture of thousands under military dictatorship, the message of the Cross goes even deeper than this.

The Cross has been throughout centuries a revelation of all of humanity’s deepest wickedness, and not only that, a confrontation of our tendency to evade accountability, to create untruths to hide atrocities, to make evil banal. Yet as Christians of different denominations commemorate the crucifixion at Holy Communion, Eucharist, Mass, we are reminded of a God who suffers for the sins of the world. Perhaps this meal nourished Eunice Paiva in her fight against tyranny. Perhaps this memorial of a suffering saviour served as an inspiration to retain the memory of all those who suffer, to expose the evils that so often go unseen.

In any case, I’m Still Here, while giving an honest critique of Brazil’s history, ends up being a memorial - even a celebration - of the resilient, Brazilian spirit, exemplified in the lives of families like the Paivas.

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Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

A tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.