How Film And Literature Have Influenced The Acceptance Of Assisted Suicide

(MENAFN- Swissinfo) Powerful stories of assisted dying are etched in our collective memory. Now, a groundbreaking research project from Switzerland is gathering artistic works on the subject from across the globe. But how much impact does this art form have on Politics and society?

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The Sea InsideExternal link and The Intouchables stand out as two of the most impactful stories about tetraplegics from the past two decades. Both are inspired by true events, yet they could not be more different.

The first is a melancholy, hypnotic film about a Spanish seaman who fights for the right to die after a diving accident. He finally ends his life with the help of friends. The second is a French buddy comedy about a carer who helps a wealthy businessman get a new lease on life after a paragliding accident.

The Sea Inside, which won an Oscar for best foreign film, earned approximately $43 million (CHF39 million) at the box office. The IntouchablesExternal link grossed nearly ten times that amount. While film audiences chose life, those directly affected by tetraplegia often choose death.

More and more countries around the world have taken steps to legalise assisted suicide in recent years. In addition to Switzerland, which was a forerunner in this field, almost a dozen European countries now allow assisted suicide or even active euthanasia, which involves a doctor directly administering a lethal substance to end the patient's life.

Among them is Spain, where the 1990s court case about the seaman Ramón Sampedro sparked a debate that The Sea Inside later rendered in powerful imagery.

Earlier this year, the French government tabled a bill that would give access to assisted dying for the terminally ill. This was preceded by a years-long culture war in which Philippe Pozzo di Borgo, the true-life model for the entrepreneur in The Intouchables, also weighed in. Until his death in 2023, he was the patron of the Relieve but Don't Kill (Soulager, mais pas tuer) movement, which campaigns against euthanasia and for the established practice of terminal palliative care in France.

These powerful stories about assisted dying shape our collective understanding of an ethically and legally thorny topic. But just how far-reaching is the influence of this kind of literature and film?

A Swiss research project is exploring this very question. The website Assisted Lab's Living Archive of Assisted DyingExternal link collects cultural works – including films, text and other media – from all over the world. It analyses them, providing links to how and where they have been cited, and makes them available for legal, political and societal debate.

So far, around 60 works have been prepared for the archive.“But we already have over 350 works in our collection, which we will gradually make accessible,” says Anna Elsner, professor of French culture and medical humanities at the University of St Gallen and initiator of the project*. The volume and range of materials surprised even her.“In my application to the European Research Council, I referred to just 30 works,” she notes.

Cultural productions are always seen as a by-product of political debates, Elsner says.“Yet it is fascinating to see how strong their influence is. Over the past ten years, art has increasingly been cited in legislative processes.” The genre of ars moriendi, the art of dying, has also taken on a new form, in the mediatisation of tales of suffering, she adds.

The French example of this is erotic novels author Anne Bert. She was diagnosed in mid-life with amyotrophic lateral sclerosis, better known as ALS, and campaigned actively for legislative reform in France. Bert is named as a co-author in a draft law from 2017, which ultimately did not lead to the legalisation of assisted dying.

The documentary film I've Decided to DieExternal link (J'ai décidé de mourir) shows her in the last months of her life. A few days after her assisted suicide in the more liberal neighbouring country of Belgium, her book The Very Last Summer (Le tout dernier été) was published. It is a plea for the right to choose one's own death – which she condensed into the sentence:“I love life too much to let myself die.”

Since Bert's death, her story and its artistic reworking have been mentioned many times in French parliamentary debates.

The Assisted Lab focuses on Europe and Canada, specifically the countries that have legalised assisted suicide since 2000 (the period covered by the collection). Recently, though, Elsner has added freelancers to the project's four permanent team members, to include other languages and cultural areas.

Assisted dying is no longer a purely Western issue, the academic stresses.“This is now changing. For instance, I was in contact with a filmmaker from India who accompanied an Indian artist who travelled to Zurich this year to die,” she says.

Elsner believes that art often handles the subject in a more nuanced and less binary way than political or social debate.“It shows the suffering of the relatives, even if they support the person's wish to die.”

The different disciplines each follow their own logic. Art aims at ambivalence, while the law seeks to overcome it. The collection itself is indifferent in the matter. It is a value-neutral archive, a trove of research materials that does not attempt to support a thesis.

The link between art and political debate is often not as clear-cut as one might expect. In the 2003 Canadian film The Barbarian Invasions – one of Elsner's favourite works in the collection (and which also an Oscar award for best foreign language film) – the protagonist is injected with a lethal dose of heroin at the end.

Over a decade later, Canada legalised active euthanasia. The film was discussed repeatedly in the political process, although not so much as a plea for the right to die, as for its depiction of an overstretched, inhumane public healthcare system.

In recent years, the question of assisted dying has been discussed in Switzerland mainly from the perspective of suicide tourism. There has been little debate on the boundary with palliative care, as is happening in France.

The case of the Geneva doctor Pierre Beck, who helped a healthy woman commit suicide together with her sick husband, made headlines. The Federal Court acquitted Beck in March and reaffirmed the liberal stance espoused by Switzerland, which only criminalises assisted suicide if it is motivated by selfish reasons. Based on this case, Marc Keller, a project member at the Assisted Lab, wrote a bookExternal link on the question of existential suffering, which came out in November.

Since the death of a person in the Sarco suicide capsule this autumn in the canton of Schaffhausen, Switzerland is also facing a real debate on the issue of assisted dying. With the capsule, voluntary death is just a button's press away, and no doctors are involved.

“It's all about whether the medical profession should be included,” Elsner says. This reminds her of a short story from 2016. In SuissID (published in the anthology Uncommon Futures (Futurs insolites)External link , Swiss author Vincent Gerber imagines a service that provides suicide assistance by telephone. Customers can choose from a catalogue of different methods, according to their needs and financial means.

This dystopian narrative targets the commercialisation of assisted suicide, but it also captures the true complexity of the current situation in progressive countries. Switzerland, Belgium, Canada and others are all grappling to determine at what point a liberal approach to a self-determined death becomes negligence; and when assisted suicide turns into suicide promotion.

A difficult field is opening for both politics and art.

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