Filming Death: End-of-Life Documentary Cinema

Outi Hakola's Filming Death: End-of-Life Documentary Cinema includes an impressive array of sources and close readings of films. She articulates that her work has “joined a long line of those who have pondered the relationship between mortality and cinema. For example, theorists such as André Bazin and Laura Mulvey have debated (moving) images’ symbolic relationship with temporality and mortality” (2). Thus, Hakola determines that cinema itself has intrinsic links to death: for example, death often narratively acts as the starting point, turning point, or end point in film (cf. Catherine Russell).From the outset, Hakola states that there is a need to consider issues of social justice when discussing death in the cinema. For Hakola, death as a subject has tangible, real-life consequences for actual people; thus, ethnographic studies are necessary to create a more nuanced picture of actual, lived experiences. As Hakola articulates, she “watched about ninety and analysed forty-five end-of-life documentaries from the past twenty years in Europe, Australia and New Zealand, as well as Canada and the United States” (2). She also “interviewed eighteen of these filmmakers to gain insight into their goals and backgrounds in these projects, and when not possible [used] the directors’ interviews with the media and other supporting material, such as commentary tracks, directors’ statements and blog posts” (2).Hakola is clear that these interviews are central to her approach, since they shed light on issues that film, in isolation, cannot achieve. To put it another way, her ethnographic study exemplifies the uniqueness of individual subjecthood; each individual subject's experience is different from others. Therefore, although death is a universal experience, individuals “can understand and experience death differently” (5). Thus, the contribution of Hakola's Filming Death initially goes beyond film and media studies and has an important intervention in fields such as psychology, especially in relation to concepts such as “death anxiety” (3), which Hakola refers to on several occasions, building on studies by Lehto and Stein, among others. Nevertheless, an integral component of Hakola's framework is film and media, specifically documentary cinema, due to documentaries’ “personal perspective and voice,” such as with the oral testimonies of subjects (4). Paraphrasing Ilona Hongisto, Hakola elucidates how, at “its best, documentary cinema thrives on differences in experiences” (5). Yet does documentary cinema perform the exact same function as an interview without a camera? While Hakola does not provide a definitive answer, her reliance on the spoken words of interviewed individuals would seem to imply no.Hakola defines “end-of-life documentaries” as those that concern primarily terminal illness, hospice and palliative care, and assisted dying. An end-of-life documentary would not include, then, deaths caused by accident, suicide, murder, or war (6). End-of-life documentaries are “social issue documentaries” (as coined by John Grierson), whose goal is to examine “the issue of death and dying and aim to influence how the viewer understands this” (6). The subjecthood of the viewer and interviewer, and not simply the interviewee, is thus also at stake. It is among this highly detailed literature review that Hakola's thesis statement emerges—“we recognise documentary films themselves as collaborative spaces that encourage intersubjectivity between the filmmaker, the subject and the viewer, who all contribute towards having a dialogue on chosen social issues” (11). Viewers may not be dying themselves; however, they are paradoxically “co-experiencing” and “co-living,” to borrow terms from Shaun Gallagher. Hakola does point out that there is no guarantee that viewers of end-of-life documentaries will share in the same feelings or experiences of the interview subjects—such an assumption would be absurd and reductionist. Rather, interviewees who are dying are merely offering their experiences “for the viewer to connect with, and through engagement the viewer can contribute to making these experiences meaningful” (11). Hakola concludes this section by drawing on Gilles Deleuze's notion of “embodied cinema”: film creates a space for viewers to transform and consider alternative ways of thinking.At first glance, it may seem that Hakola's analysis is overly reliant on theoretical frameworks across film and media studies and psychology. However, in Hakola's discussion, the importance of actual lived experience remains key, and those voices are the focal point of her argument. Framing Death includes ten chapters of such testimony, not including the introduction and conclusion, in three overarching sections: “Institutional Voices,” “The Voices of Dying People,” and “Personal Voices.” The first section broadly considers medicalized death (“Medical Documentaries: Demedicalisation of Death”); how documentary cinema represents hospice care (“Hospice Documentaries: Responsibility to Care”); end-of-life care from the vantage point of spirituality (“Spiritual Documentaries: Making Death Meaningful”); and a summary of the legal debates pertaining to end-of-life care (“Advocacy Documentaries: Investigating the Legalisation of Assisted Dying”). The second section further emphasizes the need for actual, genuine lived experiences to be put on camera. Paraphrasing Bill Nichols, Hakola articulates that the goal of such films is not to “provide a solution or conclusion,” but “to increase empathy and understanding of others’ experiences” (19). These chapters are “Performative Documentaries: Life-Affirming Stories about Mortality”; “Legacy Documentaries: Reaching beyond Death”; “Physical Documentaries: Experiencing the Process of Dying”; and “Dialogical Documentaries: Understanding Personal End-of-Life Choices.” The third and final section acts as an effective coda, bringing to the fore the intimate nature of the films themselves with two chapters, “First-Person Documentaries: Filmmakers’ Personal Journeys” and “Collaborative Documentaries: Intimate Testimonials of End of Life.”These chapters exemplify the breadth of Hakola's readings of films and ethnographic studies. For example, she examines the Belgian documentary End Credits (Alexander Decommere, 2013), whose subject matter is assisted dying. The film, in a sort of meta-narrative, acts as a response to the documentary Less Dead than the Others (Frans Buyens, 1992) and how this prior film influenced the assisted-dying laws in Belgium. Hakola explains that for Decommere, film as a medium has a vital role to play in creating awareness of social justice issues (91). Hakola thus puts both End Credits and Less Dead than the Others in conversation with Kevin Dunn's Fatal Flaws: Legalising Assisted Death (2018), where Dunn interviews various subjects as he journeys through Europe and North America. Of note is one scene where Dunn labels an anti-euthanasia journalist's stance as propaganda (cf. Hakola 91). These are, for Hakola, clear examples of “advocacy documentaries.”Another highly compelling example appears in the final section on filmmakers who are themselves dying. Hakola considers From the Bedroom to the Bathroom (Rosetta Life, 2022) a “collaborative end-of-life documentary” (215). Here, terminally ill individuals actively participated in the filmmaking process (planning, screenwriting, filming, producing, and so on) through Rosetta Life, an arts charity that specializes in collaborative art projects. For Hakola, such a film creates agency on the part of those at the end of their lives, and the filmmakers are working together and simultaneously in control of their own voices—both as documentary creators and as documentary subjects. In such films, there is a certain complexity on display, but these myriad—and sometimes contradictory—voices make space for a “more honest, complex and open approach to the topic when compared to the authoritative and monologic voice of the filmmaker alone” (215).Hakola's Framing Death is a needed and timely book, both in terms of its academic rigor and in how it deftly frames social issues that are often ignored or marginalized. Her conclusion rightly points to the lack of distribution for end-of-life documentaries, both in cinemas and on major streaming services such as Netflix. However, there has been some increased awareness (as small as it may be) on the film festival circuit (237). Insofar as reading Framing Death can be a deeply emotional experience, it is also a pleasure to read and highly recommended to scholars within film, psychology, and elsewhere.